P2.285: Incorporation of Screen Time Anticipatory Guidance into Infant and Toddler Well Child Visits

Purpose/Objectives: Excessive screen time in early childhood has been linked to developmental delays, behavioral issues, and sleep disturbances. The American Academy of Pediatrics advises against screen time, with the exception of video-chatting, in children under 18 months. Reviewing these recommendations during routine visits is an effective means of expanding parental awareness, which is key to decreasing screen time in this population. Therefore, the goal of this quality improvement initiative was to increase the provision of screen time anticipatory guidance by 30% over a four-month period during well-child visits for children aged 6 to 15 months in the Tuesday clinic.

Design/Methods: We utilized a screen time smart phrase to document provider guidance and assessment of screen time exposure. Our QI project cycles were as follows: 1: We sent an educational email with the AAP screen time recommendations, our aim to increase anticipatory guidance, and a request to incorporate this smart phrase into specific notes. 2: We placed smart phrase signage reminders in our preceptor and examination rooms. 3: We sent providers weekly EPIC chat smart phrase reminders.

We reviewed 3 months of baseline data and performed weekly chart reviews after each intervention.

Results: Baseline documentation of screen time guidance was 0%. After PDSA cycle 1, it remained 0%. Following PDSA cycle 2, it increased to 32%. In PDSA cycle 3 it has reached 50%.

Conclusion/Discussion: Our screen time smart phrase is a practical and effective means of documenting anticipatory guidance. Provider email education alone had no effect on utilization of this smart phrase. However, compliance dramatically improved with our use of physical signage and weekly EPIC chat reminders.