Establishing a hospital-based early intervention program for young children with cancer: A quality improvement initiative.


Objective: Through the use of quality improvement methodology, we aimed to increase the percent of eligible patients seen for developmental testing at our institution from 2.6% to 25% within a 36-month timeframe. Method: The Model for Improvement (Langley et al., 2009) was utilized as a framework to develop and implement an interdisciplinary, hospital-based early intervention program that included comprehensive developmental assessments intended to inform intervention services. A kaizen event was used to map current processes, identify desired future state, and identify potential interventions. Outcomes were demonstrated through use of an annotated run chat and calculation of the percent of eligible patients seen. Descriptive feedback was solicited by e-mail from interdisciplinary team members. Results: The percent of eligible patients seen for clinical comprehensive developmental assessments and provided in-house early intervention services increased to 35.5% (N = 155). Multidisciplinary team members reported that collaboration has improved, leading to enhanced developmental service delivery. Conclusions: This quality improvement initiative resulted in a program that filled a substantial clinical need at our institution. Pediatric psychologists could utilize the model for improvement to similarly enhance the quality of care for very young patients with cancer in their hospital settings. In doing so, professionals who work at hospitals dependent upon clinical revenues may consider utilization of Medicaid’s early and periodic screening, diagnostic, and treatment benefit. (PsycInfo Database Record (c) 2020 APA, all rights reserved)


Andrew Molnar, Ph.D.