Paediatric Outpatients Model of Care: Advanced Allied Health Practitioners Using Single Session Therapy
Creators: name: Creen, Julie
Publisher: name: University of the Sunshine Coast, Queensland
Year: 2023
Subjects: advanced allied health practice
occupational therapy
psychology
speech and language pathology
single session therapy
single session thinking
paediatrics
child development
child behaviour
adolescent health
Paediatrics
Allied health and rehabilitation science
Health services and systems

description: An innovative model of care for developmental and behavioural paediatrics (DBP) was implemented at the Sunshine Coast Hospital and Health Service (SCHHS), Queensland, Australia, to improve service efficiency and experience for families. This involved a Single Session Therapy (SST) approach conducted by Advanced Allied Health Practitioners (AAHP). Single session therapy is a treatment approach that maximises the first, and sometimes only, encounter with patients. It provides a framework that aims to create patient therapeutic change within each consultation. Advanced allied health practitioners have expert knowledge, competence, and leadership in managing complex conditions, such as DBP, and providing access to conservative specialised therapeutic care through various therapeutic approaches like SST.
description: There is emerging evidence in the literature, predominantly in adult health speciality areas, that AAHP and SST have reduced wait lists and improved patient flow, with associated high satisfaction levels, increased patient safety, and cost-benefit savings. There is a paucity of evidence for the effectiveness and efficacy of AAHP and SST approaches in paediatric settings, with no known evidence that supports either AAHP or SST in DBP.
description: This research investigated the organisational impact, parent and child experience, and parent engagement in SST conducted by AAHP. An exploratory case study methodology (Yin, 2012) involved three studies using qualitative and quantitative methods.
description: The first study was a quantitative comparative review of medical-only and AAHP-led clinics using SST. The analysis found a significant statistical reduction in wait time and time to receive a diagnosis. Consistently 50% of children were managed independently by the AAHP. In addition, there was improved diagnostic specificity and accuracy.
description: The second study explored the parent and child experience of AAHP SST through interviews with 38 parents and 12 children. Reflexive thematic analysis (Braun &amp; Clarke, 2019) showed positive experiences of empowerment and validation within the AAHP SST. This included improved understanding, valued time, confidence in actions and mutual presence for all parties.
description: The final study included focus groups to develop a measure of parent engagement in an AAHP SST. Four focus groups and individual interviews (n=14) provided in-depth understanding of the factors that facilitate parent engagement in AAHP SST consultations. Reflexive thematic analysis led to the development of overarching themes of clinician connection, parental attributes, organisational and environmental factors. The Parent Engagement Measure (PEM) was developed based on the associated understanding of engagement and experience in AAHP SST. Content and ecological validity was explored through a feasibility study.
description: It is recommended that health services use SST approaches delivered by AAHP within DBP caseloads. This will provide improved engagement, quicker access to care, reduced demand on medical officers, and anticipated cost-saving service efficiencies. The delivery of SST in DBP is complex and the interrelatedness of the AAHPs connection, parental status, and organisational factors must be considered.