Improving Patient Access to a Rural Autism and Developmental Medical Center

Abstract

The Geisinger Autism & Developmental Medicine Institute (ADMI) serves approximately 1000 new patients per year who are presenting for initial diagnostic assessment for a wide range of neurodevelopmental disabilities (NDDs) including global developmental delay, intellectual disability, and autism spectrum disorder. As with other medical centers evaluating for NDDs, ADMI has experienced excessive wait times; however, it has implemented several approaches to reduce its wait times to approximately 6-9 months. Since ADMI is in a rural area it serves a large catchment region, and many patient visits need to include both a diagnostic evaluation and a medical evaluation. Thus, all parts of new patient evaluations need to occur in one visit rather than multiple visits, thereby increasing the complexity of the schedule and expanding wait time. The typical approach to reduce wait times in any process is to obtain more bottleneck resources. However, due to the shortage of neurodevelopmental pediatricians and developmental-behavioral pediatricians, this is not possible for ADMI. Thus, ADMI modified its evaluation process for new patients to allow for clinical psychologists, speech pathologists, and advanced practice providers (physician assistants and nurse practitioners) to conduct new patient evaluations. In ADMI’s unique multidisciplinary approach, new visits are paired between clinical psychologists who provide diagnostic evaluations and advanced practice providers who provide medical evaluations, resulting in medically and behaviorally comprehensive assessments in a single visit. This multidisciplinary approach has resulted in reduced wait times for new evaluations, ADMI has a need to understand the process from a systematic viewpoint.