Improving Engagement in ADHD Care

Chan, Eugenia

doi:10.1542/peds.2021-050766

Cited by 1 publication

(2 citation statements)

References 10 publications

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“…Previous ADHD quality improvement studies have examined strategies to enhance monitoring of children with known ADHD diagnoses, most often focusing on collection of ADHD diagnostic rating scales such as the Vanderbilt ADHD Diagnostic Rating Scale (VADRS) through the use of care managers, PCP education, and internet portals. [13][14][15]24 Few studies have focused on evaluation and monitoring of children at high risk for ADHD, 15 and none have systematically implemented and assessed a 2-step screening process.…”

Section: Discussionmentioning

confidence: 99%

“…These studies have used strategies such as care management, pediatric primary care clinician education, and internet portals to collect rating scales and improve communication among parents, teachers, and clinicians for care of children with ADHD. [13][14][15][16] However, to our knowledge, none of these studies have sought to implement a stepwise screening process in primary care linking use of a universal screener with an ADHD diagnostic tool. Abiding by the Standards for Quality Improvement Reporting Excellence 2.0 guidelines, 17 we report on results from our program evaluation 10 months postinitiation, using the same 10 months of the previous year for comparison.…”

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confidence: 99%

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A Quality Improvement Initiative for Detection of Attention-Deficit/Hyperactivity Disorder in an Urban, Academic Safety Net Hospital

Roberts,

Loubeau,

Hasan

et al. 2024

J Dev Behav Pediatr

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Objective: Improve detection of Attention Deficit/Hyperactivity Disorder (ADHD) in a safety net, hospital-based, academic pediatric practice by optimizing screening with the Pediatric Symptom Checklist attention score (PSC-AS) and further evaluation with the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Methods: We implemented a multi-component intervention by (1) optimizing electronic medical record (EMR) features; (2) adjusting clinic operational workflow; and (3) creating a decision-making algorithm for pediatric primary care clinicians (PPCCs). We extracted 4 outcomes manually from the EMR (pediatrician acknowledgment of a positive PSC-AS, documentation of a plan for further evaluation, distribution of VADRS, and completion of at least 1 VADRS). Outcomes were measured monthly in run charts compared to the preintervention control period, and implementation was optimized with Plan-Do-Study-Act cycles. Results: PPCCs were significantly more likely to acknowledge a positive PSC-AS in the intervention versus control (65.3% vs 41.5%; p < 0.001), although this did not change documentation of a plan (70% vs 67.1%; p-value 5 0.565). Significantly more children with a positive PSC-AS were distributed a parent or teacher VADRS in the intervention versus control (30.6% vs 17.7%; p-value 5 0.0059), but the percentage of returned VADRS rating scales did not improve (12.9% vs 9.2%; p-value 5 0.269). Conclusion: Our ADHD detection quality improvement initiative improved use of the PSC-AS to identify attention problems and distribution of VADRS diagnostic rating scales, but additional interventions are needed to improve the completion of ADHD evaluations in primary care to ensure that children are appropriately identified and offered evidence-based care.

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