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Adolescents, well visits, and immunizations: can quality improvement move the needle?
Journal article   Open access   Peer reviewed

Adolescents, well visits, and immunizations: can quality improvement move the needle?

Eileen Thompson, Susan Kressly, Alice He, Lori Rutman, Zekarias Berhane and Renee M. Turchi
Discover Medicine, v 2(1), 195
19 Jul 2025
DOI: https://doi.org/10.1007/s44337-025-00390-x
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https://doi.org/10.1007/s44337-025-00390-xView
Published, Version of Record (VoR) Open

Abstract

Biomedical and Life Sciences Biomedicine Medicine/Public Health
Objective Adolescent well-visits and vaccinations are part of the Bright Futures recommendations for well-rounded childcare; however, practices still experience care gaps with these measures. The Pennsylvania Medical Home Program (PA MHP), a network ( n  = 186) of primary care practices, conducted a quality improvement (QI) initiative to increase adherence to these recommendations. Methods Participants included 12 pediatric primary care practices (urban, suburban, and rural) from the statewide network and 76 practice team members, with 31 practitioners (MD, DO) eligible for MOC Part 4 credits. From January 2018 to January 2019, the PA MHP team conducted educational CME/CEU webinars, one QI boot camp conference, monthly practice QI calls, and ongoing technical support. Key driver diagrams, PDSA cycles, and the Quality Improvement Data Aggregator (QIDA) data tracker were utilized to track this initiative. Results Our analysis indicated a slight increase in adolescent well-visits and vaccination rates for meningococcal and Tdap. Attendance for adolescent annual well visits in Cycle 3 versus Cycle 1 was statistically significant ( P  = 0.04). There were no significance differences between males and females in well-visit and vaccination rates. Conclusion This PA MHP QI initiative focused on increasing adolescent immunizations and well-care visit rates demonstrated moderate success. The role of a learning community in a primary care practice network with a diverse geography, practice demographics and patients, ongoing technical assistance, and emphasis on continuous QI holds promise and value for future work and projects.

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