Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Quality Improvement, EMR Reminder,

Intervention Description: The interventions included nurse-champion training, standardized screening using the Patient Health Questionnaire-9 (PHQ-9), a reminder system for nurses to conduct screenings, and a video training program for nursing staff. These interventions align with a discernable strategy of implementing evidence-based screening tools and providing education and training to healthcare providers to improve their knowledge and comfort level in addressing perinatal mood and anxiety disorders. The study analyzes a multicomponent intervention that includes the four interventions mentioned above. The study aimed to determine if these interventions improved the PPD screening rate, PPD screening positive rate, and related social work referrals and consultation rates at Cedars-Sinai’s postpartum and maternal-fetal care units. The study found that all four interventions were successful in achieving the main outcomes, and the program has improved depression screening and increased social work referral rates at Cedars-Sinai.

Intervention Results: The four interventions increased nurse-champion screening comfort and perinatal mood and anxiety disorder knowledge, PHQ-9 screening rates from 10% to 99%, and screen-positive rates from 0.04% to 2.9%, and rates of social work consultation from 1.7% to 8.4% . Before training, 43% of surveyed nurses felt “very comfortable” screening patients for depression. After training, overall comfort increased to 73%. Nurse champions showed increased comfort discussing perinatal mental health, facilitating mental health referrals, and providing information to patients . After completion of 5 months of video training, the screening rate remained at 99%. Of those screened, 19% screened positive and as many as 39% of them consulted with social work . The SPC chart showed that screening rates had a sharp increase between March 2017 and June 2017 from 0.01% to 59.54% . The program sustained progress achieved by the first 4 interventions detailed in the report, and data from the next 4 interventions are currently being analyzed.

Conclusion: Quality improvement results from the first 3 years of the program suggest that 4 interventions improved screening rates, screen-positive rates, and social work consultation rates. Future work will focus on method of screening, patients at highest risk of perinatal mood and anxiety disorders, and ongoing nurse training.

Study Design: The study design used the Standards for QUality Improvement Reporting Excellence 2.0 guidelines to report outcomes from the four interventions. The study aimed to evaluate the impact of the interventions on the postpartum depression screening, education, and referral program at Cedars-Sinai. The interventions included nurse-champion training, use of the 9-item Patient Health Questionnaire-9 in the postpartum unit, a series of brief in-service trainings, and a 10-minute video training. The study collected data including nurse feedback, screening rates, screen-positive rates, and social work consultation rates

Setting: The study was conducted at Cedars-Sinai, a nonprofit hospital located in Beverly Hills, California. The hospital has a postpartum and maternal-fetal care unit where the interventions were implemented to improve the screening, education, and referral program for postpartum depression. The study included a sample of 19,564 women who delivered their babies at Cedars-Sinai over the course of two years

Population of Focus: The target audience of this study appears to be healthcare professionals, specifically those working in the postpartum and maternal-fetal care units at Cedars-Sinai. The study aimed to improve the screening, education, and referral program for postpartum depression at Cedars-Sinai, and the interventions were targeted towards nursing staff and social workers. The study also reported on the outcomes of the interventions, including nurse feedback, screening rates, screen-positive rates, and social work consultation rates, which may be of interest to healthcare professionals working in similar settings.

Sample Size: The sample size for the study was 19,564 women who delivered their babies at Cedars-Sinai over the course of two years. This sample size was used to evaluate the outcomes of the interventions aimed at improving the screening, education, and referral program for postpartum depression at the hospital

Age Range: The study did not report a specific age range for the sample of women who delivered their babies at Cedars-Sinai. However, the study did report that the average patient age was 33.95 years old

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder,

Intervention Description: The intervention described in the study involved the implementation of electronic medical record (EMR) functionality to address barriers to influenza vaccination adoption in a pediatric emergency department. A multidisciplinary team utilized Lean methodology to design triggers, alerts, and orders in the EMR. These triggers and alerts were likely designed to identify eligible patients for influenza vaccination and prompt healthcare providers to order and administer the vaccine. The study also mentions the use of visual cues in the EMR to support the intervention. The intervention aimed to streamline the process of identifying eligible patients and ordering/administering influenza vaccines, ultimately increasing vaccination rates. The study reports the number of vaccine doses administered before and after the implementation of the EMR tool, indicating a substantial increase in vaccination rates following the intervention. Overall, the intervention involved leveraging the EMR to facilitate and promote influenza vaccination within the pediatric emergency department, with a focus on improving workflow efficiency and increasing vaccination rates.

Intervention Results: The study reported significant improvements in influenza vaccination rates following the implementation of the electronic medical record (EMR) intervention in the pediatric emergency department. Specifically, the results indicated a substantial increase in the number of influenza vaccine doses administered after the implementation of the EMR tool. Before the intervention, the pediatric emergency department administered 42 doses of the vaccine during the 2013-2014 influenza season, representing 0.3% of eligible visits. However, after the implementation of the EMR functionality, the department administered 1320 doses of influenza vaccine, representing approximately 8.8% of qualified patients based on age group and eventual discharge from the ED. The results were sustained during the 2015-2016 influenza season, with 1031 doses administered, representing 6% of eligible visits. These findings suggest that the EMR intervention led to a substantial increase in the number of influenza vaccines administered, indicating the effectiveness of the intervention in improving vaccination rates within the pediatric emergency department.

