在繁忙的住院医师连续门诊中加强自闭症儿童的诊断随访和护理协调:利用电子健康记录。

IF 3.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL
Laleh Bahrami, Cara T Miller, Holly Miller, Kathryn L Carlson, Tori E Foster, Abhinaya Ganesh, David Johnson, Barron L Patterson, Jeffrey F Hine
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引用次数: 0

摘要

目的:高质量的初级保健诊所应为接受自闭症谱系障碍(ASD)新诊断的儿童提供明确的行动要点和重要的护理协调。遗憾的是,有相当一部分护理人员表示,他们的家庭诊所几乎没有提供诊断后支持,而初级保健提供者往往表示在提供这些支持方面缺乏培训和资源:我们实施了一套干预措施,以研究在一个繁忙、工作量大的居民连续性诊所中对 ASD 儿童后续护理的频率和质量的影响。这套干预措施包括护理协调调度路径和标准化临床模板(嵌入到电子健康记录(EHR)中),通过最佳实践建议和患者资源来指导医疗服务提供者:由于采取了这些干预措施,74% 的患者接受了针对 ASD 的随访,比基线提高了三倍多,大多数医疗服务提供者使用嵌入式电子病历模板来指导他们的就诊。医疗服务提供者还表示,该系统的可用性很高,有助于他们遵循 ASD 护理的最佳实践指南:通过明确的日程安排途径和新颖的电子病历模板,我们发现针对 ASD 的随访和 ASD 护理最佳实践的实施显著增加,这证明了一种新的培训流程,可让初级保健提供者参与诊断后护理的明确行动步骤,而无需依赖三级转诊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enhancing Diagnostic Follow-up and Care Coordination for Children with Autism in a Busy Resident Continuity Clinic: Leveraging the Electronic Health Record.

Purpose: A high-quality primary care clinic should provide clear action points and important care coordination for a child receiving a new diagnosis of autism spectrum disorder (ASD). Unfortunately, a substantial proportion of caregivers report little-to-no post-diagnosis support from their home clinics and primary care providers often report lack of training and resources in providing these supports.

Methods: We implemented an intervention package to investigate the impact on the frequency and quality of follow-up care for children with ASD in a busy, high-volume resident continuity clinic. The package consisted of a care coordination scheduling pathway and a standardized clinical template-embedded in the electronic health record (EHR)-that guided providers through best-practice recommendations and patient resources.

Results: As a result of these interventions, 74% of patients had ASD-specific follow-up, a more than threefold increase from baseline with a majority of providers using the EHR-embedded template to guide their visit. Providers also indicated a high degree of usability for the system and that it aided them in following best-practice guidelines for ASD care.

Conclusion: Through explicit scheduling pathways and a novel EHR template, we saw a significant increase in ASD-specific follow-up visits and implementation of best practices for ASD care, demonstrating a new process for training and engaging primary care providers in clear action steps for post-diagnostic care without having to rely on tertiary referrals.

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来源期刊
CiteScore
8.00
自引率
10.30%
发文量
433
期刊介绍: The Journal of Autism and Developmental Disorders seeks to advance theoretical and applied research as well as examine and evaluate clinical diagnoses and treatments for autism and related disabilities. JADD encourages research submissions on the causes of ASDs and related disorders, including genetic, immunological, and environmental factors; diagnosis and assessment tools (e.g., for early detection as well as behavioral and communications characteristics); and prevention and treatment options. Sample topics include: Social responsiveness in young children with autism Advances in diagnosing and reporting autism Omega-3 fatty acids to treat autism symptoms Parental and child adherence to behavioral and medical treatments for autism Increasing independent task completion by students with autism spectrum disorder Does laughter differ in children with autism? Predicting ASD diagnosis and social impairment in younger siblings of children with autism The effects of psychotropic and nonpsychotropic medication with adolescents and adults with ASD Increasing independence for individuals with ASDs Group interventions to promote social skills in school-aged children with ASDs Standard diagnostic measures for ASDs Substance abuse in adults with autism Differentiating between ADHD and autism symptoms Social competence and social skills training and interventions for children with ASDs Therapeutic horseback riding and social functioning in children with autism Authors and readers of the Journal of Autism and Developmental Disorders include sch olars, researchers, professionals, policy makers, and graduate students from a broad range of cross-disciplines, including developmental, clinical child, and school psychology; pediatrics; psychiatry; education; social work and counseling; speech, communication, and physical therapy; medicine and neuroscience; and public health.
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