دورية أكاديمية
أعرض في EDS

Sustained increase in annual transcranial Doppler screening rates in children with sickle cell disease: A quality improvement project.

التفاصيل البيبلوغرافية
العنوان: Sustained increase in annual transcranial Doppler screening rates in children with sickle cell disease: A quality improvement project.
المؤلفون: Edwards JG; Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA., Yan AP; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.; Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Yim R; Division of Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA., Oni M; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA., Heeney MM; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA., Johnson D; Boston Children's Hospital Program for Patient Safety and Quality, Boston, Massachusetts, USA., Wong CI; Division of Hematology/Oncology, Rainbow Babies and Children's Hospital and Seidman Cancer Center, University Hospitals, Cleveland, Ohio, USA., Ilowite M; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA., Archer NM; Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
المصدر: Pediatric blood & cancer [Pediatr Blood Cancer] 2024 Aug; Vol. 71 (8), pp. e31088. Date of Electronic Publication: 2024 May 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hoboken, N.J. : John Wiley, c 2004-
مواضيع طبية MeSH: Anemia, Sickle Cell*/diagnostic imaging , Anemia, Sickle Cell*/complications , Ultrasonography, Doppler, Transcranial*/methods , Quality Improvement*, Humans ; Child ; Female ; Male ; Adolescent ; Child, Preschool ; Stroke/etiology ; Stroke/prevention & control ; Stroke/diagnostic imaging ; Mass Screening/methods ; Mass Screening/standards ; Follow-Up Studies ; Prognosis
مستخلص: Introduction: Individuals with sickle cell disease (SCD) at increased risk for stroke should undergo annual stroke risk assessment using transcranial Doppler (TCD) screening between the ages of 2 and 16. Though this screening can significantly reduce morbidity associated with SCD, screening rates at Boston Children's Hospital (and nationwide) remain below the recommended 100% screening adherence rates.
Methods: Three plan-do-study-act (PDSA) cycles were designed and implemented. The Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) aim of our quality improvement (QI) initiative was to sustainably increase the proportion of eligible patients receiving a TCD within 15 months of their last TCD to greater than 95%. An interrupted time series (ITS) analysis was performed, comparing TCD adherence rates from PDSA Cycle 1 to those from PDSA Cycles 2 and 3.
Results: Mean TCD adherence increased across all three PDSA cycles, from a baseline of 67% in the first cycle (January 2015 to September 2020) to 92% in the third cycle (May 2021 to March 2023). In the ITS analysis of TCD adherence rates, there was a significant difference in the final TCD adherence rate achieved compared to the rate predicted, with a total estimated increase in adherence of 17.9% being attributable to the interventions from PDSA Cycles 2 and 3.
Discussion: Although other QI initiatives had demonstrated ability to increase adherence to TCD screening for patients with SCD, this is the first QI project to collect data over such a prolonged period of time to demonstrate a sustained increase in screening rates throughout the intervention (an 8-year period).
(© 2024 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: quality improvement; sickle cell disease; transcranial Doppler
تواريخ الأحداث: Date Created: 20240529 Date Completed: 20240626 Latest Revision: 20240626
رمز التحديث: 20240627
DOI: 10.1002/pbc.31088
PMID: 38809385
قاعدة البيانات: MEDLINE
الوصف
تدمد:1545-5017
DOI:10.1002/pbc.31088