Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vermont;
Department of Prevention, American Academy of Pediatrics, Elk Grove Village, Illinois;
Pediatrics. 2015 Jan;135(1):e178-86. doi: 10.1542/peds.2013-3119.
To determine if clinicians and staff from 21 diverse primary care practice settings could implement the 2008 Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd edition recommendations, at the 9- and 24-month preventive services visits.
Twenty-two practice settings from 15 states were selected from 51 applicants to participate in the Preventive Services Improvement Project (PreSIP). Practices participated in a 9-month modified Breakthrough Series Collaborative from January to November 2011. Outcome measures reflect whether the 17 components of Bright Futures recommendations were performed at the 9- and 24-month visits for at least 85% of visits. Additional measures identified which office systems were in place before and after the collaborative.
There was a statistically significant increase for all 17 measures. Overall participating practices achieved an 85% completion rate for the preventive services measures except for discussion of parental strengths, which was reported in 70% of the charts. The preventive services score, a summary score for all the chart audit measures, increased significantly for both the 9-month (7 measures) and 24-month visits (8 measures).
Clinicians and staff from various practice settings were able to implement the majority of the Bright Futures recommended preventive services at the 9- and 24-month visits at a high level after participation in a 9-month modified Breakthrough Series collaborative.
确定来自 21 个不同初级保健实践环境的临床医生和工作人员是否能够在 9 个月和 24 个月的预防保健访问中实施 2008 年《婴幼儿和青少年健康监督的光明未来指南》，第 3 版的建议。
从 51 名申请者中选择了来自 15 个州的 22 个实践环境，参加预防服务改进项目（PreSIP）。实践从 2011 年 1 月至 11 月参加了为期 9 个月的改良突破系列协作。结果衡量标准反映了在 9 个月和 24 个月的访问中，至少 85%的访问是否实施了《光明未来》建议的 17 个组成部分。其他措施确定了在协作之前和之后存在哪些办公系统。
所有 17 项措施都有统计学上的显著增加。总体而言，参与实践的所有预防保健措施的完成率达到 85%，除了讨论父母的优势，这在 70%的图表中报告。预防保健评分，所有图表审核措施的综合评分，在 9 个月（7 项措施）和 24 个月访问（8 项措施）中都显著增加。
在参加为期 9 个月的改良突破系列协作后，来自各种实践环境的临床医生和工作人员能够在 9 个月和 24 个月的访问中高水平地实施大多数《光明未来》推荐的预防保健服务。
