Requirements from the American Board of Pediatrics for physicians to participate in quality-improvement (QI) programs to maintain certification have been controversial, in part because there is limited evidence these programs improve patient care. A study conducted by researchers at The Children’s Hospital of Philadelphia published in the journal Pediatrics this month provides some of that needed evidence.
CHOP’s program improved human papillomavirus (HPV) vaccination rates while being low-cost and satisfying for participating physicians. HPV is a common sexually transmitted infection that can cause cervical and other cancers.
A total of 27 primary care pediatricians in the CHOP Care Network from various locations in Pennsylvania and New Jersey participated in the QI program. Alexander Fiks, MD, MSCE, associate medical director for CHOP’s Pediatric Research Consortium and associate director of the Center for Pediatric Clinical Effectiveness, and colleagues designed and led the program, focused on improving HPV vaccination rates, for pediatricians to meet maintenance of certification (MOC) requirements.
Elements of the program included an educational component delivered via webinar, personalized quarterly performance feedback reports summarizing individual and practice- and network-level vaccination rates, and quarterly teleconferences to discuss results of the feedback reports and plan improvement strategies for the next quarter.
Overall, adolescents cared for by pediatricians participating in the CHOP MOC program received the HPV vaccine more often than those cared for by peer physicians who did not participate in the program. These rates were easy to measure and compare because both participating and non-participating pediatricians used the same type of electronic health records, which captured this data.
“The gains we saw were modest,” Dr. Fiks noted. “To see more blockbuster results, it may be important to go beyond engaging the physicians to engaging the administration and the rest of the care team. More work is needed to determine how to do that more effectively.”
See the full version of this article in the March issue of Bench to Bedside.