A Quality Improvement Initiative to Screen for Bullying in Pediatric Orthopedic Outpatient Clinics.

Autor:	Hoover LA; From the Nationwide Children's Hospital, Center for Clinical Excellence, Columbus, Ohio., Holstine JB; From the Nationwide Children's Hospital, Center for Clinical Excellence, Columbus, Ohio., Williamson J; From the Nationwide Children's Hospital, Center for Clinical Excellence, Columbus, Ohio., Samora JB; From the Nationwide Children's Hospital, Center for Clinical Excellence, Columbus, Ohio.
Jazyk:	angličtina
Zdroj:	Pediatric quality & safety [Pediatr Qual Saf] 2023 Aug 07; Vol. 8 (4), pp. e677. Date of Electronic Publication: 2023 Aug 07 (Print Publication: 2023).
DOI:	10.1097/pq9.0000000000000677
Abstrakt:	Bullying annually affects 20%-25% of middle- and high-school children. Persistent bullying can lead to feelings of isolation, rejection, and despair and trigger depression and anxiety. In addition, pediatric patients have presented to outpatient orthopedic clinics with injuries consistent with physical bullying. Due to the high prevalence and negative ramifications of bullying, we developed a quality improvement (QI) initiative to screen for these behaviors. We aimed to increase the screening for bullying in pediatric orthopedic outpatient clinics from 0% to 60% by the end of 2020 and sustain these levels for 6 months. Methods: Using the Institute for Healthcare Improvement Model for Improvement QI methodology, including Plan-Do-Study-Act cycles, we developed a four-question yes/no screening tool that asked patients (ages 5-18) and parents/guardians about bullying experiences in the preceding 3 months. To increase screening rates, we trained staff, integrated the screening form into the electronic medical record, initiated interscreener competitions, and shared unblinded data with screeners. Results: The bullying screen rate of pediatric orthopedic patients increased from 0% to a process mean of 80%. In just over 1 year during the COVID-19 pandemic, clinics screened nearly 8,000 patients for bullying. Two percent of patients reported bullying in the prior 3 months. We offered patients who reported bullying literature and referrals to social work and/or behavioral health. Conclusions: Implementing a QI initiative to provide universal bullying screening and increase bullying awareness in outpatient pediatric orthopedic clinics is feasible and sustainable. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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