OBJECTIVE At our large, university-affiliated primary care clinic, we aimed to enhance the quality of well-child checkups (WCCs) to align with Bright Futures/American Academy of Pediatrics recommendations. Our primary goal was to increase the rate of complete WCCs from 45.6% to 80% by April 2024. Our secondary aims were to ensure WCC improvement for all language groups and to increase referrals to 2 community partners. METHODS A multidisciplinary team initiated a quality improvement project primarily focused on transitioning from paper-based to electronic questionnaires for patient screenings. Clinic processes were developed to assist families in completing questionnaires. The percentage of complete WCCs was the primary outcome measure. We defined complete WCCs as those that included note documentation of all required patient-reported elements. Our primary outcome measure was analyzed by using statistical process control charts to identify special cause variation. RESULTS We reviewed 51 809 WCCs from July 2022 to April 2024, and the rate of complete WCCs improved from 45.6% to 84.7%. We significantly improved the rates for all measured aspects of WCCs as follows: 7 different common pediatric questionnaires and 7 routine WCC assessments. Referrals to 2 community nutrition and literacy resources increased. Despite large improvements across all language groups, disparities remained for patients who spoke languages other than English. CONCLUSIONS Transitioning to electronic questionnaires and revised clinic procedures led to more comprehensive WCCs and connected more families with community resources. Although progress was made across all language groups, we note ongoing challenges in eliminating disparities.

中文翻译：

---

走向无纸化：使用电子问卷提高儿童健康检查的质量。


目的 在我们大型的大学附属初级保健诊所，我们的目标是提高儿童健康检查 （WCC） 的质量，以符合 Bright Futures/美国儿科学会的建议。我们的主要目标是到 2024 年 4 月将完全 WCC 的发生率从 45.6% 提高到 80%。我们的次要目标是确保所有语言群体的 WCC 改进，并增加对 2 个社区合作伙伴的推荐。方法 一个多学科团队启动了一个质量改进项目，主要侧重于从纸质问卷过渡到电子问卷进行患者筛查。制定诊所流程以帮助家庭完成问卷调查。完全 WCC 的百分比是主要结局指标。我们将完整的 WCC 定义为包括所有必需的患者报告要素的注释文档的 WCC。通过使用统计过程控制图来分析我们的主要结局指标，以确定特殊原因变异。结果 我们回顾了 2022 年 7 月至 2024年4月的 51 809 例 WCCs，完全 WCCs 的发生率从 45.6% 提高到 84.7%。我们显著提高了 WCC 所有测量方面的发生率，如下所示： 7 种不同的常见儿科问卷和 7 项常规 WCC 评估。对 2 个社区营养和扫盲资源的转介增加了。尽管所有语言组都有很大的改善，但说英语以外语言的患者仍然存在差异。结论 过渡到电子问卷和修订的诊所程序导致了更全面的 WCC，并将更多家庭与社区资源联系起来。尽管所有语言群体都取得了进展，但我们注意到在消除差异方面仍然存在挑战。