Transcript Community Clinic Partnerships

Effective referrals for child development
needs…
How one non-profit is partnering with the medical
community to improve the health of Oklahoma children.
Objectives
 Describe the structure and function of a community clinic
partnership
 Framework- Collective Impact
 Function- Who are we Really Reaching?
 Describe the benefits of coordinated primary care
screening coupled with systematic referrals
 Examples of Structures
 OU-Tulsa Pediatric Department
 Next Steps Developmental Clinic
 Morton Comprehensive Health Services
 Private Pediatric Practices
 Closing the Referral Loop
 Partnership Opportunities
What is Sprouts?
Hint… it’s not the Grocery Store
 Sprouts Child Development Initiative offers
developmental resources and information to engage
young children in experiences that help them grow!
 Do this through:
 Online Developmental Screening
 Early Literacy
 Developmental Resources
 Intervention
 Outreach
Sprouts…
Creating a continuum of service for child development
 Unique service in the community
 Tremendous case management experience
 Response to changing child care and healthcare needs
 Remaining lack of developmental specialist in Tulsa
and surrounding areas
 Needed to put a more formalized structure around
child development activities
…Through Collective Impact
Commitment of a group of actors from different sectors to a
common agenda for solving a specific social problem, using a
structured form of collaboration
•Common Agenda
•Shared Communication
•Shared Measurements
•Cascading Collaboration
•Backbone Organization
Common Agenda
 Increase developmental screening rates for children
under 60 months
 Promote Family Resiliency and Engagement
 Promote Early Literacy
 Increase access to child development services
Common Measurements




ASQ-3
Battell
Denver Developmental
And more….
 All validated tools with measures which are easily built
into electronic medical records
 Sprouts utilizes only best-practices in child
development
Mutually Reinforcing Activities:
We Can’t All Do Everything, But Everyone Can Do Something!
Clinical
Promotion of
Provider/Patient
Relationship
Preventive
Empowered
Consent and
Shared Decision
Making
Increase
Information
Seeking Behaviors
for Health
Concerns
Navigational
Empowered
Consent and
Shared Decision
Making
Promote Existing
Resources to
Support Change
Behaviors
Increased
Comprehension
and Confidence of
Healthcare
Delivery System
Increase
Awareness of
Personal
Susceptibility
Develop. Delays
Promotion of
Existing Services
to Eliminate
Barriers into Care
Creation of an
Integrated Medical
Neighborhood to
Improve Access
into Care
Shared Communication
 We must address our weaknesses in the process
 We are trying to partner better here…
 Emails (secure), faxes, tele-health
 Early phases of working out a relationship with
Doc2Doc services
 MyHealth has been engaged in developed HIE
connectivity
Backbone Organization
 Who is going to manage all of this work???
 There is sooo much to do!!!
 We need:
 A convener of activities
 Administrative oversight
 Creative Minds
 Passion for Improvement
Functions of a Backbone Organization
Function
Description
Strategic Coherence
•Guide vision and strategic direction
•Analyze landscape, build common understanding,
identify gaps
Data Management
•Collect, house, analyze, report, and provide TA on
data
•Manage development of shared measurement
systems
Facilitation
•Manage meetings and logistics, acting as a neutral
convener
Community Outreach
•Support meaningful cross-sector community
engagement
•Help develop policy agenda and coordinate advocacy
Funding
•Coordinate grant writing among partners, seek
grants
•Possible: Re-grant, serve as fiscal agent
Programs
•Possible: Pilot innovative programs
•Possible: Assist is scaling proven programs
Collective Impact in Infant
Mortality
Backbone Organization
 Family Health Coalition new 5-year Strategic Plan focuses on new
direction of collaboration and partnerships
 Activities are focused on:
 Healthcare transformation
 Public/Private partnerships
 Leveraging shared resources
 Social marketing
 Development of child development continuum
 Collective application for funding opportunities around
preventative health
We Are Sprouting Across Tulsa
Why do Child Development Resources need to
partner with the Medical Community?
 Where are children best observed?
 Natural environment or Physicians Office
 Do you know all of the child development resources in the
community?
 Do you have time to case manage and coordinate the care
of children with developmental needs?
 Can you help the parents?
 We need to work better to understand the natural
alignment of our work efforts… This again is an example of
why collective impact works for us!
Sprouts Child Development Initiative
A New Online Developmental Screening Link
and Child Development Resource Website
(formerly the LINK Project)
Transition
The LINK Project
Initiative
Sprouts Child Development
LINK Project numbers 2006-2013
6788 children participated in screenings
 Suspect developmental
 Suspect social-emotional
 Minnesota Developmental Inventory NWNL
 Overall monitor or delay identified
30-35%
Age Groups






