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Children’s Hospital Boosts Varnish Rates Eightfold in Just 1 Year

A quality improvement program at Children’s Hospital of Philadelphia increased fluoride varnish application rates from 3.7% to 30.5% across its pediatric network, far surpassing its 20% target. The intervention proved effective across all insurance types, races, and ethnicities, offering a model for national adoption.

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Researchers at Children’s Hospital of Philadelphia (CHOP) have shown that a multifaceted quality improvement initiative can dramatically increase the use of fluoride varnish in pediatric care. While fluoride varnish is a safe and effective caries-prevention agent, application rates have historically remained low. Nationally, fewer than 10% of Medicaid-insured children and just 5% of commercially insured children receive varnish during pediatric visits. To address this gap, CHOP researchers launched a system-wide initiative from July 2023 to October 2024 aiming to boost varnish rates among children ages 6 months to 6 years from 5% to 20%. The program combined electronic health record prompts, practice-level education, certification audits, and financial incentives. More than 92,000 preventive care visits, application rates surged from 3.7% to 30.5%, and the proportion of children receiving annual varnish doubled from 25% to more than 50%. The findings appear in Pediatrics. Click here to read more.

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