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Keeping Up - Tracking Health Services: [A Learning Activity]
 

Each Head Start program is required to create a tracking system for maintaining children's health records. Health managers and health staff can use this learning activity to assess their program's system and to develop skills in tracking and determining for whom health follow-up is needed and when it should occur. Requiring approximately 60 to 90 minutes to complete, the activity utilizes handouts and state Early and Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines, both included here.

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The following is an excerpt from Well-Child Care: Making It Happen.
Keeping Up-Tracking Health Services: [A Learning Activity]

Purpose
For This Activity You Will Need
Trainer Preparation Note
Steps
Points to Consider
Handout: Sample Child Health Records
Handout: Trackville Head Start Tracking Instrument
Trainer Handout: Keeping Up
Child Health Record Form (Blank)

Purpose: This coaching activity helps participants assess their program's health tracking system and develop skills in tracking and determining what and when health follow-up is needed.

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For this activity you will need:

  • Handout: [Sample] Child Health Records or your own agency records

  • Handout: Trackville Head Start Tracking Instrument

  • ...Your own state EPSDT guidelines

  • [Handout] Keeping Up -- Tracking Health Services (For Trainer Only)

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Trainer Preparation Note:

If you want to update the child health records and tracking instrument so that they reflect current information and have current dates, you will find blank copies of these handouts that you can fill out in
Child Health Record Form (Blank)

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Step 1: Explain that this activity will help assess your program's health tracking system and develop skills in reviewing tracking records.

Step 2: Ask the participant(s):

  • What is the current system that you use to track children's health services in your program? How has it been working for you? What are your system's strengths? What are its' weaknesses?

  • Are you considering upgrading to a new computerized system or an improved version of an existing system? What have been your sources of information? What have you learned? What else do you need to find out? (Make plans to get the additional information needed.)

Step 3: Distribute Handout: Child Health Records ... Explain that this child, Janine, is attending Trackville Head Start. Distribute Handout: Trackville Head Start Tracking Instrument. Explain that this tracking instrument includes the health records of Janine's class in the program. Ask participants to enter Janine's health record into the Trackville Head Start Tracking Instrument in space #15.

Step 4: Distribute … your own state EPSDT guidelines. Ask participants to use the preventive care guidelines and review the Trackville Head Start Tracking Instrument to identify children or records that need follow-up for any reason. For example:

  • Is any data entered incorrectly?

  • Are any records or health services not up-to-date with the EPSDT guidelines?

  • Are there children with abnormal results who need repeat screening, follow-up evaluation or treatment?

  • Are more than the usual number of children failing a screening? Is there a problem with its administration?

Instruct participants to circle elements that need follow-up and note what follow-up is needed for each. Allow 10-20 minutes.

Step 5: Review with participants the Trackville Head Start Tracking Instrument. Beginning with Janine, identify any elements in the health records that need follow-up. Then proceed with each of the children, identifying the follow-up needed. (See Keeping Up-Tracking Health Services [for trainer only].)

Step 6: Explain that, once a need for follow-up and a timeframe has been determined, programs need a "tickler file" or reminder system. Ask:

  • What system do you have to remind you of follow-up needed to complete missing health services, further evaluation or treatment, and follow-up for children to stay up-to-date on age-appropriate preventive health care and immunizations?

  • How has your system been working for you? What are your system's strengths? What are its weaknesses?

  • Do you need to improve your reminder system? What have been your sources of information? What have you learned? What else do you need to find out? (Make plans to get the additional information needed.)

Step 7: Have participants look at the entire class of children on the Tracking Instrument. Ask:

  • Are there any common problems that are apparent? (For example, are many children missing growth measurements or vision screening? Are many children not up-to-date on their immunizations? Do many children have anemia?) What plans might you make to address these concerns?

  • How are you using this information to plan services with your Health Services Advisory Committee, Policy Council, and health care providers in your community?

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Points to Consider:

  • Tracking involves systematic documentation and review of children's health records. Effective tracking tools help identify the health services that children have received and children who require follow-up.

  • The program's tracking system must facilitate the sharing of necessary information among staff including the program director, component coordinators and other designated staff.

  • Specific staff must be designated, trained and monitored in entering and reviewing tracking data.

The program's tracking system must be reviewed regularly to ensure that the information is current and relevant to the program.

See also:
     Handout: Child Health Records [PDF, 326KB]
     Trackville Head Start Tracking Instrument [PDF, 295KB]
     Trainer Handout: Keeping Up [PDF, 16.0KB]
     Child Health Record Form (Blank) [PDF, 2.70MB]

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"Keeping Up – Tracking Health Services: [A Learning Activity]." Well-Child Health Care: Making It Happen. Training Guides for the Head Start Learning Community. HHS/ACF/ACYF/HSB. 1998. English.