Riley M, Patterson V, Lane JC, Won KM, Ranalli L. The Adolescent Champion Model: Primary Care Becomes Adolescent-Centered via Targeted Quality Improvement.
J Pediatr 2018;
193:229-236.e1. [PMID:
29198766 DOI:
10.1016/j.jpeds.2017.09.084]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/21/2017] [Accepted: 09/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE
To evaluate the effects of implementing the Adolescent Champion model, a novel quality improvement program targeted at helping primary care sites become more adolescent-centered.
STUDY DESIGN
Nine primary care sites from pediatrics, family medicine, and medicine-pediatrics implemented the Adolescent Champion model. Each site identified a multidisciplinary champion team to undergo training on adolescent-centered care, deliver prepackaged trainings to other staff and providers, make youth-friendly site changes, implement a standardized flow to confidentially screen for risky behaviors, and complete a quality improvement project regarding confidentiality practices. Adolescent patients, staff, and providers were surveyed at baseline, year-end, and 1-year follow-up to assess changes.
RESULTS
Adolescent patients' experiences with both their provider and the site overall significantly improved (P values from <.0001 to .004, N = 474 baseline, 386 year-end). Staff perceived an improvement in clinic practices relating to adolescents and in their ability to make institutional and personal change (P < .0001, N = 121 baseline, 109 year-end). The majority of changes were sustained 1-year postintervention. Frequently noted site improvements included: (1) initiating a method to gather feedback from adolescent patients; (2) adding trainings on confidentiality, cultural humility, and using a nonjudgmental approach; (3) updating immunizations at every visit; and (4) training providers in long acting reversible contraception via implant training.
CONCLUSIONS
Implementing the Adolescent Champion model successfully helped primary care sites become more adolescent-centered. Further studies are needed to evaluate the effects of this model on patient outcomes.
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