Clinic Lead Prevention Workflow

  1. Start with the lead screening questions: Children need testing for lead if they:

    • are on Medicaid and are 12 or 24 months old, or

    • are 6 years old or younger and never been tested for lead.

    • have a “YES” answer on any of the screening questions.
    • should be tested based on other considerations and clinical judgment. This could be due to neurodevelopmental delays or behaviors such as pica behavior (repeatedly eating non-food items).
  2. Test for lead 
    • Determine what test is best to start with (capillary vs. venous).
  3. Provide families with lead education
  4. Report lead results to the state.
  5. Inform families of lead test results and next steps.
    • Retesting as needed.
    • Reinforce lead education (see step 3).
    • Encourage families to work with public health for Lead Case Management.
  6. Schedule follow-up blood lead testing if necessary.

Recommended Tasks and Roles for Lead Testing in Clinics

Front Desk Staff:  scheduling future appointments, taking calls, directing families to the lab.

Medical Assistants:  rooming patients, asking screening questions, notifying provider of need for blood lead testing, ordering future lead labs for provider to sign/approve, possibly conducting point-of-care (POC) blood lead testing, scheduling future appointments, notifying family of need for future blood  lead test via phone call or messaging, relaying blood lead test results to family after provider has reviewed blood lead lab result, reinforcing lead education provided by registered nurse or healthcare provider.

Registered Nurses:  asking screening questions, notifying provider of need for blood lead testing, ordering future lead labs for provider to sign/approve, possibly conducting point-of-care (POC) blood lead testing, scheduling future appointments, notifying family of need for future blood lead test via phone call or messaging, relaying blood lead test results to family after provider has reviewed blood lead lab result, providing education to families regarding how lead poisoning occurs, sources of lead, mitigation/lead exposure reduction strategies, nutrition, etc.

Healthcare Providers:  ask screening questions, order blood lead tests for current care day and future tests, interpret blood lead lab  results, provide education to families regarding how lead poisoning occurs, sources of lead, mitigation/lead exposure reduction strategies, nutrition, etc.

Lab staff:  conduct venous blood lead test, report results to provider and the Washington State Department of Health.

Click here or click the image below for a full-size printable graphic

Clinic Flowchart of Lead Prevention Tasks Opens in new window