Below are summaries of the final project reports for the 2024 recipients of The Ergen Family Chair in Pediatric Outcomes Research Pilot Program.
Law Enforcement Involvement During Pediatric Emergency Department Encounters and Related Clinical Outcomes
Anna Abrams,MD, Assistant Professor, Department of Pediatrics, Section of Emergency Medicine
Clinical experience suggests that the presence of law enforcement officers (LEOs) at the time of emergency department (ED) encounters can significantly affect the care patients receive and, potentially, patient outcomes. The prevalence of LEOs in the emergency department and associated patient and encounter characteristics is unknown, and pediatrics perspective and context are lacking. This pilot study developed a novel electronic health record (EHR)-based algorithm to retrospectively identify and quantify the presence of LEOs during pediatric ED encounters and explored pediatric clinician perspectives about and experiences with LEO presence in the pediatric ED via in depth interviews. Dr. Abrams leveraged these pilot data in applying for next step funding and was awarded a 2.25-year AHRQ PEDSnet Scholars award to continue building on this work by testing the model at other sites and interviewing pediatric patients and families.
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Understanding the Role of Clinical Support Staff in Team-Based Vaccine Recommendations within Pediatric Primary Care
David M. Higgins, MD, MPH, MS, Fellow in the ACCORDS Primary Care Research Fellowship, Department of Pediatrics, Section of General Academic Pediatrics
Vaccines remain one of the most effective means of protecting children from numerous vaccine-preventable diseases, but many parents have concerns about their safety or effectiveness. Physicians have historically been the primary source of education and advice regarding vaccines, but research in many fields suggest that a team-based approach to preventive health care delivery may be superior to relying solely on the physician. This project aimed to explore the roles, barriers, and facilitators for all pediatric primary care team members to participate in delivering high-quality vaccine communication. The goal was to inform future interventions that engage not just clinicians but also medical assistants and front office staff in team-based vaccine promotion. Over the course of the grant, we conducted 174 direct observations of medical assistants (MAs) and front office staff and 24 semi-structured interviews of MAs and clinicians at two pediatric practices in the Denver metro area. Major accomplishments include identifying unique communication roles for non-clinician staff, characterizing barriers to team-wide vaccine messaging, and developing a preliminary framework for a team-based vaccine communication training intervention. Post-funding, the relationships built and knowledge gained will support sustained engagement with partners, with potential for long-term impact on pediatric vaccine delivery models. These data formed the basis for a Career Development Award submission that will be submitted in June to support 75% of Dr. Higgins’ time for research.
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Using process mapping to optimize the integration of child psychosocial screenings in primary care, and increase family linkages to behavioral and safety net services
Monica Perez-Jolles, PhD, Associate Professor, Department of Pediatrics, Section of General Academic Pediatrics
The high prevalence of mental health problems and social factors that negatively impact children’s health make it crucial to screen for psychosocial problems during well child visits. Even if screening occurs, however, the linkages to community services to address identified problems is frequently inadequate due to lack of effective systems to support this linkage. The CARELOOP Pilot was a collaborative effort between Denver Health, ACCORDS, and three Community-Based Organizations (CBOs) with the objective of understanding the pathways from psychosocial screenings at clinics to service referrals and strengthening the connection between clinics, caregivers and community partners in the primary care setting. Through four process service mapping sessions, valuable lessons were learned about the importance of communication and coordination across all groups.
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