PMID- 27244777
OWN - NLM
STAT- MEDLINE
DCOM- 20170531
LR  - 20220409
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 137
IP  - 5
DP  - 2016 May
TI  - Practice-Based Quality Improvement Collaborative to Increase Chlamydia Screening 
      in Young Women.
LID - e20151082 [pii]
LID - 10.1542/peds.2015-1082 [doi]
AB  - BACKGROUND AND OBJECTIVE: Chlamydia trachomatis infections are common among 
      sexually active young women. We developed a practice-based quality improvement 
      (QI) collaborative to increase Chlamydia screening in at-risk young women. 
      METHODS: Structured data fields were integrated into the electronic record for 
      practices affiliated with Boston Children's Hospital. A learning community (LC) 
      was developed. Content included the adolescent well visit, assessment of 
      sexual/risk behaviors, epidemiology of sexually transmitted diseases, and 
      screening methods. The QI initiative effectiveness was assessed by comparing 
      preintervention and postintervention rates of Chlamydia screening by using 
      statistical process control analyses and logistic regressions. RESULTS: LC 
      participants demonstrated significant increases in recommended Chlamydia 
      screening, as illustrated by using Healthcare Effectiveness Data and Information 
      Set (HEDIS) screening rates (LC1: 52.8% preintervention vs 66.7% postintervention 
      [P < .0001]; LC2: 57.8% preintervention vs 69.3% postintervention [P < .0001]). 
      Participating practices reported total improvements larger than nonparticipating 
      practices (13.9% LC1, 11.5% LC2, and 7.8% nonparticipants). QI and LC efforts 
      also led to increased documentation of sexual activity status in the record (LC1: 
      61.2% preintervention to 91.2% postintervention [P < .0001]; LC2: 43.3% 
      preintervention to 61.2% postintervention [P < .0001]). Nonparticipating 
      practices were more likely to perform indiscriminate screening. CONCLUSIONS: 
      Through our QI and LC efforts, statistically and clinically meaningful 
      improvements in Chlamydia screening rates were attained. Differences in rates of 
      improvement indicate that LC participation likely had effects beyond electronic 
      medical record changes alone. During the project time frame, national HEDIS 
      screening rates remained unchanged, suggesting that the observed improvements 
      were related to the interventions and not to a national trend. As a result of QI 
      tools provided through the LCs, HEDIS screening goals were achieved in a primary 
      care setting.
CI  - Copyright (c) 2016 by the American Academy of Pediatrics.
FAU - DiVasta, Amy D
AU  - DiVasta AD
AD  - Divisions of Adolescent Medicine and Department of Pediatrics, Harvard Medical 
      School, Boston, Massachusetts; and amy.divasta@childrens.harvard.edu.
FAU - Trudell, Emily K
AU  - Trudell EK
AD  - Pediatric Physicians' Organization at Children's, Brookline, Massachusetts.
FAU - Francis, Mary
AU  - Francis M
AD  - Pediatric Physicians' Organization at Children's, Brookline, Massachusetts.
FAU - Focht, Glenn
AU  - Focht G
AD  - Pediatric Physicians' Organization at Children's, Brookline, Massachusetts.
FAU - Jooma, Farah
AU  - Jooma F
AD  - Pediatric Physicians' Organization at Children's, Brookline, Massachusetts.
FAU - Vernacchio, Louis
AU  - Vernacchio L
AD  - Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and 
      Pediatric Physicians' Organization at Children's, Brookline, Massachusetts 
      Division of General Pediatrics, Boston Children's Hospital, Boston, 
      Massachusetts;
FAU - Forman, Sara F
AU  - Forman SF
AD  - Divisions of Adolescent Medicine and Department of Pediatrics, Harvard Medical 
      School, Boston, Massachusetts; and.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - IM
MH  - Adolescent
MH  - Boston
MH  - Chlamydia Infections/*diagnosis
MH  - Electronic Health Records
MH  - Female
MH  - Humans
MH  - Intersectoral Collaboration
MH  - Mass Screening/organization & administration/standards/*statistics & numerical 
      data
MH  - Primary Health Care
MH  - *Quality Improvement
MH  - Risk-Taking
MH  - Sexual Behavior
MH  - Young Adult
EDAT- 2016/06/01 06:00
MHDA- 2017/06/01 06:00
CRDT- 2016/06/01 06:00
PHST- 2015/11/16 00:00 [accepted]
PHST- 2016/06/01 06:00 [entrez]
PHST- 2016/06/01 06:00 [pubmed]
PHST- 2017/06/01 06:00 [medline]
AID - peds.2015-1082 [pii]
AID - 10.1542/peds.2015-1082 [doi]
PST - ppublish
SO  - Pediatrics. 2016 May;137(5):e20151082. doi: 10.1542/peds.2015-1082.