Articles

The Best Resources For Practices:
Resource Fair for Practice Managers
Meet Representatives From 17 Different Organizations That Can Help Your Practice

Reminder: What to do when a child has commercial insurance and Medicaid

Medicaid Rate Cuts

What you should know about Ramadan

Practice Manager’s Corner

Medical Home Tool Kit is Now Available

 

Ongoing Services
- Announcing an Interactive Cross-Cultural Communications Website
  Designed Especially for Healthcare Professionals
- Language as a Communication Barrier in Medical Care for Hispanic Patients
  Plus A Spanish Course For Providers
- Postpartum Depression Screening For Mothers And Training For Your Practice
- Child Psychiatrist Available to Provide Conferences for You In your Office
- The Cross-cultural Curriculum for the Department of Pediatrics
  The syllabus is now available for you and your practice
- Child Psychiatry Telephone Consultation on Medicaid Children
- Practice Manager's Meeting September 17 @ TCH 12pm
  RSVP carter.joyce@tchden.org
- Integrating Developmental Screening In a Pediatric Practice
- Medical Spanish Training For Your Office Staff

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The Best Resources For Practices:
Resource Fair for Practice Managers

 
Meet Representatives From 17 Different Organizations That Can Help Your Practice

 
Finding the correct Community Resources for your patients can sometimes be a difficult task.  CCHAP is sponsoring a RESOURCE FAIR at the next Practice Manager’s Meeting. The next Practice Manager's Meeting will be from 11:30 to 1:30 on September 17, 2009 in the Maroon Peak Conference Room at The Children's Hospital.  Participating agencies include:

ABCD	Access Behavioral Health
Behavioral Health, Inc.	Foothills Behavioral Health
Colorado Adolescent Maternity Program (CAMP)
Cavity Free by Three	CCHAP – Cultural Competency Training
Colorado Access	Early Intervention Colorado
Colorado Children’s Immunization Coalition
EPSDT	CIIS
Family Voices	Medical Home Certification
Provider Resource Helpline	Health Care Program
HCPF	Jewish Family Services
Vaccines for Children

This is an excellent opportunity to talk to your community partners and expand your knowledge base regarding the services they can provide the children and families in your care.  This Resource Fair promotes the Colorado Medical Home standard which supports making information regarding community resource information available to patients and families. Each service will be bringing information about their services that you can take back to your office.

You will also have the opportunity to sign up for cultural competency training, Medical Home certification, and training for the Cavity Free by Three program.

Take advantage of this collection of resources! Practice Managers as well as Providers are welcome.  Contact Anita Rich (rich.anita@tchden.org) for more information.  See ya’ at the Fair!

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Reminder: What to do when a child has commercial insurance and Medicaid

 
Add this to your staff’s information regarding Medicaid –

When a child is covered by both private insurance and Medicaid, private insurance must be billed before Medicaid and co-pays collected from the policy holder or other family member.  Medicaid is always payer of last resort and can not be used to pay co-pays or deductibles.  Medicaid will only pay for those services not covered by the private insurance plan.  Billing Medicaid instead of the private insurance plan will be looked at as fraud.

To report coverage by a private plan, follow this link to the reporting form. - CLICK HERE -
If your patient has dropped their private insurance and you or the family is having problems removing the insurance information, call or e-mail Kevin Heckman 720-777-6309, heckman.kevin@tchden.org  

Correction:

When a patient has commercial insurance and Medicaid (additional information)

By Anita Rich, MSW

When writing the article regarding private insurance and Medicaid an important part of the process was left out.  The article should read as follows:

When a child is covered by both private insurance and Medicaid, private insurance must be billed before Medicaid.  Co pays and deductibles can not be collected from the policy holder or other family member.  Medicaid is always payer of last resort and can not be used to pay co pays or deductibles.  Medicaid will only pay for those services not covered by the private insurance plan.  Billing Medicaid instead of the private insurance plan will be looked at as fraud.

