Standardizing and Improving Primary Care-Based Electronic Developmental Screening for Young Children in Federally Qualified Health Center Clinics.

Objectives: Many barriers to implementation of developmental screening in primary care exist, especially for children from under-resourced communities. Developmental screening is vital to early detection of developmental delay and autism spectrum disorder, and early intervention (EI) referral. This...

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Publicado en:Maternal & Child Health Journal Vol. 28; no. 10; pp. 1716 - 1726
Autores principales: Felix, Gladys, Deavenport-Saman, Alexis, Stavros, Sophia, Farboodi, Niloofar, Arvizu, Ramon Durazo, Garcia, Joanna, Yin, Larry, Gera, Mona Patel
Formato: research tables/charts Journal Article
Publicado: Springer Nature Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2024
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      pub: Springer Nature
      place: New York, New York
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          Felix, Gladys
          Deavenport-Saman, Alexis
          Stavros, Sophia
          Farboodi, Niloofar
          Arvizu, Ramon Durazo
          Garcia, Joanna
          Yin, Larry
          Gera, Mona Patel
        affil: https://ror.org/00412ts95 Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, 90027, Los Angeles, CA, USA
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        subj:
          Primary Health Care Administration
          Child Development
          Health Screening Standards
          Quality Improvement
          Hospitals, Federal
          Workflow
          Clinical Assessment Tools
          Developmental Disabilities Risk Factors
          Risk Assessment
          Human
          Male
          Female
          Infant
          Funding Source
          Retrospective Design
          Questionnaires
          Checklists
          Chi Square Test
          Fisher's Exact Test
          Pretest-Posttest Design
          Descriptive Statistics
          Data Analysis Software
          Post Hoc Analysis
          Infant: 1-23 months
          Male
          Female
      ab: Objectives: Many barriers to implementation of developmental screening in primary care exist, especially for children from under-resourced communities. Developmental screening is vital to early detection of developmental delay and autism spectrum disorder, and early intervention (EI) referral. This study sought to examine whether implementation of a standardized clinical workflow using electronic screening tools improved both rates of developmental screening, and the number of children identified at risk for developmental delay, in a federally qualified health center (FQHC). Methods: A retrospective study was conducted at an academic-affiliated FQHC. Electronic versions of the Ages and Stages Questionnaire 3 (ASQ-3) and Modified Checklist in Autism for Toddlers Revised (M-CHAT-R) were implemented at well-child visits. New clinical workflow training on developmental screening and EI referral was provided. Chi-square and Fisher's Exact analyses were conducted. Results: ASQ-3 screening rates increased from 62.7 to 73.6% pre- to post-intervention. Post-intervention, there was a significant decrease in paper screens (p <.001), and a significant increase in the percentage of children with ASQ-3 results in the below cutoff range from 14.7 to 18.2% (p <.002). M-CHAT-R screening rates increased from 56.4 to 59.4% pre- to post-intervention. Post-intervention, there was a significant increase in electronic screens (p <.001). Conclusions for Practice: Implementation of electronic screening tools improved universal developmental screening in a FQHC. To decrease barriers in under-resourced communities, the use of electronic tools may decrease the rate of screening error seen with paper screening and have the potential to better identify children at risk for developmental delay. Significance: What is Already Known on this Subject?: Developmental screening is critical to early detection of developmental delay and autism spectrum disorder, and referral to early intervention services; however, many barriers exist especially for children from under-resourced communities. What this Study Adds?: The primary care intervention in an FQHC increased universal developmental screening overall, as well as electronic screening and detection of potential developmental delay through training and uptake of screening practices at multiple clinic sites. Electronic screens increased for ASQ-3 and M-CHAT-R with subsequent decreases in paper-related screening errors.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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