Active Healthy Living Quality Improvement Collaborative
Developed by an Advisory Committee of the Alabama Chapter American Academy of Pediatrics executive leadership, Alabama Chapter-AAP member pediatricians, the University of Alabama at Birmingham (UAB) Department of Pediatrics, the Alabama Department of Public Health, and the Alabama State Obesity Task Force, the Active Healthy Living Quality Improvement Collaborative goal will be to: Train pediatric primary care providers and their office staff to use the 2007 Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Obesity.

The Advisory Committee has recommended a learning collaborative approach that offers pediatricians the opportunity to participate with other practices in a structured process to improve the quality of care they deliver around childhood obesity. The learning collaborative model includes several important components:

An initial objective assessment of current practice;
  • Participation in learning sessions to hear the evidence behind the "best practices" and to learn how to implement process improvement in practice;
  • Ongoing follow-up and technical assistance, including: periodic assessments/chart audits (to assess whether improvement is happening), conference calls (to get questions answered and learn from other practices); and an end-of-collaborative assessment to measure the improvements, allow comparisons with other practices, and guide next efforts;
  • A formal or informal wrap-up session to help organize thoughts and to provide advice on maintaining the improvements in the future.
The aim of the one-year collaborative is to engage pediatricians to both improve their approach to the prevention, recognition and treatment of childhood obesity as well as improve their capacity to implement future changes into their practice.   Participants will develop improvement plans that address: 1) incorporating a brief evidence/expert opinion-based primary prevention message into all well-child care visits during infancy and childhood; 2) employing evidence/expert opinion-based tools for recognition of those at higher than average risk of developing obesity and utilizing appropriate intervention strategies; and/or 3) recognition, evaluation and treatment of children and adolescents with established obesity.

  • Recruit and train 10 – 15 motivated pediatric primary care practices and their office staffs on quality improvement methods using a learning collaborative model to effectively use the 2007 CDC/AMA Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Obesity in the medical home setting.
  • Promote clinical and social/behavioral (motivational interviewing) best practices for assessment, preventative, and treatment to improve the management of childhood obesity.
  • Contract with quality improvement and expert clinical faculty from the UAB Department of Pediatrics to provide technical assistance and help to develop a practice change toolkit and training curriculum borrowed from previous state obesity collaboratives and regional childhood obesity training.
  • Employ the Institute for Healthcare Improvement Breakthrough Series training approach to conduct three face-to-face learning sessions, monthly teleconferencing practice calls to map tests of change at the practice level, internet-based training, and, if possible, academic detailing from practice coaches.
  • Collaborate with expert clinical consultant(s) to drive clinical goals; track provider behaviors with monthly chart audits throughout the 12-month collaborative; and examine changes in weight management, physical activity and nutrition counseling over the course of the collaborative.
  • Increase practice quality improvement capacity to implement future guideline recommendations.

Alabama Early Screening Improvement Training (Developmental Screening)

The Alabama Early Screening Improvement Project (Project) is an evidence-based educational program adapted by the Alabama Chapter of the American Academy of Pediatrics to help pediatric care providers and their staffs learn skills and strategies to implement routine developmental and behavioral screening using standardized screening tools as a port of their pediatric care practice. Using QI principles the training will give pediatricians the information and tools to develop and promote an optimal protocol to increase early identification and referral of children with potential developmental, behavioral, or emotional problems using standardized tools without adding more time to the office visit; better understand what community referral resources are available; and code appropriately for these services. Training is tailored to each individual community. Because each community has different resources available for children, training includes a panel of representatives from local community agencies that serve children. The project tracks your progress implementing screening tools and achieving universal screening for your patients over a nine (9) month period of time.

The training incorporates the medical home, team-based care model and includes pediatric primary care providers (physicians, nurse practitioners, and physician’s assistants), nurses and office staff. The goals of the project are as follows:
  • Improve developmental and autism screening in pediatric practices, in accordance with the AAP policy statements and Bright Futures guidelines.
  • Improve physician understanding and utilization of standardized screening tools for developmental delays and autism.
  • Educate pediatricians in proper documentation and coding to optimize billing for the appropriate screening
  • Improve provider knowledge of and referral to community resources particularly Early Intervention providers and services.