Value in ADHD Management

Many kids in Chehalis and Centralia know Northwest Pediatric Center as a safe place.  The clinic has worked hard to nurture community relationships, become a hub of activity, and deliver excellent and timely care, and the community in turn trusts Dr. Jennifer Polley and her team to help with a wide spectrum of challenges their kids face.  Seventy percent of the children the clinic serves are insured by Medicaid.

About 1600 of the children served at Northwest Pediatric Center have an ADHD diagnosis and about 90% of those children take medication for their ADHD. Dr. Polley and her team have developed strong policies and a robust process to care for these kids. ADHD management is a good illustration of the philosophy Northwest Pediatric Center: they do not see their work in terms of production, but in terms of value.

What happens when a family under Northwest Pediatrics’ care believes they have a child with ADHD?
  • Initial ADHD evaluations are one hour in duration
  • Medication follow-up visits are 30 minutes
  • A comprehensive assessment packet is completed by parents and teachers prior to the initial appointment and reviewed with the family during the appointment.
What does a clinic need to do to implement a more robust education and monitoring system for ADHD?
  • Develop a standard system that everyone will follow for assessments and medication monitoring.
  • Get buy-in from everyone impacted, from front desk to referral coordinators to providers.  “Sell” the mission: our end goal is the best outcome for the child.
  • Spend significant time on the initial evaluation. This is an important opportunity to educate the family and saves time down the road.
  • Stay tight with schools. Dr. Polley and her team maintain close ties with the school nurses and other school leaders in their community by partnering on projects and conducting workshops at the schools. This makes it easier to get evaluation forms completed in a timely manner and helps the clinic track of a child’s progress.

There are some other factors that help Northwest Pediatric Center be successful. They are fortunate to have a psychiatrist embedded in the clinic two days per week. They employ a full time medication refill RN and a full time triage RN, which frees up time for providers to focus on the ongoing care plan during visits. While an embedded psychiatrist is out of reach for many primary care clinics, attention to scheduling and medication recall visits and establishing a reliable system for ADHD diagnosis and management are meaningful and attainable.

Joining the Pediatric Transforming Primary Care Initiative will give you the chance to receive behavioral health training based on the Partnership Access Line (PALS) and the expertise of Dr. Bob Hilt from Seattle Children’s and a Behavioral Health Team of experts in pediatric care.  Our goal is to help providers in the primary care setting feel more comfortable and confident in caring for kids with behavioral and mental health needs, including ADHD and depression.  For more information please email us at pediatric-tcpi@wcaap.org

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