Creating “one door” access to development and rehabilitation

By Dave Scharf

Ottawa’s pediatric health and research centre, including a pediatric teaching hospital — has streamlined getting the right development and rehabilitation care for children, youth and families. Access to development and rehabilitation services is now accessed with a single phone call.

Navigating the health-care system can be complex, let alone when compounded by additional anxiety if one is worried about a child. Imagine a mom, concerned that her two-year-old daughter may be missing some developmental milestones. She wants the same thing that all moms want — the best life for her child. She wants a simple way to get the right diagnosis and treatment, right now.

In October 2016, the Children’s Hospital of Eastern Ontario (CHEO) amalgamated with the Ottawa Children’s Treatment Centre (OCTC). Prior to this, families dealt with each organization separately. Does a child go to CHEO or OCTC for physiotherapy? For speech language pathology? Parents and family doctors sometimes had trouble knowing what was available and where to find it.

This amalgamation provided a unique opportunity to simplify access to development and rehabilitation — to create “one door” through which children and youth can be shepherded to the best services for their individual needs. Creating a streamlined intake system was made a transformational goal.

“We wanted to make accessing these services at CHEO, now including the Children’s Treatment Centre, easier for families and referral services like physicians and school boards,” says Susan Mendelsohn, CHEO Director of Development and Rehabilitation.

In March 2017, a multi-disciplinary team representing all the included services was brought together to design a new, simple access system — the “one door.” This included physiotherapy, occupational therapy, speech language therapy, the Autism Program, social workers, recreation therapy, respite services, behaviour services and the First Words Preschool Speech and Language Program.

“We have an incredible group of people. Throughout the process, everyone was dedicated and passionate about making sure that this was going to be the very best system we could build for children, youth and families,” Mendelsohn says.

Over the next year, this group consulted with families, community physicians, and more. They consulted with organizations like Holland Bloorview Kids Rehabilitation Hospital who had recently streamlined their intake system. The result of these consultations was a rigorous list of things that the new “one door” needed to include.

Three possible models were proposed. Again, families and referral sources were consulted. The three models were subjected to thoughtful analysis and by March 2018 the single best system was decided upon.

Then came the hard work of bringing the plan to life. What staff would be required to make the Access Team work? How could Epic, CHEO’s electronic health records system, be integrated? What information needed to be included on the new intake form? How would this new system be communicated to families and the community? What training would staff require?

Finally, more than 18 months after work began, the CHEO Access Team launched on November 5, 2018.

Families no longer need to contact services separately. One call starts the ball rolling. After the initial call, if it’s not immediately clear which service a child needs, a CHEO Access Team outreach worker speaks directly with the family to understand their concerns and get a medical history.

The right services are identified and the family is placed with the correct booking lists. One child might only need one service, like speech language pathology, whereas another child may have more complex needs and require several services. The expert CHEO Access Team is trained to identify the services which will most benefit each child.

Now, when a child enters walks through CHEO’s “one door” to development and rehabilitation, the family only needs to tell their story once.

Dave Scharf is a Communications Specialist at the Children’s Hospital of Eastern Ontario (CHEO).