Childhood Obesity: The Primary Care Provider's Role in Recognition, Diagnosis, and Management

Abstract

Abstract The number of obese children and adolescents has skyrocketed in recent years. As of 2012, one-third of American youth were considered to be overweight and obese (Centers for Disease Control [CDC], 2014). Primary care providers have a vital role in the recognition and management of childhood obesity. However, studies demonstrate that primary care providers do not consistently adhere to recommended guidelines. Primary care providers must take action and make changes to maximize outcomes and reverse current trends. The purpose of this quality improvement project was to increase the recognition, diagnosis and management of overweight/obese children in primary care by increasing provider awareness of current practice guidelines set forth by the American Academy of Pediatrics (AAP) Expert Committee Recommendations. The following question was developed to address this issue: What is the status of guideline adherence (recognition, diagnosis, and management) for overweight/obese children in the primary care setting and how can any areas of practice weakness be improved? A chart review was utilized based on AAP (2007) recommendations to determine rates of body mass index (BMI) percentile documentation, appropriate ICD-10 weight diagnosis, and documentation of weight-based counseling for all patients seen for well-child visits with BMI greater than or equal to the 85th percentile. Audit results demonstrated both provider strengths and challenges in their documentation. A guided discussion session was held to share audit results and plan for practice improvement. This discussion addressed issues and suggested future plans including electronic health record improvements, enhanced patient education resources, and ongoing quality improvement strategies. A planning summary was disseminated back to the providers for their reference. This project took place in family practice outpatient care setting.