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American Academy of Pediatrics
Quality Report

Improving Developmental Screening Documentation and Referral Completion

Ayelet Talmi, Maya Bunik, Ryan Asherin, Michael Rannie, Tyler Watlington, Brenda Beaty and Stephen Berman
Pediatrics October 2014, 134 (4) e1181-e1188; DOI: https://doi.org/10.1542/peds.2012-1151
Ayelet Talmi
aDepartments of Psychiatry, and
bPediatrics, University of Colorado, School of Medicine, Aurora, Colorado;
cChildren’s Outcomes Research, and
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Maya Bunik
bPediatrics, University of Colorado, School of Medicine, Aurora, Colorado;
cChildren’s Outcomes Research, and
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Ryan Asherin
aDepartments of Psychiatry, and
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Michael Rannie
dClinical Informatics, Children’s Hospital Colorado, Aurora, Colorado; and
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Tyler Watlington
bPediatrics, University of Colorado, School of Medicine, Aurora, Colorado;
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Brenda Beaty
ePreventative Medicine and Biometrics, Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado
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Stephen Berman
bPediatrics, University of Colorado, School of Medicine, Aurora, Colorado;
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Abstract

BACKGROUND AND OBJECTIVES: Screening, early identification, and referral improves outcomes for young children at risk for developmental delays. Effective developmental screening processes should include efforts to ensure referral completion and documentation of evaluation results and service eligibility in the child’s medical record. Our objectives were to improve provider documentation of actions taken after an abnormal developmental screening result and increase Early Intervention (State Part C) referrals.

METHODS: Various strategies including an electronic medical record template, monthly clinical informatics reporting, and a phone follow-up after an abnormal screening result were implemented to enhance provider documentation of screening results and improve referral actions and outcomes.

RESULTS: Of the children eligible for screening (n = 3023), 2610 (86%) were screened, with 382 (15%) scoring in the abnormal range. With phone follow-up, 50% of the abnormal screenings were referred to community resources, including 43% to Early Intervention (EI), in contrast to 20% community referrals and 13% EI referrals with the screening template only (P < .0001). Provider documentation of EI outcomes increased when screening templates and follow-up calls were implemented together (31%) as compared with using the screening template alone (15%).

CONCLUSIONS: Enhanced documentation of developmental screening efforts using screening templates and clinical informatics reporting in combination with phone follow-up after an abnormal screening result improved developmental screening outcomes, including referral rates, completed evaluations, and provider documentation of EI services. Such strategies can be effectively used in pediatric primary care settings to improve screening processes and ensure that young children access appropriate services.

  • developmental assessment
  • quality improvement
  • early intervention
  • pediatric
  • primary health care
  • Accepted May 7, 2014.
  • Copyright © 2014 by the American Academy of Pediatrics

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Pediatrics
Vol. 134, Issue 4
1 Oct 2014
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Improving Developmental Screening Documentation and Referral Completion
Ayelet Talmi, Maya Bunik, Ryan Asherin, Michael Rannie, Tyler Watlington, Brenda Beaty, Stephen Berman
Pediatrics Oct 2014, 134 (4) e1181-e1188; DOI: 10.1542/peds.2012-1151

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Improving Developmental Screening Documentation and Referral Completion
Ayelet Talmi, Maya Bunik, Ryan Asherin, Michael Rannie, Tyler Watlington, Brenda Beaty, Stephen Berman
Pediatrics Oct 2014, 134 (4) e1181-e1188; DOI: 10.1542/peds.2012-1151
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