A Quality Improvement Initiative to Optimize Low Dose Aspirin Use in Patients with Moderate Risk Factors for Pre-eclampsia.

To increase the rate of low dose aspirin (LDA) counseling and treatment in patients with 2 or more moderate risk factors of preeclampsia(PMRF) from 9% to 50% within a four-month period after implementation of interventions. A single-institution quality improvement initiative aimed at LDA screening and counseling of those with PMRF. Two groups were evaluated: pre-intervention (January - April 2022) and post-intervention (January - April 2023). This initiative focused on identifying PMRF and monitoring rates of LDA counseling and treatment. Rates were assessed at two-week intervals and presented on a run chart to visualize trends and measure progress over time. Providers underwent education utilizing preeclampsia (PEC) screening flowsheets and integrated a clinical decision-making (CDM) tool in initial prenatal visit documentation using a smart-tool. Patients were provided with educational flyers. In the pre-intervention group (n=126), 8.7% of patients received counseling on PMRF risk factors and LDA use, 7.9% were treated with LDA. In the post-intervention group (n=112) 52.7% of patients received counseling on PMRF risk factors and LDA use, and 35.7% were treated with LDA. There was an 83.5% increase in the percentage of patients counseled following intervention implementation. A progressive increase was noted in counseling rates within the 18 weeks post-intervention. Integrating PEC screening flowsheets, clinical decision-making tools, and patient education flyers effectively enhances LDA counseling for patients with ≥2 PMRF with additional benefits seen in high-risk patients. These interventions offer a replicable model to enhance guideline adherence and reduce preeclampsia risk in vulnerable populations.