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Service Model OverviewService Model OverviewPresented by:Presented by:Mary KingMary King--Lyons Lyons Vice President, Strategic InitiativesVice President, Strategic Initiatives
Presentation OutlinePresentation Outline
ErinoakKids Background Integrated Service Delivery Design
Intake Service Delivery Discharge / Transfer / Transition to School
Management – Structural Changes Community Collaboration / Feedback
Mission Statement:The mission of ErinoakKids is to help children and youth with physical, developmental and communication disabilities achieve optimal levels of independence, learning, health and well-being.
Vision Statement:Children and youth reaching their potential supported by a full continuum of integrated family centred services.
Values:
1. Family Centred Care2. Leadership and innovation3. Community collaboration and partnerships4. Advocacy for positive system change5. A professional, respectful and accountable
work environment6. Continuous pursuit of efficiencies in
utilizing all our resources
ErinoakKids in OverviewErinoakKids in Overview
Provide a comprehensive range of services to children with physical, developmental, communication challenges, autism and children who are blind or have a permanent hearing loss
Children served in 2010-11: 12,000
Budget 2011-12: $60 million
Staffing 2010-11: 650 employees
Multiple Sites (3 in Mississauga, 1 each in Brampton, Burlington, Oakville, Milton, Orangeville and Guelph)
History of ErinoakKids ProgramsHistory of ErinoakKids Programs
Child and Youth Rehabilitation Program (1978)
Halton-Peel Preschool Speech & Language Program (1998)
Central West Autism Intervention Services* (2000)
Central West Infant Hearing Program* (2004)
Central West School Support Program* - Autism Spectrum Disorders (2005-2010 )
Central West Blind Low Vision Program* (2007)
Central West Connections for Students Program* [formerly SSP-ASD] (2010)
Central West ABA-Based Supports for Children with Autism Spectrum Disorders [co-lead with Kerry’s Place Autism Services] (2011)
* Lead agency and service provider* Lead agency and service provider
Former Service ModelFormer Service Model
CENTRAL
INTAKE
Intake 2SchedulingData entry
Health Record
Intake 2SchedulingData entry
Health Record
Intake 2SchedulingData entry
Health Record
Intake 2SchedulingData entry
Health Record
Intake 2SchedulingData entry
Health Record
WAITLIST
WAITLIST
WAITLIST
WAITLIST
WAITLIST
Child & Youth Rehabilitation ProgramPT, OT, SLP, ECRS, BEH C, SW, ADRS, SSAH
Halton Peel Preschool Speech & Lang. ProgramSLP
Autism Intervention Services
PSYCH, IBI, SW
Infant Hearing Program
AUD, SW
Blind Low-Vision Program
ECVC, SW
Child & Youth Rehabilitation ProgramPT, OT, SLP, ECRS, BEH C, SW, ADRS, SSAH
Waitlistbetweenprograms
if otherservicesrequired
A Blueprint for Organizational A Blueprint for Organizational Transformation Transformation -- Strategic Plan 2009-12
Integration of programs and services
A streamlined service experience
Removal of barriers for clients and families
Increased access for clients and families
Leveraging of community partnerships
Clinical Service Delivery:
Integrated Service ModelIntegrated Service Model
Core ServicesCore Services These are the services which specifically address physical,
developmental and communication disabilities / challenges, Autism (i.e., the reason children are referred to ErinoakKids [EOK])
Medical Services, Physiotherapy, Occupational therapy, Communication Services (Speech-Language, Auditory Verbal Therapy, American Sign Language, Infant Hearing Screening, Audiology), Vision Services, Intensive Behavioural Intervention Services, Connections for Students, ABA Based Services and Supports
The initial Intake screening at ErinoakKids confirms a child’s referralcriteria and access for one or more of Core Services.
