Quality initiatives are an essential part of becoming recognized as a Patient-Centered Medical Home (PCMH). However, quality is essential for all pediatric practices, not just those seeking the PCMH designation. Having good quality of care attracts patients to your practice and keeps them returning for care. And that means your business thrives financially and can continue to operate as a successful, independent pediatric practice.

If you’ve never conducted a quality initiatives project, you might be wondering how it works. And even if you have in the past, it’s always helpful to keep learning and growing. Here are three steps to starting a quality initiatives project in your pediatric practice.

Determine Your Baseline

Begin by asking, “What is a problem we need to resolve?” or “How can we improve?” You have to identify deficiencies in your pediatric practice and understand why it’s important to fix them. In other words, what are you hoping to achieve by implementing quality initiatives?

Next, you should decide who will be involved in this effort. In a pediatric practice, it’s best if all staff members participate. With everyone’s involvement, all employees will feel as though they have input and can make a difference in the project. Let your team have the opportunity to make suggestions.

You may find your staff has different ideas about areas of improvement. For example, the front desk employees might want to decrease the rates of no-shows for scheduled patients, or they may hope to address wait times in the waiting room or on the phone. In addition, the clinical team might see a need to examine specific immunization rates or improve the percentage of teenage patients who come for preventative exams.

Don’t be afraid to go outside the box. Consider what your patients and their parents would like to see as a quality initiative. They might have comments about your phone system, appointment reminders, follow-ups, or cohesiveness within the practice.

After you’ve gathered all that feedback, you have to decide what you want to improve. Is it one initiative or multiple initiatives? Then, you’ll need to compile the necessary data, which can come from various sources: your EHR, payer lists, or parent surveys. Determine your baseline by asking, “Where do we currently stand in this practice?” If you don’t know where you stand, you’re not going to know where you lack, where to improve, and where your priorities should be.

Identify Your Gaps

After you have your baseline, you’ll need to investigate further to see your gaps. Look at your data and say, “This is where we are today but where do we want to be?” Evaluate the practice’s current policies and procedures and it relates to your initiative. The practice may reach out through a patient portal, social media, surveys, or face-to-face with patients and parents to obtain information.

Let’s use an example of improving the HPV immunization rate, which is currently at 45 percent. The practice has reached out to parents on the patient portal with a survey to understand why their child has not been vaccinated. Responses returned varied from times of appointments not convenient, need a walk-in vaccination time to unaware of the need.

At this time we are going to bring the staff together and brainstorm. In addition to the gaps identified by parents, the staff will also have ideas, and they might surprise you. We have identified our gap and have a plan on how to improve by a specific percentage. 

Next, we need to ask, “How are we going to know we are making improvements?”

Establish Benchmarks

When working on a quality initiatives project, you will need to evaluate with benchmarks along the way. Ask yourself, “Is what I’m doing working?” Make sure your goals are realistic.

Perhaps that happens every three months. You’ll need to compile the necessary data again, which can come from various sources: your EHR, payer lists, or parent surveys. Staying with our example for the HPV vaccination rate, after three months, you benchmark was to have gone from 45 to 48 percent. 

When you look at your benchmarks, re-evaluate your policies and procedures. Think about the question, “What have we tried in this particular area?” Make adjustments if necessary.

As you meet a goal, always make sure the process becomes part of your practice’s culture. Don’t forget what you’ve done; make sure it’s ingrained. And if you meet your goal of 55 percent for HPV vaccination rate, increase your next goal — possibly 80 percent. It’s important to keep moving on and growing.

When you achieve your goals, celebrate with your staff members and the community. One idea is to include posters, signs, balloons, or stickers in the office. You could also buy T-shirts for your employees and have everyone wear them on the same day. Other suggestions are providing lunch for your team or having a dress-down day. Remember, having good quality of care attracts patients to your practice and keeps them returning.