Assisting Primary Care Practices in Using Office Systems to Promote Early Childhood Development

ObjectiveThe aim of this study was to use family-centered measures to estimate the effect of a collaborative quality improvement program designed to help practices implement systems to promote early childhood development services.MethodsA cohort study was conducted in pediatric and family practices in Vermont and North Carolina. Eighteen collaborative education practices and 17 comparison practices participated in a 12-month program to assist practices in implementing improved systems to provide anticipatory guidance and parental education. The main outcome measures were change over time in parent-reported measures of whether children received each of 4 aspects of recommended care, documentation of developmental and psychosocial screening, and practice-reported care delivery systems.ResultsThe number of care delivery systems increased from a mean of 12.9 to 19.4 of 27 in collaborative practices and remained the same in comparison practices (P = .0002). The proportion of children with documented developmental and psychosocial screening among intervention practices increased from 78% to 88% (P < .001) and from 22% to 29% (P = .002), respectively. Compared with control practices, there was a trend toward improvement in the proportion of parents who reported receiving at least 3 of 4 areas of care.ConclusionThe learning collaborative was associated with an increase in the number of practice-based systems and tools designed to elicit and address parents’ concerns about their child's behavior and development and a modest improvement in parent-reported measures of the quality of care.