pennsylvania’s epic-ehdi physician outreach initiative
DESCRIPTION
Pennsylvania’s EPIC-EHDI Physician Outreach Initiative. Robert C. Cicco, M.D. - President, Pennsylvania Chapter, American Academy of Pediatrics; Neonatologist, West Penn Hospital, Pittsburgh, PA Diane L. Sabo, Ph.D. -Clinical Director of Audiology, - PowerPoint PPT PresentationTRANSCRIPT
Pennsylvania’s EPIC-EHDI
Physician Outreach Initiative
Robert C. Cicco, M.D.- President, Pennsylvania Chapter,
American Academy of Pediatrics; Neonatologist,
West Penn Hospital, Pittsburgh, PA
Diane L. Sabo, Ph.D. - Clinical Director of Audiology,
Children’s Hospital of Pittsburgh, Pittsburgh, PA
Robert F. Staver - Public Health Program Manager,
Pennsylvania Department of Health, Harrisburg, PA
Why physician education?
Essential for success of the program
Families refer to their Primary Care Physician (PCP) for advice
Key component to follow up is PCP
Need for EDHI Education
Knowledge of the program and program goals
Knowledge of the guidelines
Roles of the professionals
Goal: Find best way to get physicians to recognize the importance of EHDI Barriers: Geographical uniqueness of PA – state has
large urban centers in east and west with large rural mid-section and north central area.
Large number of small hospitals with birthing centers.
“Old School” disbelievers still exist.
What is EPIC?
Educating
Physicians
In The
Community
Advantages Of An EPIC Model
Presenters model a multidisciplinary and team- oriented approach.
Learning takes place in a local hospital or office setting so that problems unique to that hospital (or practice) can be addressed.
Presenters are most often from the local community and are familiar with the people they’re teaching.
Goal of presentations is to affect positive change and not just present information.
EPIC Programs In PA
Existing EPIC-IEP—Immunizations EPIC-SCAN—Suspected Child Abuse and Neglect EPIC-IC—Medical Home Clean Air—Tobacco Cessation
New EPIC-EHDI—Early Hearing Detection and Intervention
Proposed Obesity Emergency Preparedness Asthma
Pennsylvania’s 3-year EPIC-EHDI project was . . . Conceived as a multi-faceted outreach strategy to inform
pediatricians and PCPs about the importance of EHDI consistent with the Medical Home model.
An outgrowth of an existing PA AAP Medical Home grant.
Proposed as a key feature in PA DOH’s grant application to HRSA/MCHB for UNHSI funding as the primary means of program outreach to physicians.
Formulated in cooperation with PA AAP using multi-disciplinary input from PA DOH’s Infant Hearing Screening Advisory Committee.
Three-year Contract between PA-AAP and PA DOHTotal amount ~ $452,000 EPIC Team Training (1½-day team training seminar
at beginning of project -- $15,000 Teleconferences (one per year) -- $18,000 Grand Round Presentations (26 per year, includes
travel, lodging & honorariums) -- $93,000 Technical Assistance (up to 15 per year) -- $12,000 CDs , Video & Audiotapes, web dev. -- $27,000 Education & Outreach Materials -- $79,000 Salaries & Administration -- $208,000
Steps in Organizing the Program
Establish Multidisciplinary Advisory Committee
Develop Content Goals and Objectives
Determine Optimal Learning Modalities
Identify EPIC Team Members
Plan Training Session for EPIC Team Members
Steps in Organizing the Program cont.
Identify Target Hospitals/Practices
Market Program to Target Audience
Conduct Educational Programs and Incorporate Improvements and Adjustments Based on Audience Feedback
Evaluate Effectiveness of Educational Programs
Formulating the Content . . .
Full-day work session with Infant Hearing Screening Advisory Committee to plan content.
Attention paid to all perspectives: parents, PCPs, audiologists, hospital staff and public health administrators.
Inventory taken of key themes and messages.
Trial run and critique of prototype presentation during team training workshop.
Development of teleconference script dialogue followed by rehearsal and team critique.
Pennsylvania’s EPIC-EHDI Initiative is a multi-faceted educational approach, utilizing . .
Hospital-Based Grand Rounds Presentations Mentoring and Technical Assistance Audio Teleconference Training Video Web Based Learning Modules Resource Parent Packets available in offices
This concept allows educational goals to be achieved in a number of learning formats.
