Improving the Reach Out and Read Program at a Student-Run Free Clinic for Homeless Women and Children

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Publication year

2017

study description

Quality improvement project.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

Medical Trainees

Exposures, Outcomes, Other

Anticipatory Guidance , Implementation and Evaluation , Provider Behaviors and Skills , Provider Knowledge, Attitudes, and Beliefs

objectives

Objectives were to improve documentation of book delivery and provision of anticipatory guidance in electronic health records (EHRs) and determine changes in student managers knowledge, attitudes, and practices towards pediatric literacy.

exposure

Reach Out and Read (ROR).

outcomes evaluated

Documented provision of books and anticipatory guidance, and changes in knowledge, attitude, and practice toward pediatric literacy.

setting

Student run free clinic serving homeless women and children.

methods

We evaluated eligible pediatric visits (N=201) and compared the number of books distributed to patients documented on paper to those documented in SOAP notes, which provides a clinic visit summary in EHRs. Student managers received didactic trainings on pediatric literacy, documentation skills, and ways to train volunteers. Student managers were trained to document that a book was provided to the patient, identify which book was provided, and specify that anticipatory guidance about reading was given to the parent in the SOAP note. Student managers were advised to train other student volunteers in this skill. Pediatric literacy knowledge and attitudes were evaluated before and three months after didactic training. Practice behaviors were evaluated after training. SOAP notes were evaluated six months later to determine improvements.

sample size

n=201 (visits)

measures

Measure of AG and Books Provision: documentation in paper inventory compared to SOAP notes in electronic health record.

 

Measure of Knowledge, Attitudes, Practice: survey using True/False (knowledge about ROR, pediatric literacy, and practice) and 5-point Likert scales (attitudes about comfort level and necessity).

results

Documentation of book delivery in SOAP notes increased (12.5-77.8%) after didactic training (p<0.001). Significant improvements in students literacy knowledge were found (p=0.0201). Most students (67%) practiced reading aloud to patients and asked parents to demonstrate reading. After training, all SOAP notes included the name of the book and that anticipatory guidance was provided.

conclusions

Our results emphasize that training can be effective at improving student managers knowledge, attitudes, practices, and documentation skills in student-run clinics.

limitations

A limitation of this project was the small number of students managers (<10) who received the didactic training. Due to the high turnover of volunteers, we were not able to train all students who volunteered at the clinic.