To report coverage by a private plan, follow this link to the reporting form. If your patient has dropped their private insurance and you or the family is having problems removing the insurance information, call or e-mail Kevin Heckman 720-777-6309, heckman.kevin@tchden.org  

Additional information:
When payment is received for a particular service from the private insurance company, check to see if the Medicaid payment for the service is greater.  If that is the case, the difference between the Medicaid payment and the private insurance can be billed to Medicaid.

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Medicaid Rate Cuts

 
As you recall, the Ritter Administration and the leadership at state Medicaid went to bat for primary care providers on the budget cutting process that took effect July 1, 2009.  They did not cut any rates on primary care codes.

Unfortunately, they have had to go through another round of budget cuts.  This time to be fair, they had to give a small cut to primary care providers.  Given the state of the nation's economy and the budget challenges faced by Colorado, we feel fortunate that the Medicaid physician reimbursement rates have been limited to a very minimal 1.5% reduction effective September 1, 2009.  We are also pleased to report that the CCHAP Medical Home "bump" for preventive codes has not been reduced. 

CLICK HERE to download a copy of the announcement 
The new Medicaid fee schedule is available for download at: www.colorado.gov/hcpf > Providers > Provider Services

Please contact Kevin Heckman (heckman.kevin@tchden.org) for more information.

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Observing Ramadan

 
A Newsletter Written by Marcia Carteret   

(Copyright © 2008. All Rights Reserved.)

Ramadan is expected to begin on or around August 22, 2009 and will finish on or around September 20, 2009. (The exact dates of Islamic holidays cannot be determined in advance, due to the nature of the Islamic lunar calendar.)

Ramadan, the holiest month of the year for Muslims around the world, occurs during the ninth month of the Islamic calendar. During this holy month, Muslims from all continents unite in a period of community-wide fasting and spiritual reflection.

The annual fast of Ramadan is considered one of the five "pillars" of Islam.  Muslims who are physically able are required to fast each day of the entire month, from sunrise to sunset.  The evenings are then spent reading from the Qur'an and engaging in prayer and spiritual reflection.  Muslims also enjoy family and community meals after sunset. There are no dietary restrictions specific to Ramadan; the usual Islamic dietary law applies.

Ramadan isn’t just about avoiding eating and drinking.  From dawn to dusk during Ramadan, time is focused on purifying the soul, refocusing attention on God, and practicing self-sacrifice. The term for fasting (sawm) literally means “to refrain” and it applies to a broad spectrum of behaviors and bad habits – to thoughts, feelings, and actions.  As examples, one should refrain from gossip and unkind speech, looking at unlawful (obscene) things, taking things that belong to others, and telling lies.  Essentially, every part of the body and soul observes the fast. By refocusing the self on the worship of God, one cleanses the body and the spirit.

Time for Prayer:  Muslims observe five formal prayers each day. The timings of these prayers are spaced fairly evenly throughout the day, so that one is constantly reminded of God and given opportunities to seek His guidance and forgiveness.

Muslims observe the formal prayers at the following times: Fajr (pre-dawn), Dhuhr (noon), 'Asr (afternoon), Maghrib (sunset), and 'Isha (evening).  In Muslim communities, people are reminded of the daily prayer times through the calling of the adhan. For those in Muslim-minority communities, computerized adhan programs are available.

In Healthcare Settings: It is important to be aware of Ramadan because, depending on the individual/family, there may be strict adherence to prayer times and fasting. In a hospital setting it is important to note that a patient might refuse to eat during “regular” meal times and leave food untouched and then be demanding of food at unusual hours.  Nurses who are being asked to bring fruits and vegetables all night might be annoyed by odd eating patterns until they learn that the patient/family is following the dictates of their religion. For many Muslims illness provides an exemption from the rules. However, the most devout may insist on following the patterns of fasting and prayer despite extenuating circumstances.

Children and Ramadan: Muslim children may participate in fasting during Ramadan if they want to, but it is not required of them until they reach the age of maturity (puberty). Younger children, however, may enjoy participating along with their family and community by practicing fasting for part of a day, or for one day on the weekend, especially in the shorter winter months.

