Promoting routine use of developmental and autism-specific screening tools by pediatric primary care clinicians.

INTRODUCTION: In 2006, the American Academy of Pediatrics published a policy statement recommending routine developmental screening for all children. Most clinicians at that time were using informal methods to monitor child development. METHODS: Outreach to Wisconsin primary care clinicians designed to promote use of validated developmental screening tools began in 2006. A survey of 157 Wisconsin primary care clinicians was conducted in late 2012 to assess routine use of developmental and autism-specific tools. RESULTS: As compared with a similar survey conducted in 2007, where only 25% of clinicians reported use of a validated developmental screening tool, over 55% of clinicians in this survey reported routine use of validated developmental and autism-specific screening tools within well-child care. CONCLUSION: Outreach to clinicians and their care teams, in conjunction with policy statements from national professional organizations and supporting evidence, can contribute to quality improvement in well-child care delivery.

Wisconsin Birth Defects Registry collecting data.

Wisconsin Statute 253.12 was enacted in May 2000 to create the Wisconsin Birth Defects Registry (WBDR), replacing the Birth and Developmental Outcome Monitoring Program, a previous birth defects and developmental disabilities reporting system initiated in 1989. In the summer of 2004, the new registry began collecting demographic, diagnostic, and identifying information for children from birth to 2 years of age who are born with reportable birth defects and/or are receiving health care services for them in Wisconsin. This article describes the development of the registry and outlines expectations for reporting of birth defects.

Wisconsin Medical Home Learning Collaborative: a model for implementing practice change.

A child with special health care needs is defined as having, or are at increased risk for, a chronic physical, developmental, behavioral, or emotional condition that requires health and related services of a type or amount beyond that required by children generally. In Wisconsin nearly 14% of children are identified as having or being at risk for special health care needs. Healthy People 2010 and the federal Child Health Maternal Bureau have challenged each state to "assure access to ongoing comprehensive health care through a medical home" for all children with special health care needs. A medical home is defined as "an approach to providing continuous and comprehensive primary pediatric care." States are challenged to translate the concepts of medical home to clinical practice activities. This article discusses Wisconsin's participation in a national Medical Home Learning Collaborative and Wisconsin's replication of the Collaborative as a means to develop practical strategies for practice implementation of a medical home.

Voluntary progress toward universal newborn hearing screening.

OBJECTIVES: This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs. METHODS: The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database. RESULTS: Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program. CONCLUSIONS: A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.