Evidence Tools
MCHbest. NPM 6: Developmental Screening

Strategy. Quality Improvement Programs in Health Care Settings

Approach. Support practice-based learning collaborative for primary care practices.

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Overview. Systems level approaches can involve groups such as local public health agencies (LPHAs) and other health care providers using quality improvement components to improve communication and to increase developmental screening delivery. The utilization of practice-based learning collaboratives has been found to be effective.^1,2

Evidence. Moderate Evidence. Quality improvement in health care settings appears to be effective. This strategy could include a statewide learning collaborative for pediatric practices. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Health care practices.

Outcome. Increased developmental screenings performed with a validated screening tool (>80% sensitivity and specificity). The literature shows a dramatic increase during well-child visits. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

In New Mexico, seven pediatric primary care practices participated in the New Mexico Developmental Screening Initiative in a year-long quality improvement project. The goal was to implement standardized developmental screening tools. Using a collaborative learning approach and the Model for Improvement to promote AAP best practice. Overall, the use of standardized developmental screening tools increased from 27% at baseline to 92% at the end of the project.³

The Role of Title V. Title V agencies can support quality improvement programs in health care setting through a number of approaches:

• Use Medicaid to fund learning collaboratives to engage health care practices in the quality improvement process around developmental screening.
• Have an agreed-upon set of quality standards based on evidence and best practices, creating a common foundation for community and health care partners to implement screening and referral processes.

For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.

Sample ESMs. Using the approach “Support practice-based learning collaborative for primary care practices,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Note. When looking at your ESMs, SPMs, or other strategies: (1) move from measuring quantity to quality; (2) move from measuring effort to effect; (3) Quadrant 1 strategies should be used sparingly, when no other data exists; and (4) the most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References:

¹ Barry S, Paul K, Aakre K, Drake-Buhr S, Willis R. Final Report: Developmental and Autism Screening in Primary Care. Burlington, VT: Vermont Child Health Improvement Program; 2012.

² Garcia S, Brown E, Strobino D, & Minokovitz C. National Performance Measure 6 Developmental Screening Evidence Review. Strengthen the Evidence for Maternal and Child Health Programs. 2018. Women's and Children's Health Policy Center, John Hopkins University, Baltimore, MD.

³ Malik F, Booker JM, Brown S, McClain C, & McGrath J. Improving developmenta screening among pediatricians in New Mexico: Findings from the developmental screening initiative. Clinical Pediatrics. 2014: 53(6):531-538.