RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Increasing Childhood Literacy Through Reach Out and Read, At The West Salem Clinic. Project Date: 7/2/2007 Reading aloud to children is an important tool to increase childhood literacy. Exposure to books at a young age helps build literacy in children. Sixteen percent of parents of young children do not read to their children at all and almost a quarter only read to them once or twice a week (1). Reach Out and Read (ROR) is a national program that seeks to increase childhood literacy rates by providing a new book to a child at each well-child check health care appointment between the ages of 6 months to 5 years. The goal of this community project was to establish an ROR program at the West Salem clinic. There were three parts to the project. The first was to contact the national ROR program to request application materials, and then compile the information needed to complete the application. The second part of the project was contacting other ROR sites around the state for information about the logistics and funding for their ROR programs. The third part of the project was to establish funding sources for both the start-up costs and the continuing costs of running the program. Grants/solicitations were submitted to various businesses and funding sources. A database of possible funding sources was created for future years to help sustain the program. Identifying a need for pediatric specialists in Coos Bay, Oregon Project Date: 8/7/2006 Coos Bay, Oregon is 212 from Portland, 111 miles from Eugene and 84 miles from Roseburg. These areas serve as the three major referral centers for pediatric specialists. Due to the excessive distance from specialist care, the need for greater compliance and increased quality of healthcare in rural areas the need for particular specialists in this area must be addressed. The goal of this project was to determine the current referral base for pediatric patients of the two major clinics in Coos Bay and to identify a need for a particular specialist in the area. The population studied included pediatric patients seen by the researcher while working at Bay Clinic and North Bend Medical Center during a four week period. The data gathered included type of specialist referral, problem or reason for referral, and location of the specialist. This data was correlated with qualitative data obtained from various pediatricians at both clinics regarding specialist needs, problems referred and where patients are referred. Qualitative data gathered indicates that there is a great need for a child psychiatrist in Coos Bay. Currently, there is one part-time general psychiatrist handling all of the Oregon Health Plan (Medicaid) patients. The barriers to efficient recruitment of physicians in rural areas needs to be further studied. Fathers of newborns: Are your new babies health care needs being met? Project Date: 7/3/2006 Many people consider the birth of a child to be a highlight of one's life. Naturally, bringing one's own offspring into the world can be a thrilling experience and much focus is spent on ensuring quality health care for both mother and child. The purpose of this community oriented primary care project is to investigate any potential problems with the health care of newborn babies by interviewing fathers of newborn children. Accessing the opinion of a father should reveal new insight into the success and comptetence of newborn healthcare from a perspective not usually considered. The project design included interviewing fathers of newborns in the medical clinic, night clinic and hospital. Medical Record Documentation Project Date: 3/20/2006 Medical therapy for heart failure including ACE-I/ARB and beta-blockers extend life and improve symptoms in patients with heart failure, as well as decreasing hospitalizations. They are therefore the cornerstone of therapy for heart failure. At the Cascades East Family Practice Residency, quality assurance/ chart reviews are done on inpatients that are discharged from the hospital, but this is typically not done on their outpatient clinic population. The patient population of CEFPC has a high level of medical comorbities, polypharmacy, limited follow-up as well as substance abuse and psychiatric co morbidities. I felt this made this population high risk for not receiving appropriate medical therapy. An audit was performed on pts with the ICD-9 code for heart failure, presenting for appointments over a six month period and from this list 26 patients were selected. Of the sample 34% of patients were on ACEI/ARB and beta- blocker. 