Cleveland Clinic Children's Outcomes

Asthma significantly contributes to pediatric Emergency Room usage and chronic disease burden. Our care teams aim to provide better asthma control for our patients through regular review of symptoms and education.

Our care teams are tracking the percentage of patients with asthma that receive standardized asthma action plans, and Influenza immunizations. Caregivers receive health maintenance alerts to prompt these interventions.

We are currently revising our Asthma action plan to reflect newer guidelines, add value in the management of asthma, and increase completion.

Flu vaccine is particularly important for children who have asthma as they are more likely to have more severe symptoms. We outreach to patients due for flu vaccine and provide multiple times and locations for completion.

Our goals in asthma care are lofty and we continue to use these goals to push for improvement in caring for these vulnerable children.

Lead exposure can lead to intellectual and behavioral deficits in children. Because there is no easy way to detect these symptoms, early screening for exposure is essential. We measure children due for screening who got a blood lead test by 2 years of age. We are working to improve our screening rates through alerts in our electronic medical record and bringing online a new testing methodology to make it more convenient for families and providers

The U.S. Preventative Task Force recommends depression screening for Adolescents aged 12-18. Depression can significantly impair quality of life for adolescents including difficulties with relationships and performance at school and work. Depression in adolescents is strongly associated with ongoing depression in Adulthood as well as suicidal ideation, attempts and completion.

Our care teams currently receive alerts at the point of care to prompt completion of the PHQ-A (Patient Health Questionnaire, Adolescent version) every 12 months and we measure the percentage of patients who complete the questionnaire in the last year. Care teams are also

alerted when a patient is overdue for depression screening so that care teams can prioritize which patients need outreach.

HPV vaccination is important as it can effectively prevent HPV caused cancers. We engaged in a structured quality improvement initiative regarding HPV vaccination from Jan 2021-October 2022. This project was affected by the COVID-19 pandemic both due to a decrease in adolescent well visits but also an overall increase in vaccine hesitancy. Despite these challenges we were pleased to see an increase in rates. We have now changed our electronic medical record alerts to begin HPV vaccination at 9 years of age.