Conclusion: The ED influenza vaccination program vaccinated approximately 20 times the number of eligible patients after automated EMR screening and ordering. Using knowledge of a multidisciplinary team, integration into the existing workflow, and visual cues in the EMR, we were able to increase the number of influenza vaccines administered substantially.

Study Design: the study is described as an electronic medical record (EMR) intervention aimed at increasing influenza vaccination rates in a pediatric emergency department. The study utilized Lean methodology and a multidisciplinary team to design triggers, alerts, and orders in the EMR to address barriers to adoption and root causes of low vaccination rates. Reports on compliance with each EMR step were completed for the 2014-2015 and 2015-2016 influenza seasons. The study presents the number of vaccine doses administered as a result of the intervention. Based on this information, it can be inferred that the study utilized a pre-post design to evaluate the effectiveness of the EMR intervention in increasing influenza vaccination rates.

Setting: The setting of the study discussed in the PDF file is a pediatric emergency department.

Population of Focus: The target audience for this PDF file is healthcare professionals, particularly those working in pediatric emergency care settings, who are interested in utilizing clinical decision support to improve influenza vaccination rates. It may also be of interest to researchers and policymakers in the field of healthcare quality improvement.

Sample Size: It mentions that the ED administered 42 doses of the vaccine in the 2013-2014 season and 1320 doses after the implementation of the EMR tool. Additionally, it states that the results were sustained during the 2015-2016 influenza season with 1031 doses administered.

Age Range: the study does mention that the ED administered influenza vaccines to qualified patients based on age group and eventual discharge from the ED

Intervention Components (click on component to see a list of all articles that use that intervention): Referrals, Administration/Practice Management, Quality Improvement, HOSPITAL, PATIENT_CONSUMER, Patient Reminder/Invitation, HEALTH_CARE_PROVIDER_PRACTICE, EMR Reminder

Intervention Description: Researchers implemented process changes in 3 phases: phase 1, changing the screening instrument and adding decision support; phase 2, adding automatic reminders; and phase 3, adding a referral option for autism evaluations in primary care. We analyzed the proportion of visits with autism screening at 2 intervention clinics before and after implementation of process changes versus 27 community clinics (which received only automatic reminders in phase 2) with χ2 test and interrupted time series.

Intervention Results: In 12 233 visits over 2 years (baseline and phased improvements), autism screening increased by 52% in intervention clinics (58.6%-88.8%; P < .001) and 21% in community clinics (43.4%-52.4%; P < .001). In phase 1, interrupted time series trend for screening in intervention clinics increased by 2% per week (95% confidence interval [CI]: 1.1% to 2.9%) and did not increase in community clinics. In phase 2, screening in the community clinics increased by 0.46% per week (95% CI: 0.03% to 0.89%). In phase 3, the intervention clinic providers referred patients for diagnostic evaluation 3.4 times more frequently (95% CI: 2.0 to 5.8) than at baseline.

Conclusion: We improved autism screening and referrals by changing the screening instrument, adding decision support, using automatic reminders, and offering autism evaluation in primary care in intervention clinics. Automatic reminders alone improved screening in community clinics.

Setting: Pediatric and community clinics

Population of Focus: Pediatricians and staff

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family), EMR Reminder, Technology-Based Support,

Intervention Description: The intervention described in the document aligns with a discernible strategy. The specific intervention involved a comprehensive educational in-service for the providers at the clinic, which included an overview of the significance of postpartum depression (PPD), the consequences associated with PPD among women and their children, instruction and directions regarding how to use the Edinburgh Postnatal Depression Scale (EPDS) screening tool, and how to document PPD screening in the electronic health record (EHR) system . This intervention aligns with a strategy of education and training to improve providers' knowledge and skills in PPD screening and documentation. Additionally, the implementation of the EPDS dialog box with a flag in the EHR system was part of the intervention, which aimed to facilitate standardized screening and documentation practices . This aligns with a strategy of integrating technology and standardized tools into clinical practice to improve screening and documentation processes. The study described in the document does analyze a multicomponent intervention. The intervention included multiple components such as the educational in-service, development of the EPDS dialog box in the EHR system, and provider follow-up. The study involved pre- and post-education questionnaire results, electronic health record chart reviews, and data analysis to assess the impact of the multicomponent intervention on PPD screening practices.

Intervention Results: The study found that PPD screening documentation rates increased from 56% to 92.7% after the intervention, indicating a significant improvement in PPD screening rates. Of the 124 electronic health record (EHR) charts audited after the project intervention, 115 charts had documentation of EPDS screening, demonstrating a substantial increase in provider-documented screening rates with the implementation of the EPDS tool . The data analysis showed a significant improvement in PPD screening rates from 56% before the project to 92.7% after the project intervention . The project outcomes identified greatly improved provider self-reported knowledge of the Affordable Care Act (ACA) preventive PPD perinatal care services . These results indicate that the multicomponent intervention, including education, training, and the implementation of the EPDS tool in the EHR system, had a significant positive impact on PPD screening practices among providers in the community women's health care clinic.

Conclusion: PPD screening education for health care providers and the addition of EPDS criteria to the electronic health record were associated with increased screening rates for PPD at a community women’s health care clinic.

