Pediatrics

E-mail: chuck.norlin@hsc.utah.edu
Address: SOM Rm 2A244
Phone: 581-5239

Analysis of Well Child Care Delivery

Providing high quality preventive and health maintenance care (well child care or WCC) to children presents substantial challenges to physicians because the number of recommended elements of care far exceed the time usually available.  Little is known about how physicians prioritize which elements of care to deliver to which patients or the outcomes of that care in terms of physician satisfaction, parent/patient satisfaction, or patient outcomes.  New recommendations for WCC have recently been published, as have several expert opinions recommending changes in how well child care is organized and delivered.  If physicians are to successfully improve their approach to WCC, changes will be required in their knowledge, office systems, and parent/patient expectations.  Understanding current delivery of WCC and how office systems (e.g., forms, protocols, trained staff, billing mechanisms, etc.) support that care is needed to guide development of methodologies for effecting improvement. 

We propose to study the delivery of WCC by Utah pediatricians and family physicians through direct observation of and feedback from physicians.  The student(s) will spend 1 or 2 days with each of 10-15 primary care physicians, observing all well child care visits, recording the elements of care provided, estimating the time spent on each element, noting the office systems that supported the delivery of each element, and obtaining physician input on their prioritization of elements.  The data recording format will be based on the limited published literature and will be developed with the input of practicing physicians and office staff.  Analysis of the data will include evaluation of the proportion of recommended elements delivered, the reasons offered by physicians for their priorities among the recommended elements, and the relationship of elements delivered/not delivered with the existence of supporting office systems. 

In order to optimize the variety of physicians observed and the amount of data available for analysis, it would be ideal to have two students participating for the summer.  If only one participates, we may need to extend the study into the academic year, hopefully involving a senior student for a pediatric research project.

12/2008