Caring for Children With Developmental and Behavioral Disorders: Impact of a Developmental Outreach Clinic Within a Primary Care Setting

Abstract

To evaluate the impact of implementing a Developmental Outreach Clinic within a primary care practice, we implemented a Developmental Outreach Clinic that involved relocating 2 developmental pediatricians to a primary care practice for one half day per week to conduct developmental assessments and consultations on-site. This care model included co-location, sharing of: administrative booking process, electronic medical record messaging, and a charting system between the developmental pediatricians and the family physicians. To evaluate this clinic, a retrospective chart review cohort study was conducted. We compared patients who participated in the Developmental Outreach clinic with those who received standard care (i.e., pre-implementation, family physician referred to the hospital-affiliated developmental pediatrics clinic serving the same catchment). Health charts of all patients who were booked for a consultation with Developmental Pediatrics 23 months prior to the implementation of the Developmental Outreach Clinic and 23 months following were reviewed. Main outcome measures included changes in service usage (i.e., number of completed assessments/consultations, time from referral to consult) from pre- to post-clinic implementation. A greater number of non-Autism Spectrum Disorder (ASD) assessments/consultations were completed after implementation of the Developmental Outreach Clinic, with no change in the number of ASD assessments/consultations conducted pre- to post-implementation. The wait time from referral to first appointment was significantly lower for the post-compared to the pre-implementation cohort. A Developmental Outreach Clinic within a primary care practice may help improve access to developmental pediatricians through co-location, including sharing of administrative processes and an Electronic Medical Record. This represents a relatively low-cost way to reduce administrative inefficiencies while enabling specialists to support a greater number of families alongside family physicians.