Step 2: Form Your Screen Team and Maintain a Quality Improvement Approach

The Screen Team

So you’ve gotten a general consensus to implement developmental screening at your practice. Congratulations! But now what? It is time to put together a Screen Team. Practice change requires a team engaged in the process. The team should represent the different roles in the clinic, and is charged with initiating and evaluating screening implementation. The team is often led by the screening champion(s).

The Role of the Champion

Champions serve to encourage staff members to implement screening, provide feedback about the process and help make improvements as needed. During implementation, every part of the practice workflow is critical for sustainable success. Therefore, champions should represent the different parts of the practice: for example, someone from the front desk, someone from nursing, and someone from the physician level. When initiating screening at your practice, it is best to get buy-in starting from the top-down for the planning stage, and then from the bottom-up for the implementation stage. In other words, there needs to be both formal administrative leadership commitment as well as informal staff leadership commitment.

The Role of Each Team Member

For sustainable practice change, everyone must take on a small part of the process. Although roles vary based on how the flow will be implemented, here are some roles to consider when including each department in the process:

• Practice Administrator/Manager: Often a key link to a practice, the Practice Manager can give insight into feasibility/flow/personalities of the practice and facilitate next steps for screening

• Clerical: Front desk staff are the first people to interact with patients at the practice. Patients expect to fill out forms and wait during this time, making it an ideal place to feel out a developmental screen. The clerical staff thus needs to be included in all communications about developmental screening and seen as an integral part of the process. The reason for screening should be particularly driven home with clerical staff- they must handle a lot of paperwork, and it is helpful for them to understand the importance to the practice and the family of this additional form to their current flow.

• Assessment/Triage: The medical staff in charge of triage are typically the most ready to add screening to their typical flow, and are also expected to do the most. Therefore their buy-in and feedback is crucial to the success of the screen. Additionally, ongoing evaluation should attend to any issues that may arise in screening during triage, and feedback given to triage staff as soon as possible.

• Doctors/Providers: Doctors already review child development with parents when children come for a well-visit. Standardized screens provide richer clinical data to guide these conversations. 

Tips for Engagement

• Share benefits of developmental screening with the practice, including short-term (i.e. meeting national standards/practice goals) and long-term (impacting the life trajectories of young children)

• Make the case around local statistics in an area that you think would be compelling to the stakeholder- for example, what are the graduation rates like in your community? What percentage of children are served by Early Intervention compared to the number of children we know may have developmental delays?

• Many times clerical/registration staff are thrilled to feel like a valuable part of the team contributing to care- emphasize that!

• Offer Maintenance of Certification (MOC) opportunities for physicians and others

Included in this Step:

• Sample Staff Roles from the CDC regarding screening implementation
• Engagement Blockers