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Pediatric Practice Redesign with Group Well Child Care Visits: A Multi-Site Study
Suzanne Friedman1, Bianca Calderon2, Amanda Gonzalez3
1Department of Pediatrics, Columbia University Irving Medical Center, 622 W168th St. VC4-417, New York, NY, 10032, USA. Sf2723@cumc.columbia.edu.
Insights
Group well child care is a feasible practice redesign for underserved immigrant families, improving screening and guidance retention. This model enhances patient satisfaction and provider face time without increasing clinic visits.
Area of Science:
- Pediatrics
- Health Services Research
- Community Health
Background:
- Barriers to efficient well-child care disproportionately affect low-income, immigrant communities.
- Group well-child care models show potential for improving care delivery and health outcomes.
- Practice redesign is crucial for enhancing healthcare services in underserved populations.
Purpose of the Study:
- To assess the feasibility of group well-child care in urban academic practices serving immigrant children.
- To evaluate health outcomes and process measures of group well-child care versus traditional care.
- To compare screening rates, guidance retention, and patient satisfaction between the two care models.
Main Methods:
- Prospective intervention control study design.
- Recruitment for group well-child care or traditional visits during the first year of life.
- Culturally sensitive curriculum based on American Academy of Pediatrics (AAP) guidelines; analysis via surveys and medical records.
Main Results:
- Group care enrolled 101 families; traditional care enrolled 74.
- Higher rates of postpartum depression and domestic violence screening in group care (65% vs 37%; 38% vs 17%).
- Improved anticipatory guidance retention (67% vs 37%) and higher patient satisfaction in group care, with no increase in clinic time.
Conclusions:
- Group well-child care is a feasible practice redesign for low-income, immigrant families.
- This model increases psychosocial screening and anticipatory guidance delivery and retention.
- Parental satisfaction is higher with group care, offering more provider face time without extending practice duration.
Objectives:
Multiple barriers exist to delivering efficient, effective well child care, especially in low-income, immigrant communities. Practice redesign strategies, including group well child care, have shown promise in improving care delivery and healthcare outcomes. To assess the feasibility of a group well child care program at multiple urban, academic practices caring for underserved, mostly immigrant children, and to evaluate health outcomes and process measures compared to traditional care.
Methods:
Prospective, intervention control study with participants recruited to group well child care visits or traditional visits during the first year of life. A culturally sensitive curriculum was designed based on American Academy of Pediatrics (AAP) recommendations. Process and health outcomes were analyzed via patient surveys and medical record information.
Results:
One hundred and one families enrolled in group care and 74 in traditional care. Group care participants had higher rates of all recommended postpartum depression screening and domestic violence screening (65% vs 37%, 38% vs 17% respectively), higher anticipatory guidance retention (67% vs 37%) and higher patient satisfaction with their provider. The group care redesign did not increase length of time spent in clinic.
Conclusions For Practice:
Group well child care is a feasible method for practice redesign, which allows for increased psychosocial screening and anticipatory guidance delivery and retention compared to traditional visits, for low income, predominantly immigrant families. Parental satisfaction with group care is higher and these visits provide greater face-to-face time with the provider, without increasing time spent in the practice.
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