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Healthy Weight Plans in Pediatric Primary Care Clinic

Friday, October 23, 2015
202 (Walter E. Washington Convention Center)
Kerri R. Wade, RN, MSN, PPCNP-BC, Lien P. Russell, MD and Sarah E. Hampl, MD, General Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO

Purpose

Because obesity is epidemic in children, and parents listen to their health care providers, weight-related health habits must be addressed by children’s primary care providers. The purpose of this project is to improve the number of Healthy Weight Plans (HWP’s) documented by primary care providers during Well Child Visits (WCV’s) in an urban, hospital-based teaching clinic.

Methods

Utilizing a Quality Improvement Model, including Plan Do Study Act cycles, clinic providers and project leaders made small changes over time to increase the numbers of Healthy Weight Plans documented on patients ages 2-21 at WCV’s. The methods used that led to the greatest improvement were 1) Improving  electronic charting to prompt  providers to document a HWP; 2) Developing a Part 4 MOC program, giving physicians incentive to participate;   3) Selecting documentation of a HWP during WCV’s as the division goal linked to annual physician merit increase; and 4) Collecting and reporting monthly data  on project progress, including individual provider feedback, as well as giving brief education on a variety of Healthy Weight Plan topics, including motivational interviewing, nutrition and physical activity, empowered the providers to provide accurate and useful information to their patients.   

Results

From July, 2014 to March, 2015, the percentage of documented HWP’s has increased from 77.6% to 92.1%.  

Conclusion

Utilizing a QI model to increase documentation of nutrition and physical activity counseling in a primary care setting was successful. Involving the providers in the process and giving them incentives, using the EMR to prompt provider documentation, and giving providers frequent feedback on their progress were the most important factors in increasing the percentage of documented counseling.

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