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From Evidence-Based Guidelines to Clinical Practice: Pediatric Neuropsychology Care in Multidisciplinary Clinics
Elise M Turner1, Greta Wilkening1, Christa Hutaff-Lee1
1Department of Pediatrics, Section of Neurology, Children's Hospital Colorado/University of Colorado School of Medicine, Aurora, CO 80045, USA.
Insights
Tiered neuropsychological care in pediatric multidisciplinary clinics (MDCs) is feasible and highly acceptable to providers. This approach improves patient care and informs clinical decisions within MDCs.
Area of Science:
- Pediatric Neuropsychology
- Healthcare Delivery Models
- Multidisciplinary Care
Background:
- Traditional pediatric neuropsychological evaluations are time- and resource-intensive.
- Emerging care models aim to optimize service delivery.
- Multidisciplinary clinics (MDCs) offer a context for innovative service provision.
Purpose of the Study:
- To demonstrate the feasibility and acceptability of tiered neuropsychological care within MDCs.
- To provide examples of tiered care implementation at a single institution.
- To assess provider perceptions of tiered neuropsychological services in MDCs.
Main Methods:
- Review of current MDC practices at a tertiary pediatric care center.
- Description of clinic workflow, services, and triage strategies.
- Survey of pediatric neuropsychologists (n=5) and other health professionals (n=31) on their experience with MDCs.
Main Results:
- Neuropsychologists delivered care in 11 MDCs, offering universal monitoring and targeted screening.
- High reported satisfaction: 89% of neuropsychologists and 100% of other health professionals found tiered services improved patient care.
- Other health professionals utilized neuropsychology MDC findings for clinical approach (48-90%), referrals (58%), and treatment decisions (55-71%).
Conclusions:
- Tiered neuropsychological care within pediatric MDCs is feasible and demonstrates high provider acceptability.
- Implementation of MDCs requires careful planning regarding teams, goals, logistics, and billing.
- This model enhances patient care and optimizes resource utilization in pediatric neuropsychology.
Objective:
High demand for pediatric neuropsychological care has highlighted the time- and resource-intensive nature of traditional comprehensive evaluations. Emerging care models address these constraints by facilitating tiered neuropsychological services provided in various contexts, including multidisciplinary clinics (MDCs). We aim to demonstrate feasibility and acceptability of tiered neuropsychological care in MDCs through examples from a single institution.
Methods:
A review of all current MDC practices at a tertiary pediatric care center was conducted to describe clinic workflow, services provided, and triage strategies. Pediatric neuropsychologists (n = 5) and other health care providers (n = 31) completed a survey focused on experience with neuropsychology consultation in MDCs.
Results:
Neuropsychologists provided care in 11 MDCs, including universal monitoring with consultative interviews and questionnaires, as well as targeted screening. Neuropsychologists (89%) and other health professionals (100%) reported that tiered neuropsychological services improved patient care within MDCs. Other health professionals reported utilizing results from neuropsychology MDC care to inform their clinical approach (48-90%), referrals (58%), and treatment or surveillance decisions (55-71%).
Conclusion:
Tiered neuropsychological care in pediatric MDCs is feasible, and provider experience ratings indicate high acceptability. Practical steps for development of MDCs are provided, including identifying teams, clinic goals and outcomes, operational logistics, and billing.
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