Study Design: The study design/type used in the project to improve postpartum depression (PPD) screening practices among providers in the community women's health care clinic is a quasi-experimental study. The study used a pre- and post-intervention design to evaluate the impact of the multicomponent intervention on PPD screening practices and providers' knowledge in the community women's health care clinic. The study involved pre- and post-education questionnaire results, electronic health record chart reviews, and data analysis to assess the impact of the intervention on PPD screening practices , . However, the study did not include a control group, which is a characteristic of a true experimental study design. Therefore, the study design/type used in this project is a quasi-experimental study.

Setting: The setting for the study was a local community women's health care clinic located in the southwestern United States. The clinic primarily served minority women of lower socioeconomic status, including Hispanic and African American women, and those who were uninsured. The clinic provided care for postpartum women and was the focus of the project to improve postpartum depression (PPD) screening practices among healthcare providers. The clinic also served as a teaching setting for obstetrician-gynecologists, family practice medical residents, medical students, and nurse practitioner students. The average birth rates per physician in the clinic ranged from 40 to 45 births per month

Population of Focus: The target audience for the study is healthcare providers, specifically obstetrician-gynecologists and advanced practice registered nurses, who provide care to postpartum women in a community women's health care clinic. The study aimed to improve the PPD screening practices among healthcare providers in the clinic by implementing a standardized screening tool and providing education and training on preventive PPD screening practices and documentation recommendations . The study's findings and recommendations are relevant to healthcare providers who care for postpartum women and can be applied in various healthcare settings to improve PPD screening practices and outcomes. Additionally, the study's findings may be of interest to healthcare administrators, policymakers, and researchers who are interested in improving maternal mental health outcomes and reducing the burden of PPD.

Sample Size: The project involved the audit of 125 electronic health record (EHR) charts to assess the pre-intervention PPD screening rates . Additionally, after the project intervention, data were collected from 124 EHR charts over a 3-month period to evaluate the impact of the intervention on PPD screening practices . Therefore, the sample size for the EHR chart audits was 125 before the intervention and 124 after the intervention.

Age Range: The age range of the study was not explicitly mentioned in the provided document. Therefore, I cannot provide specific information regarding the age range of the participants in this study. If you have access to the original document, I would recommend checking the full text for any additional details on the age range of the participants.

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder, Screening Tool Implementation,

Intervention Description: Children with health insurance have increased access to healthcare and receive higher quality care. However, despite recent initiatives expanding children's coverage, many remain uninsured. New technologies present opportunities for helping clinics provide enrollment support for patients. We developed and tested electronic health record (EHR)-based tools to help clinics provide children's insurance assistance. We used mixed methods to understand tool adoption, and to assess impact of tool use on insurance coverage, healthcare utilization, and receipt of recommended care. We conducted intent-to-treat (ITT) analyses comparing pediatric patients in 4 intervention clinics (n = 15,024) to those at 4 matched control clinics (n = 12,227). We conducted effect-of-treatment-on-the-treated (ETOT) analyses comparing intervention clinic patients with tool use (n = 2240) to intervention clinic patients without tool use (n = 12,784).

Intervention Results: Tools were used for only 15% of eligible patients. Qualitative data indicated that tool adoption was limited by: (1) concurrent initiatives that duplicated the work associated with the tools, and (2) inability to obtain accurate insurance coverage data and end dates. The ITT analyses showed that intervention clinic patients had higher odds of gaining insurance coverage (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [95% Cl] 1.14-1.51) and lower odds of losing coverage (aOR = 0.77, 95% Cl 0.68-0.88), compared to control clinic patients. Similarly, ETOT findings showed that intervention clinic patients with tool use had higher odds of gaining insurance (aOR = 1.83, 95% Cl 1.64-2.04) and lower odds of losing coverage (aOR = 0.70, 95% Cl 0.53-0.91), compared to patients without tool use. The ETOT analyses also showed higher rates of receipt of return visits, well-child visits, and several immunizations among patients for whom the tools were used.

Conclusion: This pragmatic trial, the first to evaluate EHR-based insurance assistance tools, suggests that it is feasible to create and implement tools that help clinics provide insurance enrollment support to pediatric patients. While ITT findings were limited by low rates of tool use, ITT and ETOT findings suggest tool use was associated with better odds of gaining and keeping coverage. Further, ETOT findings suggest that use of such tools may positively impact healthcare utilization and quality of pediatric care.

Study Design: Mixed methods study

Setting: Eight community health centers (CHCs) in Oregon

Population of Focus: Pediatric patients who were eligible for Medicaid or the Children's Health Insurance Program (CHIP), were at risk of being uninsured, and who received care at the community health centers (CHCs)

Sample Size: 15,024 pediatric patients (7,918 were from intervention clinics and 7,106 from control clinics

Age Range: Children and youth ages 0-19 years

Intervention Components (click on component to see a list of all articles that use that intervention): Consensus Guideline Implementation, EMR Reminder,

Intervention Description: With assistance from the clinical informatics department, a postpartum-specific note template was created in the electronic health record (EHR) to increased adherence with counseling guidelines recommended by the American College of Obstetrics and Gynecology (ACOG). The template addressed birth spacing, breastfeeding, contraception, depression, and sleep/fatigue, as well as comorbidities requiring follow-up (abnormal Pap smear, gestational diabetes mellitus, and pre-eclampsia). Patients were seen in a resident-run clinic: 100 consecutive visits occurred prior to implementation of the template, while 100 consecutive visits occurred post-implementation with use of the template.

