Research In Action

Children’s Hospital of Philadelphia (CHOP) has a large primary care network with over 30 sites and annually sees over 50,000 teens of driving age for preventive care visits. During these visits, providers may screen for various medical conditions, counsel on reducing injury risk, provide immunizations, and give general health guidance. Until recently, driver readiness has not been a standard component of preventive healthcare for adolescents, despite motor vehicle crashes (primarily due to driver error) being a leading cause of death for teens and young adults. 

I work as the Senior Manager of The Possibilities Project at CHOP, where we are reimagining pediatric care delivery to improve patient health outcomes, enhance the patient and provider experience, and meet the future health needs of our patients and families. We approach innovation projects with an open mind and a “learning through doing” approach, which allows us to learn from front line staff and iterate on our implementation to achieve the best result. 

Collaborating On Implementation 

When Dr. Flaura Winston and her team at the Center for Injury Research and Prevention approached us with the idea to leverage the preventive care visit to potentially prevent crashes involving young drivers, we were excited to collaborate and to share recently published research that shows our implementation of a virtual driving assessment in the primary care setting as part of routine care is not only feasible, but also desired by adolescents. 

The research describes how an interdisciplinary team from The Possibilities Project, the Center for Injury Research and Prevention and the CHOP Primary Care Network partnered closely with the clinical teams at each of our primary care pilot sites to support the integration of the novel virtual driving assessment into the clinical workflows of our clinics. Throughout the process, we learned a tremendous amount about potential barriers and strategies to increase its utilization in a busy practice setting, as well as how much those taking the assessment liked it and would recommend it to their friends. 

We piloted the virtual driving assessment in 6 sites across the Care Network in partnership with our clinical champions, providers or clinical staff members who self-selected to champion teen driving at their clinical site. By meeting regularly with our clinical champions throughout the innovation process, we were able to learn more about these barriers and to design and test solutions that worked for all our pilot sites. 

One of the primary barriers we encountered during this process is time, both for the busy clinical team as well as for teens and their parents who may have taken time off from school to go to the appointment or need to get back to school for sports, extra-curricular activities, or work. We found that when clinical teams work together to offer the virtual driving assessment to a teen at multiple points in their visit, including ahead of it via a text message reminder, when checking in, and when seeing their care team, teens are more likely to complete a virtual drive and to receive their feedback. In addition, regular data sent to the practices about eligible patients and completed drives maintained an open line of communication for all. 

We are excited to continue to expand the availability of this assessment across our Care Network, with 90% of our primary care offices. To date, over 6,000 teens and counting have completed a virtual drive and have received valuable feedback on their driving performance. Our goal is to give even more teens the opportunity to take our virtual driving assessment and to provide support in other ways to promote healthy behaviors, including safe driving.

Watch a video about the research findings from study co-author, Dr. Alex Fiks: