Initiatives to improve the quality of care delivered to patients with autism spectrum disorder (ASD) not only at the level of the individual healthcare provider but at the system level across entire hospitals, clinics, and healthcare networks have the potential to have a positive impact on the lives of many patients. This chapter provides guidance about how to initiate and affect change at this level and provides detailed information about an initiative at Massachusetts General Hospital, as a case study demonstrating how such change can be brought about. Key principles that can optimize a quality improvement initiative’s chance of success include clearly defining the target population and specific goals for the intervention, gathering preliminary data to help support the need for intervention, engaging key stakeholders and champions who will carry the initiative forward, efficiently and effectively implementing concrete changes, and measuring the impact of interventions in a quantifiable way. At its best, quality improvement is an ongoing, cyclical process that continually moves forward with the identification of new targets for intervention as well as areas that were not adequately impacted in previous interventions.
KeywordsAutism Quality improvement ASD Care gaps Case study
The authors would like to acknowledge all members of the MGH Autism Care Committee, without whom the work described would not have been possible. These members include Zary Amirhosseini, Sarabeth Broder-Fingert, Kathleen P. Buckley, Debra Burke, Roger Gino Chisari, Amanda B. Coakley, Eve Megargel, Mary O. Cramer, Richard H. Evans, Theresa M. Gallivan, Ann M. Giauque, Peter T. Greenspan, Eric P. Hazen, Ann Kao, Robin Lipkis-Orlando, Denise Jordan Lozowski, Christopher J. McDougle, Brenda Miller, Helen O’Carroll, Kristen Solemina, Michael Sullivan, Carmen D. Vega-Barachowitz, Pamela E. Wrigley, Sheila Golden-Baker, Tristan Gorrindo, Carole Mackenzie, Karen E. Morse-Gallagher, Janet S. Rico, Jamie Lee Rossi, Pamela E. Wrigley, Ann Martha Neumeyer, Karen A. Turner, Kerstin Zanger, Ann Fonseca, Rachel Toran Tobin, Amy Mcguire, and Victoria Peake.
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