Funded Projects

Problem:

Physicians have been slow to integrate developmental screening using standardized tools into their practices. Even those who do, report they often don't make referrals when a child is at risk. The developmental service system needs to improve so it can serve all children with developmental problems. Goals and Objectives Goal 1: Improve communication and collaboration among community and health care providers conducting developmental screening by forming a Developmental Screening Network (DSN). Objective 1: HMG-OC will establish the DSN within the first 2 months of funding. Objective 2: Identify data that can be collected from the Developmental Screening Registry (DSR) to measure participation in the DSR, identify gaps in the service system, and inform and engage physicians to improve developmental screening rates by the end of Year 2. Objective 3: Improve coordination among entities that screen children for developmental problems to make the system more efficient, promote training and information sharing among participants, identify service system gaps and propose options for filling them - in Years 3-5. Goal 2: Proactively connect children whose developmental screening results indicate risk or need for further assessment to developmental services.. Objective 1: HMG-OC will work with the CHOC Primary Care Clinics to be included in the electronic health record referral system so HMG-OC can automatically receive notice when a child has an abnormal developmental screening score and contact the parents to help connect them to services. Objective 2: HMG-OC and the DSN will outline the STAR enhancements for the Developmental Screening Registry will contract with the STAR database developer, KJMB Solutions, to design, program and implement the DSR, to be completed within the first 18 months of funding. Objective 3: Develop training curriculum and protocols for users of the DSR within the first 18 months of funding. Goal 3: Increase care coordination and communication by sharing referral outcomes with primary health care providers. Objective 1: HMG-OC and the DSN will develop an outline of the feedback mechanism requested by providers, within the first 12 months of funding. Objective 2: HMG-OC will implement the feedback reporting within the first 18 months of the project. Objective 3: HMG-OC and the database developer will include physician feedback as part of the DSR -- to be completed within the first 18 months of funding. Goal 4: Increase the number of children who are screened for development and receive appropriate follow-up by increasing physician engagement and improving screening practices through outreach and education. Objective 1: Promote the availability of the HMG Maintenance of Certification (MOC) service and provide updates on development of the DSR -- throughout the 5 years of the project. Objective 2: Promote the use of the DSR among all physicians in Orange County including those participating in the MOC -- throughout the 5 years of the project.

Methodology:

HMG-OC will establish the Developmental Screening Network; work with medical clinics to proactively receive automated electronic referrals directly from the electronic health record; build out their STAR data system to include the Developmental Screening Registry; develop a feedback report so physicians can learn whether families were connected to developmental services; and engage with physicians to promote screening and follow-up.

Coordination:

These agencies are participating in the Developmental Screening Network, a monthly meeting led by Help Me Grow. Children and Families Commission of Orange County; Orange County Health Care Agency; Social Services Agency; Cal Optima; Regional Center of Orange County; Family Support Network; CHOC Children's Hospital; American Academy of Pediatrics, CA Ch. 4; Orange County Head Start; MOMS Orange County; Pretend City Children's Museum; Orange County Department of Education; Child Abuse Prevention Center.

Evaluation:

Goal #1: Document DSN meetings including # of attendees & role. Topics covered & issues raised. Progress on protocols for sharing information. Strategies for overcoming hurdles in protocol development. Goal #2: Document # of kids connected to HMG. Document changes proposed for the DSR STAR enhancements. Goal#3: Document feedback mechanism. Goal#4: # & type of promotional activities for MOC. # who receive MOC information. # pursuing MOC. # & types of promotional activities regarding DSR use.

Experience to Date:

The DSN continued to meet on a monthly basis, holding 10 meetings between March 2015 and February 2016 with an average of 14 participants per meeting. During each meeting we focused a portion of the agenda on the Registry development where the vendor, KJMB Solutions, provided progress via simulated screen shots and received feedback on the ease of use. Additionally, the DSN came to agreement on the formal name of OC Children's Screening Registry. Supplemental meetings were held as the DSN prepared to respond to a RFA for a Capacity Building Program coordinated by the Children and Families Commission of Orange County. In October we received a positive award notice and the DSN became part of this Capacity Building Program. The specific purpose is to help the DSN continue to progress through the stages of readiness to achieve collective impact: universal developmental screening and referral service coordination and long-term service sustainability. Substantial progress has been made on the testing of the Registry. By April 2015, a "demo site" was made available for testing by pilot users who made numerous entries in the Registry. A focus group was held where we received useful feedback and utilized this information to make programming changes to ensure we create a user friendly Registry. From 3/1/15 through 2/29/16, 1732 children received an ASQ -3 or ASQ: SE due to Help Me Grow efforts. Of those referred for additional resources, 397 were connected to a program or service