Children meeting referral criteria for Core Services may be referred to other internal services
Additional ServicesAdditional Services
Assistive Devices Resource Services, Specialty Clinics, Nursing Services, Social Work, Behaviour Consultation / Therapy, Psychology & Psycho-educational Services, Early Childhood Education Services, Respite Services, Recreation Therapy (Drama,Music), Special Services Support at Home (SSAH), Transition to Adult Services, Parent Education Services
Complementary services which enrich and expand the delivery of core services
Referrals for these services are generally made by EOK clinicians
General principle: only refer these services if unable to access in the community e.g., recreation
(Referral criteria established for each Core and Other Services –available on EOK website www.erinoakkids.ca)
Increase hours of service (8:00 a.m. – 6:00 p.m., evening hours)
Overbook to equalize no show / cancellation rate of 10%Ensure clinicians are functioning at “top of licence” use of more therapy assistants remove non-clinical tasks (e.g.., scheduling, material
preparation) Increase use of group interventions Increase emphasis on client groupings to further develop
service pathway and tailor service plansLeverage community partnerships (build on existing expertise,
reduce duplication)
Serving More Children within Current Serving More Children within Current Resource Allocation Resource Allocation
Client IntakeClient Intake
IntakeIntake
Consolidation of all clinical administrative support services into centralized department (CLASS):
Data Entry Health records Community Wide Scheduling
All intake for Central West Region occurs through one toll-free number, 1-877-ERINOAK (1-877-374-6625)
Incoming calls to intake received “live” (8 am – 6 pm)
The Beginning – Front End Integration
Majority of referrals are received by telephone
Optional single written referral form has been created for all services
Referral form includes a section for a signed medical referral (required for OHIP funded services i.e., medical assessment and occupational therapy / physiotherapy, as latter may result in referral to medical clinics)
IntakeIntake
IntakeIntake
Referrals requesting service(s) for children with Developmental Delay and / or Physical Disabilities:
Intake directs to the Clinical Intake Review Team (CIRT) Once the referral is accepted, the CIRT will
determine the appropriate service stream
IntakeIntakeReferrals requesting Preschool Speech and Language service only:
Intake will administer the ERIK (Early Referral & Identification Kit) Questionnaire / checklist, age sensitive 10 – 15 minutes completion by trained intake worker
Of the 2,700 children referred for Preschool Speech and Language each year, 40% (1,100) will have other challenges
Enable earlier identification of possible ASD or other diagnoses / delays, allows for immediate streaming to diagnostics and / or other requisite services
IntakeIntake
Referrals requesting Autism, Medical (a portion), Infant Hearing and Blind Low Vision Services:
Intake will stream clients directly to the appropriate service(s)
Service DeliveryService Delivery
Service DeliveryService Delivery
Brief Intervention Clinic Mild fine / gross motor needs, 0 – 18 years
Inter-professional Assessment / Treatment Multiple special needs, 0 – 7 years Retain on caseload
Needs Review Clinic Multiple special needs, 7 – 18 years Not on caseload
Service Models Expanded:
Service DeliveryService Delivery
Transition through various therapy models as appropriate - individual, group, mediator training, consultation
Utilization of inter-professional groups e.g., speech language pathology / music therapy
Enhanced parent support groups / coaching / education
Service Options:
Service DeliveryService Delivery
Frequency related to critical periods for skill acquisition
Service must produce functional, measurable outcomes
Discharge planning an integral part of plan of care
Education for families regarding need for service re-activation
Service Journey:
Service DeliveryService Delivery
Co-ordinates the client’s service plan
Functions as the key contact between the family and the service team
Clinician whose service is deemed to be the priority will be the LP
As priorities for the service needs of the child change the LP will change to align with service
Lead Professional
Service DeliveryService Delivery
Provides service coordination for childrenWith complex care needs and / or complex family
situationsRequiring multiple services both internally and
externally
Aligned with community service coordination programs e.g., Kids Pathways Peel
Service Navigator
Client Discharge / TransferClient Discharge / Transfer
Discharge / TransferDischarge / Transfer Child ages out of service stream e.g., Preschool
Speech only
Service Goals are met
More appropriate community service provider(s) (Link initiated as required)
No service within last year and no future booked appointments
Services may be re-activated when new needs identified – contact Intake
Management Management –– Structural ChangesStructural Changes
Moved from a program-based management structure to a site-based management structure
Clinical Operational Managers (COMs) oversee all clinical and administrative services from 5 designated sites (except Autism services which is overseen by AS Program Directors)
COMs report to the VP Clinical Services
Management Management -- Structural ChangesStructural Changes
Moved from Discipline / Program specific Clinical Coordinators to site-based Clinical Services Supervisors
Clinical Services Supervisors (CSSs) oversee multidisciplinary clinical teams at designated sites (20 – 25 staff)
CSSs report to the Clinical Operational Managers
Management Management –– Structural Changes Structural Changes
In place for the disciplines of OT, PT, SLP, SW, Psych, Nursing, ECRS
Discipline specific consultation across all sites
Ensure the delivery of evidenced based practice for each respective discipline
Roles overseen by the VP Medical Services
Clinical Practice Leaders (CPLs)
Management Management –– Structural ChangesStructural Changes
Senior Leadership Team
August 2011
Management Management –– Structural ChangesStructural Changes
Clinical Services
August 2011
Community CollaborationCommunity Collaboration
Collaboration with community partners
Welcome opportunities for joint service provision
View clients as belonging to the service system as a whole
SummarySummary
Innovation in service delivery Efficient use of all our resources More service to more children within a finite funding
envelope Collaboration with community partners Good stewardship of taxpayer / government funds
An accessible, streamlined continuum of care for clients and families that builds on their strengths
Next StepsNext Steps
Thank you Thank you -- we value your responses!we value your responses!
Refine / recalibrate service model over next 6 monthsObtain community feedback.
Questions / Comments / SuggestionsContact: Mary King-Lyons
[email protected] 905 491 4327
or [email protected] 905 491 4460
