O1006: Quality Improvement Project to Increase Patient Portal Activation Rates on a Pediatric Unit

Purpose/Objectives: Patient portals promote disease self-management, patient engagement, and have been associated with improved health outcomes across a variety of patient groups. Portal activation during hospitalization can improve the hospital to home transition by enabling patients and their caregivers to access information about the hospital stay and facilitating communication after discharge. Our project aimed to increase patient portal activation rates from a baseline of 9.1% to a goal of 50 % over a 16-month period for patients admitted to the pediatric unit.

Design/Methods: The quality improvement (QI) team included pediatric hospitalists and residents. The team used the Model for Improvement as improvement methodology and completed a Key Driver Diagram to identify key drivers and change ideas (Figure 1). The following Plan- Do- Study-Act (PDSA) cycles were conducted throughout the project: providing tip sheets for patient portal activation, adding portal activation into the floor orientation, and creating resident-led portal activation rounds. The outcome measure was the proportion of patients with an active patient portal account at hospital discharge as determined by a report run in the electronic medical record. For the process measure, frequency of resident led rounds were tracked. As a balancing measure, the team tracked the time it took to conduct portal activation rounds.

Results: MyChart activation rates increased from a baseline of 9.1% to 33.1% after providing the pediatric resident floor team with tip sheets and adding portal activation instructions into the floor orientation. A second midline shift to 51% occurred after creating resident-led portal activation rounds (Figure 2a). Portal activation rounds took on average 27 minutes. The most common reasons for not activating were unavailable caregivers at the bedside and caregiver refusal. (Figure 2b)

Conclusion/Discussion: Patient portal activation during hospitalization improved with QI interventions. The success of portal activation rounds underscores the importance of having dedicated trained staff members for assisting patients and caregivers with portal activation.