Process Improvement of Lipid Screening at Walter Reed PCMH

Abstract

Purpose

In 2008, The American Academy of Pediatrics (AAP) released guidelines supporting universal lipid screenings for children between the ages of 9 and 11 years old with the goal of accomplishing earlier detection of children who may be at risk of developing cardiovascular issues. A review of our current practice at Walter Reed National Military Medical Center found that only 17% of children ages 9-11 years old had lipid screenings, showing missed opportunities for early intervention.

Methods

This project aimed to improve the lipid screening process with the implementation of countermeasures amongst a target population of children ages 9-11 in our pediatric clinic. Utilizing the CarePoint database, baseline data was gathered for the target population of children who were enrolled in the Walter Reed PCMH in September 2023. Countermeasures focused on addressing inconsistent recommendations from providers, lack of a lipid screening prompt in standard intake paperwork, and lack of patient/parent awareness.

Results

Re-evaluation of CarePoint data after countermeasures implementation revealed an increase in the percentage of children aged 9-11 years old with lipid screening performed from 17% to 19%. Factors affecting the lack of change may include late introduction of countermeasures, incomplete acceptance of guidelines, and difficulty for families to get labs drawn at our crowded outpatient laboratory.

Conclusions

Implementation of a multifaceted approach to increase education and awareness of lipid screening in the Walter Reed PCMH may improve adherence to the current AAP lipid screening guidelines. However, with our limited data we are not yet seeing substantial change.