Medical Home Screening Tool Development and Validation Among a Sample of Infants and Young Children

BACKGROUND: Medical home (MH) is a financially viable, all-inclusive primary care model that can enhance communication, improve care coordination and support patients, families and healthcare providers. No standard screening tool exists for use by hospital-based healthcare providers to identify children with medical complexity (CMC), which can result in inconsistent MH referrals. The purpose of this research was to develop and validate a screening tool for use in identifying CMC who would benefit most from early MH referrals prior to hospital discharge home. METHODS: This mixed-methods research utilized e-Delphi methodology and retrospective chart review to develop and validate a screening tool for MH referrals. RESULTS: Twenty-three nurses, nurse practitioners, physicians, social workers and case managers participated in four e-Delphi rounds to develop the Pediatric Medical Home Screening Tool (PMHST). The PMHST consists of four sections and 20 criteria. Reliability testing of the PMHST revealed 82% agreement with medical complexity categorization of infants and young children. CONCLUSION: The PMHST may enhance future care transitions, improve quality of care and reduce the risks of safety events. The PMHST was validated in a sample of infants and young children and will be tested with a broader sample of children in the future.