A barrier cited by primary care administrators in integrating behavioral health is financial risk. Fee-for-service billing mechanisms remain complex and there is little empirical guidance on cost-effective models. This study was an economic evaluation of an integrated care model in a pediatric private practice clinic. The study evaluated cost benefits by examining specific delivery indices such as concerns presented, time spent, billing codes used, and reimbursement received in regards to pediatric primary care visits by comparing days when an on-site Behavioral Health Consultant (BHC) was available versus Non-BHC Days. All 3 hypotheses were supported: 1) more patients were seen in clinic on BHC Days; 2) more revenue was generated on BHC Days; and 3) incorporation of the BHC was cost-effective. Findings showed that time saved by having a BHC onsite increased provider productivity, resulting in an additional $1,142 in revenue generated on a BHC Day when compared to a Non-BHC Day.

"Practice transformation" toward team care as a singular undertaking can be daunting. In this presentation, we describe the development of a mechanism for small, iterative and sustainable practice changes toward team care known as "Champion Teams." Champion Teams are based on the Institute of Medicine's "learning health care system" approach in which practitioners develop an internal mechanism for and culture around digesting and implementing new evidence based practices on an ongoing basis. In addition to presenting the Champion Team concept as a strategy for implementing new team care initiatives, interprofessional providers will present two case examples from each adult and pediatric primary care. At the conclusion of this presentation, participants will be able to: Define the term "learning healthcare system" and its application to Champion Teams. Describe the utility of and keys to implementing Champion Teams. Describe two examples of Champion Teams and the application of this mechanism to making data-informed changes toward team-based care in their own setting.

"Practice transformation" toward team care as a singular undertaking can be daunting. In this presentation, we describe the development of a mechanism for small, iterative and sustainable practice changes toward team care known as "Champion Teams." Champion Teams are based on the Institute of Medicine's "learning health care system" approach in which practitioners develop an internal mechanism for and culture around digesting and implementing new evidence based practices on an ongoing basis. In addition to presenting the Champion Team concept as a strategy for implementing new team care initiatives, interprofessional providers will present two case examples from each adult and pediatric primary care.At the conclusion of this presentation, participants will be able to: Define the term "learning healthcare system" and its application to Champion Teams. Describe the utility of and keys to implementing Champion Teams. Describe two examples of Champion Teams and the application of this mechanism to making data-informed changes toward team-based care in their own setting.

No description available.

Professional identity drives the development of work force, commitment to goals and objectives, and the extent to which an organization like CFHA flourishes. However, many clinicians have simply "found" their way in terms of professional identity and roles within primary care, and tend to struggle with divergences between their identified disciplines and the roles they find themselves within an integrated care model. Behaviorists who strongly identify with their roles as a primary care provider within integrated care will inherently be a driving force in achieving the objectives of the Triple Aim Model. The aim of the session will be to address how training programs, corporations, and national associations like CFHA can foster professional identity through a lively panel discussion representing various disciplines working in integrated care models. The intent would be to offer up some solutions and ideas leading to improved professional identity, there by positively impacting the cost, outcomes, and effectiveness of patient care as intended by the Triple Aim Model.

No description available.

Postpartum depression (PPD) refers to the onset of depressive symptoms anytime within first year following the birth of a child. PPD affects approximately 10-20% of new mothers and often goes underdiagnosed and untreated. Left untreated, PPD can predispose women to more severe and frequent future depressive episodes. Literature suggests depression in mothers may have long-term negative effects on infants’ and children’s psychosocial development. The American Academy of Pediatrics (AAP) has identified pediatric primary care as the ideal location to screen and refer mothers possibly suffering from depression. Routinely assessing PPD in mothers during well-child checks is not only recommended, it is increasingly being considered a best practice standard. The AAP calls for further research to improve the feasibility of assessing and treating PPD in mothers in pediatric primary care. This paper is part of a larger study that will be evaluating the effectiveness of screening new mothers for PPD in pediatric primary care settings and providing a brief same day interventions. The current aims of this portion of the study will be to evaluate 1) referral results, and 2) mothers’ level of satisfaction with the protocol. Research assistants (RA) will approach mothers of infants, birth to 6 months of age in the waiting rooms of ETSU Pediatrics in Johnson City, TN. Mothers will be given a brief description of PPD, the study and will be asked to participate by signing a voluntary informed consent document. As part of the visit, nurses will distribute and score the Edinburg Postpartum Depression Scale (EPDS). Mothers scoring 9 or above will receive a brief educational brochure about PPD, a brief intervention and a one week follow-up phone call with an onsite behavioral health consultant (BCH) or social worker (SW). At mothers’ discretion, an appropriate outside referral to preferred provider will be made, if necessary. Approximately two weeks post- intervention, a satisfaction survey by phone will be administered by RAs. The survey will examine referral results (e.g., of high scores, what recommendations were made, did mothers follow through, treatments received, was there improvement in EPDS score) and the mothers’ level of satisfaction with the protocol (e.g., satisfaction with how protocol was handled by staff and how well mothers felt their needs were addressed). Satisfaction will be noted on a likert-scale ranging from 0 (no satisfaction) to 10 (very satisfied). Data is pending and collection will start during the first week of March showing EDPS uptake, referral results and mother satisfaction. Data is expected for approximately 60-100 new mothers.

No description available.

In this paper, old as well as new technological findings to decrease premature infant mortality are reviewed. This paper discusses fetal development throughout pregnancy from conception to full-term status as well as fetal lung development specifically from conception until full-term status. Several ideas to rapidly develop and mature fetal lungs are discussed such as mothers ingesting artificial surfactant supplements, either independently or coupled with antenatal corticosteroids, as well as intra-amniotic instillation prior to 28 weeks gestational. Drawbacks regarding these two are mentioned as well such as the fetus’s lungs not being mature enough to use the artificial surfactant leading into the idea of researching ways to rapidly develop fetal lungs, either week-by-week or stage-by-stage. Lastly, if the baby is born pre-maturely and is severely underdeveloped, research is currently being done on an artificial womb that the baby can be placed in to simulate a uterus where the fetus can develop on a normal timeline as he or she would in the mother’s womb.

Atrophy of the corpus callosum (CC) is a documented consequence of moderate-to-severe traumatic brain injury (TBI), which has been expressed as volume loss using quantitative magnetic resonance imaging (MRI). Other advanced imaging modalities such as diffusion tensor imaging (DTI) have also detected white matter microstructural alteration following TBI in the CC. The manner and degree to which macrostructural changes such as volume and microstructural changes develop over time following pediatric TBI and their relation to a measure of processing speed is the focus of this longitudinal investigation. As such, DTI and volumetric changes of the CC in participants with TBI and a comparison group at approximately three and 18 months post injury and their relation to processing speed were determined.