Intervention Results: In visits that occurred without use of the template, counseling was charted as low as 1.0% for birth spacing to as high as 86.0% for contraception. With use of the template, counseling was charted as 100% in all visits for each of the recommended counseling guidelines (all p < 0.001).

Conclusion: A postpartum specific EHR note template shows improvement in adherence with recommended postpartum counseling. We propose that managers in hospitals and clinical practices create OBGYN-specific EHR note templates for clinical use to potentially improve documentation quality. This may increase adherence to documentation of postpartum counseling, with the ultimate goal of increasing adherence to evidence-based counseling guidelines.

Study Design: Retrospective cohort study

Setting: Resident run clinic, Nassau University Medical Center

Population of Focus: Postpartum patients

Sample Size: 200

Age Range: Mean age 30

Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, Pediatric to Adult Transfer Assistance, PROVIDER/PRACTICE, EMR Reminder, Nurse/Nurse Practitioner, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: An EMR-based transition planning tool (TPT) was introduced into the Pediatric CHD Clinic. Two nurses used the TPT with eligible patients. Independent of the intervention, two medicine-pediatric CHD physicians and one nurse practitioner were added to the ACHD Clinic to address growing capacity needs.

Intervention Results: Control patients waited 26 ± 19.2 months after their last pediatric clinic visit for their first adult visit. Intervention patients waited 13 ± 8.3 months (P = .019). Control and Intervention patients experienced a lapse in care greater than two (50% vs 13%, P = .017) and three (30% vs 0%, P = .011) years, respectively. The difference between the recommended number of months for follow-up and the first adult appointment (15.1 ± 17.3 Control and 4.4 ± 6.1 Intervention months) was significant (P = .025). NYHAFS deteriorated between the last Pediatric visit and the first ACHD visit for seven (23%) Control patients and no Intervention patients (P = .042). Four of seven Control patients whose NYHAFS declined had a lapse of care of more than two years.

Conclusion: There is a need for improved HCT planning for patients with moderate to severe CHD, otherwise, lapses of care and adverse outcomes can ensue.

Study Design: Prospective study

Setting: Clinic-based (Children’s hospital pediatric cardiology clinic)

Population of Focus: Adolescent patients with moderate to severe congenital heart disease (CHD)

Data Source: Electronic medical records; New York Heart Association Functional Assessment of Heart Failure instrument

Sample Size: 25 intervention, 30 control

Age Range: Intervention 16- 25 years, control 18 years or older

Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, PROVIDER/PRACTICE, EMR Reminder

Intervention Description: We developed a Transition EHR activity (TEA) to track patients through a standardized process where transition readiness is annually assessed and services distributed based on need. The process assesses transition skills starting at age 12 years and sets goals through shared decision-making, delivers resources according to need, reviews patients' personal medical histories, and documents healthcare transfer to adult gastroenterology. We piloted TEA among patients with inflammatory bowel disease (IBD) ages ≥12 years. Distribution to patients was measured and tolerability assessed via patient self-report evaluations.

Intervention Results: Since launch, TEA has been distributed to all eligible patients (N = 53) with a median age of 16 (14,18) years (median [IQR]), 62% male, 58% white, 26% Hispanic at our weekly dedicated IBD clinic. All have performed the transition skills' self-assessment and practicum, and set transition goals with their healthcare provider. Of these individuals, 41 (77%) participated in survey feedback. On a utility rating scale of 0 (not helpful at all) to 10 (very helpful), patients reported median (IQR) utility scores of 8 (7,10) for the transition readiness assessment, 9 (7,10) for transition resources provided, and 9 (7,10) for the medical history summary. Most (91%) would recommend TEA to other patients.

Conclusion: TEA standardized delivery of resources among pediatric IBD patients and was well received and friendly to clinical workflow.

Study Design: Cohort pilot

Setting: Clinic-based (Pediatric gastroenterology clinic)

Population of Focus: Adolescents with IBD

Data Source: Surveys; self-assessment

Sample Size: 53

Age Range: 12-18 years (median age 16)

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation, Assessment, YOUTH, HEALTH_CARE_PROVIDER_PRACTICE, EMR Reminder

Intervention Description: This study aimed to assess the feasibility of a CDSS to address caregivers' tobacco use and child tobacco smoke exposure (TSE).

Intervention Results: We screened 185 caregivers whose children were exposed to TSE for study inclusion; 155 (84%) met the eligibility criteria, and 149 (80.5%) were included in the study. Study nurses advised 35.2% of the caregivers to quit, assessed 35.9% for readiness to quit, and assisted 32.4%. Of the 149 participants, 83.1% were female; 47.0% were white and 45.6% African American; 84.6% had public insurance or were self-pay; 71.1% were highly nicotine dependent; 50.0% and 50.7% allowed smoking in the home and car, respectively; and 81.3% of children were biochemically confirmed to be exposed to tobacco smoke. At follow-up (86.6% retention), 58.9% reported quit attempts at 3 months. There was a significant decrease in nicotine dependence and a significant increase in motivation to quit. Self-reported quit rate was 7.8% at 3 months.

Conclusion: An electronic health record-embedded CDSS was feasible to incorporate into busy UC nurses' workloads and was associated with encouraging changes in the smoking behavior of caregivers. More research on the use of CDSS to screen and counsel caregivers who smoke in the UC and other acute care settings is warranted.