It is also common for children to participate in Ramadan in other ways, aside from the daily fast. They may collect coins or money to donate to the needy, help cook meals for breaking the day's fast, or read Qur'an with the family in the evening.

At the end of Ramadan, during the joyous three-day celebration called Eid al-Fitr (the festival of breaking the fast), children are often indulged with gifts of sweets and money.

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Practice Manager’s Corner

By Kevin Heckman

The Vaccines for Children Program and Vaccine Storage Guidelines

Myth:  You must keep VFC vaccines stored in a separate refrigerator
Fact:  VFC vaccines need only to be clearly separated from your commercial and CHP+ patient vaccines, typically on separate shelves in the same refrigerator.

Myth: Dorm style small refrigerators are acceptable for storing VFC (or any other) vaccines
Fact:  Typically, 11 cubic ft. is the minimum requirement.  Smaller, under the counter units may only be used for very small vaccine quantities and must be a pharmacy or biological grade unit.

More Facts:

• A combination refrigerator/freezer unit sold for home use is acceptable for vaccine storage if the refrigerator and freezer compartments each have a separate external door.
• Vaccines that require storage temperatures between 35° and 46°F (2° and 8°C) may be stored in the refrigerator compartment of a household- or commercial-style refrigerator-freezer unit. Vaccines that require storage temperatures at 5°F (-15°C) or colder may be stored in the freezer compartments of such units.
• The unit must be dedicated to the storage of vaccines. Food and beverages should not be stored in a vaccine storage unit because this practice results in frequent opening of the door and destabilization of the temperature.
• Small single-door (dormitory-style or bar-style) combined refrigerator-freezer units should not be used for permanent vaccine storage. The freezer compartment in this type of unit is incapable of maintaining temperatures cold enough to store MMRV, varicella, and zoster vaccines. However, this type of unit may be adequate for temporarily storing small quantities of inactivated vaccines and MMR vaccine in the refrigerator compartment (not the freezer compartment) if the refrigerator compartment can maintain temperatures at 35° to 46°F (2° to 8°C).
• MMRV, varicella, and zoster vaccines may be stored in either a manual defrost or a frost-free freezer at 5° F (-15° C) or colder.
• Providers enrolled in the Vaccines for Children (VFC) Program are required to have certified calibrated thermometers in all refrigerators and freezers used for vaccine storage.
• The temperature inside each compartment of the vaccine storage unit must be checked with a certified calibrated thermometer at least twice each day, once in the morning when the door is first opened, and once at the end of the clinic day just before the door is closed for the last time.

For more detailed information about the VFC Program please refer to the following website: http://www.cdphe.state.co.us/dc/Immunization/vfc.html
or call 303-692-2650.

 
Medicaid Nurse Advice Line

Medicaid provides a no cost Nurse Advice Line that is available to your Medicaid patients for after-hours coverage.  A practice can add this information to their after-hours phone message and meet the minimum requirements of 24x7 accessibility for Medical Home Certification.  
Medicaid Nurse Advisor Line 1-800-283-3221.

 
Cost Saving Vaccine Management Program

The Children’s Hospital, through a partnership with Child Health Corporation of America (CHCA), can offer a cost savings vaccine management program to pediatricians and family physicians statewide.  Analysis shows an immediate savings of 15-25 percent on immunization products that physicians can purchase through this cooperative. Contact mike.bomstad@chca.com for more information and be sure to mention that you are affiliated with The Children’s Hospital.

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Building Your Medical Home Toolkit - Online Launch June 1, 2009
www.pediatricmedhome.org

Brought to you by the AAP/MCHB/National Center for Medical Home Implementation, the Building Your Medical Home Toolkit supports the primary care pediatrician's development and improvement of a pediatric Medical Home.  It also prepares a pediatric office to apply for and potentially meet the National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient Centered Medical Home (PPC-PCMH) Recognition program requirements.  The Toolkit can help a practice assess and improve its medical home capacity with resources and downloadable tools organized into six building blocks that provide guidance for implementation:

• Care Partnership Support addresses family access and communication
• Clinical Care Organization addresses standards for practice organization and use of clinical information 
• Care Delivery Management addresses the promotion of clinical care that is consistent with scientific evidence, as well as patient and family preference 
• Resources and Linkages addresses successfully linking patient and families with community resources to help meet their needs 
• Practice Performance Measurement addresses the organization and promotion of safe and high quality care 
• Payment and Finance addresses the need to match quality care and NCQA recognition with payment and value

The National Center for Medical Home Implementation is a cooperative agreement between the Maternal and Child Health Bureau/HRSA and the American Academy of Pediatrics.  The National Center works to ensure that all children and youth, including those with special health care needs, have the services and support necessary for full community inclusion through medical homes.
 
