An Action Plan for Improving Efficiency and Quality of the Process of ASD Diagnosis in Adults and Children

Background: Delayed diagnosis is one of the main reasons for dissatisfaction with services expressed by families of individuals with ASD. However a challenge for ASD diagnostic services is to maintain a high quality and robust diagnostic standard whilst improving efficiency. This balance is reflected in a range of evidence based clinical guidelines and national targets, which services are expected to adhere to.

Objectives: To explore ways to improve the efficiency and quality of ASD diagnostic processes with local services to inform a national action plan.

Methods: Following a retrospective audit of 150 case notes from 16 Scottish ASD diagnostic services, focus groups were conducted with the diagnosing professionals in each team. The results of the notes audit were used to inform the content of the focus group discussion. This centred around challenges and solutions related to improving the efficiency and quality of the ASD diagnostic process. Local action plans were generated, which were subsequently aggregated to form a national action plan.

Results: The key themes generated by the services which formed the national action plan were:

• Educating and informing referrers, multi-agency partners and families
• Having structured  processes for requesting and gathering  relevant contextual information
• Continuing professional development and training for diagnosing staff
• Having dedicated multi-disciplinary time for assessment and diagnosis of ASD
• Using time constructively with clear tools and processes at each stage
• Having clear pathways and good administrative processes

Conclusions: The mixed methodology provided an effective means of identifying challenges and solutions to achieving the balance between service efficiency and quality. The methodology and results from this research may be used to inform service structure in other countries.