Optimizing Care for Children with Autism: The Role of the Military Primary Care Provider to Maintain Autism Services
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Enriquez, Erin M.
Purpose: The purpose of this quality improvement project was to increase PCP knowledge of the CARS-2 validated assessment tool, DSM-5 checklist, Autism Attestation form, and the current changes in the Autism Care Demonstration Act, subsequently increasing use of these forms with appropriate referrals to Applied Behavior Analysis (ABA) therapy. Background: Prior to the recent changes in Tricare’s Autism Care Demonstration, validated assessment tools were not required for referrals to ABA services. Historically, developmental pediatricians were tasked with diagnosing and referring patients with autism. After the new changes to Tricare’s Autism Care Demonstration were implemented, PCPs were left with new responsibilities and little to no training for completing the validated assessments. Sample/Setting: The sample included six pediatricians and two pediatric nurse practitioners who care for multiple patients with autism in a military pediatric primary care clinic. The setting was the Lackland pediatric clinic located in Wilford Hall Ambulatory Surgical Center on Lackland Air Force Base in San Antonio, Texas. Methods: This was a quality improvement project where pediatric providers were educated and surveyed, with data analyzed using the paired t-test. Results: Provider participation for the educational sessions was 100%, with provider knowledge increasing by 37.3% between pre- and post-implementation. ABA referrals were appropriately placed 100% of the time, with two CARS-2 validated assessment tools completed. Conclusion: There is a need for provider education for new practice changes when they take place. It is key for providers to stay up to date with best practice, along with preventing delays in a patient’s healthcare. Even with several study limitations, a significant increase in provider knowledge after education and training was provided can be achieved.
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