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Practicing safety: a quality improvement intervention to test tools to enhance pediatric psychosocial care for children 0-3 years.
Abatemarco, Diane J; Gubernick, Ruth S; LaNoue, Marianna D; Pohlig, Ryan T; Slovin, Sara R; Healy, Jill A; Kairys, Steven.
Afiliação
  • Abatemarco DJ; 1Departments of Pediatrics, Obstetrics, and Gynecology,Sidney Kimmel Medical College,Thomas Jefferson University,Philadelphia, PA.
  • Gubernick RS; 2RSG Consulting,Collingswood,New Jersey.
  • LaNoue MD; 3Family Medicine,Thomas Jefferson University,Philadelphia, PA.
  • Pohlig RT; 4Biostatistics Core Facility,University of Delaware,Newark, DE.
  • Slovin SR; 1Departments of Pediatrics, Obstetrics, and Gynecology,Sidney Kimmel Medical College,Thomas Jefferson University,Philadelphia, PA.
  • Healy JA; 6American Academy of Pediatrics,Jersey Shore University Medical Center,Itasca, IL.
  • Kairys S; 7Department of Pediatrics,Jersey Shore University Medical Center,Hackensack Meridian Health, Professor and Chair Seton Hall School of Medicine,Neptune, NJ.
Prim Health Care Res Dev ; 19(4): 365-377, 2018 07.
Article em En | MEDLINE | ID: mdl-29248033
BACKGROUND: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents. OBJECTIVE: This paper describes the testing of bundles of tools and processes, part of a larger intervention, Practicing Safety, targeted at changing physician and staff behavior to identify families at risk for child maltreatment, provide anticipatory guidance, refer to community resources, and follow-up and track at-risk families. The intervention was implemented with 14 pediatric primary care practices throughout the United States; the study was completed in 2011. METHODS: A within-subjects repeated measures pre-post follow-up design was used to evaluate the intervention. Baseline and repeated measurements of pediatric practices' processes were collected using qualitative and quantitative methods. In total, 14 core improvement teams from across the country tested three bundles of tools (maternal, infant, toddler) within a quality improvement framework over seven months. RESULTS: Quantitative results showed statistically significant adoption of tools and processes and enhancement of practice behaviors and office environmental supports. The increase in tool use was immediate and was sustained for six months after implementation. Qualitative data provided insight as to how meaningful the intervention was to the core improvement teams, especially with more complicated behaviors (eg, engaging social workers or community agencies for referrals). Barriers included lack of community resources. Findings showed unanticipated outcomes such as helping practices to become medical homes. CONCLUSION: Lessons learned included that practices appreciate and can adopt brief interventions that have meaningful and useful tools and process to enhance psychosocial care for children 0-3 and that do not place a burden on pediatric practice. An innovative, quality improvement strategy, intuitive to pediatricians, with a brief intervention may help prevent child maltreatment.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Pediatria / Atenção Primária à Saúde / Maus-Tratos Infantis / Aconselhamento / Segurança do Paciente Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Adult / Child, preschool / Female / Humans / Infant / Male / Middle aged / Newborn / Pregnancy País/Região como assunto: America do norte Idioma: En Revista: Prim Health Care Res Dev Ano de publicação: 2018 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Pediatria / Atenção Primária à Saúde / Maus-Tratos Infantis / Aconselhamento / Segurança do Paciente Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Adult / Child, preschool / Female / Humans / Infant / Male / Middle aged / Newborn / Pregnancy País/Região como assunto: America do norte Idioma: En Revista: Prim Health Care Res Dev Ano de publicação: 2018 Tipo de documento: Article País de publicação: Reino Unido