BACKGROUND AND OBJECTIVE: Poverty is a risk factor for both language delay and failure to access appropriate therapies. The objective of this study was to increase the percentage of children 0 to 3 years old referred from an urban primary care center who attended an initial appointment with speech pathology or audiology within 60 days from 40% to 60%. METHODS: The Model for Improvement was used to develop and test the intervention, which addressed potential logistical barriers faced by low-income families. Adherence was plotted on run charts in time series to assess overall improvement, and subgroups were analyzed to identify reduction in disparities. RESULTS: Median referral adherence improved from 40% to 60%. Families from lower income neighborhoods had lower preintervention adherence; these differences were eliminated postintervention. CONCLUSIONS: System-level changes improved access to evaluation and treatment for low-income children with language delay and narrowed the gap in access between families in lower versus higher income neighborhoods.
BACKGROUND AND OBJECTIVE: Poverty is a risk factor for both language delay and failure to access appropriate therapies. The objective of this study was to increase the percentage of children 0 to 3 years old referred from an urban primary care center who attended an initial appointment with speech pathology or audiology within 60 days from 40% to 60%. METHODS: The Model for Improvement was used to develop and test the intervention, which addressed potential logistical barriers faced by low-income families. Adherence was plotted on run charts in time series to assess overall improvement, and subgroups were analyzed to identify reduction in disparities. RESULTS: Median referral adherence improved from 40% to 60%. Families from lower income neighborhoods had lower preintervention adherence; these differences were eliminated postintervention. CONCLUSIONS: System-level changes improved access to evaluation and treatment for low-income children with language delay and narrowed the gap in access between families in lower versus higher income neighborhoods.
Authors: Rebecca F Slykerman; John M D Thompson; Phillipa M Clark; David M O Becroft; Elizabeth Robinson; Jan E Pryor; Chris J Wild; Edwin A Mitchell Journal: Paediatr Perinat Epidemiol Date: 2007-03 Impact factor: 3.980
Authors: Manuel E Jimenez; Frances K Barg; James P Guevara; Marsha Gerdes; Alexander G Fiks Journal: Acad Pediatr Date: 2012 Nov-Dec Impact factor: 3.107
Authors: Jeanne Van Cleave; Karen A Kuhlthau; Sheila Bloom; Paul W Newacheck; Alixandra A Nozzolillo; Charles J Homer; James M Perrin Journal: Acad Pediatr Date: 2012-05-08 Impact factor: 3.107