Increasing Early Childhood Screening in Primary Care Through a Quality Improvement Collaborative

Area of Science:

• Pediatric Primary Care
• Quality Improvement Science
• Early Childhood Development

Background:

• Early childhood screenings are crucial but often underimplemented.
• Gaps exist in screening, discussion, referral, and follow-up for key developmental and health areas.
• Improving these processes is vital for early intervention and better child outcomes.

Purpose of the Study:

• To enhance the screening, discussion, referral, and follow-up of development, autism spectrum disorder (ASD), maternal depression, and social determinants of health (SDoH).
• To achieve a 90% implementation rate for these screenings and subsequent actions by July 2018.
• To assess the impact of a quality improvement collaborative on pediatric primary care practices.

Main Methods:

• A 1-year national quality improvement collaborative involving 19 pediatric primary care practices.
• Implementation of changes to early childhood screening processes supported by learning opportunities.
• Monthly chart reviews and parent surveys to assess screening, discussion, referral, and follow-up rates.

Main Results:

• Development and ASD screening goals exceeded 90%.
• Significant increases in maternal depression screening (27% to 87%) and SDoH screening (26% to 76%).
• Statistically significant improvements in discussion and referral rates across all screening areas, with parent-reported increases as well.

Conclusions:

• Pediatric practices can successfully implement multiple early childhood screenings.
• Quality improvement initiatives can enhance screening, discussion, referral, and follow-up processes.
• Continued advocacy for resources is necessary to ensure improved health outcomes from increased screening.