Quality Initiative to Increase Delivery of Adolescent Hospital-Based Reproductive Health Care. Hosp Pediatr 2022 Jan 01;12(1):53-61
Date
12/18/2021Pubmed ID
34918092DOI
10.1542/hpeds.2021-006038Scopus ID
2-s2.0-85127162126 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
OBJECTIVES: Hospitals are an important nontraditional setting in which to address adolescent reproductive health. However, opportunities for intervention are frequently missed, especially for boys and patients hospitalized for noningestion complaints. Our global aim was to increase delivery of reproductive health care to adolescents hospitalized through our children's hospital Pediatric Hospital Medicine service.
METHODS: We performed 2 quality improvement intervention cycles: (1) provider education and monthly reminder e-mails and (2) an automated electronic health record (EHR) adolescent history and physical note template with social history prompts while discontinuing reminder e-mails. The primary outcome measure was sexual history documentation (SHD). Secondary measures were sexually transmitted infection (STI) testing and contraception provision. Statistical process control charts were used to analyze effectiveness of interventions.
RESULTS: From July 2018 through June 2019, 528 Primary Hospital Medicine encounters were included in this study and compared with published baseline data on 150 encounters. Control charts revealed a special cause increase in SHD from 60% to 82% overall, along with 37% to 73% for boys and 57% to 80% for noningestion hospitalizations. Increased SHD correlated with cycle 1 and was maintained through cycle 2. Percent STI testing significantly increased but did not shift or trend toward special cause variation. Contraception provision, length of stay, and patient relations consultations were not affected.
CONCLUSIONS: The interventions were successful in increasing SHD, including among boys and noningestion hospitalizations. The EHR enhancement maintained these increases after reminder emails were discontinued. Future interventions should specifically address STI testing and provision of contraception.
Author List
McFadden V, Bauer SC, Porada K, Mehta S, Pickett MLAuthors
Sarah Bauer MD Associate Professor in the Pediatrics department at Medical College of WisconsinVanessa Mcfadden MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michelle L. Pickett MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentChild
Contraception
Hospitals, Pediatric
Humans
Male
Reproductive Health
Sexual Behavior
Sexually Transmitted Diseases
