Quality Improvement in Rural Primary Care Practices Lichtfuss, Ellis; Mouton, Elizabeth; Sohl, Kristin MD; Curran, Alicia; Bopp, Kenneth University of Missouri, Health Management & Informatics Quality Improvement in Rural Primary Care Practices Do Study Act Plan Background In the U.S. approx. 13% of children age 3-17 have a developmental or behavioral disability (CDC, 2017) There is vast evidence that early intervention can greatly enhance the lives of children with developmental delays and disabilities, yet current practice continues to lag behind research, and integration of routine developmental screening into the pediatric primary care setting is still an unrealized goal (Pinto-Martin, 2005) In addition to the challenge of implementing developmental screening, many primary care practices struggle to implement any type of Quality Improvement (QI) projects into their practice Quantitative Findings: Overall, screening rates & PDSAs improved over the three month period for physicians participating in ECHO Autism 18 month MCHATs: 9 out of 15 physicians improved overall 24 month MCHATs: 10 out of 15 physicians improved overall 18 month General Development: 7 out of 15 physicians improved overall 24 month General Development: 7 out of 15 physicians improved overall Physicians utilizing PDSA increased from 0 to 5 over 3 mos. Qualitative findings: ECHO has been beneficial in streamlining processes Examples: giving patients screening tools before their appointment, huddles with staff frequently, making changes with new research and practices Key barriers to QI Implementation identified by phone survey Resistance to change Difficulty developing/implementing new processes Non-compliant staff Patient barriers Results Barriers to Screening Implementation November January Objective To increase developmental screening rates through the ECHO training model in pediatric primary care settings so that a greater number of children can reap the benefits of early intervention To determine the effectiveness of the ECHO training model in increasing developmental screening rates by PCPs To identify major barriers in implementation of developmental screening and other QI initiatives To suggest best practice for implementation of developmental screening and QI projects in rural primary care practices November January Conclusions The ECHO Autism model is effective in increasing screening rates for physicians in rural clinics Allows physicians to streamline processes and make changes within the clinic to improve adherence to best practice guidelines, leading to enhanced patient care Educating PCPs about QI tools such as PDSA increased implementation of QI initiatives in the practice of participating physicians Methods Through the use of Survey Monkey, data on the number of 18 and 24 month well child checks, MCHATs, and developmental screeners completed during each month was reported for each physician Qualitative information was obtained through brief phone calls with 3 participating providers This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant #T73MC00022, Missouri LEND. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.

Do Study Act Plan