Document Type
Manuscript
Submission Date
2025
Abstract
Introduction: Patients who qualify for NeoMed - the high-risk infant follow-up clinic at UVMMC - are at specifically greater risk of developmental delays. Therefore, they are indicated to have selective developmental screening at around 4 months of age and another screen in the first year of life. Early identification through timely screening allows Early Intervention (EI) services to be accessed as soon as possible for the best possible developmental outcomes. However, not all patients receive the proper screening, and by identifying the reasons why, the rate of proper developmental screening can be improved. Methods: We performed a chart review on all NeoMed patients born between 1/7/2022 and 10/17/2022 to assess the rates of developmental screening at different time intervals, Primary Care Pediatrician (PCP) contributions, and measures on EI referrals and connections. The review identified reasons for missed developmental screenings. Interviews were conducted with NeoMed and Neonatal Intensive Care Unit (NICU) staff, including nurses, social workers, providers, and PCPs to further identify the drivers for missed screenings, and to gain insight on the likelihood of success of proposed interventions. Results: 38% of patients were found not to have received proper follow-up by missing a developmental screening in the first 6 months of life, 2 within the first year, or both. Of the 38%, 33% were referred to EI but had no connection with EI documented. The main drivers for missed screenings included patients not attending NeoMed visits, issues within NeoMed workflow, and communication between NeoMed and PCP. These chart review findings were corroborated by interviews with NeoMed and NICU staff and PCPs. Discussion: By identifying the primary drivers for missed developmental screening we proposed interventions to increase screening rates and gained insight from NeoMed staff, NICU staff, and PCPs about the likelihood of the interventions’ success. Our recommended interventions included the NeoMed office requesting PCPs perform developmental screening at subsequent PCP office visits if a NeoMed visit was missed, and to document results in a consistent location. Conclusions: Given the results from chart review and interviews with inpatient and outpatient staff and providers, we have identified several drivers for missed developmental screenings and proposed interventions that could lead to the greatest increase in screening rates. Further conversations among EI coordinators and NeoMed staff will ensure the increased rates are beneficial through an improved referral process and closed loop communication to improve overall developmental outcomes.
Recommended Citation
Barker, Katie, "QI Project: Increasing Rates of Developmental Screenings for NeoMed Patients" (2025). Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects. 49.
https://scholarworks.uvm.edu/m4sp/49
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Presentation given at operations meeting with NICU and NeoMed staff to discuss proposed interventions
