Background and objective: Poverty is a risk factor for both language delay and failure to access appropriate therapies. The objective of this study was to increase the percentage of children 0 to 3 years old referred from an urban primary care center who attended an initial appointment with speech pathology or audiology within 60 days from 40% to 60%.
Methods: The Model for Improvement was used to develop and test the intervention, which addressed potential logistical barriers faced by low-income families. Adherence was plotted on run charts in time series to assess overall improvement, and subgroups were analyzed to identify reduction in disparities.
Results: Median referral adherence improved from 40% to 60%. Families from lower income neighborhoods had lower preintervention adherence; these differences were eliminated postintervention.
Conclusions: System-level changes improved access to evaluation and treatment for low-income children with language delay and narrowed the gap in access between families in lower versus higher income neighborhoods.
Keywords: achievement gap; developmental screening; health disparities; language delay; primary care; quality improvement; referral adherence.
© The Author(s) 2015.