Mary Wyrwich & Pat Egan Health Management and Informatics, University of Missouri, Columbia, MO Literature Review Methods PurposeSample Clinic Flow Discussion.

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Presentation transcript:

Mary Wyrwich & Pat Egan Health Management and Informatics, University of Missouri, Columbia, MO Literature Review Methods PurposeSample Clinic Flow Discussion The main purpose of this study was to understand the process of interdisciplinary clinical practice through a review of the research literature on children with special health care needs and observation of an existing clinic for school-age children with ASD. The aim was to clarify the strengths and challenges of this clinical approach to service delivery for those with ASD. We conducted a systematic review of literature on comprehensive coordinated care for Children with Special Health Care Needs to examine the results of studies on the benefits of multidisciplinary coordinated care among this population. The studies show that there are significant results for reduction in utilization and costs, as well as improvement in family satisfaction, quality of life, health/functional status, and the services provided. Results of this literature review, combined with observations of the existing CAT clinic, were used to identify strengths and challenges of this approach and to make recommendations for next steps in improving interdisciplinary clinics. An extensive systematic literature search was conducted to assess the current research on the efficacy of comprehensive coordinated care for children with special health care needs. After conducting the literature review, the Clinical Assessment Team (CAT) clinic at the MU Thompson Center was selected for use as an existing real life example. We observed the clinic and conducted informal interviews with all providers involved. A work flow diagram was created to visualize the process and resources used in providing the CAT interdisciplinary clinic. CostsUtilizationSatisfactionQuality of Life Health/Fucntional Status Services Provided Cost per hour of each discipline Rate of referral visits kept Access to and satisfaction with health care and related services Time family spent traveling Complexity of Patient Activities involved in providing interdisciplinary care Cost per hour of personnel Resources used Satisfaction with costs Time family spent coordinating services Child functioning Number of disciplines involved in child‘s care Out-of-pocket patient/family costs Missed work Type of Clinic Health Insurance Coverage Missed school Time with patient of each discipline The strengths of interdisciplinary practice for children with ASD are improved coordination of care and access to early intervention services. The challenges of this approach to care are providing adequate financial support to all involved providers and coordinating all providers. To address these challenges and improve access to quality care, interdisciplinary teams should consider routine collection and review of key process and outcome data. Suggested measures are below. Sample Measures Discipline Months Prior Week Prior Clinic Day Weeks Post Clinic Total Hours Psychologist Psychiatrist01517 SPL OT01517 Administrative30003 Total CAT Clinic Total Hour Estimates