Building Your Medical Home Toolkit content was developed by Jeanne McAllister, Director of the Center for Medical Home Improvement, Crotched Mountain Foundation in New Hampshire, with guidance from AAP leadership and the National Center's Project Advisory Committee members.  For more information about the National Center, please visit www.medicalhomeinfo.org or contact Angela Tobin, Manager of Technical Assistance, at atobin@aap.org.
 
Thank you.
Angela Tobin, AM, LSW
Manager, Technical Assistance
Division of Children with Special Needs
The National Center for Medical Home Implementation
American Academy of Pediatrics
phone:  800/433-9016, ext. 7621 direct:  847/434-7621  fax:  847/228-5034
e-mail: atobin@aap.org

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Announcing an Interactive Cross-Cultural Communications Website
Designed Especially for Healthcare Professionals

dimesionsofculture.com

 
Register now! Click the link above and get full access
with your own secure login and password!

A Website to Support On-going Training for Healthcare Professionals in Colorado

Because culture can have important clinical consequences, this website is devoted to supporting the self- development of healthcare professionals in basic cross-cultural communication competencies that impact health outcomes for patients. In place of the typical "diversity training" approach, practical communication strategies are emphasized that can be put to use immediately in private practices, clinics, and hospital settings.

An Interactive Website for Building a Learning Community
 
The content of this cross-cultural communications website focuses on reinforcing key concepts presented in cross-cultural communication trainings by Marcia Carteret. Additionally, this site presents the opportunity for physicians and staffs in multiple healthcare settings to interact with one another through threaded discussions. Because nothing can replace real life experience in the learning process, a virtual learning community will make it possible to share true stories and post useful questions while culture and medical experts facilitate discussions.
 
Website Features
 
Listed here are the pages that currently make up dimensionsofculture.com. Please note that some pages require a login and password because only select groups of healthcare professionals, including all CCHAP pediatric practices, will have full access to the “community” pages.

Public Pages

• Home Page
• Greetings from the Site Editor
• Culture Calendar- Monthly religious and cultural holidays
• Culture Quest – Information about cultural happenings in our community, as well as statewide and nationally.

Healthcare Community Pages (Login/Password Protected)

• Newsletters – Monthly articles addressing key cross-cultural communication topics written by Marcia Carteret and other guest contributors.
• Interactive Forums– an interactive on-line community dialogue between healthcare professionals about communicating with patients from different cultural backgrounds. 
• Provider Profiles– An ongoing series of profiles introducing some of the dynamic and culturally diverse doctors working in the CCHAP network of pediatric practices
• Culture Ambassadors – A panel of representatives from cultures around the globe, with a strong focus on the cultures most heavily represented across out state.

This website is designed to meet the needs of the healthcare community served by Colorado Children’s Healthcare Access Program. If you are a participating CCHAP provider or staff member and have suggestions for the website, please contact Marcia Carteret at mcarteret@gmail.comor 720-777- 3124. Your comments and suggestions will help make dimensionsofculture.com an effective tool for learning and community building.

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Abe Grinberg MD, FAAP MPH
   

Language as a Communication Barrier in Medical Care for Hispanic Patients

           Communication with patients and their families is essential in providing quality medical care. Cultural and language barriers create a void in the delivery of safe health care, customer satisfaction and quality of care. The public debate on how to bridge cultural and language barriers has a long history. The use of formal interpreters and translators is associated with the ability to eliminate these barriers; however, the ability to communicate directly with health professionals in a common language is associated with an increase level of trust in medical settings.

