The Pediatric Resident Help Me Grow Experience: Engaging Health Professionals. Help Me Grow National Forum, May 24, 2016

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Rudolf Willis
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1 The Pediatric Resident Help Me Grow Experience: Engaging Health Professionals Help Me Grow National Forum, May 24, 2016

2 Jill Kelly COMMUNITY OUTREACH COORDINATOR Chris Corry, LMSW CARE COORDINATOR Lorraine Cragan-Sullivan, LMSW, MA, NCC DEVELOPMENTAL SCREENING COORDINATOR Steven Ma, MD DEVELOPMENTAL-BEHAVIORAL PEDIATRIC FELLOW Matt McGee, MD FIRST YEAR PEDIATRIC RESIDENT Rob Winningham, MD FIRST YEAR PEDIATRIC RESIDENT

3 ICE BREAKER We challenge everyone to a guessing game of States!

4 STATE FACT Dog mushing is the official state sport.

5 ANSWER Dog mushing is the official state sport of Alaska. The Alaska Legislature adopted it in 1972.

6 STATE FACT This state is home to the hottest, driest place in the United States.

7 ANSWER Death Valley, California is recognized as the hottest, driest place in the United States. It isn't uncommon for the summer temperatures to reach more than 115 degrees.

8 STATE FACT This state is home to 90,000 miles of shoreline, more shoreline than three other states combined!

9 ANSWER Minnesota has 90,000 miles of shoreline, more than California, Florida, and Hawaii combined.

10 STATE FACT This state is home to the world s largest college campus.

11 ANSWER Berry College in Rome, Georgia has the world's largest college campus.

12 STATE FACT Between 1,000 and 1,200 items are found on the Metro every month.

13 ANSWER Although not a state, Washington DC s Metro is home to 1,000 to 1,2000 lost items each month.

14 STATE FACT The lady bug is this state s official bug.

15 ANSWER Delaware s official state bug is the Lady Bug.

16 STATE FACT A town in this state is home to the most crooked street in the world.

17 ANSWER Ripley's Believe It or Not has dubbed Burlington, Iowa s Snake Alley the most crooked street in the world.

18 STATE FACT This state is home to the tallest man ever recorded in history.

19 ANSWER The tallest man in documented medical history was Robert Pershing Wadlow from St. Louis, Missouri. He was 8 feet, 11.1 inches tall.

20 STATE FACT This state is home to the longest freshwater shoreline in the world.

21 ANSWER Michigan has the longest freshwater shoreline in the world.

22 STATE FACT This state is home to native Venus Fly traps.

23 ANSWER The Venus Fly-Trap is native to Hampstead, North Carolina.

24 STATE FACT This state is home to the one and only Jimmy Fallon, host of the Tonight Show.

25 ANSWER Although Jimmy Fallon was born in Long Island, NY, he grew up in Saugerties, NY.

26 STATE FACT This state is known for it s beautiful sweetgrass baskets.

27 ANSWER Sweetgrass basket making has been a part of the Mount Pleasant community in South Carolina for more than 300 years. Basket making is a traditional art form that has been passed on from generation to generation.

28 Experience the Help Me Grow SC Pediatric Residency Training Introduction to Help Me Grow Care Coordination Role Play Developmental Screening Role Play Summary Physician Feedback Question and Answer

29 Greenville Health System Pediatric Residency Advocacy Program Material in this Residency Training can be applied to other professionals: home visiting programs early care and education/child care nursing/nurse practitioner/physician asst. college students

31 Pediatric Residency Pre-Work with case scenarios Complete ASQ-3 and ASQ:SE based on case scenarios Investigate screenings in pediatric practice What screenings are completed? Who is completing screenings? When are screenings completed?

32 Pediatric Residency Case Studies

33 Case Scenario #1: Do Parents Know Best? At a well child visit, parents of a 2 year old boy express concern about his continued lack of speech after a history of repeated ear infections that resolved with placement of tubes at 19 months. They are seeking further intervention. Questions What is the role of parental concerns in the assessment of a child s development? What steps would you take next in your assessment of this child?

34 Case Scenario #2 The Accuracy of Subjective Impressions The mother of a 4 year old girl is seeking assistance because of her behavioral problems. She had started a new job and placed her daughter in day care but she has been expelled from there and her grandmother is now watching her. The girl has a limited vocabulary and mostly plays alone, but her mother s primary concern is her behavior. During the office visit the pediatrician noted the child s behavior was appropriate and recommended waiting until she started kindergarten to address the concerns. Questions What assumptions does the primary care provider make regarding this child s development? What effect do these assumptions have on the plan of care for this child?