0-12 months
12-24 months
24-36 months
36-48 months
48-60 months
Over 60 months
32%
12%
8.5%
9%
17%
23%
25%
19%
7%
Challenges
 9,500 babies born each year
 1,400 spend time in the NICU
 500 diagnosed with chronic medical conditions
 900 discharged back into the community
AAP Statement
Early identification of developmental disorders is
critical to the well-being of children and their families.
It is an integral function of the primary care medical
home1 and an appropriate responsibility of all pediatric
health care professionals.
And please tell us if we can do it better!
National Call to Action
Healthy child development is multidimensional.
2. Health practitioners are the “first contact” with young
children.
3. Exemplary strategies exist that address the
multidimensionality of child health, starting with
developmental screening.
4. Federal health provisions offer the opportunity to
address children’s healthy development.
5. States and communities must be intentional and
creative to take advantage of these federal provisions.
Examples from the field…
OU-Pediatric Clinic
 Working towards implementation of specialized pilot
project focusing on emerging language development;
 Children will be screening during 30-36 month range
for emerging language concerns;
 Social Work staff is already sending Sprouts team
referrals for evaluation for suspected developmental
delays; and
 Reporting channels are still underdevelopment.
Next Steps Child Development
 Business Associate Agreement in place;
 Next Steps provides triage form to Sprouts staff for
review and initial contact with families for
developmental services;
 Sprouts team works with families to conduct ASQ-3 or
other required screenings;
 Reports/evaluations are provided back to Next Steps in
secure fashion; and
 Sprouts provides information on referrals provided.
Morton Comprehensive Health
Services
 Embedding services in clinics on specific days
weekly/monthly to deliver developmental
observations/assessments on patients;
 This model works for Morton due to FQHC billing and
Medicaid billing requirements;
 Working with Social Work staff to have all families
complete online developmental screening; and
 Going through credentialing process with Morton to
assist in billing and increasing access to
developmental services.
Private Pediatric Doctors
 Parent Guides
 Referral Cards
 Early Literacy Promotion
 Direct referrals
 Fax
 Online
 Email
 Expanding to Family Practice partnerships
Closing the Referral Loop
 When an ASQ-3 is completed… What happens next?
 Reports
 Evaluations
 Referrals
 Case Management
 Care Coordination
 Follow-up
Sprouts Child Development Initiative offers
developmental resources and information to engage
young children in experiences that help them grow!
http://sproutsdevelopment.com/
ASQ LINKS
Family Access URL
https://www.asqonline.com/family/24016d
Screening Management
https://www.asqonline.com/screening_managemen
t
Facebook
https://www.facebook.com/pages/Sprouts-Child-Development-Initiative/188004068048028?ref=hl
References
http://www.nichq.org/pdf/2010_Presentations/A2%20Guevara_James%20ppt.pdf
http://pediatrics.aappublications.org/content/118/1/405.full
http://www.ncqa.org/Programs/Recognition/PatientCenteredMedicalHomePCMH/DuringEarnItPC
MH/OtherPCMHResources/FAQsforPediatricPractices.aspx
http://www.medscape.com/viewarticle/727970_print