Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.
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DOI：
10.1186/s12913-016-1700-3
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发表时间：
2016-08-31
影响因子：
2.8
通讯作者：
Lix LM
中科院分区：
文献类型：
--
作者：
Wittmeier KD;Restall G;Mulder K;Dufault B;Paterson M;Thiessen M;Lix LM
有复杂需求的儿童可能会面临与他们对多种服务和医疗保健提供者的需求相关的系统访问和导航障碍。2008年，加拿大温尼伯马尼托巴省制定并实施了儿童康复中心，以加强服务协调和儿童及其家庭获得服务的机会。本研究以小儿物理治疗为例，评估实施中央进气系统的过程和影响。一个混合的方法工具的案例研究设计。与9人进行了面谈。数据被转录和分析的主题。定量数据（等待时间，转诊量和照顾者的满意度）被收集的儿童提到物理治疗与复杂的需求（n = 1399），和一个对照组的儿童提到骨科问题（n = 3901）。使用Kruskal-Wallis检验分析等待时间，使用Fisher精确检验分析护理人员满意度，并应用变点模型检查研究期间的转诊量。访谈参与者将集中接收的实施描述为创建更精简的流程。促进成功实施的因素包括：（1）利益攸关方之间的协议，（2）雇用一名中央接收协调员，（3）政府的财政承诺，（4）个人和组织一级的领导。具有复杂需求的儿童的平均等待时间有所改善（从转诊到与家人联系的12.3（13.1）至8.0（6.9）天，p < 0.0001;从转诊到预约的29.8（17.9）至24.3（17.0）天，p < 0.0001），而转诊量保持不变。观察到对照组的等待时间略有增加（从转诊到与家人联系的9.6（8.6）至10.1（6.6）天，p < 0.001;从转诊到预约的20.4（14.3）至22.1（13.1）天，p < 0.0001），同时该组的转诊量也在增加。在整个过程中，护理人员的满意度一直很高（p = 0.48）。集中接收的实施实现了简化流程、提高透明度和获得儿科物理治疗的预期结果（即，减少等待时间）。未来的研究需要建立在这个单一学科的案例研究方法，以检查在等待时间的变化，治疗协调和利益相关者的满意度范围内不断改善省内儿科治疗服务。本文的在线版本（doi：10.1186/s12913-016-1700-3）包含补充材料，可供授权用户使用。
Children with complex needs can face barriers to system access and navigation related to their need for multiple services and healthcare providers. Central intake for pediatric rehabilitation was developed and implemented in 2008 in Winnipeg Manitoba Canada as a means to enhance service coordination and access for children and their families. This study evaluates the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. A mixed methods instrumental case study design was used. Interviews were completed with 9 individuals. Data was transcribed and analyzed for themes. Quantitative data (wait times, referral volume and caregiver satisfaction) was collected for children referred to physiotherapy with complex needs (n = 1399), and a comparison group of children referred for orthopedic concerns (n = 3901). Wait times were analyzed using the Kruskal-Wallis test, caregiver satisfaction was analyzed using Fisher exact test and change point modeling was applied to examine referral volume over the study period. Interview participants described central intake implementation as creating more streamlined processes. Factors that facilitated successful implementation included 1) agreement among stakeholders, 2) hiring of a central intake coordinator, 3) a financial commitment from the government and 4) leadership at the individual and organization level. Mean (sd) wait times improved for children with complex needs (12.3(13.1) to 8.0(6.9) days from referral to contact with family, p < 0.0001; 29.8(17.9) to 24.3(17.0) days from referral to appointment, p < 0.0001) while referral volumes remained consistent. A small but significant increase in wait times was observed for the comparison group (9.6(8.6) to 10.1(6.6) days from referral to contact with family, p < 0.001; 20.4(14.3) to 22.1(13.1) days from referral to appointment, p < 0.0001), accompanied by an increasing referral volume for this group. Caregiver satisfaction remained high throughout the process (p = 0.48). Central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy (i.e., decreasing wait times) for families of children with complex needs. Future research is needed to build on this single discipline case study approach to examine changes in wait times, therapy coordination and stakeholder satisfaction within the context of continuing improvements for pediatric therapy services within the province. The online version of this article (doi:10.1186/s12913-016-1700-3) contains supplementary material, which is available to authorized users.
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影响因子：
3.2
作者：
Creswell, JW;Miller, DL
通讯作者：
Miller, DL
影响因子：
1.3
作者：
Camden, Chantal;Swaine, Bonnie;Carriere, Monique
通讯作者：
Carriere, Monique
影响因子：
2.8
作者：
Camden, Chantal;Swaine, Bonnie;Brodeur, Marie-Michele
通讯作者：
Brodeur, Marie-Michele
案例研究方法。
影响因子：
4
作者：
Crowe S;Cresswell K;Robertson A;Huby G;Avery A;Sheikh A
通讯作者：
Sheikh A
DOI：
10.1177/146642400212200412
发表时间：
2002-12-01
期刊：
JOURNAL OF THE ROYAL SOCIETY FOR THE PROMOTION OF HEALTH
影响因子：
--
作者：
Clow, D;Mustafa, A;Sinden, S
通讯作者：
Sinden, S