Successfully Integrating Emotional Health Assessments into Pediatric Care
Research By: Carole Lannon, MD, MPH
Post Date: November 11, 2024 | Publish Date: September/October 2024
Living with a chronic condition is emotionally challenging for children and their families. Yet only 20% of almost 4,000 graduating pediatric subspecialty fellows recently surveyed indicated that they felt competent to address patients’ mental health needs.
The American Board of Pediatrics (ABP) Roadmap for Emotional Health Project aims to support pediatricians in addressing these concerns. After pilot testing measures, resources, and strategies with more than 25 pediatric subspecialty clinical teams, the ABP launched the online Roadmap Maintenance of Certification (MOC) Part 4 activity.
The Roadmap MOC Improvement Activity
A recent publication in the journal Pediatric Quality and Safety describes how the first cohort of both general and subspecialty pediatricians completing the online activity improved their assessment of emotional health in patients. The publication concludes that Roadmap MOC Part 4 activity is a useful and feasible resource to support physicians in addressing the emotional health of children with chronic conditions and their families.
The MOC activity prompts physicians to complete a checklist that helps to identify opportunities for improvement in addressing emotional health. Physicians can review relevant strategies and tools that are part of the MOC activity:
- Short videos by pediatric psychologists on how to begin conversations about emotional health and equitably addressing the emotional health needs of those living with a chronic condition who are diverse and marginalized;
- Templates for developing therapy resources lists and crisis plans;
- Outpatient billing strategies, developed with the American Academy of Pediatrics Section on Billing and Coding.
Participants must complete at least two plan-do-study-act (PDSA) cycles and collect data at three time points: baseline, midpoint, and completion for two measures — the checklist progress and an assessment of emotional health.
Of the initial cohort of 29 physicians, 22 submitted three sequential checklist assessments. Scores increased for all checklist categories: “developing a family resource list” (by 90%), “confidence to address emotional health” (79%), “having a family crisis plan” (78%), and “staff awareness” (34%).
Twenty-four physicians who measured whether clinical encounters addressed emotional health documented an increase from 21% to 77%.
Physician reflections on lessons learned
Upon completing the Roadmap MOC Part 4 activity, physicians are asked to reflect on lessons learned. Several responses are listed:
“This project has had a profound impact on our practice of medicine … Projects like these, bring emotional health to the forefront and in many ways may be first steps of battling the huge existing problems (of addressing pediatric mental health).”
“I work primarily with a medically complex population and have heard from a lot of parents about the stressors they feel but haven’t had a good framework to use to respond/help.”
“We learned that families with young children with chronic illness experience significant social and emotional stressors and we were not identifying these as often as we should.”
“I think as pediatric subspecialists, we tend to concentrate on the physical well-being of the child and leave the emotional challenges to the general pediatrician. However, we understand the disease complexity and the possible clinical course of the disease and may be better at managing the fears of the unknown.”
About the study
Authors include Carole Lannon, MD, MPH, LaCrecia Thomas, RN, BSN, and Emily Gehring, MPH, all with the James M. Anderson Center for Health Systems Excellence; Christine Schuler, MD, MPH, Division of Hospital Medicine; and colleagues Keith Mann MD and Laurel Leslie MD, MPH, of the American Board of Pediatrics. Leslie will be joining Cincinnati Children’s in February as Director of the Mental Behavioral Health Institute.
The project is funded by the American Board of Pediatrics Foundation and the David R. Clare and Margaret C. Clare Foundation.
| Original title: | Integrating Emotional Health Assessments into Pediatric Care: Initial Learnings from an MOC Part 4 Activity |
| Published in: | Pediatric Quality & Safety |
| Publish date: | September/October 2024 |
Research By
Identifiable gaps in health outcomes piqued my research interests. I now work with patients, families, clinicians and researchers to improve care and outcomes for children and families using learning health networks. These networks, used for improvement and research, can accelerate population health outcomes at scale.
