Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development

Margolis, Peter A.; McLearn, Kathryn Taaffe; Earls, Marian F.; Duncan, Paula M.; Rexroad, Annette; Reuland, Colleen Peck; Fuller, Sandra; Paul, Kimberly C.; Neelon, Brian; Bristol, Tara E.; Schoettker, Pamela J.

doi:10.1016/j.ambp.2008.06.007

Cited by 15 publications

(11 citation statements)

References 31 publications

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“…Use of quality improvement science methods has been successful in a wide variety of settings, including the care of patients with chronic illness, primary care, hospital care, and public health. [24][25][26] A major emphasis is on sustainability by providing care providers with the skills and tools required to continue changes over time.…”

Section: Quality Improvementmentioning

confidence: 99%

ImproveCareNow: The development of a pediatric inflammatory bowel disease improvement network

Crandall

Kappelman

Colletti

et al. 2011

Inflammatory Bowel Diseases

190

133

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Section: Quality Improvementmentioning

confidence: 99%

ImproveCareNow: The development of a pediatric inflammatory bowel disease improvement network

Crandall

Kappelman

Colletti

et al. 2011

Inflammatory Bowel Diseases

190

133

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“…These innovators often deployed inoffice consultants who coached teams using specific approaches to change management, combined with specific tools such as flow charts and reminder systems. Margolis' program of primary care office practice improvement in primary care settings 16 showed significant improvements in the performance of preventive services in pediatrics; similarly the STEP-UP program in northern Ohio showed significant and sustained improvements (although absolute levels of performance remained lower than desirable) 17,18 while other projects had less positive results. [19][20][21] A reasonable conclusion from these projects is that, in some settings with sufficient support, practices could operate with a higher level of reliability in the performance of preventive interventions, but that meaningful and sustained adoption of these reliability practices was difficult.…”

Section: How?mentioning

confidence: 99%

How to Scale Up Primary Care Transformation: What We Know and What We Need to Know?

Homer

Baron

2010

J GEN INTERN MED

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Becoming a medical home is a radical change, requiring both a new mental model for primary care and the skills and resources to accomplish it. Although numerous reports indicate practice change is feasible-particularly with technical support and either insulation from or alignment with financial incentives-sustained transformation appears difficult. We identified the following critical success factors: leadership, financial resources, personal and organizational relationships, engagement with patients and families, competence in management, improvement methods and coaching, health information technology properly applied, care coordination support, and staff development. Each factor raises researchable questions about what policies can facilitate achieving success so that transformation becomes mainstream rather than the province of the innovative few.

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“…[1][2][3][4][5][6][7][8] In the past decade, numerous studies have addressed the growing number of anticipatory guidance topics, 9 disparities in access, 10,11 and discrepancies in quality. 2,[12][13][14] The new Bright Futures guidelines 15 provide the pathway for many advancements, but as the history of well-child care shows, pediatrics will continue to strive for additional improvement.…”

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confidence: 99%

What Do Families Want From Well-Child Care? Including Parents in the Rethinking Discussion

et al. 2009

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WHAT'S KNOWN ON THIS SUBJECT:Schor called on pediatricians to rethink well-child care. Gaps exist between traditional wellchild care and contemporary needs and pressures. A key, but largely missing, perspective in the rethinking of discussions has been that of parents. WHAT THIS STUDY ADDS:In this qualitative study, we asked parents to address several core issues including why they attend well-child care visits, the aspects of care they find most valuable, and what changes could enhance the well-child experience.abstract OBJECTIVE: The content and systems surrounding well-child care have received increasing attention, and some propose that it is time to rethink both the delivery structure and central themes of well-child visits. A key, but largely missing perspective in these discussions has been that of parents, whose experiences and expectations are central to developing approaches responsive to family needs. In this study, we asked parents to address several core issues: why they attend wellchild visits; aspects of well-child care that they find most valuable; and changes that could enhance the well-child care experience. METHODS: Twenty focus groups with parents (n ϭ 131 [91% mothers])were conducted by using a semistructured interview guide. Verbatim transcripts were coded for key words, concepts, and recurrent themes. RESULTS:Primary reasons for visit attendance included reassurance (child and parent) and an opportunity to discuss parent priorities. Families valued an ongoing relationship with 1 clinician who was childfocused and respected parental expertise, but continuity of provider was not an option for all participants. Suggestions for enhancement included improved promotion of well-child care, greater emphasis on development and behavior, and expanded options for information exchange. CONCLUSIONS:As the consumers of care, it is critical to understand parents' needs and desires as changes to the content and process of well-child care are considered. Taking into account the multifaceted perspectives of families suggests both challenges and opportunities for the rethinking discussion. Pediatrics 2009;124:858-865

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Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development

Cited by 15 publications

References 31 publications

ImproveCareNow: The development of a pediatric inflammatory bowel disease improvement network

ImproveCareNow: The development of a pediatric inflammatory bowel disease improvement network

How to Scale Up Primary Care Transformation: What We Know and What We Need to Know?

What Do Families Want From Well-Child Care? Including Parents in the Rethinking Discussion

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