Jeffery Epstein, PhD
Collaborators: Joshua Langberg, PhD ; Phil Lichtenstein, MD ; Lori Stark, PhD
ADHD Task Force Members: John Brewer, MD (Community Physician); Allan Robinson, MD (Community Physician); David Schonfeld, MD (Developmental and Behavioral Pediatrics); Michael Sorter, MD (Psychiatry); Marty Visscher, PhD (Parent Advocate)

Funded by the Patient Innovation Fund (2004-2009), Cincinnati Children’s developed its own intervention model termed the ADHD Collaborative to promote the adoption of evidence-based practices among community pediatricians. More than 278 physicians at 64 practices throughout Greater Cincinnati and Northern Kentucky have enrolled in the project.

The ADHD Collaborative works with the entire office staff to modify office systems to promote the systematic use of American Academy of Pediatrics (AAP) guidelines across the whole practice. Physicians are informed about the rationale and implementation of AAP prescribed guidelines for assessing and treating children with ADHD.

These teachings are followed by office flow training sessions during which pediatric offices work to modify their individual office systems to derive systematic office procedures for collecting ADHD rating scales, establishing written care management plans and monitoring treatment response. ADHD Collaborative staff work with the physicians and office staff to ensure that the new office flow system is implemented effectively.

The adherence of each participating physician to AAP-recommended practice behaviors is monitored by ADHD Collaborative staff through quarterly patient chart reviews. Each physician is provided with summaries of the chart review results. Quality-improvement strategies are used to teach practices how to problem-solve systemic glitches and continually improve their office system. Practices use this feedback to derive PDSA cycles to address any practice behaviors that are below established goal levels.