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Improving Quality of Care for Childhood-onset Systemic Lupus Erythematosus: Cardiovascular and Bone Health Screenings

Smitherman, Emily A
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535381218464551

Abstract Details

2018, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Objective: Childhood-onset systemic lupus erythematosus (cSLE) is associated with poor health outcomes, and initial benchmarking of cSLE quality measures has revealed suboptimal performance and significant variation in cardiovascular and bone health screenings. The aim of this study was to implement a reliable intervention to improve performance of recommended health maintenance screenings of annual serum vitamin D, annual serum lipid profiles, and bone mineral density testing via dual x-ray absorptiometry (DXA) in a local cSLE cohort. Methods: Quality improvement methodology was applied. The primary intervention implemented was standardized pre-visit planning, including pending electronic orders for screenings prior to a visit. The primary outcome measure was the percentage of clinic visits with compliant screenings over time. Additional analyses were completed to assess the reliability and effectiveness of the intervention. Results: During the study period, a total of 123 cSLE patients were evaluated over 619 visits. After the intervention was implemented, performance of recommended screenings improved from 60% to 90% for vitamin D, 53% to 80% for lipid profiles, and 60% to 76% for DXA, which was sustained for over a year. The majority of abnormal test results were acted on by clinicians without implementing a treatment algorithm. Higher disease activity, damage index, and number of clinical encounters were observed in the group of patients with 100% screening completion compared to patients with only partial screening completion at the end of the study period. Conclusion: In addition to improving performance for cardiovascular and bone health screenings, our study suggests that more active disease may encourage successful completion of screenings. This is an initial step towards enhancing preventive care and health maintenance for cSLE.
Erin Haynes, Dr.P.H. (Committee Chair)
Bin Huang (Committee Member)
Esi Morgan (Committee Member)
23 p.
Surgery
quality improvement; childhood-onset systemic lupus erythematous; health maintenance; pediatric rheumatology; implementation; quality measures

Recommended Citations

Citations

  • Smitherman, E. A. (2018). Improving Quality of Care for Childhood-onset Systemic Lupus Erythematosus: Cardiovascular and Bone Health Screenings [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535381218464551

    APA Style (7th edition)

  • Smitherman, Emily. Improving Quality of Care for Childhood-onset Systemic Lupus Erythematosus: Cardiovascular and Bone Health Screenings. 2018. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535381218464551.

    MLA Style (8th edition)

  • Smitherman, Emily. "Improving Quality of Care for Childhood-onset Systemic Lupus Erythematosus: Cardiovascular and Bone Health Screenings." Master's thesis, University of Cincinnati, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1535381218464551

    Chicago Manual of Style (17th edition)

ucin1535381218464551
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© 2018, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.