Bright Futures : Guidelines For Health Supervision Of Infants, Children, And Adolescents by American Academy of Pediatrics

Bright Futures : Guidelines For Health Supervision Of Infants, Children, And Adolescents by American Academy of Pediatrics

This essential resource provides key background information and recommendations for themes critical to healthy child development along with well-child supervision standards for 31 age-based visits–from Newborn through 21 Years.

What’s in the Bright Futures Guidelines, Fourth Edition?

Twelve health promotion themes addressing:

  • lifelong health for families and communities (NEW)
  • family support
  • health for children and youth with special health care needs (NEW)
  • healthy development
  • mental health
  • healthy weight
  • healthy nutrition
  • physical activity
  • oral health
  • healthy adolescent development
  • healthy and safe use of social media (NEW)
  • safety and injury prevention

31 age-based health supervision visits–Newborn to 21 Years

All the information and guidance that’s needed to give children optimal health outcomes:

  • Context
  • Health Supervision
  • History
  • Surveillance of Development
  • Review of Systems
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Medical Screening
  • Immunizations
  • Anticipatory Guidance

What’s NEW in the 4th Edition?

  • Builds upon previous editions with new and updated content that reflects the latest research.
  • Incorporates evidence-driven recommendations.
  • Includes three new health promotion themes:
  • Promoting Lifelong Health for Families and Communities
  • Promoting Health for Children and Youth With Special Health Care Needs
  • Promoting the Healthy and Safe Use of Social Media
  • Includes new screen time recommendations
  • Provides greater focus on lifelong physical and mental health
  • Weaves social determinants of health throughout the Visits, allowing health care professionals to consider social factors like food insecurity, violence, and drug use that may affect a child’s and family’s health
  • Features updated Milestones of Development and Developmental Surveillance questions
  • Provides new clinical content that informs health care professionals about the latest recommendations and provides guidance on how to implement them in practice:
  • Maternal depression screening
  • Safe sleep
  • Iron supplementation in breastfed infants
  • Fluoride varnish
  • Dyslipidemia blood screening
  • Includes updates to several Adolescent screenings

With Bright Futures, health care professionals can accomplish 4 tasks in 18 minutes!

  • Disease detection
  • Disease prevention
  • Health promotion
  • Anticipatory guidance

What is Bright Futures?

A set of theory-based, evidence-driven, and systems-oriented principles, strategies, and tools that health care professionals can use to improve the health and well-being of children through culturally appropriate interventions. Bright Futures addresses the current and emerging health promotion needs of families, clinical practices, communities, health systems, and policymakers.

The Bright Futures Guidelines are the blueprint for health supervision visits for all children.

Bright Futures is the health promotion and disease prevention part of the patient-centered medical home.

Who can use Bright Futures?

  • Child health professionals and practice staff who directly provide primary care
  • Parents and youth who participate in well-child visits
  • Public Health Professionals
  • Policymakers
  • Pediatric Educators
  • MD Residents

Efficiently Implementing Bright Futures Guidelines for Well Child Care

Ohio AAP Training on Well Child Visits: Tips for Efficient and Effective Care

Introduction

Good morning! Thank you all for joining us for today’s training session. We appreciate the support and partnership from the Ohio Department of Health in hosting this training. The training is part of the Preventative Health Program, which focuses on emerging health issues and child health topics. We will also be starting a quality improvement project in December and encourage interested pediatricians and primary care providers to participate. Please make sure to mute your lines and turn off your cameras. Let’s begin.

About the Speaker and Program

Today, we have Dr. Rupert Tacoor, a pediatrician at Cleveland Clinic and the lead for the Ohio AAP’s Free Donut program. The Preventative Health Program has created resources for families and physicians, which are available on our website. Our next training session will be on oral health, so make sure to register if you’re interested in that topic. We also have new resources available for this training, including a handout in Spanish. Now, I’ll pass it over to Dr. Tacoor to get started. Please feel free to ask questions in the chat box, and we’ll address them at the end.

The Value and Components of Well Child Visits

As primary care providers, we understand the importance of well child visits. However, it can sometimes be overwhelming to keep up with all the recommended screenings and understand why they are necessary. Today, we will clarify the screening schedule, discuss efficient ways to complete all screenings, and review panel management behaviors that can improve completion rates.

The Four Domains of Well Child Visits

Bright Futures outlines four domains or tasks that well visits should achieve:

  • Prevention
  • Tracking growth and development
  • Addressing parental concerns
  • Fostering relationships

These domains aim to promote the health, education, and well-being of infants, children, adolescents, families, and communities. By addressing all these aspects, we can enhance the overall health of children and improve health outcomes.

The Benefits of Well Child Care

Providing quality preventive care has been shown to decrease overall healthcare costs and improve health outcomes. When patients and their families have a trusting relationship with their primary care provider, they are more likely to have better healthcare utilization, fewer hospital admissions, and higher satisfaction with their care. Well child visits also allow us to address important topics such as vaccination and weight management, promoting overall health and well-being.

Key Components of Well Child Visits

In order to have a successful well child visit, it is important to address the concerns of both the child and the parent. The visit should be unhurried, allowing for adequate time for questions and discussion. The provider should take a comprehensive history to assess strengths, accomplish surveillance, and enhance their understanding of the child and family. Developmental surveillance should occur at every visit, and a physical exam should be comprehensive yet focused on age-specific assessments. Health supervision activities should also include observing the parent and child interaction, as this can provide valuable insights. Screening and immunizations should be offered at every visit, and anticipatory guidance should be provided according to the child’s age and priorities defined by Bright Futures.

Screening Guidelines

Bright Futures recommends various screenings at different ages to ensure early detection and intervention. Some of the screenings include anemia screening at 12 months, blood pressure screening annually after the age of three, developmental screening at 9, 18, and 30 months, and dyslipidemia screening once before pubertal onset. These are just a few examples, and it is important to consult the Bright Futures guidelines for specific recommendations.

Utilizing Resources and Tools

Bright Futures provides comprehensive resources for well child visits, including pre-visit questionnaires, documentation templates, and parent handouts. These resources can be adapted and used in your practice to streamline workflows and improve efficiency. Additionally, leveraging your electronic medical record (EMR) can help automate documentation and streamline processes. EMRs can provide health maintenance alerts, best practice advisories, and facilitate communication with patients.

Leveraging Community Partners

Collaborating with community partners can help address social determinants of health and ensure comprehensive care for your patients. Partnering with organizations that provide transportation services, food assistance, or other social services can greatly benefit your patients. Building relationships with community partners through community advisory councils can also help improve care delivery and address community needs.

Re-engaging Patients

Re-engaging patients who may have missed well child visits, especially during the pandemic, is crucial. Strategies for re-engagement include appointment reminders, outreach through telehealth or home visits, financial incentives, and connecting families to community resources. Using EMRs to identify patients who are overdue for care and sending bulk reminders can also be effective in re-engaging patients.

Conclusion

Well child visits are an essential part of pediatric care, and prioritizing efficiency can help ensure that all necessary screenings and interventions are completed. By utilizing resources, engaging the entire team, leveraging technology, and partnering with community organizations, we can provide high-quality care and improve outcomes for our patients.

References:

  • Bright Futures. (n.d.). Retrieved from [website link]
  • Center for Health Care Strategies. (2020). Innovations in Well-Child Care: Strategies for Improving Screening, Addressing Gaps in Care, and Enhancing Patient Engagement.

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