Increasing Universal Lipid Screening Among 9- to 11-Year-Old Children Through a Quality Improvement Initiative

Clin Pediatr (Phila). 2017 Jun;56(7):640-647. doi: 10.1177/0009922816670979. Epub 2016 Sep 23.

Abstract

In 2011, the National Heart Lung and Blood Institute recommended universal lipid screening (ULS) in 9- to 11-year-old children. This study aimed to determine whether a quality improvement (QI) initiative increased ULS. Data were abstracted from the electronic medical record to compare screening behaviors 1 year preimplementation and postimplementation. A focus group was conducted to examine physicians' attitudes. In preimplementation and postimplementation years, the number of 9- to 11-year-olds seen for well-child checks were 356 and 357, respectively. The first and second phases of the intervention were associated with a 64.3% ( P < .001) and 2.3% ( P = .75) increase in ordering, respectively. The rate of abnormal results was similar (21.4% vs 20.1%, P = .91). Physicians reported "some benefits" to screening but expressed concerns about cost-effectiveness and impact. The QI initiative resulted in high rates of ULS. Nonetheless, physicians continue to question the impact of screening on long-term health. More research on the benefits, costs, and outcomes of ULS is needed.

Keywords: lipid screen; nutrition; provider behaviors; quality improvement; universal screening.

MeSH terms

  • California
  • Child
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Lipids / blood*
  • Male
  • Mass Screening / economics
  • Mass Screening / methods*
  • Quality Improvement / economics
  • Quality Improvement / statistics & numerical data*

Substances

  • Lipids