27% were on an ACE only, 12% were on a beta blocker only and 27% were on neither. In conclusion, treatment with Angiotensin agents and B-blockers could be improved. There may exist absolute or relative contraindications for some patients, however these could be better documented in the problem/med list. In addition in patients with heart failure it would be useful to briefly summarize the results of the most recent echocardiogram including ejection fraction (EF), hypertrophy, valvular lesions, bundle branch block, and atrial fibrillation. A Suggested Protocol for the Management of ADHD in School-Aged Children of Coquille, Oregon Project Date: 9/12/2005 Attention Deficit/Hyperactivity Disorder (ADHD) is the most common neurobehavioral disorder of childhood, affecting 3% to 12% of school-aged children. ADHD may cause children and their families significant problems; symptoms may result in academic underachievement and difficult relationships. However, pharmacologic treatment of ADHD is largely effective, and is promoted by the American Academy of Pediatrics and the American Academy of Family Physicians. As no standardized ADHD management algorithm was available to the physicians of Coquille Valley Medical Center, this study sought to merge national treatment recommendations with the community standard of care to develop an ADHD management strategy for the treatment of school-aged children with ADHD in Coquille, Oregon. Prevalence of Eating Disorders in a Klamath Falls Pediatric Clinic Project Date: 8/9/2004 Eating disorders represent a significant cause of morbidity and mortality and typically present in adolescents and college-aged young women. Pediatricians have a unique opportunity to detect and treat these disorders.6 At the Klamath Pediatric Clinic it was noted that a large proportion of the visits were for mental health, however none of these were for the treatment of eating disorders. The purpose of this study was to specifically screen for eating disorders to determine if the prevalence was low or if the disorders were not being identified. A screening questionnaire was developed and given to patients at the clinic aged 10 and over, over a two week period. None of these patients screened positive for anorexia or bulimia, however the prevalence of obesity appeared to be fairly high. In addition, a brochure was developed to use as an informational and screening handout for concerned patients and an initial assessment form was made to use for a patient presenting with an eating disorder. I also visited the mental health treatment center for the area, which had the ability to provide outpatient treatment for eating disorders. ADHD vs. Bipolar Affective Disorder: a Comparison of the Two Mental Health Problems in the Pediatric Population of Klamath Falls. Project Date: 5/10/2004 Mental illness is an important medical problem in the pediatric population that affects communities ranging from large metropolitan areas like Portland to small towns such as Klamath Falls. Although the prevalence of attention deficit hyperactivity disorder (ADHD) and bipolar affective disorder (BAD) are significantly different in the pediatric population, they are often confused with one another due to the overlap of common symptoms. Therefore it is important to identify children with these disorders and make an accurate diagnosis to ensure that they receive the proper medical and psychological treatment. Analysis of ICD9 codes from 2003 demonstrated almost 1,000 visits for ADHD and BAD at The Klamath Pediatric Clinic. These numbers were confirmed by my own record keeping during a three week period which showed 16% of all visits were for mental health issues. Given the number of patients with ADHD and BAD, a screening tool was utilized to try to find differences in the presentation of these two illnesses at the time of diagnosis. Results from questionnaires handed out in the clinic showed higher scores by patients with BAD (24 versus 15; p 0.011). In addition, three specific categories including irritability, thought content, and disruptive behavior were significantly higher in children with BAD. The results of this project suggest that mental illnesses, specifically ADHD and BAD are an important healthcare issue at The Klamath Pediatric Clinic and that there may be ways to better screen for and treat these patients. A Survey Of Teacher Satisfaction With The Woodburn Pediatric Clinic's Monitoring Practices Of Students Diagnosed With Attention Deficit-Hyperactivity Disorder. Project Date: 11/5/2001 Attention-deficit/hyperactivity disorder is the most common school-aged behavioral problem with a prevalence of 3-5%. The Woodburn Pediatric Clinic has a large subset of these patients on its census. Management and monitoring included a questionnaire sent to the teachers and counselors of these patients concerning AD/HD-specific behaviors. This study investigated the efficacy of this questionnaire by employing a teacher survey. Generally, feedback concerning the questionnaire was positive. Suggestions for improvement centered on changing the format from fax to e-mail and giving respondents more lead time in completing the questionnaire. Back to subject search page or search by preceptor site