Clinical Practice

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Many pediatric health care providers have asked whether it is really possible to implement the recommendations in Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition, in daily clinical practice. The answer is Yes! 

In fact, you already may be using many of the Bright Futures principles and recommendations. The material in this section makes implementation even easier for you.  These handy tip sheets offer practical advice to help you integrate the Bright Futures approach, tools and resources into your daily practice.

 Get to Know the Bright Futures Guidelines and Core Tools

  • Make the Bright Futures Guidelines, 3rd Edition, the foundation of your pediatric practice.
  • Keep the Bright Futures/American Academy of Pediatrics (AAP) Periodicity Schedule and the Bright Futures Pocket Guide handy as practice reference tools.
  • Consider using the Core Tools from the Bright Futures Tool and Resource Kit during each visit. The Core Tools are the Previsit Questionnaires, Visit Documentation Forms, and Parent/Patient Education Handouts. Previsit Questionnaires and Parent/Patient Education Handouts are available in English and Spanish. Or use these tools to update your own practice tools.
  • Consider using a Previsit Questionnaire to gather important information to individualize the visit and prioritize what is most important for each patient and family during the well-child visit. 

 Take Advantage of Other Practice Tools and Resources that Support Implementation of the Bright Futures Guidelines

  • Become familiar with the Bright Futures Performing Preventive Services Handbook, which provides guidance on the most effective way to deliver the preventive services recommended in the Bright Futures Guidelines.
  • Refer to Bright Futures: Nutrition and the Bright Futures: Nutrition Pocket Guide for the latest nutrition guidance. Use the practice tools and forms in these resources to promote and support healthful eating among your patients.
  • Use the Bright Futures Oral Health Risk Assessment Tool to identify children who are at highest risk for oral health problems and need additional care and guidance.
  • Take advantage of TXT4Tots, a message library you can use to send nutrition and physical activity texts to parents and caregivers.
  • Display family-friendly posters in your office to support healthful eating and good nutrition. Promote early literacy with the Books Build Connections Toolkit. This toolkit includes material for health professionals and easy-to-understand material for families.
  • Download the Bright Futures VisitPla​nner app to customize patient visits based on each child's health care needs and parent/family concerns.
  • The Rapid Assessment for Adolescent Preventive Services© (RAAPS) is a Web-based, validated risk assessment and counseling system (age range: 9-24 years). As part of the system, health messages appear for teens following completion of the RAAPS. Health messages provide professionals evidence-based behavior change ideas to assist in discussions with teens. A sample questionnaire of the standard RAAPS survey instrument (for ages 12-18) can be downloaded for review upon your acceptance of the conditions stated on the RAAPS Web site.  The AAP is not responsible for the content of this resource.

 Organize Your Office Practice to Make Implementing Bright Futures Easy

  • Start gradually. Some health care providers may see efforts to implement all recommendations in the Bright Futures Guidelines at once as overwhelming. Implementing Bright Futures recommendations in parts and stages can ease the transition.
  • Involve your entire team. Include, for example, a physician, nurse practitioner, medical ancillary staff or assistant, child development specialist, nutritionist, and administrative office system staff. These individuals help ensure that Bright Futures components permeate the entire practice and that all workers are invested in the implementation effort.
  • Use the Bright Futures Preventive Services Measures, which will help you incorporate quality improvement into your practice on an ongoing basis.
  • Use Achieving Bright Futures, a guide that matches the visits on the Bright Futures/AAP Periodicity Schedule with the Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes used to document and pay for screenings, assessments, and other recommended services.
  • Set up a preventive services prompting system to ensure that your patients receive all the preventive services recommended in the Bright Futures Guidelines.
  • Develop and use a recall-and-reminder system.
  • Connect and build relationships with community resources that can reinforce your work with patients and families.
  • Integrate the Bright Futures Guidelines into your electronic health record (EHR) system. See reviews of various EHR systems.

Visit the Quality Improvement section to learn more about these items and download useful tools and tips.

 Use a Strength-based Approach to Partnering With Patients and Families

  • Work with the patients and families in your practice to assess and build their strengths so that they can say YES! to a healthy life. 
  • When encouraging behavior changes from patients and families, use shared decision-making strategies and motivational interviewing techniques to arrive at a workable plan to solve problems.  
  • Become familiar with the Strengthening Families Protective Factors Framework.

 Share Bright Futures Materials With Families

  • Use the Bright Futures Family Pocket Guide, available in English and Spanish. This pocket guide provides family-friendly tips, strategies, and resources for every stage of a child's development, from infancy through adolescence.
  • Encourage expectant and new moms in your practice to sign up for text4baby. This mobile information service provides free text messages on a variety of topics to women throughout their pregnancy and up until their baby's first birthday.
  • Promote use of the mobile Child Health Tracker for families.
  • Share Child Care Health Partnership Parent Handouts consistent with Bright Futures recommendations, available in English and Spanish.
  • Display family-friendly posters in your office to support healthful eating and good nutrition.
  • Keep a supply of Bright Futures Activity Books in English and Spanish on hand to occupy children while they wait to see you.

 Share Your Bright Futures Knowledge With Others

  • Promote preventive care in your community by using the About Bright Futures video, presentation templates and handouts, and the online resources available from this Web site.  
  • Connect with your state child health department and your local AAP chapter or other professional organizations whose members are involved in state or local partnerships that promote healthful child activities.​

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