Quality Improvement to Eliminate Disparities in Developmental Screening for Patients Needing Interpreters

Area of Science:

• Pediatric primary care
• Health equity
• Quality improvement in healthcare

Background:

• Children with preferred languages other than English face disparities in timely developmental delay identification and treatment.
• Primary care pediatrics plays a crucial role in establishing equitable screening and referral systems.
• A systematic disparity existed in developmental screening rates between families requiring and not requiring interpreters.

Purpose of the Study:

• To eliminate the disparity in developmental screening rates between families who required interpreters and those who did not.
• To increase developmental screen completion among patients needing interpreters from 86% to 92% during age-appropriate well-child visits.

Main Methods:

• Utilized electronic health records (EHR) to track developmental screen completion rates at well-child visits for 31,461 patients.
• Implemented a quality improvement initiative based on the Institute for Healthcare Improvement's Model for Improvement in 12 pediatric primary care centers.
• Employed statistical process control to evaluate changes in screening rates.

Main Results:

• Developmental screen completion for patients needing interpreters increased from 86% to 93% across all clinics after process standardization.
• Screen completion rates for patients not requiring interpreters remained stable at 92%.
• The standardized process successfully eliminated the disparity in screening rates.

Conclusions:

• A standardized, EHR-supported process effectively improved developmental screening for patients requiring interpreters.
• This initiative successfully eliminated disparities in developmental screening, promoting health equity.
• The findings highlight the impact of systematic process changes in primary care to address inequities in child development services.