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Pre-visit Screening Tools Like Safety Checklists Can Save Children’s Lives and Your Time!

Pre-visit safety checklist can help meet Bright Futures guidelines

Checklists are vital to general pediatric health care to identify specific areas of health concern. As noted by Dr. Howard in her previous blog on Screening Tools to Assess and Address Social Determinants of Health, “healthcare settings use specific screening tools to assess and monitor the social needs and risk factors of patients.”

The PROBLEM OF TIME: Asking about numerous issues during a health maintenance visit can be very time-consuming. This is especially true for issues of safety, where many risk behaviors are answered negatively yet require asking to identify the few areas of risk that need to be addressed during the visit by the health care practitioner.

The PROBLEM OF SAFETY BEING NEGLECTED: Checklists for lead screening, autism, postpartum depression, and adolescent suicidality risk, just to mention a few, are considered a hallmark of good pediatric preventive health care and are frequently required activities. Safety is another area of concern that is often neglected due to the broad spectrum of areas encompassed under the umbrella of “safety.” The fourth edition of Bright Futures, Guidelines for Health Supervision of Infants, Children, and Adolescents (often considered the “Bible” in pediatric preventive care), has provided a comprehensive approach to safety management in its 868 page Fourth Edition tome. This document contains many excellent recommendations for safety checklists at every health maintenance checkup from Prenatal through Age 21. However, these would be difficult to implement because they are embedded among hundreds of pages of guidance and many other topics. Consequently, safety is easily neglected.

The SOLUTION: Dr. Howard also emphasized the importance of a program like CHADIS, which can collect “everything from current symptoms to medical history” all before an online visit. (See Dr. Howard’s blog of Feb. 7, 2024, Collecting Patient Data for Visits: Streamlining Telehealth, One Click at a Time.) This is equally true for in-person visits. By quickly allowing parents/guardians and patients who can read to respond to many issues before an

appointment, much appointment time can be saved. CHADIS, while recognizing the importance of such checklists, as well as the time constraints of a busy pediatric practice, has created a unique pre-office Safety Checklist (from Prenatal to Young Adult and modeled on the Bright FuturesTM Guidelines) that eliminates the need to query everyone during their visit and produces a short list of only those issues considered “at risk” for each child/family. These Safety Checklists can be completed quickly (< 10 min), and (for those practices that have the CHADIS Care Portal) can also provide access to safety-reinforcing age- and development-specific educational Safety Guidance specific to any of their at-risk Safety Checklist responses.


Recognizing the importance of including youth in the dialogue about safety, CHADIS provides

age- and development-appropriate safety checklists and safety guidance for youth who can read and mirror those of the parents/guardians. This provides an additional avenue for pediatric healthcare practitioners and parents/guardians to open a dialogue about safety with their youth.


Recognizing that unintentional injuries are responsible for about 10% of outpatient visits by children, the AAP’s The Injury Prevention Program (TIPP) recently completed a study (Perrin EM, et al. Pediatrics, April 1, 2024), which aimed to evaluate the effectiveness of TIPP’s provision of anticipatory guidance on injury prevention from the newborn period through age 12. TIPP includes written information for parents on topics such as car injuries, falls, burns, firearm injuries, bicycle crashes, drowning, poisoning, and choking. The study showed significantly fewer injuries reported at clinics that implemented TIPP compared to those that did not, and the authors concluded that the “study provides important evidence that a primary care-based intervention can be effective in reducing injury.”


See the complete list of questionnaires at:

For more information on CHADIS, go to or


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