Current Position Information
Family Practice Physician, Westmoreland Family Medicine - UPMC, Irwin, Pennsylvania
Scholarly Research Project
Developmental Screening Improves with Physician and Staff Education
Tyler Reinthaler, MD; Lori Stiefel, MD; Jacqueline Weaver-Agostoni, DO; Madeline Simasek, MD
In a 2007 CDC survey, parents reported that developmental screening occurs at only 52% of well-child visits. The Shadyside Family Health Center (SFHC) uses two screening forms, the PEDS response form, and the MCHAT, and had a pre-intervention screening rate of 40% for children age 9 months to 4 years.
After obtaining Quality Improvement Committee approval, the pediatric LOPIR group reviewed charts from January through June 2016 for all well-child visits ages 9 months to age 4 (n=170), noting screening test orders, documentation of screening test results, and referrals to developmental services. Providers received feedback on both the individual and group level, via private staff messages through EPIC and via a group presentation and quarterly email. A post-intervention chart review was performed from January through June 2017 (n=187).
Ordering rates for the PEDS and MCHAT improved from 31% to 50%, and 24% to 36%, respectively. Documentation of results increased from 41% to 55%, and 73% to 93%, for the PEDS and the MCHAT, respectively. The referral rate using the PEDS improved from 2.4% to 4.8%, and from 2.2% to 3.5% for the MCHAT.
The SFHC increased screening and referral rates for pediatric patients. Barriers to screening included busy offices, busy well-child visits, lack of provider education and issues with EPIC compatibility.
Family physician provider education and reminders can lead to improved developmental screening.