Putting the Office System in Place

1. 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.

2. 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

3. 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

4. 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

5. Office Systems Resources

6. 1 2 No 5a 6a 3 Yes Yes 7 No 6b 5b 4 Yes Yes No 8 Related Evaluation and Followup Visits No 10 9 No Yes

8. Chart Label

11. Data Collection Strategies

13. 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 ID#s, etc.

14. 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

15. See Data Collection Strategies handout for more information

16. 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

18. Questions?