Best Practices for Increasing Lead Screening Rates

In an effort to increase lead testing scores among NJ FamilyCare providers, five Managed Care Organizations (MCOs) in New Jersey joined together to examine the processes and procedures of providers with superior lead testing rates.

This MCO collaborative identified providers with overall lead testing compliance scores greater than or equal to 80 percent. They then conducted interviews with these providers to determine best practices that can be easily replicated by you and other health care professionals to increase lead screening rates.

The collaborative is proud to publish the following compilation of best practices as shared with us by New Jersey practitioners caring for this young, vulnerable population.

Internal Office Procedures

• When a lab order for a lead test is given to the parent/guardian, follow up in one month to ensure testing was completed.
• Offer Saturday and walk-in appointments for lead testing.
• If you do not receive lead test results from an outside lab, call the parent/guardian.
• Confirm current and emergency contact information at each visit.
• Train staff on caring for crying children, filter-paper (MedTox) testing and verbal risk assessments.
• Build a trusting rapport with parents/guardians, have bilingual office staff, and practice cultural sensitivity and empathetic care.
• In-office lead testing helps improve compliance and prevent missed opportunities. Use MedTox testing for patients with poor venous access and non-compliant patients after repeated scripts are given to the parent/guardian.

Parent/Guardian Education

• Discuss the importance of early lead screening during both well and sick visits.
• Discuss the risks of not being tested, including the possibility of behavioral and cognitive issues.
• Make information about lead testing available on the office’s patient portal.
• Provide posters with lead information in exam rooms and have written education available.
• Stress that lead testing is mandatory in New Jersey for children under the age of 6 years old.
• Provide a written summary of each visit to the parent/guardian that includes outstanding items to be completed, such as lead testing.

Outreach Techniques

• Send appointment reminders one week and one day before scheduled visits.
• If an appointment is missed, follow up in one week.
• Make calls to the parent/guardian when a child is due for a lead test.
• Make at least three attempts to contact the parent/guardian and use phone, text and email. If still no response, send letters to the child’s home.
• Try reaching both parents/guardians, if applicable. If you are not successful, try an emergency contact.