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NS19006A Results: . Aim: That the Child Development Service (CDS) will provide assessment for a broader range of children with complex neurodevelopmental disorders. SMART Aim: Within 12 months, CDS will provide 24 assessment for Autism, FASD, and other complex multifactorial developmental disorders, in addition to the existing clientele with Intellectual Disability. Extended goal: To create a long-term sustainable model of care for all children with neurodevelopmental disorders. . Project Lead: Dr Con Papadopoulos. Director, Child Development Service, NSLHD [email protected] Team Members Elizabeth Connellan (CDS Psychologist), Kimberly Barry (Social Worker CDS), Jenny McDonald (NSLHD PACH Quality Advisor) Stakeholders: Dr Jane Son (Paediatrician), Allison O’Tool (ECEI provider, Cerebral Palsy Alliance), Emma Cushing & Steph Sanbrook (Consumer Advisor ) Project Sponsors: Kim Lyle (Manager CYFH Services), Elisabeth Murphy (CYF Network Director) Keeping up with ASD, FASD & other Neurodevelopmental Disorders. Providing Assessments for Children in Need References This is where you place your references. Overall Outcome: The Child Development Service can provide additional services for children with broader complex neurodevelopmental problems such as ASD and FASD Improved and diversified capacity was achieved 1. in a cost neutral way 2. without detriment to existing services 3. with numbers on target, as per the project goal. National Standards & Clinical Services Plan: Comprehensive Care Standard https://www.safetyandquality.gov.au/ • Coordinated delivery of total health care • Aligned with the patient’s expressed goals and their wellbeing • Integrate care processes to identify needs and prevent harm NSLHD CYF Services: Clinical Services Plan 2019-22 • Improve ease of access for consumers and streamline pathways to primary, secondary and tertiary child and family health services. • Improve collaboration with other service providers to reduce the number of children starting school with identified vulnerabilities Sustainability & Future Prospects: The Project was cost neutral Efficiencies achieved with: 1. Flexible streamlined processes, 2. Reduced staffing cost for many clinics, 3. Better Access to early intervention and NDIS. Project shared with other services: 1. Other LHD Child Development Services 2. Primary Health Network 3. Abstract submission IACAPAP Conference Singapore 2020 4. Children’s Healthcare Australia 5. ACI Innovation Exchange New Collaborative Ventures: 1. Journal Publication initiated – FASD. Perceptions and knowledge of Community Health Clinician 2. Australian Government Department of Health: The Drug and Alcohol Program, Fetal Alcohol Spectrum Disorder (FASD) Australian Register Grant Opportunity. 3. Parliament of Australia Senate Inquiry: Effective approaches to prevention, diagnosis and support for Fetal Alcohol Spectrum Disorder- June 2020 4. Commonwealth Government MYEFO 2019-20 allocation of $25M for a national campaign to raise awareness of risks caused by drinking alcohol during pregnancy Background: Increasing neurodevelopmental evidence and recent Australian National guidelines are driving the need to provide more varied multidisciplinary diagnostic assessments to ensure more accurate diagnosis and initial support to children and families adjusting to diagnosis of complex neuro-developmental disorders such as Autism (ASD), Fetal Alcohol Spectrum Disorder (FASD) and multifactorial developmental impairments. The NSLHD Child Development Service (CDS) has 40 years experience, of offering standard multidisciplinary diagnostic assessments for children with suspected intellectual disability. The plan is to build CDS capacity and provide more individualised assessment and disability adjustment support for children, with a broader range of neuro-developmental disorders, and their families and carers. Whereas, the previous model tended to involve conducting the same suite of diagnostic assessments for all children. This expanded, more inclusive, service model will require cultural change, staff skill development and role realignment, new clinical resources and educational services and consultation with referrers, to design new referral pathways, minimise additional workload, and prevent detriment to quality of care, wait lists and service expenses. The project will ultimately reduce missed diagnoses, improve care planning and instill confidence in NSLHD specialist services for children with developmental disorders. The model of care has potential to inform service delivery in other LHDs. Method: Driver Diagram . Rolling PDSA Cycles Determine needs of clients not accessing service PLAN: Survey families referred to but not seen for assessment. MEASURES & OUTCOMES: Compare incidence of ASD and FASD with prevalence diagnosed via CDS Developmental outcomes, satisfaction of parents and access to alternative service NEXT STEPS: Community needs established and changes to CDS recommended Access Equipment and training for new services PLAN: ADOS training for psychologist MEASURES & OUTCOMES: FASD training for core team Purchase new psychometric equipment Service competency for new range of services NEXT STEPS: Team capable of providing new assessments Improve staff confidence and motivation for new services PLAN: Identify and Overcome staff barriers to seeing different clientele MEASURES & OUTCOMES: Anonymous survey of staff regarding 1. Knowledge, 2. Skills and 3. Perceptions Provide additional in- services, including guest speakers and families with FASD, NEXT STEPS: Provide more support for clinical experience. Establish support links with State Quaternary Services Ensure existing services are not disrupted PLAN: Establish baseline measure of client perception and unmet needs and repeat survey following service changes MEASURES & OUTCOMES: Survey of clients seen over the last 12 months NEXT STEPS: Repeat survey following changes to service delivery Make provisions for more clinical services within existing resources PLAN: Improve efficiency of existing clinics by providing new clinics which reduce repetition and focus on practical client goals. MEASURES & OUTCOMES: New clinical services achieve shares goal. Consumers and staff are satisfied with new services . Same number of client seen with less resources. NEXT STEPS: Draft new guidelines for clinical services and integrate into established practices Provide client centred services beyond the diagnosis PLAN: Reflect on client journey by seeking feedback . Use previous survey or …… MEASURES & OUTCOMES: Feedback from clients and staff on their experiences NEXT STEPS: Establish new client care pathways Improve number of referrals for FASD PLAN: Host Educational seminars to improve awareness and skills MEASURES & OUTCOMES: Multiple seminars to maternity and obstetrics, pediatricians, allied health, nursing, social work, GP and interested professionals NEXT STEPS: Repeat as required
