Organize Your Office Practice to Implement Bright Futures Recommendations

​​​​​​​​​​​​​​​​​​​​​Tips for Organizing Your Office Practice​

Using lessons learned from the 2006 Bright Futures Training Intervention (BFTI) project (described below), plus other tips from practitioners, nurses, and office staff members who have implemented the Bright Futures Guidelines in their practice settings, consider the following ways to organize your office practice to implement Bright Futures recommendations.

 Involving your practice support and nursing staffs in using the Core Tools and supplemental resources can ensure that Bright Futures implementation is an office-wide effort

Consider these ideas:

  • Hold a session with staff members to reinforce the importance of preventive services visits and how using Bright Futures tools, materials, and strategies can help. Solicit their ideas for how to efficiently incorporate Bright Futures components into daily practice.
  • Train staff members on how to use and distribute the Previsit and Medical Screening Questionnaires when indicated. Make sure they can help parents and patients with literacy or language difficulties fill out the forms.
  • Have all tools and supplies ready for distribution at each visit.

 Establishing a Bright Futures workflow can make integration job specific, not person specific

Consider these ideas:

  • Start at the initial entry point to the medical office. Have the receptionist provide visitors with age-appropriate Previsit Questionnaires and other questionnaires needed for specific visits (eg, MCHAT questionnaire to screen for autism at the 18-month visit).
  • Ask the medical assistant to check that the Previsit Questionnaire has been completed and to attach the completed questionnaire to the chart or to enter the results into the EHR system.  
  • Have the clinician review and discuss the Previsit Questionnaire during the visit and complete the Visit Documentation Form. 
  • Have the medical assistant or nurse provide appropriate Parent/Patient Education Handouts at the end of the visit.
  • Assign referral tracking, if warranted, to a staff member to follow up on the visit.

 Setting up a preventive services prompting system can help ensure that patients receive all the preventive services recommended by the Bright Futures Guidelines

Consider these ideas:

 Refining your recall-and-reminder system can help identify patients who may be missing out on Bright Futures preventive health services

Consider these ideas:

  • Use your scheduling system for recalls and compile a list of patients who are due for Bright Futures visits.
  • Use your EHR system to run a report of patients who have missed their well-child visits or immunizations.
  • Consider automating your recall-and-reminder messages to parents' preferred methods of communication (ie, text, phone, or mail).
  • Create a chronic condition list from the billing or EHR system. Identify children with special health care needs in the scheduling system so that you can schedule longer appointment times.
  • Review the Bright Futures Tool and Resource Kit, 2nd Edition for more ideas and tools.

 Incorporating Bright Futures into your EHR system will speed the integration of these services into daily practice

Consider these ideas:

  • Incorporate the elements of the Previsit Questionnaire and Visit Documentation Form into your EHR system to ensure that all components of the Bright Futures visit are covered at each visit.
  • Visit the Integrate Bright Futures Into Your Electronic Health Record System page in this section of the Bright Futures Web site for more information.

 Using the Bright Futures Preventive Services Quality Improvement Measures can help you incorporate quality improvement into clinical practice

Consider these ideas:

  • Measure and document your preventive care activities and services. This critical step facilitates the translation of the Bright Futures Guidelines into quantifiable components that can help you incorporate quality improvement into your practice on an ongoing basis.
  • Visit the Quality Improvement section of the Bright Futures Web site for more information about the Bright Futures Preventive Services Quality Improvement Measures.

 Using AAP coding resources to ensure appropriate coding for preventive services

Consider these ideas:

 Linking to community resources can reinforce your work with patients and families

Consider these ideas:

  • Assign an office or clinic staff member to be a liaison with community organizations and to maintain a list of community resources for parents. Hire a care coordinator or use current staff members with skills in this area.
  • Use the community liaison in your practice to handle referrals, communicate with specialists, and coordinate services/resources for families.
  • Consider hosting mixers with potential referral sources in the community to establish relationships.
  • Use this Community Resources Handout to get started! Visit the Bright Futures Tool and Resource Kit, 2nd Edition for more ideas, strategies, and tools.

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The Bright Futures Training Intervention project served as the foundation for the Education in Quality Improvement for Pediatric Practice (EQIPP) courses. Conducted by AAP Bright Futures in 2006, with funding from the Commonwealth Fund, the BFTI project tested a framework that included 6 office system components:

  1. Using a preventive services prompting system
  2. Using structured screening to assess developmental and behavioral needs
  3. Evaluating parental strengths and needs
  4. Using recall-and-reminder systems
  5. Linking to community resources 
  6. Identifying children with special health care needs

BFTI represents a unique office-systems approach to specifically improving the delivery of developmental screening and preventive services for children younger than age 5. This approximately 1-year collaborative learning intervention involved engaging multidisciplinary office teams from primary care practices in implementing all 6 of the key components and strategies that embody the Bright Futures philosophy. Learn more by visiting the Quality Improvement section of this Web site.