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Abstract
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OBJECTIVE: Increase the frequency and documentation gun safety discussions during well-child checks in the Pediatric Primary Care resident clinic to 50% within 6 months.
METHODS: This is a quality improvement study in a pediatric resident continuity clinic. Before implementing any interventions, a survey was conducted to understand residents' attitudes and practices regarding gun safety screening and counseling. Interventions included a parent safety survey, Be SMART materials in clinic, and a prompt embedded into EHR templates. Chart reviews were conducted to determine frequency of gun safety discussion. Resident self-reported comfort with gun safety counseling was also evaluated.
RESULTS: A statistical process control chart was generated to track documentation and found the baseline mean rate of gun safety discussions during well-child checks was 3%. Rates increased following the addition of the EHR prompt, with the mean further increased to 84% in July 2019. A sustained rate of over 75% was achieved through February 2019. Over four study months, the proportion of trainees reporting feeling very uncomfortable/uncomfortable with gun safety counseling decreased from 22% to 15%. The Be SMART program was identified as a key intervention increasing gun safety counseling.
CONCLUSIONS: Our study identified an effective approach to documentation of gun safety discussions in an academic primary care setting, providing a unique blueprint for firearm screening and safe storage counseling success. Ultimately, we believe this will increase safe storage behaviors in the home and reduce risks of child death from firearms.
Language: en |