Improving Child Development Screening: Implications for Professional Practice and Patient Equity.

Area of Science:

• Pediatric Health
• Quality Improvement Science
• Health Services Research

Background:

• Child developmental screening is crucial for early identification of concerns.
• Implementing standardized screening processes in pediatric settings can be challenging.
• Electronic Health Records (EHRs) offer potential for improving screening workflows.

Purpose of the Study:

• To implement and evaluate a multifaceted approach to improve child developmental screening rates.
• To assess the impact of workflow processes and EHRs on developmental screening.
• To identify disparities in screening and referral based on patient demographics.

Main Methods:

• A pediatric group with 25 clinics and 150 providers utilized quality improvement interventions.
• Interventions included appointing champions, staff training, standardized tools, plan-do-study-act cycles, EHR prompts, financial incentives, and monitoring.
• Data from EHRs were analyzed for screening documentation, results, and referrals; 15 professionals were interviewed.

Main Results:

• Screening rates increased from 60% to over 95% across three age groups (8-36 months) for over 30,000 children.
• Significant disparities were observed in screening and referral rates based on insurance status, race/ethnicity, and income.
• Developmental screening results varied significantly by gender, race/ethnicity, insurance, and income.

Conclusions:

• A multifaceted approach effectively improved child developmental screening rates and was valued by providers.
• Demographic analyses revealed persistent disparities in screening and referral services for vulnerable families.
• Ongoing quality improvement, research, and advocacy are essential to address health inequities.