Screening for Adverse Childhood Experiences in Primary Care: A Quality Improvement Project

Introduction: The American Academy of Pediatrics (AAP) advocates for the screening of Adverse Childhood Experiences (ACEs) during well-child care visits by pediatric health care providers. The evidence shows a strong correlation between children with high ACE scores and the likelihood of physical and mental health problems as adults. The purpose of this Quality Improvement (QI) project was to increase pediatric providers' awareness on ACEs through education and increase the utilization of an ACE screening tool. Method: This QI project used a pre-post test to evaluate the effectiveness of the educational model and the utilization of the screening tool within an urban pediatric primary care clinic. Results: This project demonstrated an increase in provider awareness as well as a marked increase in the utilization of the screening tool. Discussion: Four hundred eighty ACE screening tools were collected over a 12-week period. By introducing the ACE screening tool as the standard of care in the primary care office, providers can provide early interventions to mitigate the potential untoward outcomes. This QI project also demonstrated that there was a statistical and clinical significance (p value < 0.001) in the provider's knowledge pre-post the educational intervention.