35 Pediatric Residency Agenda Overview of Help Me Grow system Importance of Early Intervention and IDEA Care Coordination and Role Playing ACE s, Protective Factors, Developmental Surveillance Developmental Screening (ASQ-3, ASQ:SE, and MCHAT-R/F) Role Play and Debriefing Feedback/Questions

36 Pediatric Residency Learning Objectives Describe the purpose of Help Me Grow and accurately explain Help Me Grow to a family or colleague Discuss the importance and benefits of early identification and intervention; gain knowledge about the Individuals with Disabilities Education Act (IDEA) Discuss the importance of developmental surveillance and universal screening; gain knowledge about the Adverse Childhood Experiences (ACE s) and the protective factors Complete and review an ASQ-3 (a standardized developmental screening tool) and discuss the findings and implications with a parent or caregiver Demonstrate knowledge of the referral process and the care coordinator s role in assessing the needs of the family and helping them connect to community services and programs

37 Help Me Grow SC

38 What does Help Me Grow SC do?

39 HMG Information Shared with Residents HMG Assumptions Physician Care Pathway The Challenge

40 Early Intervention Information Shared with Residents Need for early intervention

Care Coordination Information Shared with

Referral received Prepare for initial contact

potential resources in area Contact parent

Parent s desired course of action Proceed with

41 Care Coordination Information Shared with Residents Care Coordination start to finish Referral received Prepare for initial contact Review medical record, if appropriate Research potential resources in area Contact parent (active listening) Parent s identified concerns Parent s desired course of action Proceed with identified plan Send correspondence to medical home IDEA Part C Part B

42 Care Coordination Role Play Pediatric Resident will have the opportunity to role play as a Help Me Grow PARENT calling a Care Coordinator

43 Care Coordination Role Play

44 Care Coordination Role Play Break into pairs Select role Parent Care Coordinator Enact Role Play Share with group

45 Developmental Screening Information Shared with Pediatric Residents Adverse Childhood Experiences Protective Factors Developmental Surveillance Child Development

46 Developmental Screening Information Shared with Pediatric Residents Screening Review Home Work Screenings completed, by whom, when Screening Tools used by HMG SC ASQ-3 Review their screening Explain scores, sharing results with parents, referral recommendations ASQ:SE Review their screening Explain scores, sharing results with parents, referral recommendations MCHAT-R/F Explain scores, follow-up screening, sharing results, referral recommendations When NOT to screen

47 ASQ-3 Results: Consider Child and Family in Context Questions to ask parents: Health and Biological Factors: Environmental Factors: Cultural Factors:

48 When NOT to Screen? If a child is diagnosed with an identified delay or disability AND connected to an appropriate developmental service

49 Physician Role Play Pediatric Resident will role play as a PHYSICIAN discussing concerns and HMG SC referral with parent

50 Pediatric Residency Bringing It All Together Review the referral process Review the developmental screening pathway Summarize Certificate Survey Monkey Feedback

51 The Help Me Grow Referral Process 1. Health care or service provider sends referral to HMG HMG staff contacts family Family utilizes resource(s) HMG followsup with family 2. Family calls HMG at HMG staff provides contact information for appropriate resources HMG notifies health care provider of assessment/ referral

The Help Me Grow Developmental Screening

indicates concern or parent identified a

al screening (available to age 5 ½) Family

(if consent provided) Family not ready for

52 The Help Me Grow Developmental Screening Pathway Family calls HMG at Family s HelpMeGrowSC.org Family completes an ASQ-3 and/or ASQ:SE online Screening indicates typical development and no parent concerns Screening indicates concern or parent identified a concern Letter and activities sent to parent Letter sent to Physician (if consent provided) Care Coordinator contacts parents to discuss readiness for referral to services Participate in on-going development al screening (available to age 5 ½) Family agrees to Care Coordination: assist family in connection, family/hmg contact MD if referrals needed, share information with MD (if consent provided) Family not ready for Care Coordination: rescreen in 1, 2, or 3 months, share information with MD (if consent provided)

53 In Conclusion Help Me Grow advances developmental promotion, early detection, and linkage to services HMG promotes healthy development for all children HMG promotes the protective factors AAP recommends routine developmental screening to ensure early identification of problems and linkage to the most effective early interventions NOTE: Children who already have an identified or diagnosed developmental disorder should already have case management services and should not be referred to Help Me Grow, unless they are NOT connected to a developmental, learning, or behavioral service

54 Thoughts From the Docs Dr. Steven Ma Developmental-Behavioral Pediatric Fellow Dr. Matt McGee Pediatric Resident

55 Feedback and Questions

Assuring Better Child Health and Development Initiative (ABCD)

Assuring Better Child Health and Development Initiative (ABCD) Presented by Jennifer May National Academy for State Health Policy Act Early Region X Summit Feb 4-5, 2010 Seattle, Washingon Supported by