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Improving Psychosocial Risk Assessment and Service Provision for Craniofacial Team Patients: A Quality Improvement
Canice E Crerand1,2, Meghan O'Brien1, Hillary M Kapa3
1Cleft Lip and Palate Center and Center for Complex Craniofacial Disorders, 2650Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Implementing the Psychosocial Assessment Tool-Craniofacial Version (PAT-CV) significantly improved psychosocial risk identification and consultation completion for children with craniofacial conditions. This enhanced screening led to more children receiving necessary support services during their annual visits.
Area of Science:
- Pediatric Healthcare
- Quality Improvement Science
- Psychosocial Health
Background:
- Children with craniofacial conditions often require specialized care, including psychosocial support.
- Assessing and addressing psychosocial risks is crucial for holistic patient care during interdisciplinary visits.
- Existing screening processes may not consistently identify all children needing psychosocial services.
Purpose of the Study:
- To enhance psychosocial risk assessment and service provision for pediatric patients with craniofacial conditions.
- To implement and evaluate the effectiveness of the Psychosocial Assessment Tool-Craniofacial Version (PAT-CV) within an interdisciplinary clinic setting.
- To improve the rate of psychosocial consultation completion for at-risk children.
Main Methods:
- A quality improvement initiative was undertaken at a U.S. pediatric academic medical center.
- Key interventions included standardizing pre-visit triage, administering the PAT-CV, real-time utilization of scores for scheduling, and family education.
- Clinic flow, patient screening, and team roles were modified to integrate PAT-CV administration and scoring.
Main Results:
- The percentage of patients with elevated psychosocial risk receiving a consultation increased from 86.7% to 93.4%.
- The proportion of children receiving a psychosocial consultation due to elevated PAT-CV scores at their annual visit rose from 72% to 90%.
- PAT-CV completion rates and the identification of patients needing psychosocial services were enhanced.
Conclusions:
- Integrating a validated psychosocial risk screening instrument like the PAT-CV effectively improves identification and service completion.
- Standardized screening and real-time data utilization are key drivers for successful psychosocial service integration.
- A multi-faceted approach to risk screening may be necessary to ensure all patients in need receive timely psychosocial support.
Abstract:
To improve psychosocial risk assessment and service provision for children with craniofacial conditions presenting for annual interdisciplinary team visits.
Abstract:
Institute for Healthcare quality improvement model.
Abstract:
U.S. pediatric academic medical center.
Abstract:
Caregivers of children ages 0-17 years with craniofacial conditions presenting for 1692 team visits between August 2017 and July 2019.
Abstract:
Key drivers included: (1) standardizing pre-visit triage processes; (2) administering the Psychosocial Assessment Tool-Craniofacial Version (PAT-CV); (3) utilizing PAT-CV scores in real time to add patients to psychosocial provider schedules; and (4) family education. Interventions included improving patient screening, increasing PAT-CV completion rate, altering clinic flow, providing patient and parent education about psychosocial services, and altering team member roles to fully integrate PAT-CV administration and scoring in the clinic.
Abstract:
The primary outcome was the percentage of patients identified for psychosocial consultations via nurse triage, PAT-CV score, family or provider request who completed consultations. The secondary outcome was the percentage of patients completing needed psychosocial consultations based on elevated PAT-CV scores.
Abstract:
Use of the PAT-CV resulted in an increase in the percentage of patients with elevated psychosocial risk who received a psychosocial consultation from 86.7% to 93.4%. The percentage of children receiving psychosocial consultation at their annual team visit due to elevated PAT-CV scores increased from 72% to 90%.
Abstract:
Integrating a validated psychosocial risk screening instrument can improve risk identification and psychosocial consultation completion. A combination of risk screening approaches may be indicated to identify patients in need of psychosocial services.
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