O2120: Bright Smiles From Birth II: A Quality Improvement Project to Improve Pediatric Oral Health Within the Primary Care Setting

Purpose/Objectives: While pediatric oral health promotion has improved, barriers to care persist, especially among high-risk children. To address this, the Illinois Chapter of the American Academy of Pediatrics (ICAAP) implemented the Bright Smiles from Birth (BSFB) II Quality Improvement Project. This initiative focused on enhancing the capacity of pediatric primary care practices to improve oral health outcomes for children aged 6 months – 5 years old through training and support in the application of fluoride varnish, referrals to a dental home, and provision of anticipatory guidance for oral health and nutrition. From March 2024 to June 2024, quality improvement methods were employed to achieve a 20% improvement from baseline in these key oral health measures.

Design/Methods: This project provided participants with clinical and QI education and facilitated participant application of educational content using QI methods. This project included six webinar sessions, with didactic clinical content on oral health and quality improvement methods, interactive QI data reviews and roundtable discussions. Between webinars, participants implemented QI methods at their practice by conducting Plan-Do-Study-Act cycles to test changes in oral health care practices. Participants submitted data on project QI measures for four data cycles to monitor the impact of quality improvement methods. Project measures are detailed in Table 1.

Results: Eight sites conducted at least one Plan-Do-Study-Act cycle where they implemented an intervention, submitted data on the project QI measures, and then made subsequent changes. Sites submitted 685 patient charts over the four data collection cycles. Substantial improvements were observed across all targeted measures, successfully achieving all project goals. Rate increases from baseline to Cycle 4 ranged from 23% to 56% across measures, underscoring the effectiveness of the BSFB II project in enhancing key oral health practices in pediatric primary care settings. Run charts for each measure are displayed in Figure 1.

Notably, the percentage of eligible patients aged 6 months to 5 years who received fluoride varnish application during well-child visits increased from 5% at baseline to 61% at Cycle 4. This increase surpassed the project goal of a 20% improvement from baseline, and it is likely that this upward trend would have continued with additional data cycles. This measure showed the greatest increase from baseline to Cycle 4 of all measures in the project.

Conclusion/Discussion: By leveraging QI methods and clinical resources from ICAAP, the project enhanced key practices, including fluoride varnish application, dental home status documentation, and oral health anticipatory guidance.

The project exceeded its goals, with improvements ranging from 23% to 56% across all measures, laying a strong foundation for sustainable pediatric care practices. The statistically significant increase in participants' knowledge and confidence, high participant satisfaction, and self-reported and observed practice improvements, underscores the effectiveness of BSFB II interventions.