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G456(P) Improving the diagnostic process and delivery of interim intervention for pre-school autism spectrum disorder children in a developmental clinic
  1. SB Lim,
  2. HH Lim,
  3. CM Wong,
  4. S Singhal,
  5. PH Yang,
  6. KC Wong,
  7. S Amir
  1. Department of Child Development, KK Women’s and Children’s Hospital, Singapore

Abstract

Introduction Autism Spectrum Disorder (ASD) is increasingly common, and the department we work in is a key diagnostic and interim service provider for ASD among pre-school children. To improve the diagnostic process and delivery of interim intervention services for children and families referred to our department for ASD, we established an interdisciplinary ASD team, which initiated a Clinical Practice Improvement Project (CPIP) in September 2007 to provide an “ASD track” service. In this paper, we share our learning from this project.

Methods The ASD team analysed the root cause through cause and effect analysis. We derived solutions which improved 1) case differentiation mechanism and prioritisation of services, 2) standardisation of diagnostic processes and documentation, 3) continuity of care and case management, 4) cross-disciplinary training and professional standards, 5) family-centeredness of our interim intervention services. We conducted 3 Plan-Do-Check-Action (PDCA) cycles (January 2010–April 2011) before implementing the ASD track service in May 2011.

Results This paper presents results of our implementation. From September 2011 to March 2012, 181 cases were referred to the ASD team from the DCD triage clinic. Of these, 93 were classical ASD and offered the fast-track diagnostic service, for which 73(78.5%) underwent 2-hour psychological assessment. Compared to the non-track process, the ASD track achieved 1) reduced default rates of 17.7%, 2) 45% reduction in psychological assessment duration, 3) 64.4% reduction in wait time for psychological assessment, 4) 63.3% reduction in ASD psychological assessment cycle time, 5) 32.8% reduction in ASD diagnostic process cycle time, 6) 28.1% reduction in clinic time usage, 7) enhanced case management and delivery of interim intervention services in family-centred manner.

(Illustration – Improvements of ASD Track from Old Process)

Conclusions The ASD track improved the diagnostic process and delivery of interim intervention service for Autism Spectrum Disorder in our department.

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