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...
| Publicado en: | Maternal & Child Health Journal Vol. 28; no. 10; pp. 1716 - 1726 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180849907&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180849907 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Oct2024 vid: 28 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 180849907 178965603 180849907 180849907 10.1007/s10995-024-03970-y 180849907 ppf: 1716 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Standardizing and Improving Primary Care-Based Electronic Developmental Screening for Young Children in Federally Qualified Health Center Clinics. aug: au: 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 sug: 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 refInfo: holdings: @attributes: islocal: N |
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