Affiliation:
1. Sections of Hospital Medicine
2. Medical Education
3. Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
Abstract
OBJECTIVES
Hospitals are an important nontraditional setting in which to address adolescent reproductive health. However, opportunities for intervention are frequently missed, especially for boys and patients hospitalized for noningestion complaints. Our global aim was to increase delivery of reproductive health care to adolescents hospitalized through our children’s hospital Pediatric Hospital Medicine service.
METHODS
We performed 2 quality improvement intervention cycles: (1) provider education and monthly reminder e-mails and (2) an automated electronic health record (EHR) adolescent history and physical note template with social history prompts while discontinuing reminder e-mails. The primary outcome measure was sexual history documentation (SHD). Secondary measures were sexually transmitted infection (STI) testing and contraception provision. Statistical process control charts were used to analyze effectiveness of interventions.
RESULTS
From July 2018 through June 2019, 528 Primary Hospital Medicine encounters were included in this study and compared with published baseline data on 150 encounters. Control charts revealed a special cause increase in SHD from 60% to 82% overall, along with 37% to 73% for boys and 57% to 80% for noningestion hospitalizations. Increased SHD correlated with cycle 1 and was maintained through cycle 2. Percent STI testing significantly increased but did not shift or trend toward special cause variation. Contraception provision, length of stay, and patient relations consultations were not affected.
CONCLUSIONS
The interventions were successful in increasing SHD, including among boys and noningestion hospitalizations. The EHR enhancement maintained these increases after reminder emails were discontinued. Future interventions should specifically address STI testing and provision of contraception.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health
Reference41 articles.
1. Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States;Forhan;Pediatrics.,2009
2. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008;Satterwhite;Sex Transm Dis.,2013
3. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2019. Available at: www.cdc.gov/std/statistics/2019/default.htm. Accessed June 28, 2021
4. Sexual activity, contraceptive use, and childbearing of teenagers aged 15–19 in the United States;Martinez;NCHS Data Brief.,2015
5. Births in the United States, 2018;Martin;NCHS Data Brief.,2019
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