1. Improving Diagnosis and Management of ADHD
Team Lead Call #3
Diane Liu, MD
Assistant Professor, Pediatrics
Co-Director, UPIQ

2. Welcome Practice Teams!
Families First Pediatrics
Intermountain Moroni Clinic
Mountain West Pediatrics
Ogden Clinic
Southwest Children’s Clinic
South Jordan Health Clinic
Utah Valley Pediatrics- Provo North
University Pediatrics Clinic
Wasatch Pediatrics – Draper
Please note the number next to your practice as the label for the graphs to follow. In the future the graphs will be labeled by your practice’s name

3. Agenda Mute responsibly .
Project update: review practice aggregate February data
Please submit your data – QI coaches available for support

4. Percentage of encounters for initial diagnosis and follow-up for ADHD where there is documentation of the screening tool in 2 settings documented in the chart

5. Discussion
Ideas for receipt of completed Vanderbilt tools from teachers
Informed consent for the school from the parent
Release of information for the practice from the parent
Challenges or barriers
Unknown school personnel
Communication between practice and school teacher directly vs. via parents
Current processes

6. Percentage of encounters for Initial Diagnosis where there is documentation of DSM-V criteria and Co-Existing Conditions

7. Percentage of encounters for Initial Diagnosis and ADHD follow-up where there is documentation of medication follow-up within the recommended time of days for new Rx and 6 months for maintenance Rx

8. Optional Measures: Follow-up documentation and ADHD Registry

9. ADD/ADHD (DSM V Criteria): (SOUTH JORDAN’S xfile FOR INITIAL DX) (available on QITS)
A. Inattention Questions (6 or more x 6 months if under 17 yrs. of age. 5 or more x 6 months if over 17 yrs.):
-Fails to give close attention to details or makes careless mistakes?:  ***
-Difficulty sustaining attention in tasks or play activities?:  ***
-Does not listen when spoken to directly?:  ***
-Does not follow through on instructions or fails to finish schoolwork/work duties?:  ***
-Has difficulties organizing tasks or activities?:  ***
-Avoids tasks that require sustained mental effort (ex. homework)?:  ***
-Frequently loses things?:  ***
-Is easily distracted by external stimuli?:  ***
-Is forgetful in daily activities?:  ***
B. Hyperactivity Questions (6 or more x 6 months if under 17 yrs. of age.  5 of more x 6 months if over 17 yrs.):
-Fidgets with hands or feet, or squirms in seat?:  ***
-Often leaves seat in classroom or in other situations in which remaining seated is expected?:  ***
-Often runs or climbs excessively or inappropriately (feelings of restlessness in adults)?:  ***
-Often has difficulty playing or engaging in leisure activities quietly?:  ***
-Is often on the go as if driven by a motor?:   ***
-Often talks excessively (impulsivity)?:  ***
-Often blurts out answers before questions have been completed?:  ***
-Often has difficulty awaiting turn?:  ***
-Often interrupts or intrudes on others (butts into conversations or games)?:  ***
C. Symptoms before the age of twelve?:  ***
D. Impairment in 2 or more settings? (work, school, home, etc.):  ***
E. Clinically significant impairment in social, academic or occupational functioning?:  ***

10. ADD/ADHD Follow-Up: (SOUTH JORDAN’S xfile FOR PEDS FOLLOW-UP)
available on QI TS
History of Present Illness:
-ADD or ADHD?: ***
-Conduct at school acceptable? ***
-Conduct at home acceptable? ***
-Peer relations acceptable? ***
-Ability to concentrate acceptable? ***
-Current medication for ADD/ADHD: ***
-Daily medication schedule: ***
-Specific concerns: ***
-How are grades at school? ***
Targeted Review of Systems:
-Insomnia? ***
-Loss of appetite? ***
-Palpitations? ***
-Weight loss? ***
-Headache or vision changes? ***

11. Discussion
Successes?
Challenges?
Feedback from parents or patients?

12. Reminders Next ADHD Webinar is Tuesday, April 19th 12:15pm
Malinda Horton, CPNP, Primary Children’s Hospital Integrative Medicine Clinic
Complementary Medicine Highlights
March Data due by April 15th