PC1229: "Increasing Vitamin D Therapy in Infants to Comply with AAP Guidelines at a Primary Care Clinic “

Purpose/Objectives: Infants are at risk for Vitamin D deficiency, especially those taking no, or small amounts of fortified formula. We aimed to increase the percentage of children who were offered Vitamin D by their two month well child visit from 36% to 75% by March 2022 at a primary care clinic.

Design/Methods: Using the model for improvement and multiple plan-do-study-act cycles we carried out the following interventions:

• Held education sessions with parents
• Reviewed AAP guidelines with clinicians
• Placed Vitamin D flyers in patient’s room
• Placed Vitamin D flyers in clinicians’ workstation
• Provided information via video in English and Spanish for those in the waiting room
• We created a template and dot phrase in the EPIC electronic health record.

We plotted the proportion of infants who had been recommended Vitamin D on a statistical process control chart and reviewed the charts monthly.

Results: Baseline rates were 36%. Special cause variation was noted in November 2021 with an increase to 88%, exceeding our goal of 75%.

Conclusion/Discussion: We found that providers rarely prescribed Vitamin D to infants despite the AAP recommendations, but we were able to improve the rates through low-cost QI measures. While our primary metric focused on the recommendation of Vitamin D by the provider, we addressed patient compliance through the informational videos and provision of information on where to obtain low cost Vitamin D. We are tracking patient compliance for future study. We noted that non-exclusively breastfed infants were rarely offered Vitamin D. Clearer recommendations from the AAP may ameliorate this issue.