Grant Status: Active
Grant Title: Maternal and Child Health Collaborative Office Rounds (MCH COR)
Andrew Barnes, MD, MPH, FAAP
General Pediatrics & Adolescent Health
University of Minnesota
717 Delaware Street SE, Room 377
Minneapolis, MN 55414
Phone: (612) 624-1167
Despite increased requirements for developmental/behavioral pediatrics training, most graduates do not feel confident managing psychosocial problems. Childhood anxiety, depression, concerns of GLBTQIA youth, parenting problems, divorce and separation, ADHD, learning problems, family violence and neglect, and substance use continue to be prominent in primary care. The focus of MCH COR is training primary care pediatricians to manage these 'new morbidity' problems. MCH COR is a project designed to bring together specialists in pediatric primary care, psychiatry, developmental-behavioral pediatrics, psychology, nursing, and education to collaborate in the care of children and youth with emotional, behavioral and developmental problems. The project supports semi-monthly meetings of a multidisciplinary group to discuss a case selected by a group member that represents a current clinical dilemma in that provider's practice. The group works together to explore pertinent aspects of the case and offer new diagnostic and therapeutic directions. In so doing, this multidisciplinary team supports each other in the ongoing care of children and youth with these types of special health care needs.
The overarching goal of COR is improving socio-emotional well-being of children through identifying those at risk and facilitating early diagnosis of emotional and behavioral problems. The project's goals are as follows: Goal 1: Enhance primary care provider understanding of psychosocial aspects of child development, disorders, and disability; Goal 2: Enhance primary care provider understanding of psychosocial aspects of child development, disorders, and disability; Goal 3: Increase provider availability to help children and families address these issues; Goal 4: Expand the provider ability to distinguish between transient disturbances and more serious psychiatric disorders which referral; Goal 5: Promote collaboration among primary care providers with developmental-behavioral pediatricians and child psychiatrists; Goal 6: Facilitate a comprehensive approach to health supervision, such as outlined in Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.
The goals will be achieved through collaboration between diverse child health professionals. COR case-based sessions begin with active, "unsolved" case dilemmas from participants. Prospective and retrospective analytical approaches to case management will promote understanding and foster optimum care. Defining characteristics: 1) Focus upon practitioners' presentation of common clinical dilemmas; 2) Creation of a common language and supportive environment; 3) Enhancing understanding of psychosocial aspects of child development, emotional and behavioral disorders and disabilities, and the ability of providers to help families cope; 4) Focus designed to increase the pediatricians' ability and comfort to differentiate transient from more severe disorders.
The project's development, promotion, and evaluation will be shared by the collaborating pediatrician and child psychiatrist co-investigators, and co-moderators. Membership is designed to foster collaboration with member groups of UMN MCHB Network, with COR representation and leadership from UMN LEAH and UMN LEND groups.
Evaluation of COR is ongoing. An initial survey identifying learning needs provides foci for program planning, and serves as core objectives to measure learner outcomes. An 8-item evaluation is used at each meeting; an annual written evaluation identifies progress toward achieving measurable objectives. OUTCOMES: The overall goal of COR is improving socio-emotional well-being of children through discerning diagnosis of emotional and behavioral problems. Unresolved cases presented at the interdisciplinary conferences increase knowledge, diagnostic perspectives & broaden treatment options. Focus on common clinical dilemmas across culturally diverse communities results in enhanced comfort and competence, and promotion of interdisciplinary collegial trust.