Suzanne Friedman1, Bianca Calderon2, Amanda Gonzalez3, Caitlyn Suruki4, Ashley Blanchard5, Erin Cahill3, Kristen Kester5, Martha Muna6, Erin Elbel7, Priya Purushothaman8, M Christine Krause9, Dodi Meyer9. 1. Department of Pediatrics, Columbia University Irving Medical Center, 622 W168th St. VC4-417, New York, NY, 10032, USA. Sf2723@cumc.columbia.edu. 2. Department of Pediatrics, Albert Einstein College of Medicine, New York, USA. 3. Department of Pediatrics, NewYork Presbyterian-Columbia University Pediatric Residency Program, New York, USA. 4. Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, USA. 5. Department of Emergency Medicine, Columbia University Irving Medical Center, New York, USA. 6. Department of Pediatrics, University of California San Francisco, Berkeley, USA. 7. Department of Medicine, Boston Children's Hospital, Boston, USA. 8. Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. 9. Department of Pediatrics, Columbia University Irving Medical Center, 622 W168th St. VC4-417, New York, NY, 10032, USA.
Abstract
OBJECTIVES: Multiple barriers exist to delivering efficient, effective well child care, especially in low-income, immigrant communities. Practice redesign strategies, including group well child care, have shown promise in improving care delivery and healthcare outcomes. To assess the feasibility of a group well child care program at multiple urban, academic practices caring for underserved, mostly immigrant children, and to evaluate health outcomes and process measures compared to traditional care. METHODS: Prospective, intervention control study with participants recruited to group well child care visits or traditional visits during the first year of life. A culturally sensitive curriculum was designed based on American Academy of Pediatrics (AAP) recommendations. Process and health outcomes were analyzed via patient surveys and medical record information. RESULTS: One hundred and one families enrolled in group care and 74 in traditional care. Group care participants had higher rates of all recommended postpartum depression screening and domestic violence screening (65% vs 37%, 38% vs 17% respectively), higher anticipatory guidance retention (67% vs 37%) and higher patient satisfaction with their provider. The group care redesign did not increase length of time spent in clinic. CONCLUSIONS FOR PRACTICE: Group well child care is a feasible method for practice redesign, which allows for increased psychosocial screening and anticipatory guidance delivery and retention compared to traditional visits, for low income, predominantly immigrant families. Parental satisfaction with group care is higher and these visits provide greater face-to-face time with the provider, without increasing time spent in the practice.
OBJECTIVES: Multiple barriers exist to delivering efficient, effective well child care, especially in low-income, immigrant communities. Practice redesign strategies, including group well child care, have shown promise in improving care delivery and healthcare outcomes. To assess the feasibility of a group well child care program at multiple urban, academic practices caring for underserved, mostly immigrant children, and to evaluate health outcomes and process measures compared to traditional care. METHODS: Prospective, intervention control study with participants recruited to group well child care visits or traditional visits during the first year of life. A culturally sensitive curriculum was designed based on American Academy of Pediatrics (AAP) recommendations. Process and health outcomes were analyzed via patient surveys and medical record information. RESULTS: One hundred and one families enrolled in group care and 74 in traditional care. Group care participants had higher rates of all recommended postpartum depression screening and domestic violence screening (65% vs 37%, 38% vs 17% respectively), higher anticipatory guidance retention (67% vs 37%) and higher patient satisfaction with their provider. The group care redesign did not increase length of time spent in clinic. CONCLUSIONS FOR PRACTICE: Group well child care is a feasible method for practice redesign, which allows for increased psychosocial screening and anticipatory guidance delivery and retention compared to traditional visits, for low income, predominantly immigrant families. Parental satisfaction with group care is higher and these visits provide greater face-to-face time with the provider, without increasing time spent in the practice.
Authors: Marjorie S Rosenthal; Carole M Lannon; Jayne M Stuart; Laura Brown; William C Miller; Peter A Margolis Journal: Arch Pediatr Adolesc Med Date: 2005-05
Authors: Thomas R Konrad; Carol L Link; Rebecca J Shackelton; Lisa D Marceau; Olaf von dem Knesebeck; Johannes Siegrist; Sara Arber; Ann Adams; John B McKinlay Journal: Med Care Date: 2010-02 Impact factor: 2.983