SEEK Training and Implementation: Pediatrics and Family Medicine

The SEEK Project no longer offers CME, MOC-2, MOC Part 4 (ABP) or ABFM Performance Improvement (PI) credits. We instead provide guidance and materials for physicians to complete an ABP MOC-4 / ABFM PI self-directed activity - see information below.

Intended Audience

Pediatricians, family medicine physicians, nurse practitioners, physician assistants, and residents in pediatric and family medicine primary care settings.
Anyone can complete the SEEK online training for free. It is strongly recommended that all primary care professionals (PCPs) do so before implementing the SEEK approach.

Overview
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There are 2 ways to complete the free SEEK training:

  • Independently – at your convenience, view the SEEK training videos, read two key articles, and review related materials.
  • SEEK MOC/PI Activity – in addition to the above, view three 30-minute webinars and complete a mini–Quality Improvement (QI) project.

The SEEK independent training consists of:

The SEEK MOC-4/PI Self-directed Activity requires 8-10 hours over 8-10 weeks. In addition to that described above for the independent training:

  • View three 30-minute recorded webinars covering challenging clinical situations and instructions for the mini-QI project.
  • Conduct a mini-QI project.
  • Implement SEEK in your practice.

If you’re interested in implementing SEEK but not wanting MOC Part 4 or PI credits, go through steps 1, 2 and 4; ignore step 3. If you want to obtain these credits:

American Board of Pediatrics: Click here for the QI information, checklist, and application. Apply to them using the 'Your Own QI Project' application within your ABP portfolio ($75 fee).

American Board of Family Medicine: Click here to review the guidance for your Self-Directed Clinical PI Activity. Log into your MyABFM Portfolio, select Performance Improvement Activities and chose Self-Directed Clinical (no fee).

 
Learning Objectives
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At the conclusion of this activity, participants and/or a practice should be able to:

  • Screen parents systematically using the SEEK Parent Questionnaire-Re (PQ-Re).
  • Briefly assess targeted health-related social needs.
  • Initially help address the problems and facilitate referrals to community resources.
 
1. Initial Steps
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To help you decide whether to introduce SEEK into your practice and whether to do the MOC-4/PI Activity, we recommend first doing the following:

  1. View this 7-minute video.
  2. Read the SEEK overview article.
  3. Review SEEK’s core materials: SEEK PQ-Re, SEEK Guidelines and Responses to Barriers, the SEEK Parent Handouts, and the FAQs.
  4. Encourage other PCPs in the practice to do the same and assess interest in introducing this innovation into your practice. It’s best if all or most agree to adopt SEEK. If you have a behavioral health professional, include them.

If you wish to proceed, please go to Step 2 "Preparation”.

2. Preparation
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2A. Training PCPs Click here »

First complete the free SEEK online training. To access the initial training, please register.