Intervention Components (click on component to see a list of all articles that use that intervention): Patient Reminder/Invitation, EMR Reminder,

Intervention Description: Intervention description: The multidisciplinary team developed weekly targeted rounds to identify eligible patients with outstanding immunizations. Exclusion criteria were established, and the team implemented an in-hospital immunization record review, an email reminder, a weekly multidisciplinary eligibility discussion, and an updated rounding tool to increase and sustain immunization rates in this population of infants with CLD.

Intervention Results: Immunization of eligible patients increased from 44% to 75% and was sustained for the next 6 months. The average number of days from admission to immunization record review decreased from 71 days at baseline to 27 days.

Conclusion: The implementation of (1) an in-hospital immunization record review, (2) an e-mail reminder, (3) a weekly multidisciplinary eligibility discussion, and (4) an updated rounding tool was successful in increasing and sustaining immunization rates in this population of infants with CLD. The multidisciplinary CLD meeting was a novel opportunity to discuss immunization eligibility and safety monitoring.

Study Design: Quality improvement initiative. -

Setting: Neonatal intensive care unit (NICU) at a tertiary care children's hospital in the United States.

Population of Focus: Infants with severe chronic lung disease (CLD) in the NICU.

Sample Size: 60 patients.

Age Range: Not specified, but the study focused on 2-, 4-, and 6-month immunization rates.

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, EMR Reminder, PATIENT_CONSUMER, Telephone Support

Intervention Description: Parents completed the PSC-17P electronically before the visit and the scored data were immediately available in the patient's chart. Using billing and screening data, the study tracked rates of overall and positive screening during the first-year baseline (4 months) and full implementation phases of the project in the first (8 months) and second (12 months) year.

Intervention Results: A total of 35,237 patients completed a WCV in the first year. There was a significant improvement in PSC-17P screening rates from the first-year baseline (26.3%) to full implementation (89.3%; P < .001) phases. In the second year, a total of 40,969 patients completed a WCV and 77.9% (n = 31,901) were screened, including 18,024 patients with screens in both years. PSC-17P screening rates varied significantly across the 18 locations and rates of PSC-17P risk differed significantly by practice, insurance type, sex, and age.

Conclusion: The current study demonstrated the feasibility of routine psychosocial screening over 2 years using the electronically administered PSC-17P in a network of pediatric practices. This study also corroborated past reports that PSC-17 risk rates differed significantly by insurance type (Medicaid vs commercial), sex, and age group.

Setting: Pediatric practies

Population of Focus: Parents and caregivers

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, EMR Reminder,

Intervention Description: The intervention aligns with the strategy of improving screening and referral rates for postpartum depression in the pediatric primary care setting. The article describes a quality improvement project that analyzes a multicomponent intervention, including education and preparation, EMR adaptations, and stakeholder engagement and collaboration.

Intervention Results: The results of the intervention showed a significant increase in the clinic's screening rate from 33% to 80% and an improvement in referral rates from 66% to 79% . These findings indicate that the implementation of the standardized screening schedule and referral algorithm had a positive impact on the clinic's ability to identify and refer mothers with symptoms of postpartum depression for further evaluation and care.

Conclusion: By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.

Study Design: The study design is a quality improvement (QI) project that standardized the postpartum depression (PPD) screening schedule and implemented a novel referral algorithm in a rural primary care pediatric practice The project aimed to assess the impact of these interventions on the clinic's screening and referral rates for postpartum depression. The study utilized a pre-post intervention design to evaluate the changes in screening and referral rates before and after the implementation of the standardized screening schedule and referral algorithm.

Setting: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . This setting reflects a real-world healthcare environment where the interventions and changes in practice were implemented and evaluated. The rural context of the pediatric practice is also an important consideration, as it may have implications for the generalizability of the study's findings to similar healthcare settings.

Population of Focus: The target audience for the study includes healthcare providers in pediatric primary care settings, particularly pediatricians, pediatric nurse practitioners, and pediatric nurses. The interventions and findings of the study are relevant to healthcare professionals involved in the care of infants, children, and adolescents, as well as their mothers. Additionally, the study's insights may also be of interest to professionals involved in maternal mental health, quality improvement initiatives, and those seeking to enhance postpartum depression screening and referral practices in pediatric primary care.

Sample Size: The specific sample size for the study is not explicitly mentioned in the provided excerpts. However, the study collected baseline data from 109 well visits during a 1-month time period before the project's implementation . This information provides insight into the scale of the initial data collection. For a more detailed understanding of the sample size and its implications for the study's findings, it may be necessary to refer to the complete article.

Age Range: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . Therefore, the age range of the patients included in the study spans from newborns up to 21 years old. This broad age range reflects the pediatric focus of the primary care practice and the potential impact of the interventions on a diverse patient population.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, EMR Reminder,

Intervention Description: The intervention aligns with the strategy of improving screening and referral rates for postpartum depression in the pediatric primary care setting. The article describes a quality improvement project that analyzes a multicomponent intervention, including education and preparation, EMR adaptations, and stakeholder engagement and collaboration.

Intervention Results: The results of the intervention showed a significant increase in the clinic's screening rate from 33% to 80% and an improvement in referral rates from 66% to 79% . These findings indicate that the implementation of the standardized screening schedule and referral algorithm had a positive impact on the clinic's ability to identify and refer mothers with symptoms of postpartum depression for further evaluation and care.

Conclusion: By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.