             There are 7 important points to have in mind when addressing cultural and language barriers with the Hispanic patients and their families:

1. The number of people speaking a language other than English at home and the number of Americans Limited in English Proficiency (LEP) in the United States is significant. It is expected that the total number of people in these two groups will continue to increase at a faster rate than the one of the general population in the USA. About two thirds of them are Spanish speaking individuals (₁) (₂).
2. Multiple studies document that quality of care can be seriously compromised when Spanish LEP patients need but do not get translation and interpretation services (₃) (₄).
3. Studies also document that the quality level of interpretation offered by bilingual providers and professional hospital interpreters is high. However, the quality of interpretations offered by hospital employees who are not professional interpreters, family members, relatives, friends, and ad-hoc translators are many times incorrect and of poor quality (₅).
4. Interpretation errors are common. About 60% of the errors have potential clinical consequences. Even professional interpreters commit significant errors about 50% of the time (₅).
5. Patients, who interact with a bilingual provider, frequently rate them as more friendly, respectful, and concerned when compared to those who interact with a translator or interpreter. Patients and families who are taken care by a provider who speaks their own language frequently have a more accurate recall of critical information about the encounter than those who interact with a provider who uses a translator or an interpreter(₆)(₇).
6. There are data that suggest that the length of hospital visits, the incidence of any testing, the cost per visit and the number of hospital admissions are decreased in those patients who interact with a provider who speaks their own language when compared to those providers who use a translator or interpreter during the course of the medical encounter (₈). 
7. There is evidence that courses in Medical Spanish can help health care professional achieve fluency in Spanish at the functional level and promote cultural awareness that strengthen communication skills. The promotion of such courses is associated with decreased interpreter use and increased patient and family satisfaction (₉).

          Bear in mind that Hispanics embrace people when they make an effort to speak their own language. They tend to be tolerant and have a tendency to develop relationships that are based on friendship and respect. You will make them fill comfortable and help them feel that you are concerned about their medical care.
 
          “Dele a un hombre un pescado y él comerá por un día. Enséñele cómo pescar y comerá por el resto de su vida” (Lao Tzu. Filósofo Chino).

1. 1. Flores Glenn. 2005. The Impact of Medical Interpreter Services and the Quality of Health Care: A Systematic Review. Medical Care Research and Review 62: 255- 299
2. Colorado Alliance for Immigration Reform. U.S Immigration Data, Projections and Graphs. Retrieved: October 2, 2008. http://www.cairco.org/data/data_us.html
3. Flores, Glen., Abreu, Milagros., Schwartz, Ilan., and Schwartz, MD, and Hill, Maria. (2000). The importance of language and culture in pediatric care: Case studies from the Latino community. The Journal of Pediatrics. 137 (6): 842-848
4. Flores G. Language Barriers to Health Care in the United States. NEJM 2006; 355:229-23
5. Flores G., M.B. Laws., S.J. Mayo., B. Zuckerman., M. Abreu., L. Medina and E. J. Hardt. 2003. Errors in clinical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics 111: 6- 14
6. Baker, David W., Hayes, Risa., and Puebla Julia. 1998. Interpreter Use and Satisfaction with Interpersonal Aspects of Care for Spanish-Speaking Patients. Medical Care. 36(10):1461-1470 
7. Seijo, R., H. Gomez and J Frienderber. 1995. Language as a communication barrier in medical care for Hispanic patients. In. Hispanic Psychology_Critical issues in theory and research, edited by A.M. Padilla, 169-181. Thousand Oaks,Ca: Sage.
8. Hampers, L. C and., McNulthy, J.E. 2002. Professional Interpreters and Bilingual Physicians in a Pediatric Emergency Department. Arch Pediatr Adolesc Med. 156:1108-1113.
9. Suzan S. Mazo., Louis C. Hampers., Vidya T. Chande. Steven E. Krug. (2002).Teaching Spanish to Pediatric Emergency Physicians: Effects on Patient Satisfaction. Arch Pediatr Adolesc Med 156: 693-695

