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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 6: Developmental Screening

MCH Best Logo toddler and doctor playing with their noses

Strategy. Implementation of Quality Standards (Systems Level)

Approach. Support statewide learning collaborative for primary care practices with enhanced reimbursement for developmental screening and collaboration with local agencies.

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Overview. Systems-level approaches involving groups such as local public health agencies (LPHAs) and health care providers with quality improvement components appear to be effective for increasing developmental screening rates at well-child visits and in general. In particular the Assuring Better Child Health and Development (ABCD) program can be used in this approach.1

Evidence. Moderate Evidence. Statewide learning collaboratives for primary care practices with enhanced reimbursement for developmental screening and collaboration with local agencies combined with development of quality standards or use of quality improvement models in health care settings appears to be effective. Programs based on these strategies are likely to work. These strategies have been tested more than once and results trend positive overall. Access the peer-reviewed evidence for collaboration with local agencies and the peer-reviewed evidence for engagement with payers through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Systems.

Outcome. Increased developmental screenings performed with a parent-reported screening tool during well-child visits (at the 9-, 18-, 24-, 30-month 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. There are currently 4 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Support statewide learning collaborative for primary care practices with enhanced reimbursement for developmental screening and collaboration with local agencies,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

QUADRANT 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of LPHAs, community and/or health care partners that have implemented ABCD quality standards that support early childhood screening, referral and treatment services for developmental needs.

QUADRANT 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of LPHAs, community and/or health care partners that have implemented ABCD quality standards that support early childhood screening, referral and treatment services for developmental needs.

QUADRANT 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of LPHAs, community and/or health care partners that have implemented ABCD quality standards and have given referrals and treatment if needed after screening.

QUADRANT 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of LPHAs, community and/or health care partners that have implemented ABCD quality standards and have given referrals and treatment if needed after screening.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

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


Reference:

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.

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 number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author 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.