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Discover how New Hampshire's ECHO™ Model initiative addressed pediatric blood lead testing, enhancing provider education, and significantly improving testing rates for young children.
New Hampshire Success Story – Quality Improvement Project Utilizing the ECHO™ Model
The COVID-19 pandemic significantly disrupted routine pediatric preventative healthcare services across the United States, leading to a concerning 25% decline in blood lead level testing rates in New Hampshire from 2019 to 2021 with 5,360 fewer children tested. In response, the Statewide Clinical Lead Advisory Committee launched a comprehensive quality improvement project in January 2024 to enhance pediatric blood lead testing. Using Extension for Community Healthcare Outcomes (the ECHO™ Model), this initiative provided continuing medical education training, including 25 Maintenance of Certification Part 4 points for pediatricians while implementing performance measures via an online data repository. Over six months, January 2024 through June 2024, 38 participants from eight pediatric practice teams participated in monthly ECHO™ sessions that included expert presentations, case study review, and quality improvement discussion of aggregate data submissions.
All participating teams were required to meet at least once during the six-month quality improvement project with the quality improvement consultant to review their practice-level data and progress on performance measures.
The results were promising. Improvements were observed in various metrics, such as age-appropriate Risk Assessment Questionnaire usage (from 24% to 51%) and lead testing rates for one-year-olds (from 81% to 90%). In addition, 361 children ages 30 months to 5 years were identified as not having a blood lead test documented in their health record. Clinical staff showed a commitment to modifying practices and updating electronic medical records systems to ensure sustained progress in increasing blood lead testing rates among young children.
This project was developed through collaboration with key stakeholders, including the NH Healthy Homes and Lead Poisoning Program, NH Chapter of the American Academy of Pediatrics, and AmeriHealth Caritas NH.