Pediatrician University of Illinois College of Medicine Trivoli, Illinois, United States
Background: Atherosclerotic cardiovascular disease remains the leading cause of death in North Americans. Risk factors and risk behaviors that accelerate the development of atherosclerosis begin in childhood. In 2011, the National Heart, Lung and Blood Institute created guidelines for cardiovascular health, which includes universal screening of lipids in ages 9-11 years and 17-21 years. Objective: To improve our compliance with the universal screening for lipids in our office. Design/Methods: In October 2018 we started recommending universal screening for lipids in our patients 9-11 years old and 17-21 years old at their well child check (WCC) in our outpatient clinic. This test did not need to be fasting and labs could be drawn in our office or at the hospital lab. A note was placed on computers in the patient rooms to remind providers to discuss the screen during their appointments. In April 2019, we then placed a reminder in the “reason for visit” section on the provider’s EMR schedule. In September 2019, we discussed lipid screening at t he provider meeting and made it a priority to incorporate this in the WCC. We created a dot phrase for EMR documentation as well. In May 2021, we started using a point of care test (POCT) for lipid screening that could be completed in our office and only required a finger prick. Lastly, we refined our screening process and started having the certified medical assistant (CMA) get the POCT lipid test done as part of the rooming process starting in early 2022. Results: Baseline- of the 9-11 year old and 17-21 year old patients, 10% had lipid screening discussed during their appointment and 9% of those had the lab drawn. After office education- 75% of patients had lipid screening discussed and 67% of those had the lab drawn. After starting the point of care testing- 89% of patients had lipid screening discussed and 88% of those had the lab drawn. We then had our CMAs obtain the POCT as part of their rooming process. Following that, we did not assess if it was discussed during the appointment for it became routine for every patient to have lipid POCT done. We then found that 74% of all patients in said age ranges were getting testing done, where 80% of 9-11 year olds had the test done, and 70% of 17-21 year olds had the test done.
Conclusion(s): We were able to improve our adherence to the universal lipid screening guidelines, with point of care testing. We were able to sustain our results by making the lipid screening part of the rooming process for the well child check in these patients.
