Maternal and Child Health Training Program
Grant Title: Collaborative Office Rounds (COR) - Pediatrics and Child Psychiatry
Daniel P. Kohen, MD
University of Minnesota
Developmental-Behavioral Pediatrics Program, 717
Delaware St SE, Room 371
Minneapolis, MN 55414
Phone: (612) 626-3014
FAX: (612) 624-0997
Residency graduates do not feel confident to manage psychosocial/biobehavioral problems in pediatric practice, despite some training during residency. Goal: to improve the socio-emotional well-being of children through multidisciplinary care conferences improving clinicians' knowledge & treatment.
Goal 1: Promote and enhance understanding of cultural and linguistic competence; and promote continuation of recruitment and maintenance of diverse membership within COR. Objective 1: With the mixture of community- and University-based clinicians participating in the seminars, the case presentations provide a variety in terms of culture/ethnicity, SES, presenting condition, and treatment plans. Goal 2: Enhance understanding of biopsychosocial aspects of child development, disorders, and disability, and improve the ability of providers to help children and families deal with these issues. Objective 1: The participants are a mixture of community- and University-based clinicians, as well as being interdisciplinary, thus increasing the opportunity for an exchange from diverse perspectives and areas of expertise. Goal 3: Enhance and expand the ability of pediatricians to discriminate between transient & developmental challenges/difficulties and more serious psychiatric disorders requiring consultation and referral. Objective 1: Increase awareness of the scope of participants' competencies and strengthen orientation to consult with, and/or refer to, other professionals as appropriate. Objective 2: Promote collaboration between pediatricians, developmental-behavioral pediatricians, child psychiatrists, and child psychologists. Goal 4: Facilitate a comprehensive approach to health supervision, as envisaged in Bright Futures: Guidelines for Supervision of Infants, Children & Adolescents; and Bright Futures in Practice: Mental Health. Objective 1: Increase the proportion of persons who report their health care providers have satisfactory communication skills (HP 2020; HC/HIT-2). Objective 2: Increase the number of persons seen in primary care who receive mental health screening and assessments (HP 2020; MHMD-5, -6, -11). Objective 3: Increase the proportion of children with mental health problems who receive treatment (HP 2010; MHMD-6). Goal 5: Nurture the success of the COR program; honor its importance as an educational strategy; support and create more COR groups (i.e., COR-III for senior Peds/Med-Peds/Child Psych residents and fellows). Objective 1: COR-III was initiated in January 209 for senior Peds/Med-Peds/Child Psych residents and fellows; and continues to be held. Chief residents assign residents to present cases; DBP/Child Psych fellows or junior faculty work with the residents on the presentations and facilitate discussion.
Collaboration between multidisciplinary clinicians increases through twice-monthly seminars, which are case-based. Primary providers' knowledge, diagnostic perspectives, and treatment options will expand. Unique characteristics of COR: focus upon pediatric practitioners' presentation of common clinical dilemmas encountered in daily practice; creation of a common language and supportive environment for participants; enhancement of understanding of psychosocial aspects of child development, biobehavioral disorders, and disabilities; and the real ability of providers to help children and families manage these issues; focus designed to increase the ability and comfort of pediatricians to differentiate between transient developmental challenges and more serious psychiatric disturbances necessitating psychiatric consultation and referral. Learners with varying experiences in child health and illness are brought together, promoting interdisciplinary sharing of experiences and perspectives to enhance learning and promote excellence in child health care.
Coordination of the COR project is a share endeavor of the collaborating pediatrician and child psychiatrist coordinators. These coordinators also assist participants in selecting appropriate cases for discussion, and in preparation and distribution of learning materials for other participants.
Evaluation is ongoing. An initial annual survey/needs assessment identifying learning needs provides foci for program planning & serves as core objectives against which learners measure outcomes. Eight-item evaluation form is used at each meeting; open review of group process is encouraged. Written evaluation occurs annually to identify progress toward achieving measureable objectives.