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Toddler Track: Streamlining Developmental Assessments-A Retrospective Cohort Study
Naomi Campbell-Woods1,2, Sarah Atkinson1,2, Jessica Balfour-Ogilvy3
1Child Development Service - South, Browns Plains Community Health Centre, Hillcrest, Queensland, Australia.
Insights
The Toddler Track Model (TTM) significantly reduced wait times and assessment duration for developmental services in children aged 18 months to 3 years 11 months. This novel care model improved service capacity without compromising diagnostic outcomes.
Area of Science:
- Developmental Pediatrics
- Healthcare Management
- Service Delivery Models
Background:
- Specialist outpatient developmental assessment services face challenges with long wait times and lengthy assessment durations.
- Efficient service delivery is crucial for timely diagnosis and intervention in toddlers with developmental concerns.
Purpose of the Study:
- To design, implement, and evaluate the Toddler Track Model (TTM) for developmental assessment.
- To determine if TTM reduces wait times and assessment completion time.
- To assess the impact of TTM on the formulation of developmental profiles.
Main Methods:
- The Toddler Track Model (TTM) utilized a Plan-Do-Study-Act (PDSA) framework for service redesign.
- Children aged 18 months to 3 years 11 months were triaged into four streams with tailored pathways.
- Outcomes were measured via retrospective chart audit comparing pre- and post-TTM implementation metrics.
Main Results:
- Average time from initial clinical session to diagnostic formulation decreased from 116 to 63 days (p < 0.001).
- Service-wide wait times declined by 61.5%, with TTM contributing an estimated 68% of this reduction.
- Service capacity increased, with a substantial rise in the number of children assessed, without changes in diagnostic outcomes.
Conclusions:
- The Toddler Track Model (TTM) is an effective novel care model for toddler developmental assessments.
- TTM successfully reduced wait times and assessment duration, enhancing service capacity.
- The model maintained clinical practice standards and diagnostic outcome consistency.
Aims:
To design, implement and evaluate a novel model of care, Toddler Track Model (TTM), at a specialist outpatient developmental assessment service to determine whether the model: (1) reduced wait times to access the service; (2) reduced length of time to complete developmental assessment; (3) resulted in any change to the formulation of developmental profiles.
Methods:
TTM utilised a Plan-Do-Study-Act (PDSA) framework to redesign service delivery. Children aged 18 months to 3 years 11 months were triaged into one of four streams based on clinical information, with tailored pathways involving allied health and paediatrician input. Outcomes were measured through a retrospective chart audit, comparing key time points and service metrics before and after implementation of TTM.
Results:
The average time from initial clinical session (ICS) to diagnostic formulation decreased from 116 to 63 days (p < 0.001), with statistically significant reductions observed at all measured service time points. The number of children assessed in 2024 increased substantially (n = 132). Importantly, diagnostic outcomes did not differ between cohorts, indicating no change in clinical formulation. Service-wide wait times declined by 61.5%, with 68% of this reduction estimated to be associated with TTM.
Conclusion:
The findings suggested that TTM is a novel model of care for children aged 18 months to 3 years 11 months. Its implementation successfully reduced wait times and assessment duration while increasing service capacity, without altering diagnostic outcomes or clinical practice standards.
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