Childrens Hospital Primary Care Center (CHPRCC) | Quality Improvement and Innovations

Not only are we working every day to keep our patients and their families healthy and happy, we are also working every day to strengthen and improve the care we give. Here are a few of our ongoing endeavors and projects:

Academic Innovations Collaborative: Boston Children's Primary Care received a grant from Harvard Medical School's Center for Primary Care to work with other academic practices throughout the city to find new and innovative ways to improve the care we give our patients. Since beginning a year ago, we have:

  • Divided up into three clinical teams, so that patients and staff are more able to get to know each other better. The teams meet regularly to share ideas and discuss ways to improve day-to-day care
  • Started having regular "huddles" of staff before the beginning of a session, to plan ahead and better work together as a team
  • Worked hard to be sure that all patients have a primary care provider (PCP)--and that they know who that PCP is!
  • Hired three Patient Navigators to help families with things like coordinating specialty appointments, getting school evaluations or transferring to adult care
  • Worked with specialty services like Neurology and Gastroenterology to incorporate their knowledge (and sometimes staff) into our care of patients
  • Tried various different approaches to streamlining urgent care and decreasing wait times

Asthma Care: We are working to be sure that every patient with asthma has:

  • An Asthma Control Test, to see how well their symptoms are controlled
  • A classification of the severity of their asthma, to help us know what medications we should be giving
  • Controller medications if they need them
  • An Asthma Action Plan to use at home 

Immunizations: Because immunizations keep children and communities well, we are working to check at every visit to see if a child needs immunizations—and give them if any are missing. 

Behavioral Screening: At every well-child visit from 6 months of age on, we ask parents to fill out questionnaires that help us identify any problems with development or behavior so that we can act early and get them any help they need. 

Tobacco exposure screening: Smoking causes many serious health problems—and secondhand smoke is bad for children (and everyone). That's why we are asking families if anyone smokes at home—and if anyone does, we are connecting them to Quitworks and otherwise doing what we can to help them quit. 

Anemia screening: Anemia can lead to health and learning problems. That's why we do regular blood tests between 9 months and 4 years, and later if a child is at risk.

Lead screening: Lead is a chemical found in house paint, pipes and other household items. It can cause health and learning problems as well. We ask questions to figure out if a child is at high risk, and do regular blood tests between 9 months and 4 years. 

Dental risk assessment and fluoride varnish: dental health is important for general and long-term health. That's why we are working to do Caries Risk Assessments on all young children, and apply fluoride varnish, which can help prevent cavities, to children at high risk.

Lipid screening: Having a high cholesterol can put youth at risk of heart disease later in life. We are working with our Cardiology Department to find the best times and ways to check youth for cholesterol—and the best ways to treat and follow up on any high values we find.

Medication reconciliation and Problem Lists: At every visit, we are working with families to be sure that they have and are taking the medications they need. Because an up-to-date problem list helps us be sure we are giving each patient complete care, we are working to keep them updated.

Screening for Sexually Transmitted Infections: Infections like gonorrhea and chlamydia can lead to long-term health problems. We are regularly testing our at-risk youth to be sure we catch and treat any infections early.