Presenter Profile
Maura Powell, MPH, MBA
Children’s Hospital of Philadelphia
powellma@chop.edu
Maura Powell is the Senior Manager of The Possibilities Project (TPP), an exciting initiative to reinvent and reengineer primary care at The Children’s Hospital of Philadelphia. In her role as Manager, she is charged with overseeing the development and implementation of innovative solutions across the pediatric primary care network. Prior to her role with TPP, Maura worked in the Center for Healthcare Quality and Analytics at The Children's Hospital of Philadelphia as a Senior Improvement Advisor, where she combined improvement science and clinical data analysis to facilitate clinical improvement projects across the enterprise. She has a background in global public health, research and quality improvement. Maura received her Master’s in Public Health from The School of Population Health at Thomas Jefferson University, in Philadelphia, PA and her Master’s in Business Administration from Rosemont College in Rosemont, PA.
Presentations
Testing a New Care Model: Implementing a Virtual Driving Assessment in Pediatric Primary Care
Shannon Kelleher, MPH
Maura Powell, MPH, MBA
Uchenna Nwokeji, MS
Nicole Koepke, MSN, CRNP
Jamillah Millner, MPH
Joshua C. Fischer, BS
Alexander K Gonzalez, MS, MBA
Shukai Cheng, MS
Elizabeth A. Walshe, PhD
Colleen Schlotter, BS
Flaura Winston, MD, PhD
Alex Fiks, MD, MSCE
Motor vehicle crashes are a leading cause of death for youth, and most crashes are due to driver error. Our study objective was to implement a Virtual Driving Assessment (VDA) into adolescent well visits at a large pediatric primary care network to assess driving skills and provide customized feedback to help teenagers avoid common driving errors. Funding was provided by a gift from NJM Insurance.
Between May 2021- December 2022, we conducted a single arm implementation study utilizing the IHI Innovation Methodology, an iterative testing and refinement process. The VDA is a validated 15 minute self-guided virtual driving test. 18 urban, suburban, and semi-rural primary care sites integrated the VDA into the adolescent well-visit for teens 15 years of age and older. A multi-disciplinary stakeholder group, including clinical champions, driving experts, innovation specialists, administrative leaders, parents and teen advisors, provided input to implement strategies addressing key barriers to expanded VDA use. We measured the proportion of eligible teens by site who completed a VDA at their well-visit monthly and overall and collected user satisfaction feedback.
In total, 16,736 eligible patients had a well visit during the implementation period. Among these adolescents, 2,161 completed a VDA with an overall median network completion rate of 11% (IQR: 5-17%, Figure 1), with some sites achieving up to 31% completion rate across the study period. There were notable rate changes over the study period around COVID and winter viral surges (Figure 1). Those completing the VDA were more likely to be 16 or 17 years old compared to 15 years of age (p-value < 0.001); and the majority had not yet received a license or permit. Key implementation barriers identified by stakeholders included workflow variability by site and additional time needed to complete the VDA. To address stakeholder feedback, we implemented in-office interventions such as distributing weekly eligible patient reports posted in staff areas. A text messaging strategy was created to alert families that the VDA would be available at well-visits.
76% of teens completing the satisfaction survey both agreed or strongly agreed that they would recommend the VDA to their friends and that they would take the VDA again.
Implementing a novel virtual driving assessment into the adolescent well visit in a busy primary care setting is feasible and desired by teens, although barriers remain. This project provides a model for integrating innovative technologies into primary care to address salient health risks.
1. Why the VDA is an important tool
2. How the VDA can be implemented into a primary care network
3. Potential barriers for implementation of the VDA