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Putting Neuromotor Screening into Practice Project

Through a cooperative agreement with the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP) conducted a Quality Improvement and Innovation Networks (QuIIN) project based on the Neuromotor Screening clinical report and algorithm: Motor Delays: Early Identification and Evaluation. The Neuromotor Screening expert panel authored the clinical report and algorithm which was published in the June 2013 issue of Pediatrics.

Pediatricians often encounter children with delays of motor development in their clinical practices. Earlier identification of motor delays allows for timely referral for developmental interventions as well as diagnostic evaluations and treatment planning. Recommendations for practice made in the report include suggestions for formal developmental screening at the 9-, 18-, 30-, and 48-month well-child visits; approaches to the neurologic examination, with emphasis on the assessment of muscle tone; and initial diagnostic approaches for medical home providers. Use of diagnostic tests to evaluate children with motor delays is described and the importance of pursuing diagnostic tests while concurrently referring patients to early intervention programs is emphasized.

The QuIIN project followed the Institute for Healthcare Improvement (IHI) Web & Action model, incorporating educational Webinars with action plans and discussion/feedback by project participants. The objective of this project was to determine if physicians are able to follow the algorithm and whether the algorithm is helping them to accurately identify children with motor delay.

Teams
Fourteen clinical teams from the AAP Quality Improvement Innovation Network(s) participated in the Putting Neuromotor Screening Into Practice project. Click here to see a list of the clinical teams.

Project Background and Overview

Pre-Work Materials

QuIIN Pre-Project Survey

Review typical/atypical development comparisons videos available on the Pathways Foundation Web site

Quality Improvement Resources

QuIIN Project Activities: IHI Web & Action Model
Informational Recruitment Webinar: Putting Neuromotor Screening into Practice
Presenters: Paul Lipkin, MD, FAAP and Pat Heinrich, RN, MSN

Webinar 1: Clinical Report and Algorithm – Overview and Integration into Practice
Date/Time Wednesday, March 27, 2013 at 5:00 pm Central Time
Presenter: Garey Noritz, MD, FAAP
View the webinar slides

Action Period 1: March 28-May 1, 2013
Redesign your office flow to implement the neuromotor screening algorithm

Webinar 2: Neurological Exam and Related Tests
Date/Time: Monday, May 8, 2013 at 5:00 pm Central Time   
Presenter: Max Wiznitzer, MD, FAAP
View the webinar slides

Action Period 2: May 9-June 20, 2013
Preparation and performance of the neuromotor physical exam

Webinar 3: Patient Care if Motor Delay is Identified
Date/Time: Wednesday, June 27, 2013 at 11:00 am Central Time   
Presenter: Dipesh Navsaria, MD, FAAP
View the webinar slides

Action Period 3: June 28-August 9, 2013
Develop a system for referral and monitoring in the medical home

Follow-up Webinar (for final feedback on Action Period 3 and project overall)
Date/Time: Thursday, August 15, 2013 at 5:00 pm Central Time    
Facilitator: Pat Heinrich, RN, MSN
View the webinar slides

QuIIN Project Post-Survey

Putting Neuromotor Screening Into Practice Final Report


Acknowledgement
The development of the clinical report and algorithm that were tested as part of this project was funded by the American Academy of Pediatrics through the Public Health Program to Enhance the Health and Development of Infants and Children through a cooperative agreement (5U58DD000587) with the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities.

A special thanks to our Putting Neuromotor Screening Into Practice Expert Group Leaders
•    Paul H. Lipkin , MD, FAAP, Expert Group Chairperson
•    Ted R. Abernathy, MD, FAAP
•    Michelle Macias, MD, FAAP
•    Garey H. Noritz, MD, FAAP
•    Mark Swanson, MD, MPH, FAAP
•    Pat Henrich, RN, MSN, Quality Improvement Consultant
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