TABLE 1

Lessons Learned From Implementing a Screening Program

What Promoted Screening ImplementationWhat Challenges Remained
• Creating an office-wide implementation system• Consistent referral of children with failed screens
• Dividing responsibility among staff• Distributing screens to children at screening ages but not to others
• Actively monitoring implementation and continuing to make changes• Maintaining consistent screening practice during busy times
• Choosing screens perceived to least disrupt clinic flow• Coping with screening gaps due to staff turnover
• Aligning screening measures with those used in community based programs• Not screening when surveillance raised concerns
• Tracking referrals through a distinct implementation system from screening
• Nonadherence to the 30-mo screen because of expected nonreimbursement