Improving Firearm Screening and Safe Storage Counseling in a Primary Care Pediatric Practice

Area of Science:

• Pediatrics
• Public Health
• Quality Improvement Science

Background:

• Firearm injuries are a leading cause of death in children.
• Preventive care visits offer opportunities for crucial firearm safety screening and counseling.
• Current screening rates for firearm risks in pediatric care are often suboptimal.

Purpose of the Study:

• To implement a quality improvement initiative to increase firearm screening and safety counseling rates.
• To achieve a 25% increase in firearm screening and counseling for children aged 4-18 years within 10 months.
• To enhance provider confidence in discussing firearm safety and utilizing safety devices.

Main Methods:

• A Plan-Do-Study-Act (PDSA) quality improvement study was conducted over 10 months.
• Interventions included provider education on best practices, revision of electronic health record templates, and distribution of caregiver resources.
• Firearm screening rates were tracked before and after each PDSA cycle.

Main Results:

• Baseline firearm screening rate was 38%.
• Following interventions, screening rates increased to 95%.
• Revising the clinic note template demonstrated the most significant impact on screening rates.

Conclusions:

• The quality improvement intervention successfully increased firearm screening and safety counseling rates in pediatric preventive visits.
• Provider education and optimized clinical workflows are effective strategies for enhancing firearm safety practices.
• This QI study highlights the importance of integrating firearm safety into routine pediatric care.