Adherence to Quality of Care Indicators and Location of Sickle Cell Care Within Indiana

Trends in quality of care among children with sickle cell anemia

“…Other strategies include providing a patient navigator or case manager at the health system or health plan level, reminder letters to families regarding TCD screening and antibiotic prophylaxis, and providing health plan and/or provider-level incentives to reach performance benchmarks for the quality of care among children with SCA. [34][35][36][37][38] However, these strategies have not been Importantly, the validated performance measures described in this study for antibiotic prophylaxis and TCD screening among children with SCA have been successfully tested for use by state Medicaid programs and health plans, culminating in their endorsement by NQF. 12,13 Inclusion of one or both of these measures in the Core Set could foster increased attention by state Medicaid programs on this largely underserved population, serving to underscore the need for interventions aimed to improve consistently inadequate care.…”

“…However, there are promising strategies to mitigate these barriers, including increasing primary care provider knowledge regarding antibiotic prophylaxis, identifying robust prescription delivery services, and colocating TCD screens within sickle cell clinics to reduce travel barriers for patients. Other strategies include providing a patient navigator or case manager at the health system or health plan level, reminder letters to families regarding TCD screening and antibiotic prophylaxis, and providing health plan and/or provider‐level incentives to reach performance benchmarks for the quality of care among children with SCA 34–38 . However, these strategies have not been proven to work at the population level and are in need of additional study.…”

An Educational Study Promoting the Delivery of Transcranial Doppler Ultrasound Screening in Paediatric Sickle Cell Disease: A European Multi-Centre Perspective

“…Practitioners without previous ultrasound experience often required attendance at refresher courses to develop their TCD skills and, as a result, took longer to achieve competency. A common obstacle to achieving competency was the small number of children with SCD in the local hospital population, which limited scanning experience-particularly in trainees who did not perform any other vascular ultrasound assessments [14,15]. The effectiveness and transferable nature of the training programme was demonstrated by its success in producing competent TCD operators from diverse backgrounds in three European countries.…”

“…Therefore, TCD screening is recommended as a standard of care for children with SCD starting at an age of two years [10,12,13]. A substantial variation in the access to TCD screening has been reported, varying from as low as <50% [14,15], to as high as >90% in children with SCD [16,17]. There are a number of reasons why access to TCD services remains a challenge; funding is a major issue, but even with adequate funds, issues remain due to a lack of skills and knowledge, particularly with respect to adequately trained TCD operators.…”

A Feasibility Pilot Study of Online Modules of Hydroxyurea and Sickle Cell Disease Care for Adolescents and Young Adults for Family Medicine Residents

“…13,18 In Indiana, hematologists willing to prescribe HU for adults with SCD are located predominantly in Indianapolis (Marion County), even though other metropolitan areas like Fort Wayne (Allen County) have at least 50 adults living with SCD, based on incidence data from newborn screening follow-up and population size. 19 Family medicine (FP) residency programs are located throughout Indiana, and most adults with SCD in Indiana have access to a primary care clinic administered by a FP program (Fig. 1).…”