Putting the Office System in Place

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Putting the Office System in Place

• Paula Duncan, MD, FAAP
• Chair, AAP Bright Futures Implementation Advisory
  Committee

I have no relevant financial relationships with
the manufacturer(s) of any commercial product(s)
and/or provider of commercial services discussed
in this CME activity.
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Steps to Using Screening and Surveillance in Your
Office

• Elicit explicit support from practice leaders to
  use new structured screening tools
• Assign responsibility for coordinating the use of
  developmental screening tools
• Communicate with staff about new procedures for
  screening
• Select screening instruments
• Determine when the parent will receive the
  screening
• Who will distribute and score the screening?

Source "A Practical Guide for Improving Child
Developmental Services," from the Commonwealth
Fund
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Steps to Using Screening and Surveillance in Your
Office

• Test out ideas before implementing changes
  throughout the practice
• Prepare for the human side of change
• Train clinicians and staff
• Determine what to do with completed screenings
• Consider what new resources or referrals your
  practice may need
• Monitor progress (ask for patient feedback)

Source "A Practical Guide for Improving Child
Developmental Services," from the Commonwealth
Fund
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Integrating Developmental Screening

• Identify physician champion
• Select a developmental screening tool
• Integrate Screening and Referral Mapping the
  Workflow
• Identify Key practice staff
• Develop a formal chart that outlines
  workflow/process
• Select program support materials
• Conduct staff orientations
• Review Worksheet in Binder

Source "A Practical Guide for Improving Child
Developmental Services," from the Commonwealth
Fund
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• Office Systems Resources

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Chart Label
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• Data Collection Strategies

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Confidentiality Requirements

• All data should be in AGGREGATE form. DO NOT
  report on individual patient data.
• Please make every effort to maintain the
  confidentiality of all patient data.
• Your assistance with confidentiality is crucial
  do not send us any documents that have unique
  identifiers on them, such as patient names,
  hospital record numbers, date of visit, Medicaid
  IDs, etc.

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Data Collection

• 30 Consecutive Well-Child Visits for July and
  March (beginning and end months)
• 10 Consecutive Well-Child Visits for
  June-February (7 months in between)
• Tally method
• Keep the reporting form with you for 30
  consecutive visits and respond to questions with
  individual patients
• Chart Review
• Review 30 consecutive charts and complete the
  Monthly Data Reporting form using this info
• EHR
• Pull reports from EHR system

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See Data Collection Strategies handout for more
information
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Long Term Data Collection

• You will be asked to track all referrals made to
  see if feedback was received from the referral
  source and outcome of the referral
• You will also be asked to track all 96110 codes
  reported to determine if the code was paid and by
  whom
• These questions will be asked in the
  post-implementation survey

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Questions?