A Quality Improvement Initiative to Reduce Screen Time in a Children’s Hospital

Abstract

OBJECTIVES The American Academy of Pediatrics strongly recommends that children age 2 and under should have little to no digital media exposure. However, most children are exposed to regular screen time at home. This may also be true for hospitalized children. Through education and access to alternatives, we aimed to reduce screen exposure in our children’s hospital for children 2 and under. METHODS Between January 2020 and May 2021, we designed and implemented a quality improvement intervention to educate staff and caregivers on the American Academy of Pediatrics screen time recommendations and offer alternatives for hospitalized children. Our primary aim was to decrease screen time exposure for children age 2 and under by 50% within 12 months of project initiation. Balancing measures included staff perception of workload when using screens and perceived parental acceptance of screens being turned off. RESULTS During baseline data collection period, screens were on for an average of 63% of the audits. Following interventions, the average was reduced to 40%. The outcome measure met special cause with 8 consecutive points below the center line. There was a significant increase in staff who reported offering screen alternatives after intervention. Staff perception of workload and perceived parental acceptance was unchanged. CONCLUSIONS Through implementation of this quality improvement initiative, we reduced screen time by approximately 37% without impacting staff workload. Most importantly, we were able to educate staff and model best practices for caregivers, which may carry into the home, leading to a reduction of screen time and improved health overall.