Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development

Margolis, Peter A.; McLearn, Kathryn Taaffe; Earls, Marian F.; Duncan, Paula; Rexroad, Annette; Reuland, Colleen Peck; Fuller, Sandra; Paul, Kimberly; Neelon, Brian; Bristol, Tara E.; Schoettker, Pamela J.

doi:10.1016/j.ambp.2008.06.007

« Previous Next »Ambulatory Pediatrics
Volume 8, Issue 6 , Pages 383-387, November 2008

Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development

From the Center for Health Care Quality, Division of Health Policy and Clinical Effectiveness, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Margolis, Ms Fuller, Ms Bristol, and Ms Schoettker); Ms Bristol is now with the Duke University School of Nursing, Durham, NC; Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr McLearn); Dr McLearn is now with the Edward Zigler Center in Child Development and Social Policy, Yale University, New Haven, Conn; Guilford Child Health Inc, Greensboro, NC (Dr Earls); Department of Pediatrics, University of Vermont, Burlington, Vt (Dr Duncan and Dr Rexroad); Child and Adolescent Health Measurement Initiative, Department of Pediatrics, School of Medicine, Oregon Health & Science University, Portland, Ore (Ms Reuland); Vermont Child Health Improvement Program at the University of Vermont, Burlington, Vt (Ms Paul); and Department of Biostatistics and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Neelon); Dr Neelon is now with the Department of Health Care Policy, Harvard Medical School, Boston, Mass

Received 5 July 2007; accepted 6 June 2008. published online 26 August 2008.

Objective

The aim of this study was to use family-centered measures to estimate the effect of a collaborative quality improvement program designed to help practices implement systems to promote early childhood development services.

Methods

A cohort study was conducted in pediatric and family practices in Vermont and North Carolina. Eighteen collaborative education practices and 17 comparison practices participated in a 12-month program to assist practices in implementing improved systems to provide anticipatory guidance and parental education. The main outcome measures were change over time in parent-reported measures of whether children received each of 4 aspects of recommended care, documentation of developmental and psychosocial screening, and practice-reported care delivery systems.

Results

The number of care delivery systems increased from a mean of 12.9 to 19.4 of 27 in collaborative practices and remained the same in comparison practices (P = .0002). The proportion of children with documented developmental and psychosocial screening among intervention practices increased from 78% to 88% (P < .001) and from 22% to 29% (P = .002), respectively. Compared with control practices, there was a trend toward improvement in the proportion of parents who reported receiving at least 3 of 4 areas of care.

Conclusion

The learning collaborative was associated with an increase in the number of practice-based systems and tools designed to elicit and address parents’ concerns about their child's behavior and development and a modest improvement in parent-reported measures of the quality of care.

Key Words: collaborative, early childhood development, family centered, primary care, quality improvement

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The agencies funding this study did not participate in the design and conduct of the study, collection, management, analysis or interpretation of the data, or preparation, review, or approval of the manuscript.

PII: S1530-1567(08)00160-3

doi:10.1016/j.ambp.2008.06.007

« Previous Next »Ambulatory Pediatrics
Volume 8, Issue 6 , Pages 383-387, November 2008

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