Implementation of a Standardized Screening Tool and Referral Process for Sports Physicals

Abstract

Problem & Purpose: Sudden cardiac death (SCD) from hypertrophic cardiomyopathy (HCM) is the leading cause of death in student athletes 12-25 years of age in the United States (US). To decrease the risk of SCD, the American Heart Association (AHA) recommends preparticipation screenings using a standardized cardiac screening tool. The purpose of this project is to implement a standardized screening tool and referral process for sports physicals in an urgent care center to identify those at risk. Methods: During implementation of this quality improvement project, the urgent care’s preparticipation sports physical form was updated to include the screening recommendations from the AHA. These changes were communicated through multiple modalities to increase provider and staff awareness of the practice change. Results: Over 14-weeks, 70 student athletes presented for preparticipation sports physicals and 24 (34%) of these athletes were screened utilizing the updated screening tool. Of the 70 total athletes screened, four screened "at-risk" and were cleared for sports activity without referral for the recommended cardiovascular evaluation. Conclusion: Improvements in screening student athletes using the AHA guidelines were made, however follow-up with referrals to cardiology for athletes at risk was not completed. Future recommendations to improve the process may include incorporating forms into the electronic health record with the inclusion of pop-up alerts for a cardiology referral for any student athlete that identifies with risk for heart disease.