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Survey of Well-being of Young Children: Implementation and Impact on Care Quality

Yusuke Matsuura1,2, Felix Richter3,4, Gabrielle Block5

  • 1Department of Pediatrics, University of Washington, Seattle, WA.

Pediatric Quality & Safety
|August 29, 2025
PubMed

Insights

Implementing the Survey of Well-being of Young Children (SWYC) improved developmental screening and early intervention referrals equitably across language groups. This quality improvement project demonstrates successful adoption of standardized tools for better child development outcomes.

Area of Science:

  • Pediatrics
  • Quality Improvement Science
  • Health Equity

Background:

  • National adoption of validated developmental screening tools remains low despite American Academy of Pediatrics recommendations.
  • Quality improvement initiatives are crucial for increasing the use of standardized developmental screening.
  • Addressing developmental concerns equitably across diverse linguistic populations is a key challenge in pediatric care.

Purpose of the Study:

  • To implement the Survey of Well-being of Young Children (SWYC) in a residency clinic.
  • To assess the impact of SWYC implementation on screening coverage and early intervention (EI) referral rates.
  • To evaluate the equity of SWYC implementation and its impact on referral rates across English and non-English primary speaking families.

Main Methods:

  • A quality improvement project involving children aged 8-33 months attending well-child visits.
  • Interventions included staff education, daily huddles, and SWYC integration into the electronic health record.
  • Social work (SW) referrals were used as a proxy for EI referrals, with pre- and post-implementation referral rates compared using chi-square tests.

Main Results:

  • SWYC screening coverage reached over 50% within 4 months, with equitable usage between English and non-English primary speaking families (P = 0.131).
  • Overall SW referral rates increased by 2.9 percentage points post-implementation (P = 0.009).
  • No significant difference in SW referral rates was observed between language groups (P = 0.922), indicating language equity.

Conclusions:

  • Rapid adoption of the SWYC standardized developmental screening tool was achieved.
  • Implementation led to increased SW referrals, suggesting improved identification of developmental concerns.
  • The project demonstrated language equity in both screening tool usage and referral rates, supporting care equity and improved developmental outcomes.
Abstract

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