Melina Ortigas on making screenings more accessible

10 Minutes to Better Patient Communication

Patient screenings are widely used in medicine and public health. A public health program administrator in California shares what she and her colleagues are learning from taking a close look at screenings.

Screenings for patients are important tools. They're ubiquitous in medicine and public health. But they're not without their challenges, for professionals and for patients. Today I talk with Melina Ortigas in Yolo County, California about what she and her colleagues noticed about screenings and how they're working to improve them across the state.

Hi everybody, I'm Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. If your organization cares about equitable communication with all patients, there are some foundational concepts it's important to understand. That's why I wrote a new online course, Foundations of Equitable Interpersonal Communication in Health. It gets at the fundamentals everyone needs to know, it's world-class instructional design, and it's for all patient-facing employees. Your LMS or ours Learn more at healthcommunicationpartners.com.

You know this show is mainly a monologue, with yours truly, but every once in a while someone who's doing the work, who takes a critical, social perspective on health and on language, agrees to sit down with me and reflect on their practice as a guest of this show. Getting to spend time with my guests is a high point for me in this series.

The last interview I shared back the weekend of Thanksgiving was with Dr. Paul Ranelli, Professor Emeritus of Social Pharmacy. If you haven't gotten to hear it I'll link it for you. Dr. Ranelli talked about patient communication specifically around rare diseases, and told us about a new play about rare diseases, told from the perspectives of patients and their families. This play is called RARE: Stories of Dis-ease.

Paul was one of many collaborators in RARE. When he came on the show they had just wrapped their show run. Well, he just wrote last week and let me know the final show had been filmed and is now available! It's out on youtube, we can all see it for free, and I'm going to go ahead and put a link in the notes.

I mentioned he was one of many collaborators. It turns out the collaboration around RARE is also a story in itself. It involved patients who have rare diseases and their families; UMN students; faculty at UMN College of Pharmacy Center for Rare Diseases and Drugs; faculty at the Theater Department at the University of Minnesota Twin Cities; and professional playwright Kevin Kling best known for his work with NPR's All Things Considered; and a professional theater company.

Their coming together was so remarkable it inspired a documentary, and that documentary on the making of “RARE” is also now available for us all to see. I love behind the scenes stuff in general. I think this is great because we get to see their rigorous process. I think this would be a great resource for organizations who are interested in arts based education whether it's of the public and professionals. Links in show notes to “RARE Stories of Dis-ease and the documentary on the making of “RARE.”

Next I get to sit down with Melina Ortigas, a public health professional who tells us what happened when she and her colleagues in CA took a closer look at patient screenings.

Anne Marie: I’m live via zoom with Melina Ortigas, the Management Services Officer at First 5 Yolo Children and Families Commission, in Yolo County, California. Melina, welcome to the show!

Melina: Thank you Anne Marie, happy to be here.

I’m so glad to have you here. So can you tell us a little bit about First 5 Yolo?

Yes! First 5 Yolo Children and Families Commission administers California’s Prop 10, or tobacco tax, revenue. Together with our Community Partners, we work to identify barriers to quality health care and education, and advocate for policy change at the local, community and at the state level. we are a network of 58 County Commissions working together.

Oh so throughout the state of California then?

Throughout, yes.

Gotcha. And what do you do as the Management Services Officer?

I am responsible for overseeing projects directly working with the Healthcare System. Right now, some of our main initiatives are Help Me Grow, and Healthy Families America Home visiting, and our own behavioral health navigation and home visiting.

So Melina what is an issue or a problem that you’re facing related to communication or education?

I would say that one problem we’re seeing is just making our information more accessible to families, so they understand what our services are and how they might be of benefit to them. It’s really to build stronger relationships with all of our community members.

Very understandable issues, problems, struggles I think people are all going to be able to identify with. So how are you facing these issues right now?

One concrete example I can give you is our major priority area is to make screenings, developmental screening specifically, more accessible to families. We have a lower screening rate in the state of California than compared to other states. This is an area we need to do better in for our Medicaid beneficiaries. We are looking to understand what are the barriers and obstacles for families on MediCal to accessing those developmental screens, and other families as well, but especially those who are underserved.

So what are you doing in terms of that, of looking at those screenings, working with those screenings, working with those families?

Yes, one exciting development we had was a partnership with the LEND program at UC Davis MIND Institute. We had the opportunity to partner our Help Me Grow initiative together with LEND. We had expert practitioners and local Help Me Grow families, participants in the program, who provided feedback.

So you’re working with a lot of people on these developmental screenings. What are you finding from working with people? What are some of the things you are learning?

We’re learning that the term itself is a loaded term. It’s not as friendly as we might think.

The term “developmental screening?”

“Developmental screening,” exactly.

Oh.

We heard from practitioners saying that the tools themselves, and the information that they had access to, was full of jargon–or just not the right level for all of the families that they served. And so there was definitely a disconnect. And so we’ve learned to really message it in a much different way. You know it’s a tool that is designed to be completed by parents. And parents drive the agenda. And it’s parents' concerns for their child’s growth and development that really drives that process. And really focusing on the tool as a process that builds communication and relationship. Not a checklist, a yes/no, pass/fail type of tool. And we co-created an infographic to really make developmental screening and Help Me Grow as a service more understandable.

That’s really exciting. So you're hearing back from families, you're hearing from practitioners. And what are your next steps? What are you doing next?

Our next steps are to really look at our tools critically. And think about, you know, who are they serving or who are they not serving? What languages are available, and validated or research based? And who makes up those research studies, right? Are all of our community members in Yolo County adequately represented? If not, what can we do? What more can be done to make sure that everyone has access to quality education, information, and tools that really are meaningful, and data that’s reliable?

Melina Ortigas thank you so much for spending time with us today on the show

Thank you so much Anne Marie, it’s been a pleasure.

Melina Ortigas, Management Services Officer First 5 Yolo Children and Families Commission in Yolo County, California. I want to Thank Melina for taking time to share that story. If you're interested in the infographic and other projects Melina was talking about, you're in luck! She gave me links to share with you. I have them in the show notes at HealthCommunicationPartners.com. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

Thanks to Melina for this additional information:

Parents often have questions about their child's development during their first year of life. This checklist in English and Spanish has useful guidelines to help determine when it's time to ask for professional help. When to ask for professional help in baby's first year: Infographic Spanish, English.

Why screening in early years matters: Infographic (English only)

Thanks to LEND (Leadership Education in Neurodevelopmental and related Disabilities) trainees, Help Me Grow Yolo County (a program of First 5 Yolo), and Yolo families who helped co-create these tools. Learn more about LEND here and here.

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