Course in Medical Spanish customized for pediatric care providers. Once a week for 12 weeks (2 hour class), includes also 6 month internet access to “Spanish for health care course”. Flexible schedule to accommodate participants’ preferences; Classes take place at the providers’ office for groups of 8-12 students.
$ 389 dollars per student. Includes 6 month internet access to the on line training course.
          Contact: Abe Grinberg MD (720) 748-7669.
          abe@bilingualmed.com my web-site www.bilingualmed.com

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Postpartum Depression Screening For Mothers
And Training For Your Practice

Postpartum Depression is a significant public health issue affecting 1 out of 8 new mothers. In Colorado, it is underidentified and undertreated. The Rose Community Foundation has funded Dr. Brian Stafford and The Kempe Center¹s Postpartum Depression Intervention Program to provide Free Medical Education and On-Site assistance to practices in the Denver Metropolitan area in order to assist their identification, education, treatment, and referral for women with this condition. Practices will receive a free talk as well as a free tool kit and fliers and brochures to assist them. This provider education is paired with a public awareness campaign on this issue titled, 'Oh baby, this isn¹t what I expected.' Interested practices or practitioners should contact the Kempe Center at 303-864- 5845 or Dr. Brian Stafford at tafford.brian@tchden.org to schedule the on-site pre-clinic or lunchtime training.

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Child Psychiatrist Available to Provide Conferences for You In your Office

Rick March, MD is a child psychiatrist at the Mental Health Center of Denver.  He is available to provide teaching on a variety of child Psychiatry topics (below) in your office.  He is also willing to discuss cases with you, as well.  Please contact him to take advantage of this wonderful opportunity.
He can be reached at Rick.March@MHCD.org

Here are some of the topics he can cover for you.

• Diagnosing Depression in Children and Adolescents
• SSRI’s and Black Box warnings
• Suicide and self-abuse
• Diagnosing Bipolar Disorder in Children and Adolescents (including differential diagnosis)
• Atypical Antipsychotics
• Mood Stabilizers and Antidepressants
• Pediatric Psychopharmacology and the FDA
• Kids with ADHD who don't get better on stimulant medication
• Psychosis in Children and Adolescents

And, remember there is a child psychiatrist on call available by phone for your Medicaid children…..

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The Cross-cultural Curriculum for the Department of Pediatrics
The syllabus is now available for you and your practice

There is a syllabus available on the CCHAP web site that covers a variety of topics related to cross cultural health care.   Click Here to view the entire curriculum or visit www.cchap.org/cchc- syllabus/. The following topics are covered:

Demographics of Colorado’s Children

Health Disparities among Colorado’s Children

Health Disparities
              Poverty
              Genetics 
              Environmental exposures 
              Life style behaviors 
              Provider’s ability to understand/accommodate the patient’s / parent’s culture
              Provider’s ability to communicate well with families
              Patient’s / parents limited English proficiency
              Patient’s / parent’s limited health literacy 
              Disimination

What can Providers do to improve outcomes?

Race, Ethnicity and Culture (Definitions)

Cross-cultural Communication 
              Generalization versus stereotyping 
              What providers need to know about culture? (Dimensions of culture) 
              Basics of cross-cultural communication

How to communicate with and help families with Limited English Proficiency

How to communicate with and help families with Limited Health Literacy

The Cross-cultural Health Care toolkit 
              Keys to success in cross-cultural communication 
              LEARN mnemonic 
              Cross-cultural health care Review of Systems

Case Studies

Examining our Own Personal Biases

8 Steps You Can Take to Enhance Your Skills in Cross-cultural Health Care

The Institute of Medicine’s Guidelines

The CLAS Standards (Guidelines for organizational change)
  
References

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Child Psychiatry Telephone Consultation on Medicaid Children

The Behavioral Health Organizations and the Mental Health Centers in the greater metro area have very generously made available telephone consultation by child psychiatriststo help providers in CCHAP – affiliated practices manage their  Medicaid children with complicated mental health issues or complicated medication regimens.   These child psychiatrists are also willing to come visit your practice to get to know you and even to discuss cases.   We are very grateful for this very generous support for your Medicaid children.

