September 15, 2008
Maryssa Soots, of Bethel, enjoys participating in her hearing test during her routine Well Child exam.
Well Child Program emphasizes prevention with regular screening
By Tiffany Zulkosky, YKHC Public Relations Staff
The Early, Periodic, Screening and Diagnostic Treatment Program (EPSDT), known more commonly as the Well Child Program, has been building momentum in Yukon-Kuskokwim Delta communities since early this year.
A preventive form of healthcare, screenings provided by the program assist Southwest Alaska's health care providers in reaching out to a child to intercept potential illness that could lead to an emergency or critical care situation.
"Preventive health care is being offered in the villages at a really high rate, maybe for the first time," said Bill Schreiner, the Director of the Well Child and Community Health Aide Programs at YKHC. "Because of the Well Child exam, we can detect and prevent some illnesses that could develop into more serious conditions in a child."
While the Well Child Program has been a consistent resource for health care in the region, the upward progress of the program traces back to Jon Baker's implementation of a Xerox software called FlowPort. Baker, a former Well Child Coordinator, encouraged the Community Health Aide Program's (CHAP) use of FlowPort, a web-based software that allows users to exchange and access documents without using a computer.
"The program enables Health Aides to submit timely data from a patient encounter form to YKHC's Bethel office," Schreiner continued. "Patient registration is now taking place in a much more timely fashion. Previous use of the postal service to mail in exam forms took a week or two to arrive by mail and slowed down the process."
Baker and many others are credited for developing a solid foundation for the program's expansion and growth.
"I am fortunate to have come into this program when I did," said Kurt Kuhne, current Well Child Coordinator. "The changes that Jon Baker implemented were amazing for timeliness. YKHC has almost 100 percent of our eligible Health Aides trained to provide these exams and 90 percent of our clinics have EPSDT-trained Health Aides."
As a health training center, YKHC developed a three-day continuing education course focusing on EPSDT/Well Child screenings. Community Health Aides (CHAs) must have completed Session 3, Session 4, or Practitioner training prior to participating in the Well Child class.
"Health Aides are taught to perform Well Child exams during Session 3 training. The three-day class is more in-depth and based on the Community Health Aide/Practitioner Manual (CHAM)," said Anna Simon, PNP, former Well Child/CHAP Director. "The course provides Health Aides with additional information about growth and development, as well as behavioral health issues like substance abuse, teen depression, and safe dating practices."
The class also prepares Health Aides to participate in the national Reach Out and Read Program. The program provides brand new, developmentally appropriate books for children between the ages of 6 months to 5 years at a Well Child visit.
More than 900 Well Child exams were performed region-wide in August, a record high for YKHC's village clinics, subregional clinics, and Bethel family medicine clinics. In June and July the number of exams were 810 and 877 respectively. These numbers sharply contrast to the 104 exams performed in January of this year.
Initially, every eligible Health Aide was asked to conduct one Well Child exam per month. The goal was then adjusted to one exam per week. Eventually the benchmark was set at two exams each Wednesday or eight per month. Health Aides have continually exceeded these numbers each month and have solidified the program's presence in Southwest Alaska.
The Well Child Wednesdays campaign, developed by CHAP, sets aside time each Wednesday to schedule patients for preventive exams. Although exams may be scheduled for any day of the week, typically village and subregional clinics see fewer sick patients mid-week.
With the Well Child Wednesdays campaign, the program expects to see a high number of exams conducted as the program catches up with the population of patients from birth to age 20 that have yet to participate.
"Eventually these record-breaking numbers will begin to decrease because we will have encountered every patient at least once," concluded Kuhne. "Our hope is that once the program has established preliminary contact with a child, we can focus simply on keeping routine exams scheduled."
Schreiner feels optimistic about the program's growth. "It's a proven fact that a preventive approach to health care results in a healthier population with a reduction in long-term injuries and illnesses."
