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Partners in health

Over eighteen months in the making, the new CHEO Access Team is here

Head and shoulders photograph of the seven women who make up the CHEO Access Team. All are smiling. 

The new CHEO Access Team streamlines getting the right development and rehabilitation care for children, youth and families. 

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, 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.

Our amalgamation provided a unique opportunity to simplify access to development, rehabilitation and autism services — to create “one door” through which children and youth can be shepherded to the best services for their individual needs.

“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.

“It was an incredible group of people. 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 winnowed down to the single best system the team could design.

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 new 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.

Now, families do not 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 system is designed so that families only have to tell their whole story once.

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.

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The CHEO Access Team is: Marie-Anne Savoie – Patient Service Clerk, Anne Lukey – Administrative Assistant, Johanne Raymond, Amanda Young, Erika Bertrand and Adele Ois – Outreach Workers, and Claire Seymour, Manager. 

Phone: (613) 737-2757

The CHEO Access Team is for children who have missed important developmental milestones like sitting or talking, or children and youth who have complex physical and cognitive health issues.

It is also for children and youth with simple rehabilitation needs, like temporary treatment after a sports injury. And, it is even for families who may need a break from caring for their child or youth with complex needs. 

Some of the services included:
Social work, autism diagnosis, care and respite, physiotherapy, occupational therapy, recreation therapy, behaviour services and the First Words Preschool Speech and Language Program.

How long will my appointment take?

A head and shoulders photograph of Dr. Kevin Cheung and Ivan Terekhov standing beside a computer monitor which displays how long families should expect to wait in CHEO’s plastic surgery clinic.

“We learned from families that when they come to the plastic surgery clinic for an appointment, part of their frustration in the reception area is that they don’t know how long to expect their wait to be,” says Dr. Kevin Cheung, CHEO plastic surgeon. 

When families know what to expect, they are less likely to become impatient and anxious.

Similar to knowing whether your bus is delayed or how long the wait is for a table at a restaurant, Dr. Cheung imagined a simple way to inform families of how long they should expect to be in the waiting room, and how long their entire appointment will take. This idea won the Ottawa Hacking Health CHEO Pilot Opportunity Prize in 2017 (Hacking Health is global movement to improve health care with chapters all over the world).

The Ambulatory Care and Information Technology (IT) teams took up Cheung’s challenge. Rob Cooney, the former Manager, Ambulatory Care, and Ivan Terekhov, Business Systems Analyst, figured out how to get this information from Epic, CHEO’s electronic health record system. 

As a pilot, IT installed a monitor at the plastic surgery check-in desk which displays, in real-time, the average number of minutes families can expect to wait in the reception area and the total length of their appointments. 

Now, they intend to further improve families’ experiences. The plastic surgery waiting room display could be installed in every outpatient clinic at CHEO. 

“With enough data about a child’s age and type of injury, we hope to be able to predict their approximate visit duration,” Cheung says. “Knowing in advance how long each type of appointment will take, we will be able to change the way we schedule, not only to reduce families’ time spent in the waiting room but also to use CHEO resources more efficiently.”

MyChart powers ever more communication between families and health-care teams

 Head-and-shoulders photographs of three women standing, smiling, in front of bookshelves filled with file folders.

MyChart, CHEO’s secure, online patient portal, connects families to their CHEO electronic health record, anywhere, at any time.

More CHEO departments now include direct two-way communication between families and their health-care teams. The Asthma team, Autism program, Bone Health, Centre for Healthy Active Living, Chronic Pain clinic, Complex Care, Cystic Fibrosis, Diabetes, Endocrinology, Ear Nose and Throat, Gastroenterology, Gynecology, Interprofessional Feeding Team, Neurology, Neurosurgery, Occupational Therapy, Respirology, and Rheumatology all encourage two-way messaging.

Children, youth and families receiving care in any of these clinics can send messages directly to their CHEO health-care team. MyChart permits email-like messages to pass back and forth behind CHEO’s firewall, which keeps this information secure and makes it part of the health record.

Audiology, Dermatology, Infectious Diseases, and the Children’s Treatment Centre will be coming on board in the near future.

Since June, children, youth and families receive surgery date reminders via MyChart. Surgery date reminders are sent twice — seven days prior and 48 hours prior to scheduled surgeries. They include links to everything a family needs to know like what to expect, when to stop eating, and what to bring on the day of surgery.

For more information and to sign up, see the MyChart information page.

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