Lately our clinic shifted most well-child visits under age 3 to 15-minute slots, and I’m struggling to do meaningful developmental surveillance (ASQ/M-CHAT, parent coaching) without rushing families. How are you advocating for protected time or workflow tweaks that still honor parents’ concerns and those small milestones we don’t want to miss?
Shift ASQ/M-CHAT to pre-visit portal; MA scores; hold a 2‑minute coaching buffer for 15-minute visits, @OP.
RN-led pre-visit micro-telecheck changed it for us: ASQ/M-CHAT 24–48h before, RN flags one milestone to probe and one coaching target in the chart, so my 15-minute slot is confirm + coach; leadership okayed it when we showed higher screening rates and small payor bonuses. @p_wilkins45’s buffer helps, but ours got eaten by vaccines — could you pilot a 5-minute RN call twice a week and track cycle time?
, same — @OP, we added a waiting-room QR/iPad flow so parents finish the screeners while vitals happen, and the MA drops a smartphrase that pulls scores and auto-highlights one coaching target, which keeps a quarter‑hour slot humane. For admin buy‑in, I showed 96110 volume and got one protected “dev add‑on” per session for spillover; caveat is tech hiccups, so we keep paper plus this link handy: https://www.cdc.gov/ncbddd/actearly/milestones-app.html. Would your front desk be willing to pilot that for a week?
Carved out a 5‑minute “dev hold” every hour that only gets attached to under-3 checks when a concern pops up, so I’m not cramming surveillance or coaching. Front desk runs a simple rule: late preterm/prior delay/interpreter = attach the hold to protect those “small milestones.” @clara_holt82 do you have a quick EHR flag you like for routing these?
Quick example: we stocked a “two-minute toy kit” in each room (cups, board book, crayon), and the MA observes brief play during rooming while I talk, so I can verify one skill and drop a 30-second coaching tip — it’s like a mini crash cart for milestones. I paired it with a smartphrase that pulls the last screen and documents observation, plus 96110 when applicable, which helped leadership see the value without changing slots. @OP, would your team try a one-month kit + dotphrase pilot?
We’re in “15-minute” under-3s too, and what’s helped is asking families to send a 30‑second portal video of play/feeding with the ASQ/M‑CHAT invite; I watch it during vitals so the room time is just confirming a skill and one parent goal, @OP. Not perfect for low-tech access, but most will show a clip from their phone if I prompt them in the reminder message.
I shifted ASQ/SWYC to a quick RN phone screen the day before and kept the room time to a 60‑second “milestone lightning round,” with M‑CHAT only at 18/24 months; if anything flags, I use a protected noon call-back for coaching so the 15 minutes doesn’t implode. I tell parents, “We won’t rush this — if we need more time, I’ll call later today,” and share the CDC checklist link so we’re aligned: https://www.cdc.gov/ncbddd/actearly/milestones.html. Could your team run a pre‑visit RN queue like that, or is there another role who could own the screen?
, the “15-minute slots” make this feel impossible. Piggybacking on @cwhitson92’s prework angle, we added a 5‑minute hourly flex buffer the MA can trigger when a two‑question concern check or ASQ flag pops up — would your scheduler allow a tiny flex pool tied to flags? Tying it to 96110 revenue and completion rates got leadership to protect that time.