Study Design: The study design is a quality improvement (QI) project that standardized the postpartum depression (PPD) screening schedule and implemented a novel referral algorithm in a rural primary care pediatric practice The project aimed to assess the impact of these interventions on the clinic's screening and referral rates for postpartum depression. The study utilized a pre-post intervention design to evaluate the changes in screening and referral rates before and after the implementation of the standardized screening schedule and referral algorithm.

Setting: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . This setting reflects a real-world healthcare environment where the interventions and changes in practice were implemented and evaluated. The rural context of the pediatric practice is also an important consideration, as it may have implications for the generalizability of the study's findings to similar healthcare settings.

Population of Focus: The target audience for the study includes healthcare providers in pediatric primary care settings, particularly pediatricians, pediatric nurse practitioners, and pediatric nurses. The interventions and findings of the study are relevant to healthcare professionals involved in the care of infants, children, and adolescents, as well as their mothers. Additionally, the study's insights may also be of interest to professionals involved in maternal mental health, quality improvement initiatives, and those seeking to enhance postpartum depression screening and referral practices in pediatric primary care.

Sample Size: The specific sample size for the study is not explicitly mentioned in the provided excerpts. However, the study collected baseline data from 109 well visits during a 1-month time period before the project's implementation . This information provides insight into the scale of the initial data collection. For a more detailed understanding of the sample size and its implications for the study's findings, it may be necessary to refer to the complete article.

Age Range: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . Therefore, the age range of the patients included in the study spans from newborns up to 21 years old. This broad age range reflects the pediatric focus of the primary care practice and the potential impact of the interventions on a diverse patient population.

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement, Community Health Workers (CHWs), EMR Reminder,

Intervention Description: The intervention aimed at optimizing community-based referrals in primary care using Quality Improvement (QI) methodology. The intervention involved several components, including: Dedicating space for Community Health Workers (CHWs) near providers. Creating electronic CHW schedules and warm handoff blocks, Improving communication with providers using email and huddle reminders, Posting informative signs in exam rooms, Co-locating services with medical providers, Creating scheduled warm handoff blocks. Improving leadership involvement and communication with providers. These interventions align with a discernible strategy of optimizing workflows to increase warm handoffs with CHWs, with a focus on co-locating services, creating scheduled warm handoff blocks, and improving leadership involvement and communication with providers. The article presents a study that analyzes a multicomponent intervention aimed at optimizing community-based referrals in primary care using QI methodology. The intervention involved multiple strategies and components to improve the warm handoff rate between families with unmet social needs and CHWs, demonstrating a comprehensive approach to addressing social determinants of health in a primary care setting

Intervention Results: The CHW warm handoff rate increased two-fold from a monthly median of 11% to 24% in the intervention period. The number of social needs screenings completed and CHW referrals increased during the intervention period. Of all patients screened in the intervention period, 8.4% were referred to a CHW, significantly higher than the referral rate in the baseline period. Of all referrals made in the intervention period, 22% had a warm handoff, also significantly higher than the warm handoff rate in the baseline period. The Ages and Stages Questionnaire Third Edition (ASQ-3) screening rate at the 12-month well-baby visit showed an increase from a baseline median rate of 83% to 92% in the intervention period . These results indicate the effectiveness of the QI intervention in increasing the CHW warm handoff rate and improving the social needs screening and referral process in the primary care setting.

Conclusion: The results illustrate that QI methods can be used to optimize workflows to increase warm handoffs with CHWs. This is important as health centers work to improve their social needs screening and referral programs.

Study Design: The study design used in the article is a Quality Improvement (QI) methodology. The authors used the Model for Improvement as the QI framework to increase Community Health Worker (CHW) warm handoffs. They conducted several Plan, Do, Study, Act (PDSA) cycles, which is a key quality improvement model used for rapid change testing and process improvement. The study analyzed the impact of the intervention on process measures, outcome measures, and balancing measures

Setting: The study was conducted at an academic-affiliated federally qualified health center (FQHC) located in the South Bronx, New York. The FQHC has been established since 1967 and is located in congressional district 15, which is the poorest in the nation . The study was conducted in a single site, which may limit the generalizability of the findings to other healthcare settings. However, the study provides insights into the effectiveness of quality improvement methods in optimizing community-based referrals and warm handoffs in a primary care setting.

Population of Focus: The target audience for this study includes healthcare professionals, particularly those involved in primary care and community health settings. This may encompass physicians, nurses, community health workers, social workers, and other healthcare providers who are interested in improving the identification and referral of patients with unmet social needs. Additionally, individuals and organizations involved in quality improvement initiatives within healthcare settings may also find the study relevant. The findings and methodologies presented in the article are likely to be of interest to those seeking to optimize community-based referrals and warm handoffs in primary care using quality improvement methodology.

Sample Size: The article does not explicitly mention the sample size in terms of the number of patients involved in the study. However, it does provide specific data points related to the number of patients screened for social needs in both the baseline and intervention periods, as well as the number of CHW referrals placed. These data points indicate the scale of the study, but the exact sample size in terms of the number of patients is not explicitly stated.

Age Range: The article does not specify a specific age range for the patients involved in the study. However, it does mention that the screening was conducted most often by a parent or guardian prior to the medical exam at new patient visits and annual well-child visits from birth through age 21 . Therefore, it can be inferred that the study involved patients from birth through age 21.

