P3.D080: Using QI Methodology to Increase Reach Out and Read Training: A Multi-Site Collaborative

Purpose/Objectives: The Carolinas Collaborative (CC) is a network of pediatricians who are child health advocates representing the 8 pediatric academic institutions across North and South Carolina. In preparation for piloting a novel Reach Out and Read (ROR) training initiative integrating Emotional Connection (EC) and Early Relational Health (ERH) into the ROR model, clinicians needed to complete the most recent core ROR modules, which contain information required for successful incorporation of EC/ERH into the model. At baseline, 48.5% of clinicians had completed this training.

SMART

Aim: Increase ROR core training rates from 48.5% to 100% of current clinicians at all sites within 6 months.

Design/Methods: We assembled an implementation team including at least one contact from each institution. The IHI Model for Improvement with 4 PDSA cycles was used. The team held bi-monthly meetings to share data and different approaches to increase training rates. Interventions included connection with ROR affiliates to obtain clinic rosters and generate individual training links, updating site rosters, providing structure/creating tools for each site to measure and track their progress, and establishing MOC credit for both the implementation team and for each site to create their own site-specific QI project interventions, creating friendly competition and highlighting processes that were working well so that all sites could implement them. The outcome measure of training rates was obtained from the ROR Regional Affiliate's training platform. The process measure was the percentage change in overall training rates to evaluate each intervention's effectiveness. Since the rosters (denominator) changed throughout the study, a more concrete measure, such as number of providers completing the training/number of eligible providers, was not valid.

Results: The baseline completion rate was 48.5% for all clinicians trained in the most recent core ROR module. This rate increased to 51% during the 1st PDSA cycle, after the baseline data were initially shared. The percentage increased to 59.5% during the 2nd PDSA cycle, when the team formally began to use to use QI methodology. The percentage increased to 69.6% during the 3rd PDSA cycle after the ability to obtain MOC 4 credit was verified. After the final PDSA cycle of sharing successes and highlighting “bright spots” where training rates were improving above the average site increases, the percentage was 77.6%.

Conclusion/Discussion: There was a dramatic increase in the percentage of providers at goal training. The most successful intervention was formalizing the project as a QI project with an identified leader and offering MOC part 4 credit. Key learning points include the importance of maintaining accurate training rosters and highlighting high-performing sites to create friendly competition, team collaboration, and cross-talk between institutions.