Quality Improvement
Overview
During the SCDTDP 2017-18 grant year, we worked with the UCSF IMPLEMENT Quality Improvement Project, a project funded by the Agency for Health Research and Quality.
Nine sites within the PSCRC participated, tested sickle cell disease measures from the Pediatric Quality Measure Program.
The primary pediatric measure was Transcranial Doppler (TCD) screening for stroke risk. This measure was defined as the number of children 2 through 15 years of age with sickle cell anemia (HbSS and HbSβ0 thalassemia) who were continuously enrolled in Medicaid and who received TCD ultrasonography during the measurement year.
The primary measure for both adults and pediatrics was Hydroxyurea (Hu) Counseling, or Anticipatory Guidance Regarding Hydroxyurea Treatment.
The measure was defined as the number of patients aged 9 months and older identified as having SCA (HbSS and HbSβ0 thalassemia), during the measurement year, who received counseling regarding the risks and benefits of treatment with hydroxyurea as part of outpatient care, as measured by documentation in the medical record that anticipatory guidance* occurred.
During the 2017-2021 project period, clinical site leads focused on increasing hydroxyurea prescriptions in addition to the optional projects of TCD screening completions, increasing documentation of plans for transition from pediatric to adult care, immunization completions, and increasing Project ECHO attendance.
Next Steps
SCDTDP regional leads have formed a learning collaborative with the support of the Armstrong Institute to implement and evaluate the most effective strategies to provide evidence-based care and increase access to the latest treatment options. The PSCRC will work in partnership with the four other Sickle Cell Disease Treatment Demonstration Programs to provide QI training and implement QI projects where clinical site leads are mentored by QI experts.
