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Assessing for adverse childhood experiences (ACEs)/toxic stress (TS) is vital to comprehensive care for pediatric patients; however, no current national guidelines for pediatric ACEs/TS screening exist. Due to the similarity in externalizing behaviors for attention-deficit-hyperactivity-disorder (ADHD) and elevated ACEs/TS scores, there is a need to address ACEs and TS with patients and families when evaluating for ADHD. Implementation of a quality improvement program to standardize ACEs/TS screening during all initial ADHD evaluation visits in a private pediatric clinic resulted in increased provider awareness of ACEs/TS with an overall screening rate of 71%.

Nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes (T2D) remains underrecognized by health care providers. The primary purpose of this quality improvement project was to increase identification of NAFLD among patients with T2D followed in an endocrinology practice using an evidence-based algorithm to risk stratify patients. Pre- and post-intervention analysis revealed a significant 36% increase in screening for NAFLD post-intervention (P< 0.001).

Amblyopia is the most common cause of preventable visual impairment in childhood.1A quality improvement (QI) project was conducted at a pediatric primary care clinic located in North Carolina over a 3-month period, with the intent of improving the preschool vision screening process. Vision screening rates and time to complete a screening were compared between a Plusoptix S12C© photoscreener and a traditional eye chart. Successful vision screening rates were significantly higher and time to perform a vision screening was significantly lower using the photoscreener compared to screening with an eye chart. A significant increase in knowledge among clinic staff following an in-person educational presentation on amblyopia was also noted.