SHM Converge Scientific Abstract ePoster Gallery-Ensuring Timely Adoption of Recommendations: Post-Contrast Thyroid Screening in Pediatrics

Pdf Summary

This quality improvement project addressed new FDA guidance recommending thyroid function testing (TFT) for children under 4 years old within 3 weeks after receiving IV iodinated contrast, due to the risk of thyroid dysfunction and possible long-term developmental effects.<br /><br />The team used the Model for Improvement and PDSA cycles to increase compliance with either completing TFTs or ensuring that the need for testing was communicated to caregivers and primary care providers. They implemented several electronic medical record (EMR) changes: automated text in radiology reports, Smart Text in after-visit summaries (AVS) for inpatients and emergency department discharges, and a requested best practice advisory (BPA) to alert providers about needed TFT follow-up.<br /><br />Among 223 eligible children, 42% had high-risk comorbidities such as age under 3 months, very low birth weight, or congenital heart disease. Over 10 months, communication improved substantially. Documentation in discharge summaries informing primary care providers increased from 0% to 54%, and AVS communication to caregivers increased from 0% to 33%. After conditional automated text was added to ED AVS forms, 100% of at-risk ED discharges included TFT follow-up information.<br /><br />TFT completion within the health system also increased, from 0% initially to 19%. Of those tested, 24% had abnormal results or required additional testing/treatment. Patients discharged from the ICU were most likely to have TFTs completed, likely because they remained hospitalized during the recommended follow-up window.<br /><br />Overall, the project successfully improved communication and is on track to meet its goal, though actual TFT completion plateaued. The team expects further gains after BPA implementation, which should help identify at-risk patients more reliably.

Asset Subtitle

Christine Klingaman

Meta Tag

Author List Christa Callahan, Christine Klingaman, Courtney Port DO, MPH, Katherine Moyer, Stephanie Deveau-Rosen

Category Research

Concept Iodinated Contrast

Concept Thyroid Function Tests

Concept Thyroid Dysfunction

Concept Pediatric Patient

Concept Age Under 4 Years

Distinguished Non-Finalist

Presenter Organization Inova Children's Hospital

Presenting Author Christine Klingaman

Track Pediatric

Keywords

thyroid function testing

iodinated contrast

pediatric patients

FDA guidance

quality improvement

electronic medical record

PDSA cycles

caregiver communication

primary care provider

thyroid dysfunction

Iodinated Contrast

Thyroid Function Tests

Thyroid Dysfunction

Pediatric Patient

Age Under 4 Years