# Improving screening for disordered eating behaviors in pediatric weight management using quality improvement methodology

## TL;DR

This study shows how quality improvement methods can boost screening for eating disorders in teens managing their weight.

## Contribution

The novel use of quality improvement cycles to systematically increase screening documentation rates for disordered eating behaviors in pediatric weight management.

## Key findings

- Provider documentation of disordered eating behavior screening increased from 44% to 85% over 10 months.
- Referrals for disordered eating behaviors rose from 13% to 19% during the study period.
- Systematic screening using quality improvement methods proved feasible and effective in identifying barriers and facilitators.

## Abstract

Adolescents with obesity are at increased risk for disordered eating behaviors (DEBs). Despite screening being recommended, identification of DEBs in pediatric weight management (PWM) remains inadequate.

The aim of this quality improvement project was to increase provider documentation of screening for DEBs from 44 % to 80 % for new patients, age ≥12, seen at a PWM program over a 10-month period. Interventions were grouped into four PDSA cycles: 1. Provider education, 2. Screening tool implementation, 3. Systematic use of screening tool, and 4. Implementation of an electronic screener. The primary outcome was the percent of patients with documentation of DEB screening. Data was plotted on a p-chart. Standard statistical process control methods were used.

Mean documentation rates for DEBs increased from a baseline of 44 %–85 %, with special cause analysis demonstrating improvement. Referrals for DEBs increased from 13 % at baseline to 19 %.

Consistently screening for disordered eating behaviors in pediatric weight management is feasible. Quality improvement methodology can be utilized to help identify and act on facilitators and barriers to screening. Improved screening may lead to earlier identification of high-risk patients and prompt referral to mental health practitioners.

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