Denver County – Rick March, MD – 303-504-1520
Jefferson County – Don Bechtold, MD – 303-432- 5172
Adams, Arapaho and Douglas Counties - Joe Pastor, MD – 303-853-3888
 

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Integrating Developmental Screening
Into a Pediatric Practice

• The Colorado Assuring Better Child Health & Development (ABCD) project has received a three year grant to provide training and technical assistance to providers to implement a “validated” developmental screening tool at well child visits for infants/toddlers birth to five.
• The ABCD project is partnering with CCHAP to provide training and support to pediatric practices to implement developmental screening.
• Medicaid will reimburse $34.00 to providers if you use a standardized, validated developmental screening test at an EPSDT visit.
• The Colorado Chapter of the AAP supports the ABCD project.
• Early detection and intervention improves outcomes.  Many delays in children’s development are missed in the first 4-5 years of life without a standardized, validated screening test. 
• The most time-efficient tool is one in which the parent completes a questionnaire.
• To comply with 2010 recertification guidelines by the American Board of Pediatrics, documentation will be required to show levels of involvement in practice improvement initiatives. By implementing the use of a “validated” developmental screening with a sensitivity and specificity rating of 70% or greater like the ASQ or PEDS, practices are taking steps to integrate quality improvement into their practices.
• What providers are saying about implementing either the ASQ or the PEDS parent questionnaire developmental screening tools:
  •  
    • It takes 1-2 minutes for an MA, LPN or RN to score.
    • It takes less than a minute of the provider’s time if the MA, LPN or RN scores the questionnaire.
    • In many instances, it reduces the length of the visit.
    • It helps providers concentrate on the concerns/priorities of the parents.
    • It reduces the number of concerns that come up as you are walking out the door at a well care visit.
    • It improves patient satisfaction.
    • It promotes positive parenting practices.
    • It increases provider confidence in decision-making for when to refer a child for further developmental evaluation.
• Eileen Auer Bennett, the Colorado State ABCD Coordinator and her team are available to assist providers in getting started. Training and technical assistance will be provided to practices to implement a standardized tool such as the ASQ or PEDS. Support will also be given to office staff on how to incorporate a standardized developmental screening tool into the current office work flow.

For more information, please contact:
            Eileen Auer Bennett
            720-333-1351
            ileanben@yahoo.com

The Ages & Stages Questionnaire (ASQ) is a well respected screening tool.  It has the best sensitivity and specificity.  It is standardized across various common minorities.   Health care providers have identified the following advantages:

• Parent completed—Parents are partners in their child’s
  assessment and intervention activities.
• Serves as a talking guide with parents identifying a
  child’s strengths as well as things the child is not
  doing yet.
• Practical—Scoring takes 1-2 minutes and can be done
  by paraprofessionals.
• Cost-efficient—May be photocopied repeatedly.
• Scoring is simple—Only three responses:
  1. Sometimes, occasional or emerging response from
     child = 5 points
  2. Yes, child performs specified behavior = 10 points
  3. Not Yet = 0 points
• If the child’s total score falls in a shaded area of the bar
  graph for any developmental area, further diagnostic
  assessment is recommended.

• Developed out of four cross-validation studies on a
  nationally representative sample of families.
• Uses parent concerns or judgments about the child’s
  development and behavioral status.
• Easy to score—two minutes to elicit and interpret.
• Enables health care providers to determine the need to
  refer and where.

Visit www.pedstest.comto view and order the PEDS tool online.

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Spanish Interpretation Training for Pediatric Practices

An assessment of each individual’s skill level will be done during a 5-10 minute phone call prior to first telephone conference/class.  Maria will contact you to schedule this initial individual telephone call upon receipt of your registration email.  A certificate of completion will be given after completion of all 6 sessions. The faculty is Maria Soto, a certified Spanish interpreter and trainer with International Language Services.

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Copyright 2009 Colorado Children's Healthcare Access Program and other entities as noted.

 CCHAP Home > Newsletter Articles > Newsletter Thirty, September 2009