Assessing the quality of preschool child health surveillance in primary care: a pilot study in one health district.
OBJECTIVE
To develop a framework for measuring the quality of preschool child health surveillance acceptable to primary health care teams and measurable at individual primary health care team level.


METHODS
Published research evidence was identified and criteria developed by a local multidisciplinary expert group. The criteria were discussed with primary health care teams. How well they were achieved was assessed.


METHODS
Twenty-eight general practices in one health authority area.


METHODS
Data collection included observation of baby clinics, interviews with health visitors and general practitioners (GPs), questionnaires to parents, collation of child health surveillance reviews recorded in personal child health records and immunization rates.


RESULTS
The criteria for assessing preschool child health surveillance were thought to be acceptable and achievable by primary health care teams. Fifteen of the 22 criteria used to assess baby clinics were met by over 90 of practices. Almost all practices completed child health surveillance reviews within a standard time and achieved 90 coverage for primary immunizations. At many practices, less than 90 of parents felt welcome at the baby clinic, usually had enough time to talk to their health visitor or had the purpose or results of the 6 to 8 week child health surveillance review explained to them. GPs were less likely than health visitors to discuss health promotion at child health surveillance reviews (chi(2) 11.52, P = 0.0007). Few practices had a call-up and recall system for all reviews.


CONCLUSIONS
The framework that we developed for assessing preschool child health surveillance was acceptable and achievable by primary health care teams.
Hampshire
A J
AJ
Division of General Practice, School of Community Health Sciences, The Medical School, QMC, Nottingham, UK. mandy.hampshire@nottingham.ac.uk
Blair
M E
ME
Crown
N S
NS
Avery
A J
AJ
Williams
E I
EI
D002662:Child Health Services / Q000592:standards*; D002669:Child Welfare; D002675:Child, Preschool; D003152:Community Health Nursing; D005194:Family Practice; D006801:Humans; D010865:Pilot Projects; D011159:Population Surveillance; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D006113:United Kingdom