Improving care for children with attention deficit hyperactivity disorder: assessing the impact of self-assessment...

Area of Science:

• Pediatric Healthcare
• Clinical Practice Improvement
• Evidence-Based Medicine

Background:

• Significant disparities exist between current clinical practices and evidence-based recommendations.
• Many interventions to enhance healthcare quality are resource-intensive and costly.

Purpose of the Study:

• To evaluate if clinician self-assessment of practice performance for attention deficit hyperactivity disorder (ADHD) diagnosis and management, combined with a system-change-focused conference, improves care.
• To determine the effectiveness of a targeted educational intervention on clinical practice.

Main Methods:

• A quasi-experimental, before-and-after study design with external controls was employed.
• Clinician attendees of a 2-day conference were compared to a convenience sample of nonattendees.
• Logistic regression with generalized estimating equations was used to analyze data, accounting for practice-based clustering.

Main Results:

• Pre-intervention, widespread deficiencies in ADHD care were identified.
• Conference attendees demonstrated significant improvements in 2 of 10 performance measures, including evaluation for coexisting conditions and offering treatment options.
• Positive trends in other performance indicators were observed among attendees.

Conclusions:

• Practice assessment coupled with system-based training presents a potentially cost-effective method for enhancing clinical practice.
• This approach may be a viable strategy for improving the quality of care for children with ADHD.