  1. Log in to your account, select “SEEK Training”.
  2. View the 9 SEEK training videos.
  3. Read the 2 key articles.
  4. Review the SEEK Guidelines and Responses to Barriers (best to review the Guideline for a topic soon after viewing the related video).
  5. Review the SEEK Parent Handouts.
  6. Check the FAQs.
  7. Optional
    • Complete the SEEK Test
    • Complete the SEEK Training Evaluation
2B. Preparing Your Practice Click here »
  1. Optimal if all the PCPs in your practice implement SEEK, but it’s not essential.
  2. If you have in-house behavioral health, involve them in the planning.
  3. Innovations are tricky. Helps to have a champion lead SEEK’s implementation and a co-champion from administration/nursing.
  4. Optimal if buy-in from everyone in the practice; convey how SEEK will enhance care.
  5. Decide which visits to target for giving parents the SEEK Parent Questionnaire – Re.
    • We recommend doing so at least 3 times between 0-5 years of age; prioritize less busy visits.
  6. Decide whether to begin with all the questions in the PQ-Re and use the initial data (e.g., 1st few months for a needs assessment to decide which problems to target. Alternatively, you can prioritize problems from the start.
    • We recommend prioritizing problems that are prevalent in your patient population or ones you consider particularly important and ones where you have resources to offer.
  7. Decide what you will do with the PQ-Re information after the visit. Options include:
    • Document what screening occurred, what was positive, and actions taken.
    • Program your EHR and staff enter the positive responses.
    • Scan the PQ-re into the EHR.
    • Compile and review the questionnaires for a needs assessment.
  8. Ensure that the SEEK Guidelines and Responses to Barriers are readily accessible to PCPs and behavioral health professionals.
  9. Ensure clear referral procedures – for in-house and community resources.
  10. Decide whether to use the SEEK Parent Handouts or alternatives or a mix.
    • Best to replace the information on national resources with local ones. For guidance on this, click here.
    • These should be easily accessible to PCPs and behavioral health professionals. In addition, they can be transmitted to a patient portal and/or placed on your practice website.
2C. Training Staff Click here »
  1. Clerical staff need to identify in advance those parents who will need a PQ-Re for an upcoming visit and add it to the paperwork.
  2. Staff should provide the PQ-Re toward the start of the visit.
    • We recommend this be done when showing the family into an exam room, saying: “We want to improve the care we provide. Please fill this out and give it to your doctor or nurse”
  3. Behavioral health professionals may benefit from the PCP training. They should be involved in clarifying their role and developing the referral procedure.
3. The SEEK MOC 4/Performace Improvement Self-Directed Clinical Activity
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3A. Cycle 1 Click here »
  1. Set a period (e.g., 2 weeks) for PCPs to complete the initial training.
  2. PCPs view the SEEK MOC/PI webinar 1 - click here for the recording.
  3. The key materials
  4. Go through the Preparing to Implement SEEK Checklist.
  5. Review Parent Handouts. Decide who will replace information on national resources with that of local ones, and by when.
  6. Set start date for implementing SEEK (e.g. in 4 weeks).
  7. Cycle 1 Data Collection
    • One set of data suffices for all participating PCPs in the practice.
    • Randomly select 10-20 charts of children who had a well visit with a participating PCP in the past month. Pick visits that correspond to the ages that you’ll administer SEEK. You could select the 1stor last chart from a PCP’s session of a child whose age matches (e.g., 9-month visit, if that’s one you plan to target).
    • Enter the data on SEEK MOC/PI Medical Record Evaluation Form – click here for form and instructions. ABP requires at least 3 cycles of data, displayed in a run chart. ABFM requires just 2 cycles.
    • Share the information with all involved. Consider tweaks to improve SEEK’s implementation (e.g., remind front desk staff to include the PQ-Re with other paperwork).
3B. Cycle 2 Click here »
  1. Start implementing SEEK.
  2. Set a period (e.g., 2 weeks) for PCPs to complete the next training.
  3. PCPs view the SEEK MOC/PI webinar 2 - click here for the recording.
  4. The key materials
  5. ~3 weeks later, gather Cycle 2 data from the prior 2 weeks, after starting to implement SEEK– repeat procedure in Cycle 1.
    • Randomly select 10-20 charts of children who had a well visit with a participating PCP in the past 2 weeks. Pick visits that correspond to the ages that you’ll administer SEEK. You could select the 1stor last chart from a PCP’s session of a child whose age matches (e.g., 9-month visit, if that’s one you plan to target).
    • Enter the data on the SEEK MOC/PI Medical Record Evaluation Form – click here for form and instructions.
    • Share the information with all involved, consider tweaks to improve SEEK’s implementation (e.g., remind medical assistants to encourage parents to complete the PQ-Re).
3C. Cycle 3 Click here »
  1. Set a period (e.g., 2 weeks) for PCPs to complete the final training.
  2. PCPs view the SEEK MOC/PI webinar 3 - click here for the recording.
  3. The key materials
  4. ~3 weeks after gathering Cycle 2 data, gather Cycle 3 data – repeat prior procedure.
    • Randomly select 10-20 charts of children who had a well visit with a participating PCP in the past 2 weeks. Pick visits that correspond to the ages that you’ll administer SEEK. You could select the 1st or last chart from a PCP’s session of a child whose age matches (e.g., 9-month visit, if that’s one you plan to target).
    • Enter the data on SEEK MOC/PI Medical Record Evaluation Form – click here for form and instructions.
    • Share the information with all involved, consider tweaks to improve SEEK’s implementation (e.g., remind medical assistants to encourage parents to complete the PQ-Re).
  5. Submit your data to the ABP or ABFM.
4. Wrapping Up and the Road Ahead
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  1. Decide whether to continue implementing SEEK.
    • If yes, please send us, once a year, upon request, the SEEK Feedback Form
  2. Consider using the SEEK posters and/or video for your waiting area.
  3. Assign someone to probe billing options – see article.
  4. Periodically check and update info on local resources in your Parent Handouts.

If you need assistance, please email Howard Dubowitz, MD at hdubowitz@som.umaryland.edu