Increasing Continuity While Promoting Patient Access in Academic Pediatric Primary Care.

Area of Science:

• Pediatric primary care
• Quality improvement science
• Healthcare delivery systems

Background:

• Continuity of care is crucial for high-quality pediatric healthcare.
• Low continuity rates in young children (12-24 months) present a challenge in academic settings.
• Existing systems often struggle to balance continuity with patient access and preferences.

Purpose of the Study:

• To enhance continuity of care for young children (12-24 months) in an academic pediatric primary care setting.
• To increase continuity rates from 0.32 to 0.40 over two years.
• To maintain exceptional patient access and prioritize patient preferences throughout the intervention.

Main Methods:

• A quality improvement (QI) project was implemented in a large academic pediatric practice.
• Interventions included parent interviews, flexible scheduling windows, and soliciting patient preferences.
• Provider templates were opened further in advance, and appointments were scheduled prior to discharge.

Main Results:

• The primary outcome, continuity for well visits in 12-24 month olds, improved from 0.32 to 0.42.
• The percentage of children experiencing no continuity decreased from 71% to 54%.
• Process measures showed increased disposition notes (62% to 88%) and scheduled future appointments (31% to 61%).

Conclusions:

• Quality improvement methods effectively increased well-child visit continuity for young patients.
• The project successfully maintained high patient access and prioritized family preferences.
• This study demonstrates a replicable model for enhancing pediatric primary care continuity.