Parent and student empowerment through a child health waitlist initiative

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Parent and student empowerment through a child
health waitlist initiative

• Kim Beckers, MEd(Candidate), BSc.OT,
• Gillian Hoyt-Hallett, MSc.OT,
• Dr. Michael Enman, PhD, RPysch,
• Conny Betuzzi, BSR
• Alberta Childrens Hospital

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The Alberta Advantage.
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The Alberta Childrens Hospital
www.calgaryhealthregion.ca/ACH
4
Partnership Initiatives
www.fcrc.sacyhn.ca/index.php
www.sacyhn.ca
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Common Waitlist Issues

• No shortage of debate regarding wait times for
  health services in Canada.

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Debate issues the challenge

• System sustainability
• Population
• Public expectations
• Funding
• Resources

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What does the literature say about waitlists in
pediatric healthcare?

• Clow et al. (2002) highlight that there are few
  published studies that report initiatives to
  reduce wait times
• Parents have dissatisfaction with excessive wait
  times (Miller, 2004)
• Wait time is a major factor in patient
  satisfaction (Eilers, 2004 Keating et.al.,
  1998)
• Parents report that their childs health is
  adversely affected by waiting and a belief that
  their childs quality of life will improve once
  service is received (Miller, 2004).
• Mental health and communication issues have been
  found to worsen with increased wait times for
  service (Keating et al., 1998 Walker, 1998)

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Empowerment defined as

• Health-enhancing process
• Development of patient-centred relationships
• Education and/or self reflection tools (Aujoulat
  et al., 2007)
• Strategy of information, education, and support
• Group participation

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Neurosciences-Single Discipline OT

• History of extensive wait time due to limited
  FTE, position vacancy and frequency of referrals

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Single Discipline Occupational Therapy Referrals
REFERRAL RECEIVED

• Linear model
• Process orientation
• Referral as entry point
• Service occurs with assessment
• Exit with assessment report and discharge

TRIAGE OR ACCEPT
WAITLISTED
ASSESSMENT
REPORT PROGRAMMING
DISCHARGE
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Goal Reduce wait time for service

• Patient information
• Education
• Parent support

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Defining the gap

• Excessive wait time
• Assessment context is not right
• Stakeholders values, goals and expectations
• Absence of consistent information, education,
  and support

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Design and Development

• Engaging Stakeholders and establishing
  partnerships
• Family-Centred Care Principles
• Needs analysis for information, education and
  support deliverables

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Information

• Referral acknowledgement
• Service processes
• Reference material
• community resources
• accommodation strategies
• listing of credible web resources
• information on the Community Education Service
  and the Family Community Resource Centre.

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Education Curriculum

• Group collaboration
• Identify key issues
• Provision of strategies
• Resource Package

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Partnerships

• Multiple Service Groups
• Cross Discipline
• Collaboration with the CanChild Centre for
  Disability Research
• Parents
• Educators

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Support

• Family determined
• Contact information
• Service engagement letter
• Informal support through group dynamics during
  CES educational offerings

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Continuum of service

• Not a linear path
• Engaging parents and youth at different points

Formal Support
Information
Informal Support
Parents
Child
Education
Resources
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Implications for Practice

• Knowledge Transfer (Parent Involvement)
• Advocacy
• Self-management
• On-going service evolution
• Enhancing and expanding service with existing
  resources

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Learning for future initiatives

• Expanded participation of parents and youth
• Service commences with receipt of referral
• Service is flexible
• Parents as co-presenters

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CES/Neuroscience Child Health Waitlist Initiative

• Wait-time for service has a negative impact on
  children, families, and communities
• Patient-centred (Family Centred Care) enhances
  capacity
• Empowerment arises with client participation and
  engagement
• Collaborative partnerships
• Reflection on what service means
• Action Learning in Service Development

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Comments and Questions

• kim.beckers_at_calgaryhealthregion.ca
• gillian.hoyt-hallett_at_calgaryhealthregion.ca
• michael.enman_at_calgaryhealthregion.ca
• conny.betuzzi_at_calgaryhealthregion.ca

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Bibliography

• Aujoulat, I., dHoore, W., Deccache, A. (2007).
  Patient empowerment in theory and practice
  Polysemy or cacaphony? Patient Education and
  Counseling, 66, 13-20.
• Chiarello, L.A. Palisano, R.F. (1998).
  Investigation of the effects of a model of
  physical therapy on mother-child interactions and
  the motor behaviours of children with motor
  delay. Physical Therapy. 78(2), 1880-194.
• Clow, D., Mustafa, A., Szollar, J., Wood, N.,
  Reid, J., Sinden, S. (2002). Reducing waiting
  times associated with an integrated child health
  service. The Journal for the Royal Society of
  Promotion of Health. 122(4). 245-250
• Eilers, G.M. (2004). Improving Patient
  Satisfaction with Waiting Time. Journal of
  American College Health. 53(1), 41-43.
• Feldman, D. E., Champagne, F., Korner-Bitensky,
  N., Meshefedjian, G. (2002). Waiting time for
  rehabilitation services for children with
  disabilities. Child Care, Health and
  Development. 28(5),351-358.

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Bibliography Contd

• Hatton, C., Azmi, S., Emmerson, E., Caine, A.
  (1997). Researching the needs of South Asian
  People with Learning Difficulties and their
  Families. Mental Health Care. 1(3), 91-94.
• Jacobs, G. (2006). Imagining the flowers, but
  working the rich and heavy clay participation
  and empowerment in action research for health.
  Educational Action Research.14(4), 569-581
• Keating, D., Syrmis, L., Hamilton, L., McMahon,
  S. (1998). Paediatricians Referral rates and
  speech pathology waiting lists. Journal of
  Pediatrics, Child Health. 34, 451-455.
• Miller, G. (2004). Waiting for an operation
  parents perspectives. Canadian Journal of
  Surgery. 47(3), 179-181.
• Rachlis, M.M. (2005). Public Solutions to Health
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• Romanow, R. (2002). Building on Values The
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