Navigating the path to equitable rheumatologic care for underserved children with quality improvement.

IF 2.1 3区 医学 Q2 PEDIATRICS Frontiers in Pediatrics Pub Date : 2024-10-15 eCollection Date: 2024-01-01 DOI:10.3389/fped.2024.1426588
Sheetal S Vora, Sarah C Mabus, Talia L Buitrago-Mogollon
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Abstract

Objective: The aim of this quality improvement project is to identify children with rheumatologic conditions to prevent delayed or missed diagnosis in underserved pediatric populations. Our focus is on prompt and accurate identification and subsequent treatment of rheumatologic symptoms in pediatric patients referred from Atrium Health safety-net primary care clinics that deliver care to families without private insurance, including those lacking insurance entirely.

Methods: We collaborated with providers at one safety-net clinic to improve the processes of identification and subspecialty referral, resulting in an increase in the number of identified pediatric patients and referrals for these patients with potential rheumatologic disease. We used the Model for Improvement framework with rapid Plan-Do-Study-Act cycles and evaluated improvement with run and statistical process control charts.

Results: We achieved improvement, with zero referrals in the previous 5 years for the targeted population increasing to 15 patient referrals within 1 year of project initiation. Despite this increase in referrals, the rheumatology clinic was able to see all priority patients within 20 business days from referral.

Conclusion: An awareness of concerning rheumatologic symptoms in safety-net primary care clinics, combined with the use of both visual and decision aids, allows care teams to efficiently recognize and accurately refer patients needing specialty care.

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通过提高质量,为医疗服务不足的儿童提供公平的风湿病治疗。
目标:本质量改进项目旨在识别患有风湿病的儿童,以防止在服务不足的儿科人群中出现延误或漏诊。我们的重点是对 Atrium Health 安全网初级保健诊所转诊的儿科患者的风湿病症状进行及时准确的识别和后续治疗,这些诊所为没有私人保险的家庭(包括完全没有保险的家庭)提供医疗服务:我们与一家安全网诊所的医疗服务提供者合作,改进了识别和亚专科转诊流程,从而增加了识别出的儿科患者人数,并为这些可能患有风湿病的患者转诊。我们采用了 "改进模式 "框架和 "计划-实施-研究-行动 "快速周期,并通过运行和统计过程控制图对改进情况进行了评估:结果:我们取得了改善,在项目启动后的一年内,目标人群的转诊量从过去 5 年的零增加到 15 例。尽管转诊人数有所增加,但风湿病诊所仍能在转诊后的 20 个工作日内为所有重点病人看病:结论:安全网初级保健诊所对相关风湿病症状的认识,结合视觉和决策辅助工具的使用,可使护理团队有效识别并准确转诊需要专科护理的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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