Implementation of Standardized Autism Screenings and Referral Process in a Primary Care Clinic

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Martin, Cyilee
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2023-05-11
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Austism, Screenings, Referrals
Research Projects
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Title: Implementation of Standardized Autism Screening and Referral Process in a Primary Care Setting Purpose Statement: The purpose of this quality improvement project was to increase the number of screenings for Autism Spectrum Disorder (ASD) and referrals to early intervention diagnostic clinics for children ages 18-24 months in a primary care setting over a period of three months. The specific aims are to determine if providing an educational session and implementing the use of a standard Autism Screening tool, the MCHAT R/F will increase provider knowledge of ASD and the standardized screening process and increase the number of children who are screened using the MCHAT R/F between 18-24 months of age. Background: The Center for Disease Control and Prevention (CDC) reported data from 2018 estimating 1 in 44 children were diagnosed with ASD in the United States (2020a). According to Autism Speaks Inc. (2021), approximately 40% of individuals with autism are non-verbal and over 30% have an intellectual disability with substantial effects on daily function. While the number of children being diagnosed is increasing, missed diagnoses and late diagnoses in the clinic setting continue to be problematic. On average, children are diagnosed between ages four and five, but the diagnosis can be achieved before the age of two. Late diagnosis can lead to underdeveloped learning, speech, or social skills caused by lack of early interventions (Amen, 2021). Practice change and implementation guidelines: To increase the number of MCHAT screenings and referrals completed at Myrtue Medical Center, a “smart phrase” was created and entered into epic to allow providers easy access to the screening that could be entered into the electronic medical record (EMR). Education was presented to all clinical staff at the nurse staff meeting and the providers staff meeting through an educational oral presentation by the DNP student. A laminated infographic was given to each provider and nurse that included diagnosis codes for screenings, an MCHAT “dot phrase”, symptoms to look for, and a list of local diagnostic clinics with contact information included. Evaluation: A retrospective chart review was completed to determine what percent of ASD screenings, referrals, and diagnostic codes had been completed for 18- and 24-month well-child appointments during the 3 months prior to implementation of the quality improvement project. The project has not yet been completed, but at its completion, a similar chart review will be performed on the months the quality improvement was being implemented. Those numbers will be compared with the percent of screenings and referrals made as well as the number of people who provided diagnosis codes for screening following the project’s completion. Conclusion and implications for practice: The project is currently in process and final data will not be collected until December 2022. The anticipated outcome is that through education of health care personnel and providing helpful resources, there will be an increase in the number of screenings performed and referrals for diagnosis and early intervention. References Amen, D. (2021, October 18). What happens when people with Autism go untreated? Retrieved from https://www.amenclinics.com/blog/what-happens-when-people- with-autism-go-untreated Autism Speaks Inc. (2021). Autism statistics and facts. Autism Speaks. Retrieved, from https://www.autismspeaks.org/autism-statistics-asd Centers for Disease Control and Prevention. (2020a, February 11). Screening and diagnosis of Autism Spectrum Disorder for healthcare providers. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/ncbddd/autism/hcp- screening.html
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
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