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder, Food Prescriptions

Intervention Description: Caregivers and children participated in the program, which aimed to improve food security and dietary behaviors. Fresh fruits and vegetables were prescribed and distributed to patients via the Electronic Medical Record (EMR) system

Intervention Results: Mean caregiver-reported household food security improved from baseline to 12 months (p < 0.001), as did mean child-reported food security (p = 0.01). Additionally, child-reported intake of vegetables (p = 0.001), whole grains (p = 0.001), fiber (p = 0.008), and dairy (p < 0.001) improved after 12 months of exposure to the fruits and vegetable prescription program.

Conclusion: This study provides evidence that pediatric FVPPs may positively influence food security and the dietary patterns of children.

Study Design: longitudinal design

Setting: Pediatric clinic

Population of Focus: Children and adolescents

Sample Size: 122

Age Range: 8/18/2024

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention, EMR Reminder,

Intervention Description: he implementation of information technology prompts within the electronic medical record to improve influenza vaccination during specialty clinic visits for pediatric patients with inflammatory bowel disease. The customized prompts were designed to remind healthcare providers to offer influenza vaccination to eligible patients and to document vaccination status in the electronic medical record. The prompts were tailored to the specific needs of the pediatric patients with inflammatory bowel disease and were implemented during specialty clinic visits.

Intervention Results: ndicated significant improvements in influenza vaccination documentation and vaccine counseling following the implementation of information technology prompts within the electronic medical record. The proportion of patients with yearly influenza vaccination documentation improved from 10% at baseline to 39% by Year 1 and further to 61% by Year 2 following the implementation of the intervention. Additionally, vaccine counseling for unvaccinated patients improved from 27% to 77% by Year 2. Importantly, patients seen by gastroenterology nurses had higher vaccination documentation and vaccine counseling compared to those seen by a physician alone. These findings suggest that the use of customized prompts within the electronic medical record was effective in improving influenza vaccination rates and vaccine counseling for pediatric patients with inflammatory bowel disease

Conclusion: concluded that the implementation of information technology prompts within the electronic medical record was effective in improving influenza vaccination rates and vaccine counseling for pediatric patients with inflammatory bowel disease. The use of customized prompts tailored to the specific needs of the pediatric patients with inflammatory bowel disease was associated with significant improvements in influenza vaccination documentation and vaccine counseling. The study highlights the potential benefits of utilizing information technology to improve vaccination rates and underscores the importance of healthcare providers in offering and documenting influenza vaccination for eligible patients

Study Design: intervention study or a quality improvement initiative aimed at implementing information technology prompts within the electronic medical record to improve influenza vaccination during specialty clinic visits for pediatric patients with inflammatory bowel disease.

Setting: Johns Hopkins Childrens Center, Baltimore, MD

Population of Focus: Uptake for pediatric patients with additional illness/disease

Sample Size: 533

Age Range: Age range not specified, but within pediatric clinic

Intervention Components (click on component to see a list of all articles that use that intervention): Counseling (Parent/Family), EMR Reminder, Care Coordination, Integration into Adult Care, Pediatric to Adult Transfer Assistance, Planning for Transition, PARENT_FAMILY, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: The Multidisciplinary Intervention Navigation Team (MINT) was developed to decrease variations in pediatric to adult medical transitions. System-level goals were to (1) increase provider and leadership engagement, (2) increase transition tools, (3) increase use of electronic medical record-based clinical decision supports, (4) improve transition practices through development of transition policies and clinical pathways; (5) increase transition education for patients and caregivers; (6) increase the adult provider referral network; and (7) implement an adult transition consult service for complex patients (MINT Consult).

Intervention Results: Between July 2015 and March 2017, MINT identified 11 transition champions, increased the number of divisions with drafted transition policies from 0 to 7, increased utilization of electronic medical record-based transition support tools from 0 to 7 divisions, held seven psychoeducational events, and developed a clinical pathway. MINT has received more than 70 patient referrals. Of patients referred, median age is 21 years (range, 17-43); 70% (n = 42) have an intellectual disability. Referring pediatric providers (n = 25) reported that MINT helped identify adult providers and coordinate care with other Children's Hospital of Philadelphia specialists (78%); and that MINT saved greater than 2 hours of time (48%).

Conclusion: MINT improved the availability, knowledge, and use of transition-related resources; saved significant time among care team members; and increased provider comfort around transition-related conversations.

Study Design: Cohort pilot evaluation

Setting: Hospital-based (Free-standing tertiary pediatric academic hospital (Children’s Hospital of Philadelphia (CHOP))

Population of Focus: Patients aged 17-43 who had not transitioned from pediatric to adult care for medically complex patients

Data Source: Transition Readiness Assessment Questionnaire; electronic medical records; surveys

Sample Size: Total number not given, but there were 80 consults given over 2 years; 74 were deemed appropriate referrals

Age Range: 17-43 years (median age 20)

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder,

Intervention Description: The study aimed to assess rotavirus vaccine coverage using electronic medical records (EMRs) and to identify factors associated with series initiation and completion

Intervention Results: According to the information provided in the text, the study found that rotavirus vaccine uptake (series completion) increased each year of the first three years of the program in Ontario, from 73% to 84% . This indicates an increasing trend in rotavirus vaccine uptake over the initial years of the program implementation

Conclusion: Family physician delivery achieved moderately high coverage in the program's first three years. This assessment demonstrates the usefulness of EMR data for evaluating vaccine coverage. Important insights into factors associated with initiation or completion (i.e. high continuity of care, smaller roster sizes, rural practice location) suggest areas for research and potential program supports.

