Johns Hopkins Children’s Center experts participated in various sessions and presentations during the 2024 Pediatric Academic Societies Meeting. In this video, residents Erin Jarvis and Rachel Gilbert discuss their quality improvement project that focused on improving wait times for patients seen in their clinic, and referred to a local developmental center for autism evaluation.
Hi, my name is Rachel Gilbert. I'm a second year of pediatrics resident um at the Harriet Lane Clinic. And this year at the PAS conference, our group presented our quality improvement project that focused on improving wait times for patients seen in our clinic who have been referred to our local developmental center for an autism evaluation. And we know that for Children with developmental concerns and specifically concerns for autism access to early diagnosis and supportive services improves outcomes. Um However, there are still significant disparities among Children from minoritized racial and ethnic groups, which are often the primary patient population that we see in a resident continuity clinic. And we found that at the Harriet Lane, our patients had experienced similar challenges and often waited many, many months to be seen by a developmental pediatrician. And our aim is really to shorten the wait time by 50% from an initial positive and track screening to an evaluation by its developmental ped pediatrician over an 18 month period of time. And we did this by creating a referral pipeline from our clinic to our local developmental center by using a level two screening tool known as the rapid interactive screening test for autism and toddlers or the Rita T. And the Rita T incorporates nine semi structured play based tasks that evaluate different constructs such as joint attention or visual problem solving that are often delayed in young Children with autism. And it's a low cost tool um that can be easily implemented in a primary care setting. It takes about 10 minutes by a trained clinician. And as a level two screener, the Rita T has been shown to improve identification and wait times for Children with concerns for autism. Yet few have really studied it um in a resident continuity clinic setting and I'm Erin Jarvis. I'm a first year pediatrics resident. Our project took place in a resident continuity clinic which includes about 40 resident providers and serves our East Baltimore community. Um A few of our residents underwent a special training to administer the Rita T screener. And patients with a positive m chat screen were referred by their primary care provider for a Rita T evaluation within our continuity clinic. Those with a medium to a high risk score on the RI T were then referred to our local autism diagnostic center regarding takeaway results of this study um over an 18 month period of time using the Rita T screener shortened wait time by 60% from an average time of 45 weeks to 16 weeks overall. Our project showed that the Rita T can be easily implemented in a Resident continuity clinic. Um and it can overall improve wait times. We plan to focus our attention next on the variability in wait times as well as gather um data on time to autism specific services. We know that many of our families face transportation challenges and other barriers to accessible care. Um So we plan to formally elicit caregiver feedback on navigating the referral process with the ultimate goal of improving access to supportive services for families. We hope that this has been helpful in providing some information about our project and feel free to reach out with any questions that you might have.
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