2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

333626
Mental Health Screening in Pediatric Primary Care: Results from a Quality Improvement Learning Collaborative


Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Lee Beers, MD, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC
Leandra Godoy, PhD, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC
Mark Weissman, MD, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC
Tamara John Li, MPH, Goldberg Center for Primary Care, Children's National Health Network, WASHINGTON, DC
Amy Lewin, PsyD, Department of Family Science, School of Public Health, University of Maryland, College Park, MD
Rachel Moon, MD, Goldberg Center for Community Pediatric Health, Children's National Health System, Washington, DC
Bruno Anthony, PhD, Center for Child and Human Development, Georgetown University School of Medicine, Washington, DC
Matthew Biel, MD, Child and Adolescent Psychiatry, Georgetown University School of Medicine, Washington, DC
Audio (mp3) recording Recorded Presentation (mp4)
Background: Pediatricians are increasingly called upon to identify and address mental health (MH) problems, in part through routine MH screening. Quality improvement (QI) learning collaboratives offer an innovative model to facilitate multi-practice learning and measurable improvements in MH screening.

Methods: Fifteen practices and 142 providers enrolled in a 9-month, web-enabled QI learning collaborative aimed at improving MH screening practices using approved screening tools during annual well child visits for children 1 to 18 years. Program elements included monthly webinars on MH, monthly team leader calls, monthly practice team meetings, 3 plan-do-study-act cycles, and ongoing technical assistance from QI and MH coaches. Data, collected at the start and end of the project, included the AAP Mental Health Practice Readiness Inventory, provider reports about attitudes towards screening, and chart audits. 

Findings: Improvements were seen across all metrics.  Practices reported greater readiness to address mental health issues (Table 1) and providers reported greater confidence in doing screening (20.7% increase). Chart reviews showed an increase in overall screening rates from baseline (11%) to project end (75%). Of screens completed, results showed improvements in the percentage of practices using an approved screening tool (1% to 67%), scoring and documenting results (26% to 88%), and billing for screening (26% to 71%). 

Implications: Results show improvements in the use of routine MH screening during annual well child visits. Findings highlight the benefits of providing ongoing, extensive support to practices around screening implementation.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe changes in mental health screening practices and beliefs following a Quality Improvement Cearning collaborative for pediatric primary care providers.

Keyword(s): Child/Adolescent Mental Health, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the PI on multiple grants related to mental health in pediatric primary care and was the lead on the quality improvement project being presented. Among my research interests is the integration of mental health into primary care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4342.0: Behavioral Health in Primary Care Settings: Lessons from Research and Quality Management