0941 Improving Safe Sleep Screening and Counseling in a Pediatric Sleep Medicine Clinic

Abstract Introduction Sudden unexpected infant death is a leading cause of mortality in U.S. infants < 12 months and is often linked to modifiable sleep-related factors. Although the AAP recommends the “ABCs of Safe Sleep” (Alone, on the Back, in a Crib), safe-sleep screening is often overlooked in subspecialty clinics caring for medically complex infants. In the Sleep Medicine Clinic at Nationwide Children’s Hospital, review of visits for infants < 1 year (Jan to Aug 2025) showed that only 37% of encounters documented screening for at least one ABC component, none documented all ABCs, and counseling was recorded in just 9% of visits. Our aim is to increase both documented safe-sleep screening and counseling to ≥60% of eligible visits by March 2026 and sustain this for 6 months. Methods Using the Model for Improvement, we implemented a bundled intervention: (1) standardized screening via EMR Smart Phrase for infants < 12 months and medical assistants and nurses screening for safe sleep embedded directly into Epic workflows at check-in (2) provider education/micro-teaching on safe sleep and workflow expectations; (3) standardized education and documentation of counseling, including discharge instructions and providing Helping Hands for Safe Sleep, (4) planned EMR optimization to auto print Safe sleep instructions for patients eligible and lastly (5) weekly reminders for providers with visits for infants < 12 months. We compared pre-intervention clinic encounters for infants < 12 months (Jan 1 to Aug 31, 2025) with a 2-month post-intervention period Sept 15 to Nov 15, 2025. Percent of standardized discharge instructions utilization was tracked alongside the primary outcomes 1) percent of eligible visits with completed safe-sleep screening and 2) percent with documented counseling. Results Data reviewed from Sept 15 to Nov 15th, 2025, showed an increase in safe-sleep screening from 37% (baseline Jan to Aug 2025) to 69%. Documentation of counseling increased from 9% to 69%, and standardized discharge instructions were used in 100% of eligible encounters. Conclusion A low-cost, EMR-embedded, workflow-aligned bundle can measurably increase safe-sleep screening and documented counseling in a pediatric sleep clinic and supports alignment with AAP recommendations. This approach is feasible and adaptable to other pediatric subspecialty settings. Support (if any)