ACEs Screening Workflow and Variability among Clinics
| ACEs Screening Workflows | Description | Variability |
|---|---|---|
| Screening Frequency | Clinics varied on frequency of screening ranging from once a year to once a lifetime. | Most clinics conducted ACEs screening once in a lifetime. Few clinics collected ACEs once a year. |
| Workforce | Clinics varied on who administered the screening. | Most clinics had medical assistants distribute ACEs screening; one had dedicated ACEs navigators who distributed ACEs screening forms. Clinicians discussed the results of ACEs surveys with patients. Behavioral health clinicians sometimes readminister ACEs surveys for referred patients. |
| Screening type | Clinics varied in the type of ACEs survey they administered. | Most clinics used a de-identified screening; one used an identified survey. There was variation in the version of the ACEs survey administered (e.g., ACE-10 or ACE-8 plus “resiliency questions”). |
| Referrals | Clinic staff varied on the type of resources or referrals offered and the criteria for offering referrals. | Most clinics had access to on-site behavioral health care. The criteria for referrals were widely variable (e.g., no ACEs, 1 or more ACEs, or 4 or more ACEs). |
Abbreviation: ACEs, Adverse childhood experiences.