Peer-reviewed article
Improving Referral Adherence in a Developmental/Behavioral Clinic: A Quality Improvement Initiative.
Rysdyk SE, Roberts JL ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A quality improvement project aimed to increase the proportion of children who completed intake after referral to a developmental and behavioral clinic. The team removed barriers to referral adherence, including changing intake to phone calls and increasing outreach to families. Completion rates rose from 57% to 85% within two months and stayed between 83% and 89% thereafter, with the biggest improvements in children under five.
Key points
- Referral completion rates increased from 57% to 85% within 2 months and remained between 83% and 89% for the rest of the study
- Referral completion for children younger than 5 rose from 45% to 75% or higher
- Completion rates did not vary by ethnicity, race, or insurance type
- 83% of patients who completed an initial intake followed through with an appointment at the Center
- Key interventions included phone-based intake, direct family outreach, enhanced education about services, and improved communication with referring providers
Limitations
The report does not describe the specific location or healthcare system where this work was conducted, limiting generalizability. The study lacks detail on the comparison group or control condition, making it difficult to attribute improvements solely to the interventions versus other factors.
Abstract
Introduction Multiple studies have noted significant rates of emotional and developmental concerns in children, coupled with inconsistent rates of engagement with related services. Such inconsistency can lead to a range of negative outcomes. Our project aimed to increase the number of children who completed the intake process following referral to the Child Development Center from 57% to 80% by the end of the second quarter of 2022. Methods The project team identified barriers to referral adherence and developed targeted interventions to address them. Plan-Do-Study-Act cycles included interventions such as moving the intake process to a phone call, direct outreach to families, enhancing education on Child Development Center services, and increasing communication with referring providers. We used control charts to assess the impact of interventions. Results Completed intakes increased from 57% to 85% within 2 months and remained between 83% and 89% for the rest of the study. Referral completion rates for children younger than 5 rose from 45% to 75% or higher. The referral completion rate did not vary by ethnicity, race, or insurance type. Although increased referral completion rate led to increased wait times for appointments, 83% of patients who completed an initial intake followed through with an appointment at the Center. Conclusions We used a quality improvement methodology to increase the percentage of patients who completed an initial intake following referral to the Center. The use of a phone intake option and consistent seeking of feedback and collaboration with all stakeholders involved in the project contributed to its success.