Objective: The purpose of this literature review is to examine the most psychometrically sound (e.g., valid and reliable) instruments measuring physical activity (PA) so that reflection of preschool children’s activity and documentation of intervention effects on preschool child PA is accurate.
Methods: Rigorous validation and calibration studies and those studies designed to test the psychometric properties of PA measurement instruments were specifically sought out to include in this review. Articles were excluded if they did not include specific information about the validity and reliability of the PA measures used with preschool children.
Discussion: Of the six articles reviewed, the systematic review used the most rigorous protocols to conduct its review, yielding the highest level of evidence appraising several validation studies. Because Pfeiffer et al. (2006) utilized the most valid and reliable criterion measure (Cosmed® portable metabolic system), the validation study this research team conducted is deemed to have identified the most valid and reliable cut points to utilize when reducing accelerometry data.
Conclusion: Current cut-points vary widely and greatly affect the reported results of a study. Therefore, it is critical that authors reference validation studies used to support the cut-points that were employed in the data-reduction phase. Currently, validation methods have been identified using high quality criterion measures in rigorous validation studies and thus it is strongly recommended that those cut points be used in data reduction processes.
The concept of Nature Made Candles was to “educate candle lovers on the importance of knowing what is in the candle. Everyone should know what they are inhaling...no matter how nice (or not) it smells. Earth needed a candle for enjoying scents and sights without hindering health, so we made one.” The objective evolved into educating the student population of Arizona State University (ASU) about what ingredients go into commercial candles, with a particular focus on the wax and scent, as well as giving students a free candle that emulated the holistic ingredients they were educated on. This project was designed to be a quality improvement and health promotion project with an emphasis on the ASU student population. The purpose of the project was to find a type of candle that was friendly to the lungs of all individuals who wanted candles in their household.
The concept of Nature Made Candles was to “educate candle lovers on the importance of knowing what is in the candle. Everyone should know what they are inhaling...no matter how nice (or not) it smells. Earth needed a candle for enjoying scents and sights without hindering health, so we made one.” The objective evolved into educating the student population of Arizona State University (ASU) about what ingredients go into commercial candles, with a particular focus on the wax and scent, as well as giving students a free candle that emulated the holistic ingredients they were educated on. This project was designed to be a quality improvement and health promotion project with an emphasis on the ASU student population. The purpose of the project was to find a type of candle that was friendly to the lungs of all individuals who wanted candles in their household.
Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression management guidelines have been established. To integrate guidelines into practice, primary care providers (PCPs) must document effectively to ensure a complete treatment plan is in place in the patient’s electronic health record (EHR).
Intervention: Elements from a flowsheet were implemented into the EHR to promote thorough assessment and documentation of care delivered to adolescents with depression.
Methods: An initial chart review was completed on patients diagnosed with depression. An updated depression template was implemented within the EHR for six weeks. A follow-up chart review was completed post-intervention to determine if documentation of elements from the adolescent depression guidelines improved after the EHR update. Pre-intervention and post- intervention surveys were delivered to PCP’s to understand their perspective on adolescent depression management.
Outcomes: The chart review revealed that baseline PHQ-9 screenings were documented in 91% (n=43) of the charts reviewed in the pre-intervention timeframe. Only 78% (n=7) of the charts reviewed during post-intervention included PHQ-9 screenings. Early intervention treatment options documented in the pre-intervention timeframe included education 100% (n=47), medication prescriptions 53% (n=25), and psychotherapy referrals 18% (n=18). During post- intervention, education 100% (n=9), medication prescriptions 78% (7), and psychotherapy referrals 22% (n=7) were documented by the PCPs.
Recommendation: The quality improvement project focused heavily on documentation completed over a one year pre-intervention timeframe compared to a six-week post-intervention timeframe. Further evaluation and chart review over the next year will provide a more adequate comparison of documentation within primary care practice.
Methods: At an urban primary care pediatric office located in the southwestern US, an educational quality improvement project for healthcare practice providers and front office staff was conducted to increase the utilization of the existing EMR-linked patient portal. The healthcare providers were asked to complete a pre- and post- survey evaluation of their knowledge and usage of the patient portal. Provider and patient portal data usage was collected over a five-month period, September 2019 to January 2020.
Results: Data was analyzed using the Intellectus Statistics softwareTM. Significant results were found at the conclusion of the project in the number of active patient portal users, web-enabled, portal logins, labs published/viewed, messages sent, appointment reminders and Santovia utilization. At the end of the project no significance was found with messages received by the healthcare providers or staff through the patient portal. Survey results found significant differences between pre- and post- portal usage. No significance was found on providers’ knowledge on how to web-enable patients. Providers’ also demonstrated no significant change in their perceptions of the benefit in utilizing the portal in patient care after the educational intervention. Survey results allowed for additional analysis of commonly utilized portal functionalities, disease or health topics utilized in Santovia, and suggestions on how to make the use of the patient portal easier for providers.
Implications for Health Care Providers: This quality improvement project found that implementation an EMR-linked patient portal requires a comprehensive practice approach with structured education sessions. Including all employees can improve patient portal utilization. This educational project resulted in significant increases in most portal functionalities within 5 months. Further practice change evaluations are needed to evaluate how to improve patient portal utilization with a larger group of participants in a variety of outpatient settings.
