Dear Sir
The University of California, Irvine's pediatric residency program partnered with the American Academy of Pediatrics (AAP) Chapter 4 to improve developmental screening in an affiliated pediatric clinic (Council on Children with Disabilities 2006). Throughout an academic year, consecutive small groups of residents received instruction and mentorship from the chief residents on how to develop a Quality Improvement (QI) project during their one-month rotation at the clinic. Using the Plan, Do, Study, Act (PDSA) model, residents implemented multiple interventions to improve the rate of standardized developmental screenings at well-child visits for children aged 9 months to 36 months (N = 1061) between January 2009 and June 2010. The rate of standardized developmental screening increased from 7% to 56% after residents initiated QI interventions.
Barriers were encountered during the project, such as limited education and socioeconomic resources of the patient population, scarce time in the clinic setting, and suboptimal resident/staff knowledge of developmental screening tools and recommendations. By familiarizing themselves with the barriers that existed, and taking advantage of the AAP's mission for health promotion and connection to community-based resources, the residents were able to positively impact the developmental screening rates in the clinic.
The residents’ successful outcomes suggest that combining resident education and AAP mentorship in QI interventions can lead to substantial gains in the quality of patient care (Akins & Handel 2009). In this case, the rate of developmental screening at a general pediatric clinic improved as a result of this collaborative effort.
References
- Akins R, Handel G. Utilizing quality improvement methods to improve patient care outcomes in a pediatric residency program. J Grad Med Educ 2009; 1(2)299–303
- Council on Children with Disabilities. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics 2006; 118(1)405–420