A Quality Improvement Initiative to Optimize Low-Dose Aspirin Use in Patients with Moderate Risk Factors for...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Quality Improvement in Healthcare

Background:

• Preeclampsia poses significant risks to maternal and fetal health.
• Low-dose aspirin (LDA) is recommended for patients with two or more moderate risk factors for preeclampsia (PMRF).
• Adherence to LDA counseling and treatment guidelines remains suboptimal in clinical practice.

Purpose of the Study:

• To enhance the rate of LDA counseling and treatment in patients with PMRF.
• To implement and evaluate a quality improvement initiative utilizing screening flowsheets, clinical decision-making (CDM) tools, and patient education flyers.
• To achieve a target increase in LDA counseling from 9% to 50% within four months.

Main Methods:

• A single-institution quality improvement initiative was conducted, comparing preintervention (Jan-Apr 2022) and postintervention (Jan-Apr 2023) groups.
• Providers received education on preeclampsia (PEC) screening and utilized integrated CDM tools and flowsheets.
• Patient educational flyers were distributed, and counseling and treatment rates were monitored at 2-week intervals.

Main Results:

• Preintervention: 8.7% of patients received LDA counseling and 7.9% were treated.
• Postintervention: LDA counseling increased to 52.7% and treatment to 35.7%.
• An 83.5% increase in LDA counseling rates was observed, with progressive improvement over 18 weeks postintervention.

Conclusions:

• The integration of PEC screening flowsheets, CDM tools, and patient education effectively improves LDA counseling for patients with PMRF.
• These interventions offer a replicable model to enhance guideline adherence and reduce preeclampsia risk in vulnerable populations.
• The initiative demonstrated significant success in increasing LDA counseling and treatment rates, benefiting high-risk patients.