Improving Adherence to the AAP Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents: A Quality Improvement Initiative in Rush Pediatric Primary Care

The RUMC Primary Care Pediatrics Center (RPCPC) and Rush Lifetime Medical Associates (LMA) are two high-volume, well-established pediatric outpatient clinics serving roughly 19,000 patients each year. To date, these outpatient clinics have no formal or systematic methods for the diagnosis, evaluation, and treatment of Attention Deficit Hyperactivity Disorder (ADHD). Furthermore, the prevalence of ADHD within these clinics is roughly 2%, well below the accepted national prevalence for this condition (~11%). The discrepancy between these rates could be attributed to practice/physician factors and/or to patient/family factors. The current project aims to improve the practice/physician factors: diagnosis, evaluation, and treatment services provided to patients within these clinics between 4 and 18 years of age presenting with ADHD symptomatology and/or behavioral and academic concerns. The current project will achieve this aim by 1) implementing a Diagnostic Evaluation Protocol and ADHD Management Protocol 2) creating and implementing “smart phrase” templates within the computer information systems, 4) dedicate behavioral therapy services to families of children diagnosed with ADHD, and 5) provide specialized consultative services by a developmental-behavioral pediatrician to the participating clinicians. A Model of Improvement framework will be used to assess improvements and outcomes. In collaboration with the Illinois Chapter of the American Academy of Pediatrics (ICAAP), the leadership team will disseminate the protocol, methodology, and outcomes of the proposed initiative to pediatric primary care practices across the state of Illinois.