NPPC's Pilot Site Case Studies: Lessons Learned from ACEs Screening Implementation

The Center for Youth Wellness' National Pediatric Practice Community on ACES  (NPPC) is a co-designed community committed to collaborative learning. To promote this learning, we have been working with six pilot sites over the last year, representing practices of various sizes and service delivery settings, to implement ACEs screening and intervention. 

Beyond supporting these practices with the logistics of implementation, the broader goal was to discover and share real-world best practices, insights and resources to help other medical practices like yours. We’re also using these learnings to enhance the journey of our second cohort of pilot sites, currently in progress. 

As these sites have completed their initiative and started screening, we have put together an overview report and case studies for five of the sites. 

A few highlights: 

• All six sites succeeded in starting a screening program 
• Between 7% and 58% of screened patients had a “positive score” (each site defined “positive” differently)
• Approximately one-third to three-quarters of patients screening positive were referred to services, such as parenting classes and behavioral health
• 50% of sites strengthened their referral networks to support patients’ newly identified needs
• 50% of sites rolled out screening to other sites in their organization within the first six months of the pilot program, even though this was not an explicit goal 

And a few lessons learned: 

• Buy-in is key: Involve all stakeholders early in planning and to build support among organizational leaders, providers, and clinical support and front-line staff.
• Training is essential: Training at all levels helps build the buy-in and confidence that was critical for effectively implementing ACEs screening. 
• It’s possible to provide the needed resources: With appropriate scoring algorithms and some attention to strengthening referral systems, sites were able to adequately respond to screening results.

To access the overview report and the individual case studies, please visit the NPPC site.