Maternal and Child Health Training Program
Grant Title: New York (NY) Collaborative Office Rounds (COR): Reaching Children and Teens.
Web Site: New York University Project
Danielle Laraque, MD
New York University
Department of Pediatrics
Maimonides Infants and Children's Hospital of Brooklyn
977 48th Street
Brooklyn, NY 11219
Phone: (718) 283-7005
FAX: (718) 283-7005
Under-diagnosis, misdiagnosis, and less than optimal outcomes of psychiatric problems managed in primary care settings are pressing issues. Providers suffer from a lack of cross-training and support.
Goal 1: Enhance the pediatricians' understanding of psychosocial aspects of child development, disorders, and disability and increase their ability to help children and families deal with these issues. Objective 1: By the end of year one, pediatricians will be able to identify culturally influenced psychosocial aspects of child development, disorders, and disabilities. Objective 2: By year two, pediatricians will feel more confident in their abilities to discuss psychosocial aspects with families and engage them in a therapeutic process. Goal 2: Expand the power of the providers to discriminate between transient disturbances and more serious psychiatric disorders which require referral as needed. Objective 1: By the end of year one, pediatricians will report and demonstrate more effective triaging of cases prior to referral. They will report improved ability to help families deal with symptoms thought to be transient. Objective 2: By the end of year two, pediatricians will report increased confidence and demonstrate increased accuracy in making psychiatric diagnoses and formulating a treatment plan. Objective 3: By the end of year two, pediatricians will report and demonstrate increased comfort in managing mild/moderate mental health (MH) problems as well as more chronic MH disorders. They will demonstrate increased ability to recognize more severe MH problems requiring referral. Goal 3: Promote collaboration between pediatricians and child psychiatrists. Objective 1: By the end of year one and increasingly primary care pediatricians will improve collaboration in the management of patients. Objective 2: Over the 5 year period of the COR, pediatricians will manage increasing numbers of patients that they co-manage with child MH professionals. Goal 4: Facilitate a more comprehensive approach to health supervision, such as outlined in Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. Objective 1: By the end of year one, pediatricians will demonstrate systematic use of health supervision questions relevant to behavioral health. Objective 2: By the end of year one, pediatricians will increase use of culturally-appropriate MH identification tools.
COR meetings will use audio and web conferencing with child psychiatry and pediatric co-moderators to discuss clinical cases from participating practices. The Reaching Children Initiative (RCI) methodology will be used emphasizing interdisciplinary processes to promote improved management of children's social-emotional health.
This project will coordinate teamwork of the faculty of New York University (Maimonides and Lutheran Medical Center) and Presbyterian Children's Hospital of NY Ambulatory Care Network with researchers and teachers of child psychiatry at NYU Child Study Center.
Trainees will complete questions on knowledge, comfort with, and intentions regarding management pre and post each meeting. We will monitor new MH identification and assessment protocols initiated in the practices.