通过使用质量改进框架,加强儿童乳病的粮食不安全查
Telly Cheung1, Mala Setty1, Erica Riray1
1Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Journal of pediatric gastroenterology and nutrition
|July 21, 2025
概括
通过解决团队识别的障碍,对患有乳病 (CeD) 的儿童进行的粮食不安全查得到了显著改善. 这种系统的方法提高了对有风险家庭的早期发现和干预.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 公共卫生营养 公共卫生营养
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 粮食不安全 (FI) 影响着数百万美国家庭,不成比例地影响着儿童.
- 患有乳病 (CeD) 的儿童需要严格的无质饮食,因此FI查对他们的福祉至关重要.
- 在儿童医疗机构中,在识别粮食不安全家庭方面存在差距,阻碍了获得重要干预的机会.
研究的目的:
- 开发和实施一个系统来识别和克服FI查在儿科CeD诊所的障碍.
- 提高被诊断患有乳病的儿童中FI查率.
- 建立一个可持续的过程,以解决脆弱儿科群体的FI问题.
主要方法:
- 在12个月的时间里,在质量倡议中使用了改善模式框架.
- 进行调查以确定医疗团队对FI查的障碍.
- 实施了经过验证的查表,诊所流程表,教育模块和EHR视觉辅助.
- 采用计划-做-研究-行动循环来完善选过程.
主要成果:
- 在12个月内,FI查率的中位数从0.0%增加到75.0%以上.
- 实施后6个多月保持高查率.
- 确定了关键障碍:语言,资源的可用性,提供者遗忘,以及对查问题的不适.
- 在接受查的儿童中,报告的一般FI为19.7%,无质FI为14.8%.
结论:
- 一个系统的框架有效地解决了团队报告的障碍,显著增加了CeD儿童的FI查.
- 针对FI的干预措施对于改善粮食不安全家庭的健康结果至关重要.
- 这项质量改善计划为其他儿科诊所提供了一个可扩展的模型.
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