Conference Abstract Compendium Examples from the ... - CityMatCH

2009 CityMatCH Urban MCH Leadership ConferenceACCOMPLISHMENTS/RESULTSThe need for this initiative was demonstrated to medical center leadership and staff by:• Focus groups of adolescents at several sites, supported by a CATCH grant from the American Academyof Pediatrics (AAP), showing that younger teens often didn’t know their rights and older ones didn’talways trust doctors to keep their secrets;• An informal survey of reception staff and first level supervisors revealing gaps and variation inunderstanding of state laws; and• Review of over 300 medical records finding no documentation of teenagers being seen alone.Several thousand copies of a “Teens Health Care Bill of Rights” in a colorful, user-friendly version by theNY chapter of the AAP and the NY Civil Liberties Union have been distributed to youth at various sites.An official medical center policy, “Care of the Unaccompanied Minor” has been adopted and discussed atin-service, staff conferences and other meetings of site administrators, house officers, nurses, receptionand billing staff. It has also been posted and distributed electronically. A preprinted medical record formfor the adolescent preventive care visit has been prepared and adopted that includes a check-off box forwhen a patient is seen alone. This serves both as a reminder and for documentation.BARRIERS• Variations in size and heterogeneity of staffing patterns among different sites require multiple venuesand formats for communication.• Obtaining approval for new policies and procedures in a large medical center is a lengthy andcomplicated process.• Achieving uniform compliance when introducing new systems and procedures at multiple sites in a nonhierarchicalorganization is a continuing challenge.LESSONS LEARNEDRecognition of the problem and the need for change by a broad constituency of health professionals canhelp overcome existing barriers. Expect a multiyear effort, and prepare to do ongoing monitoring ofresults.INFORMATION FOR REPLICATIONExcept for the CATCH grant, there was no specific funding for this work. Administrators cooperated andphysicians donated their time for meetings and paper work. Materials such as the Teen Bill of Rights werealso donated. Dedicated leadership by members of the Division of Adolescent Medicine made it happen.139