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Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report

Overview of attention for article published in BMC Health Services Research, August 2016
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Title
Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report
Published in
BMC Health Services Research, August 2016
DOI 10.1186/s12913-016-1700-3
Pubmed ID
Authors

Kristy D. M. Wittmeier, Gayle Restall, Kathy Mulder, Brenden Dufault, Marie Paterson, Matthew Thiessen, Lisa M. Lix

Abstract

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.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 29%
Student > Bachelor 4 19%
Unspecified 4 19%
Student > Doctoral Student 3 14%
Librarian 2 10%
Other 2 10%
Readers by discipline Count As %
Unspecified 6 29%
Medicine and Dentistry 5 24%
Nursing and Health Professions 5 24%
Computer Science 2 10%
Social Sciences 1 5%
Other 2 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 October 2017.
All research outputs
#10,643,841
of 12,002,078 outputs
Outputs from BMC Health Services Research
#3,607
of 3,893 outputs
Outputs of similar age
#238,703
of 284,436 outputs
Outputs of similar age from BMC Health Services Research
#162
of 194 outputs
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