A Pediatric Office-Based Quality Improvement Project in a Rural Health Clinic: Retrospective Evaluation


Purpose: An office-based pediatric quality improvement project was implemented to increase the number of well-child health visits and increase the documentation of pediatric quality measures in a Midwest rural clinic.

Project Description: The Bright Futures framework provided the structure for the project and a retrospective evaluation was performed six months after the initiation of practice changes, reminder letters, and public service announcements. Chart review was performed with a convenience sample of children ages 0 to 47 months from the database of the organization that supports the family practice clinic and emergency department. The descriptive analysis included change in proportions and percentages and chi-square analyses.

Outcomes:  There was an increase the number of well-child visits by 65% in the six month period with a wider range of ages being seen. There was a 40% response rate of visits within two months of the reminder letters. Documentation increased in four out of nine quality measures with two measures remaining at 100%. Validated developmental and behavioral assessment tools were used consistently. A dialogue with the local health department was established to coordinate immunization and well-child visits.

Conclusions: The practice changes were found to be sustainable and consistent with quality pediatric care.

DOI:  http://dx.doi.org/10.14574/ojrnhc.v14i1.280 

Keywords: rural pediatric, office-based, quality improvement


Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).