The ASHEW leanring collaborative engaged primary care practices to implement early relational health principles to screen, discuss, refer, and follow up for perinatal depression, social drivers of health, and social-emotional development. Read more about the key drivers, participants, results, and feedback highlights.


ASHEW Quality Improvement Learning Collabortive Key Drivers

AAP identified practice-level key drivers including:

  • Preparing practice environment for trauma- and resilience-informed care
  • Fostering and continually expanding referral networks
  • Utilizing family-centered, strength-based approaches
  • Establishing and maintaining effective systems to support assessment, primary care intervention, referral, and follow-up
  • Ensuring care is delivered to advance racial and ethnic equity

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ASHEW Quality Improvement Learning Collaborative Participants

AAP funded AAP chapters in seven states to engage 66 primary care practices to participate in the ASHEW quality improvement learning collaborative (QILC).

ASHEW Quality Improvement Learning Collaborative

Result Highlights

The ASHEW Quality Improvment Learning Collaborative's primary aim was to implement early relational health principles to screen, discuss, refer/link, and follow up for perinatal depression, social drivers of health (SDOH), and social-emotional development at 90% of well child checks ages 6 months to 5 years. Results indicated improvements in most measures, with implementation of SDOH screening showing the largest increase over time. Screening for perinatal depression started high and ended above the goal, whereas screening for social-emotional development started low and remained relatively low, suggesting a need for additional clinical education in this area. Screening results were discussed with the patient most of the time, but referrals/linkages for positive screens were less consistent—conceivably due to external barriers.

ASHEW Quality Improvement Learning Collaborative

Stakeholder Feedback

The ASHEW QILC included a variety of stakeholders including:

  • Chapter leadership teams
  • Health care providers
  • Health care team members
  • Practice QI teams
  • Family advisors

AAP engaged JBS International, Inc. to conduct an evaluation of the ASHEW learning collaborative project, including collecting quantitative and qualitative feedback from the various project stakeholders.

  • Overall, nearly 100% of health care provider respondents agreed or strongly agreed that they felt better able to address the SDOH-related needs of patients and their families through their participation in the ASHEW learning collaborative project.
  • Chapter leadership teams noted a foundational facilitator to chapter capacity is previous experience cultivating strong relationships with practices and teaching the main priorities of the ASHEW learning collaborative: screening, establishment/implementation of workflows, and QI.
  • Family Advisors reported provision of clear expectations and responsibilities (i.e., job description) are needed to support them within their roles.
  • The most reported practice changes contributed to participation in the ASHEW learning collaborative were implementation of a new screening tool (89%) and strengthened ongoing screening practices (86%).
  • Over half of practice QI teams (53%) anticipated continuing to financially support activities to address social health and early childhood wellness within their practice following completion of the ASHEW learning collaborative through Medicaid payments.

ASHEW Quality Improvement Learning Collaborative

Resources

Several resources were developed related to the ASHEW QILC work including:

“ASHEW did a great job with facilitating screening utilization and incorporating different aspects of SDOH.”—Participating Health Care Provider
Last Updated

07/05/2023

Source

American Academy of Pediatrics