OBJECTIVES: Major gaps exist between usual clinical practice and evidence-based recommendations for care. Many interventions to improve care are costly and time intensive. This study sought to determine whether a clinician's self-assessment of their practice performance for the diagnosis and management of children with attention deficit hyperactivity disorder (ADHD) followed by attendance at a 2-day conference focused on system change would result in improvement in care. DESIGN: Quasi-experimental-before and after with external controls. PARTICIPANTS: Clinician attendees compared with convenience sample of nonattendees. OUTCOMES: Consistency with 10 specific recommendations from the American Academy of Pediatrics Guidelines concerning ADHD. ANALYSIS: Logistic regression, with use of generalized estimating equations to account for clustering of subjects within clinician practices. RESULTS: Widespread deficiencies in care were present prior to the intervention. Practice improved significantly more among conference attendees in 2 of the 10 performance measures (evaluation for coexisting conditions and offering treatment options), with positive trends in most of the other indicators. CONCLUSIONS: Practice assessment and system-based training may be a cost-effective strategy to improve practice performance.
OBJECTIVES: Major gaps exist between usual clinical practice and evidence-based recommendations for care. Many interventions to improve care are costly and time intensive. This study sought to determine whether a clinician's self-assessment of their practice performance for the diagnosis and management of children with attention deficit hyperactivity disorder (ADHD) followed by attendance at a 2-day conference focused on system change would result in improvement in care. DESIGN: Quasi-experimental-before and after with external controls. PARTICIPANTS: Clinician attendees compared with convenience sample of nonattendees. OUTCOMES: Consistency with 10 specific recommendations from the American Academy of Pediatrics Guidelines concerning ADHD. ANALYSIS: Logistic regression, with use of generalized estimating equations to account for clustering of subjects within clinician practices. RESULTS: Widespread deficiencies in care were present prior to the intervention. Practice improved significantly more among conference attendees in 2 of the 10 performance measures (evaluation for coexisting conditions and offering treatment options), with positive trends in most of the other indicators. CONCLUSIONS: Practice assessment and system-based training may be a cost-effective strategy to improve practice performance.
Authors: David J Kolko; Jonathan A Hart; John Campo; Dara Sakolsky; Jeffrey Rounds; Mark L Wolraich; Stephen R Wisniewski Journal: Clin Pediatr (Phila) Date: 2020-07 Impact factor: 1.168
Authors: Alexander G Fiks; Stephanie L Mayne; Jeremy J Michel; Jeffrey Miller; Manju Abraham; Andrew Suh; Abbas F Jawad; James P Guevara; Robert W Grundmeier; Nathan J Blum; Thomas J Power Journal: J Dev Behav Pediatr Date: 2017-10 Impact factor: 2.225
Authors: Lucy McGoron; Raymond Sturner; Barbara Howard; Tammy D Barry; Karen Seymour; Theodore S Tomeny; Tanya M Morrel; Brandi M Ellis; Danielle Marks Journal: Clin Pediatr (Phila) Date: 2014-09 Impact factor: 1.168
Authors: Melanie A Barwick; Howard M Schachter; Lindsay M Bennett; Jessie McGowan; Mylan Ly; Angela Wilson; Kathryn Bennett; Don H Buchanan; Dean Fergusson; Ian Manion Journal: J Evid Based Soc Work Date: 2012
Authors: Tycho J Dekkers; Annabeth P Groenman; Lisa Wessels; Hanna Kovshoff; Pieter J Hoekstra; Barbara J van den Hoofdakker Journal: Eur Child Adolesc Psychiatry Date: 2021-02-14 Impact factor: 4.785