Kids with developmental delay are far more likely to receive the early intervention services they need if pediatricians follow up after conducting routine screenings, researchers say.
In a study of clinic patients at a large children’s hospital in Colorado, researchers found that simply performing regular developmental screenings was often not enough to ensure kids got help.
Even after implementing standardized screening procedures for doctors, just 20 percent of the children flagged as having possible delays were referred to community resources including early intervention.
However, when the clinic began aggressively following up with phone calls in cases where children were found to have possible delays, referrals increased to 50 percent, the study found.
The abstract, from Pediatrics:
Improving Developmental Screening Documentation and Referral Completion
Ayelet Talmi, PhD, Maya Bunik, MD, MSPH, Ryan Asherin, MA, Michael Rannie, RN, MS, Tyler Watlington, MD, Brenda Beaty, MSPH, and Stephen Berman, MD
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.
