Pediatrics - Project DULCE

Project DULCE Implementation Manual 

Contents

NOTE: The Manual is still being developed and as sections are completed links to those sections will be enabled.

1. Overview

1. Guiding Principles
2. Logic Model
3. DULCE Intervention
4. DULCE Intervention Model

2. Getting Started

1. Patient-Centered Medical Home
   • Primary Care Clinicians
   • Social Work 
   • Nursing
   • Case Management
   • Support Staff
     
     
2. DULCE Partners
   • Pediatrics Primary Care
   • Healthy Steps
   • Medical-Legal Partnership|Boston
     
     
3. Required Resources
   • DULCE Staff  
     – Family Specialists 
     – Clinical Supervisors/Case Review
     – Administrative
   • Space
   • Materials
     

3. Required Training for DULCE Family Specialists

1. Parenting/Child Development (Provided by Healthy Steps/Boston)
   • Child & Family Development
   • Screening & Assessment
   • Home Visiting
   • Clinical Interviewing
     
     
2. Concrete Supports (Provided by Medical Legal Partnership | Boston)
   • Securing Nutrition and Income Supports, Stabilizing Housing, and Protecting Utilities for Families
   • Hunger Prevention
   • Income Supports
     
     
3.  Assessment Toolbox
   • Newborn Behavioral Observations (NBO)
   • Ages & Stages Questionnaires®, Third Edition (ASQ-3™)
   • Ages & Stages Questionnaires®: Social-Emotional (ASQ:SE)
   • Patient Health Questionnaire (PHQ)
   • Healthy Steps Temperament Scale

4. DULCE Intervention

1. Identifying Eligible Families
   
   
2. Creating the Relationship with the Family
   • First Week Visit
   • One Month Visit
     
     
3. Partnering with the Family
   • Two Month Visit
   • Four Month Visit
     
     
4. Family's Next Steps
   • Six Month Visit
   • DULCE Graduation to the Medical Home
     Medical Home Connections:
     – Community Link(s)
     – Early Intervention
     – Social Work
     – MLP
     – Mental Health

5. Family Assessment / Service Planning Processes

1. Queries
   • Trigger Questions
   • Housing & Utilities Screening
   • Income & Food Screening
   • Domestic Violence
   • Additional Screenings
     
     
2. Home Visits
   • Developmental: NBO/Ages & Stages
   • Safety
   • Visit Extension

6. Responding to Emergency Situations

1. Domestic Violence
2. Suicide Depression
3. Community Violence

7. Resources

1. Building Alliances with Agencies and Organizations
2. Coaching Families on How to Best Use Community Resources

8. Evaluation (Quality Improvement) of Implementation

9. Education and Training

1. Continuing Education (CE)
2. Training and Technical Assistance

Appendices

• DULCE Activity Log
• DULCE Family Profile
• DULCE Checklists
• Parent Handouts – In both English and Spanish