Development of an Evidence-Based Policy Handbook Utilizing a Hub and Spoke Practice Model: A Quality Improvement DNP Project

Abstract

Diagnosing a child with a fetal alcohol spectrum disorder in the State of Alaska requires a team-based approach. The current model is a hub model where providers refer to one of a few certified 4-Digit Code method teams in the geographically vast State of Alaska. Telehealth has been suggested as a viable alternative to in-person hub evaluations for fetal alcohol spectrum disorders (FASDs). The State of Alaska FASD program and the Alaska Mental Health Trust Fund’s goals of moving towards a telehealth program for FASD evaluation, diagnosis, and management (WICHE-BHP, 2021). This Doctor of Nursing Practice (DNP) project sought to improve the current model. After critical review and evaluation of the literature, the Hub and Spoke model was selected. The policy handbook was evaluated by experts in the field and revised. Using the Model for Improvement (2013), a policy handbook was developed incorporating the Hub and Spoke model and specific requirements and recommendations specific to Alaska. The new model is called the FASD telehealth Hub and Spoke practice model.