Article of Interest

Can't go to sleep just yet so I clipped the following from various lists (and
now I'm getting sleepy....) Hope they're useful. I'm curious whether anyone
expects Bright Futures to make any impact on daily pediatric practice.

1. Bright Futures Health Promotion
2. Pediatrics article on quality in pediatric care
3. Cite for article on pain management websites

DISTANCE LEARNING TOOL PROVIDES STRATEGIES FOR HEALTH PROMOTION IN PEDIATRICS

Pediatrics in Practice, an online professional development curriculum,
provides educators and clinicians with innovative strategies for enhancing health
care encounters with children and families. The Bright Futures Health Promotion
Workgroup, a national expert panel comprising pediatricians, clinician
educators, nurses, and parents, developed the curriculum with support from the
Maternal and Child Health Bureau. The curriculum consists of six modules that cover
the following topics: partnership, communication, health promotion, time
management, education, and advocacy. A facilitator's guide provides an overview of
teaching strategies and instruction on how to implement them. A PDF file
library, community resources, and other educational resources are also included.
The curriculum is intended to help educators and clinicians effectively
integrate health promotion into pediatric training and practice. The curriculum is
available at http://www.pediatricsinpractice.org.

Readers: More information about Bright Futures is available at
http://www.brightfutures.org.

QUALITY IMPROVEMENT AND PEDIATRIC PRACTICE MANAGEMENT

"It is critically important that providers, health care organizations,
hospitals, and physicians, be able to document convincingly the quality of their
services in an increasingly competitive marketplace," state the authors of an
article published in the November 2003 issue of Pediatrics. The purposes of this
article are to (1) raise awareness of how important it is for pediatricians to
document the value of the care they provide, (2) offer examples of published
studies in this area, (3) discuss measures of quality and initiatives to
improve the quality of pediatric care, and (4) encourage pediatricians to be
proactive with clients and payers in designing and choosing health care plans.

Value of Pediatric Preventive Services
To date, a small but growing number of studies have been published in
peer-reviewed journals on the value of immunizations, anticipatory guidance and
periodic preventive care visits, continuity of care in a medical home, and
secondary preventive services for children with chronic illness (e.g., asthma).
However, several studies have also indicated that pediatricians are not adhering to
evidence-based guidelines, and others have identified gaps in preventive
health care, medication errors, and long wait times for primary care appointments.
Payers are now monitoring the quality of primary preventive practices much
more closely and are basing contracting decisions on documented evidence of
high-quality care. The authors suggest that pediatricians be diligent in
documenting the value of their services by measuring and publishing outcome data.

Measures of Quality
Employers and federal and state governments use a variety of quality measures
to assess insurers, health care systems, and health professionals. Measures
include the Health Employer Data Information Set, the Consumer Assessment of
Health Plans Survey, the Child and Adolescent Health Measurement Initiative, and
the "quality dividend calculator" developed by the National Committee on
Quality Assurance. The authors assert that it is important for pediatricians to be
aware of measures that are used and of how they are used. Information about
these and other measures can be found in the Agency for Healthcare Research and
Quality Child Health Toolbox at http://www.ahrq.gov/chtoolbx.

Initiatives to Support Quality
The American Academy of Pediatrics (AAP) and the National Institute for
Children's Healthcare Quality (NICHQ) have partnered to develop programs to help
pediatricians improve the care they provide. For example, NICHQ has developed
toolkits to help pediatricians understand and follow guidelines for the
diagnosis and treatment of attention deficit hyperactivity disorder (see
http://www.nichq.org/resources/toolkit). AAP has made these tools available through an
online learning program called Education in Quality Improvement for Pediatric
Practice (see http://eqipp.purplemonkey.com/global/module_overview_prelog.cfm).
The authors note that insurers have provided financial incentives to groups of
pediatricians who successfully complete these online courses.

"To meet the current health care challenges," the authors conclude,
"pediatricians must (1) increase efforts that document the value of well-child and
CSHCN [children with special health care needs] pediatric services; (2) become
more involved in implementing quality-improvement methods into their practices;
(3) develop better measures of clinical performance and outcomes of care; and
(4) promote the demonstrated value of pediatric services to payers, employers,
insurers, and state and federal government agencies."

McInerny TK, Meurer JR, Lannon C. 2003. Incorporating quality improvement
into pediatric practice management. Pediatrics 112(5):1163-1165.

>From Medscape

Evaluation of Web Sites on Management of Pain in Children
Learn about the best web sites for parents of children with pain.
Pain Manag Nurs 4(3) 2003