{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:16:10Z","timestamp":1757704570958,"version":"3.40.5"},"reference-count":13,"publisher":"Walter de Gruyter GmbH","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_jpem-2018-0149_s_999_w2aab3b7c31b1b6b1aab1c16b1Aa\"><jats:title>Background<\/jats:title><jats:p>Children with congenital hypothyroidism (CH) are at risk for preventable intellectual disability without adequate medical management. The purpose of this manuscript is to discuss quality improvement (QI)-based processes for improving provider adherence to practice guidelines and ultimately identifying at-risk patients with chronic illness prior to the occurrence of adverse events.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0149_s_998_w2aab3b7c31b1b6b1aab1c16b2Aa\"><jats:title>Methods<\/jats:title><jats:p>Our study population included patients ages \u22643 years diagnosed with CH; lost to follow-up was defined as &gt;180 days since last evaluation by an endocrinology provider. Iterative testing of interventions focused on establishing standardized care through (1) registry-based identification, (2) scheduling future appointments during current visits, (3) outreach to patients lost to follow-up and (4) provider and family education of current practice guidelines.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0149_s_997_w2aab3b7c31b1b6b1aab1c16b3Aa\"><jats:title>Results<\/jats:title><jats:p>A population-validated, electronic medical registry identified approximately 100 patients ages \u22643 years diagnosed with CH; initially, 12% of patients met criteria for lost to follow-up. Through serial testing of interventions, the rate of loss to follow-up declined to the goal of &lt;5% within 8 months. Additional measures showed improvement in provider adherence to standard of care. All patients identified as lost to follow-up initially were seen within the first 3 months of intervention.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0149_s_996_w2aab3b7c31b1b6b1aab1c16b4Aa\"><jats:title>Conclusions<\/jats:title><jats:p>Applying QI methodology, a multidisciplinary team implemented a process to identify and contact high-risk CH patients with inadequate follow-up. Focused interventions targeting population management, scheduling and patient\/provider education yield sustained improvement in the percentage of patients with a chronic condition who are lost to follow-up.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpem-2018-0149","type":"journal-article","created":{"date-parts":[[2018,7,21]],"date-time":"2018-07-21T22:16:03Z","timestamp":1532211363000},"page":"987-994","source":"Crossref","is-referenced-by-count":2,"title":["Untreated congenital hypothyroidism due to loss to follow-up: developing preventive strategies through quality improvement"],"prefix":"10.1515","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3794-7076","authenticated-orcid":false,"given":"Kristal Anne","family":"Matlock","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology , Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Dawn","family":"Corathers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology , Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana-Hawa","family":"Yayah Jones","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology , Cincinnati Children\u2019s Hospital Medical Center , Cincinnati, OH , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,7,21]]},"reference":[{"key":"2021021318143394050_j_jpem-2018-0149_ref_001_w2aab3b7c31b1b6b1ab2b2b1Aa","unstructured":"Brown RS. 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