title: Does a 30-min quality improvement clinical practice meeting reviewing the recommended Papanicolaou test guidelines for adolescents improve provider adherence to guidelines in a pediatric primary care office?
abstract: OBJECTIVE
  The purpose of this quality improvement project was to evaluate adherence to Papanicolaou (Pap) test guidelines 6 months prior to and 6 months following a 30-min educational clinical practice meeting in a pediatric primary care office. Guidelines for Pap tests have been revised in recent years by the American Academy of Obstetrics and Gynecology, the American Cancer Society, and the U.S. Preventive Task Force, but providers often do not adhere to the guidelines.
  
  
  METHODS
  A total of 777 charts from a pediatric primary care office were reviewed. Eighty-four percent (652) met criteria for inclusion.
  
  
  CONCLUSIONS
  Among sexually active adolescents, there was a statistically significant relationship between rates of Pap tests following the clinical practice meeting (χ(2) (1) = 13.5, p = .001). Prior to the meeting there were 29 Pap tests recorded, whereas after there were two Pap tests done. After the focused clinical practice meeting, providers performed far fewer Pap tests, which is in accordance with the guidelines for this population.
  
  
  CONCLUSIONS
  Providers may not always practice in accordance with recommended clinical practice guidelines for various reasons. Focused, in-office educational interventions via clinical practice meetings may be an effective way of discussing recommended guidelines to improve provider adherence.
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Lozman
authors.forename: Anne
authors.initials: A
authors.lastname: Belcher
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sloand
mesh_terms: D000293:Adolescent; D005260:Female; D006126:Group Processes; D019983:Guideline Adherence; D006801:Humans; D065006:Papanicolaou Test; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D058996:Quality Improvement; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D013997:Time Factors; D055815:Young Adult
keywords: Adolescents; education; practitioners; primary care; reproductive health