Seconds for care: evaluation of five health supervision visit topics using a new method.
OBJECTIVE
To describe content and time devoted to 5 preventive health topics during health supervision visits (HSVs).


METHODS
New software (Pediatric Health Supervision Timer Software, PHSTS) run in handheld computers was developed to record time and content while observing HSVs. 185 visits of children ages 2 to 10 years (58% Medicaid/self-pay) to 28 clinicians were observed at 6 practices. Parents were surveyed on demographics. Data on times and actions related to assessments and counseling of growth, diet, physical activity, safety, and tobacco were collected using PHSTS.


RESULTS
The PHSTS method was well accepted (89% participation rate). Most visits included assessment/counseling for diet (95%), growth (84%), and safety (71%) and less often physical activity (52%) and tobacco (43%). Discussions occurring were short (median time [25th to 75th percentiles]: diet, 42 seconds [21 to 85 seconds]; safety, 24 seconds [11 to 61 seconds]; growth, 15 seconds [7 to 31 seconds]; physical activity, 12 seconds [5 to 22 seconds]; and tobacco, 3 seconds [2 to 6 seconds]). Clinicians expressed concerns about child weight during 18 of 33 visits (55%) that included an obese child and provided tobacco-related counseling at 6 of 30 visits (20%) that included a child living with a smoker.


CONCLUSIONS
The PHSTS method was successfully used. Our observations found that limited time was devoted to assessment and counseling on key health topics during HSVs.
Martin
Lisa A
LA
Department of Pediatrics, Children's Memorial Hospital, Chicago, IL 60614, USA.
Ariza
Adolfo J
AJ
Thomson
J Scott
JS
Binns
Helen J
HJ
D002648:Child; D002675:Child, Preschool; D034201:Computers, Handheld; D004032:Diet; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods*; D011314:Preventive Health Services / Q000379:methods*; D011315:Preventive Medicine / Q000379:methods*; D015397:Program Evaluation; D012449:Safety; D012984:Software