在高风险后续计划中通过质量改进方法论识别自闭症谱系障碍
Christine M Raches1, Elesia N Hines1, Abbey C Hines2
1From the Division of Developmental Medicine, Department of Pediatrics,Indiana University School of Medicine.
Pediatric quality & safety
|April 5, 2024
概括
在高风险婴儿随访计划中实施自闭症谱系障碍 (ASD) 查有效地识别了需要早期评估的儿童. 这项QI倡议改善了早产婴儿的ASD及时诊断.
科学领域:
- 儿科 儿科 儿科
- 发展心理学 发展心理学
- 提高质量 提高质量
背景情况:
- 过早出生的儿童面临自闭症谱系障碍 (ASD) 的更高风险.
- 早期的自闭症诊断,通常在18-24个月之间,往往由于访问障碍和医疗复杂性而延迟.
- 高风险婴儿随访 (HRIF) 计划对于监测这些脆弱儿童至关重要.
研究的目的:
- 在高风险婴儿随访计划 (HRIF) 中实施和评估自闭症谱系障碍 (ASD) 查协议.
- 提高ASD查率和及时转诊,以便在有风险的婴儿中进行诊断评估.
- 评估质量改进 (QI) 方法论在将ASD查整合到多学科HRIF环境中的有效性.
主要方法:
- 开发了一种标准化的工作流程,用于为年龄在16-22个月的HRIF患者使用M-CHAT-R/F查工具.
- 基于远程医疗的ASD评估 (TELE-ASD-PEDS) 用于儿童查阳性.
- 每月的团队会议促进了使用QI方法的变化周期和流程审查.
主要成果:
- 在实施7个月内,ASD查率超过了60%的目标.
- 72%的查阳性患者被转诊进行评估,其中27%的患者被诊断为ASD.
- 诊断ASD的平均年龄为22.5个月,表明相对较早的识别.
结论:
- 一个ASD查和转诊协议,利用QI,成功地集成到HRIF计划中.
- 该协议在识别有风险的婴儿和促进加速远程医疗评估方面被证明是有效的.
- 该计划的成功导致其扩展和整合远程医疗服务以满足接入需求,证明了QI的价值.
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