Study Design: The study utilized linked data from health administrative databases, indicating a retrospective observational study design

Setting: The study was conducted in Ontario, Canada, which is the most populous province in Canada

Population of Focus: The target audience of the study includes infants and toddlers in Ontario, Canada, who are eligible for rotavirus vaccination

Sample Size: The specific sample size is not provided in the given text. However, the study utilized data from Ontario's health administrative databases, which suggests a large population-based sample

Age Range: The study focuses on infants and toddlers, indicating an age range typically from birth to a few years old

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder, , HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: This study's purpose was to increase provider HCT services engagement through implementation of a transition-specific CDS and participation in a transition-focused Learning Collaborative (LC).

Intervention Results: From July 2018 through June 2019, providers at LC-participating sites engaged in HCT services at 8.0% (n = 480) and 5.3% (n = 145) of eligible patient visits compared to the control's 3.1% (n = 69). Engagement was highest for ≥18-year-olds at the LC-participating sites, 26.0% (n = 263) and 12.0% (n = 80), compared to the control's 7.2% (n = 31). After expanding from ≥16 to ≥14-year-olds, engagement decreased by 9.5% at ≥16-year-old visits. LC-participating sites reported increased HCT guideline adherence.

Conclusion: Quality improvement activities and transition clinical decision supports can improve provider engagement in recommended transition services for adolescents and young adults.

Intervention Components (click on component to see a list of all articles that use that intervention): , EMR Reminder, Targeting Interventions to Focused Groups, Educational Material, Mobile Apps, Online Material/Education/Blogging

Intervention Description: The study primarily focuses on developing a data-driven primary intervention approach using machine learning and electronic health records (EHR) data to identify pregnant women at risk for postpartum depression (PPD) . The intervention aligns with a discernible strategy of leveraging machine learning algorithms to predict PPD risk based on EHR data, with the potential for early prevention, diagnosis, and intervention . The study does not analyze a multicomponent intervention; rather, it focuses on the development and validation of a machine learning algorithm for PPD risk prediction using EHR data. The intervention strategy is centered around leveraging data-driven approaches to identify at-risk individuals and potentially tailor therapeutic interventions, screening timelines, and preventive strategies for PPD

Intervention Results: The study analyzed a total of 15,197 deliveries from January 2015 to June 2018, and the prevalence of depression was 6.7% (N=1,010) and 6.5% (N=3,513) in the WCM and NYC-CDRN datasets, respectively . The machine learning algorithm was able to predict PPD risk with an area under the receiver operating characteristic curve (AUC-ROC) of 0.83 (95% CI: 0.81-0.85) in the training dataset and 0.80 (95% CI: 0.77-0.83) in the validation dataset . The study found significant differences in age, the number of emergency department visits, and racial distribution between PPD and non-PPD groups in the training and validation data . The study demonstrates that a data-driven primary intervention approach using machine learning and EHR data may be leveraged to reduce the healthcare provider burden of identifying PPD risk.

Conclusion: Machine learning-based models incorporating EHR-derived predictors, could augment symptom-based screening practice by identifying the high-risk population at greatest need for preventive intervention, before development of PPD.

Study Design: The study design was a prospective cohort study that used electronic health records (EHR) data to develop and validate a machine learning algorithm for predicting the risk of postpartum depression (PPD) among pregnant women . The study used two EHR datasets containing data on 15,197 women from 2015 to 2018 at a single site and 53,972 women from 2004 to 2017 at multiple sites as development and validation sets, respectively . The study included all pregnant women with fully completed antenatal care procedures who had live births of infants, and the exclusion criteria were maternal age below 18 or above 45, or lack of outpatient, inpatient, or emergency room encounter information in the EHR data within 1 year following childbirth . The study was approved by the Institutional Review Board at Weill Cornell Medicine (IRB protocol# 1711018789), and data extraction and analysis were performed in 2019 . The study used a well-defined outcome measure of PPD diagnosis within 1 year following childbirth, and the machine learning algorithm was able to predict PPD risk with a high degree of accuracy

Setting: The study setting for the development dataset was a single site, and the validation dataset included data from multiple health systems across New York City affiliated with the Patient-Centered Outcomes Research Institute funded New York City Clinical Data Research Network data (NYC-CDRN) . Therefore, the study setting primarily involved healthcare institutions and systems in New York City, USA.

Population of Focus: The target audience for the study includes healthcare professionals, researchers, and policymakers involved in maternal and mental health, as well as professionals working with electronic health records (EHR) and machine learning applications in healthcare. Additionally, the findings of the study may be of interest to organizations and institutions involved in developing and implementing predictive models for identifying and addressing the risk of postpartum depression among pregnant women.

Sample Size: The study included a total of 15,197 deliveries from January 2015 to June 2018 in the development dataset, and 53,972 deliveries from August 2004 to October 2017 in the validation dataset . These datasets were used to develop and validate a machine learning algorithm for predicting the risk of postpartum depression among pregnant women.

Age Range: The study included pregnant women within a specific age range. The exclusion criteria for the study were maternal age below 18 or above 45 . Therefore, the age range of the included pregnant women in the study was 18 to 45 years old.