Hospital-Based Grand Rounds
Presentations made by 4-person EPIC teams.
Goal to provide 26 presentations each year for three years, which would cover over half of PA hospitals over the course of 3 years.
Attendees receive CMEs for participation.
Presentations geared towards physicians but attendees often also include hospital staff.
Mentoring and Technical Assistance
EPIC team members available in their local community.
Address problems such as: Hospital referral rates too high or
too low. Hospitals not sending timely
reports to state DOH. PCPs not making timely referrals
for diagnostic evaluations or to EI.
Technical assistance may occur either in person orby phone.Can be provided in a potentially less threatening manner if done by local colleague.
Audio Teleconference
Teleconference produced as part of PA-AAP’s monthly ongoing “Let’s Talk” educational series.
Presented as a scripted panel discussion in contrast to the more didactic Grand Rounds presentations.
Panel participants with same disciplines as EPIC team members (physician, audiologist, parent and DOH staff member).
Audio CD distributed to every PCP practice in Pennsylvania.
Training Video
Produced from a model Grand Rounds presentation and includes all audiovisuals used in this presentation.
Distributed to all PCP practices in PA to allow practices to view presentation even if they have not attended the Grand Rounds.
Web Based Modules
Allows use of multimedia audio and visual files.
Through these modules, learner can go into more depth in areas such as: Components of a diagnostic evaluation Accessing the EI system Communication options Understanding the coordinating role of
DOH Learners can work through modules
at their own pace.
Parent Educational Packets
Allow families to receive additional information concerning the impact of early diagnosis.
Emphasize the need to obtain timely diagnostic evaluations and to follow speech and language milestones for all children.
Each team consists of a physician, audiologist, parent advocate, and DOH staff member.
Teams received multidisciplinary training during 1½-day workshop in October 2003. Stragglers were trained by teleconference in January 2004.
Team members live in the same regions as the hospitals where Grand Round presentations take place.
DOH actively coordinates with PA-AAP to prioritize training sites based on birthing volume, screening and referral percentages, and infrequent or inconsistent submission of referrals and screening data.
Regional EPIC-style teams are the project’s core strength
EPIC Team Member Roles
Physician—conveys importance of EHDI evaluation from a medical perspective, including importance of hearing in child’s development and modeling medical home principles.Audiologist—brings auditory function, diagnosis, and assistive technology perspective; need to report diagnostic results to state DOH; key resource for technical assistance. Parent—gives firsthand description of difficulties in navigating the system, coping with ECHL & EI; presents the personal story.DOH Representative—describes EHDI from a public health program perspective, incl. reporting and follow-up tracking, educational outreach, program guidelines and ongoing program development.
Targeting Hospitals
Targeted hospitals are based on:
Recommendations from the PA Department of Health
Birthing volume and referral rates Hospitals interested in the program
When targeting hospitals, keep focus off of Newborn Hearing Screening and more on diagnosis, follow-up and the importance of intervention services.
Getting the Word Out
Calls to Hospitals
Brochure describing all aspects of the program – sent out to all PA PCPs
Other areas of interest – such as SHIP (State Health Improvement Plan) partners and Early Intervention Services
Setting Up Presentations
It is important to work closely with the hospital contact person.
Obtain a list of possible dates from hospital. Determine the date that is best for hospital
and the local presentation team.
Necessary Paperwork
Send presenters a confirmation letter along with disclosure form and anything else that needs to be completed.
Send hospital contact person a confirmation letter, evaluation forms, attendance sheet, necessary CME/CEU forms, and participant packets.
Send local PCPs a letter inviting them to the presentation.
Participant Packets
Currently, our participant packets include the following:
Handout of the slide presentation
List of related websites Copy of PA Department of Health program
guidelines Copy of the Guidelines for Pediatric Medical
Home Providers Related info. such as the PA phone number
for Early Intervention Services
Steps in Organizing the Program
Establish Multidisciplinary Advisory Committee
Develop Content Goals and Objectives
Determine Optimal Learning Modalities
Identify EPIC Team Members
Plan Training Session for EPIC Team Members
Identify Target Hospitals/Practices
Market Program to Target Audience
Conduct Educational Programs and Incorporate Improvements and Adjustments Based on Audience Feedback
Evaluate Effectiveness of Educational Programs