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

Autor: Felix G; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA.; Keck School of Medicine of USC, Los Angeles, CA, USA., Deavenport-Saman A; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA. adeavenport@chla.usc.edu.; Keck School of Medicine of USC, Los Angeles, CA, USA. adeavenport@chla.usc.edu., Stavros S; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA.; Keck School of Medicine of USC, Los Angeles, CA, USA., Farboodi N; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA., Durazo-Arvizu R; Keck School of Medicine of USC, Los Angeles, CA, USA.; Biostatistics and Data Analysis Core, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA., Garcia J; Institute of Health Equity, AltaMed Health Services Corporation, Los Angeles, CA, USA., Yin L; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA.; Keck School of Medicine of USC, Los Angeles, CA, USA., Gera MP; Division of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS #76, Los Angeles, CA, 90027, USA.; Keck School of Medicine of USC, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Maternal and child health journal [Matern Child Health J] 2024 Oct; Vol. 28 (10), pp. 1716-1725. Date of Electronic Publication: 2024 Aug 12.
DOI: 10.1007/s10995-024-03970-y
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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