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ECHO Autism: Integrating Maintenance of Certification with Extension for Community Healthcare Outcomes Improves
Katherine R Bellesheim1,2, Richard L Kizzee3, Alicia Curran1
1Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, MO.
Insights
Pediatricians improved developmental screening for autism spectrum disorder (ASD) using quality improvement training. This initiative, delivered via a virtual learning network, significantly boosted screening rates and shows promise for early intervention in underserved areas.
Area of Science:
- Pediatric Health
- Quality Improvement in Healthcare
- Autism Spectrum Disorder Screening
Background:
- Most pediatricians do not consistently adhere to developmental screening guidelines, delaying crucial interventions for autism spectrum disorder (ASD).
- Underserved, rural primary care settings face particular challenges in meeting these guidelines.
Purpose of the Study:
- To evaluate the effectiveness of Maintenance of Certification (MOC) Quality Improvement (QI) training in enhancing developmental screening rates.
- To assess the impact of virtual learning networks on primary care provider (PCP) screening practices for ASD.
Main Methods:
- 24 PCPs participated in MOC Part 4 training modules via the ECHO Autism QI Learning Network over 12 months.
- Developmental screening data (general and ASD-specific) were collected at 18- and 24-month well-child visits.
- A 1-year follow-up assessed the sustainability of improved screening rates.
Main Results:
- Baseline general and ASD-specific screening rates were 53.3% and 68.3%.
- Rates significantly increased to 88.6% (general) and 99.0% (ASD-specific) by the end of the training.
- At 1-year follow-up, screening rates remained high at 96.7% (general) and 97.1% (ASD-specific).
Conclusions:
- MOC Part 4 training via the ECHO Autism QI Learning Network effectively improved and sustained PCP developmental screening practices.
- Enhanced screening rates can reduce delays in accessing developmental evaluations and interventions for children.
- The training methodology is potentially transferable to other settings, promoting best practice implementation.
Objective:
Recent estimates indicate that most pediatricians do not consistently meet the American Academy of Pediatrics developmental screening guidelines, contributing to the delay of vital evaluations and interventions for autism spectrum disorder (ASD). Our objective was to evaluate the utility of Maintenance of Certification (MOC) Quality Improvement (QI) training designed to improve developmental screening rates in underserved, rural primary care practices. Trainings on best screening practices were disseminated to primary care providers (PCPs) through Extension for Community Healthcare Outcomes (ECHO) Autism, a virtual learning network.
Method:
Across 2 cohorts, 24 PCPs were enrolled in MOC Part 4 training modules delivered through the ECHO Autism QI Learning Network. Throughout the 12 months of enrollment, PCPs reported information on general and ASD-specific developmental screenings conducted at 18- and 24-month well-child visits. A 1-year follow-up was conducted to assess the maintenance of screening rates.
Results:
Baseline rates for general and ASD-specific developmental screenings were 53.3% and 68.3%, respectively. By the end of the 12-month learning module, screening rates increased significantly for general development (88.6%) and ASD-specific screenings (99.0%). At the 1-year follow-up, the rate for general developmental screening was 96.7% and for ASD-specific screening was 97.1%.
Conclusion:
Maintenance of Certification Part 4 training delivered through the ECHO Autism QI Learning Network was found to be incentivizing and highly effective in shaping and maintaining PCP developmental screening practices. Improved screening rates show promise in decreasing time to critical developmental evaluations, interventions, and resources. Our methodology is likely transferable to other ECHO communities and may facilitate expedient implementation of best practice standards in primary care.
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