Welcome NICU Consortium Education Program/Webinar July 31, 2019 - - PDF document

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Welcome

NICU Consortium Education Program/Webinar July 31, 2019

NICU Consortium Education Program Agenda, July 31, 2019

Welcome and Introductions

NICU Consortium Partner Updates NICU Consortium Committee Reports

Using Telehealth for Children in Early Intervention

Becky Cohill, OTD, OTR/L Judy Delaware, OTR,

Families Perspective of Telehealth

Moderator: Beth Cole, Provider Relations Manager, Early Intervention North Metro Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee Nancy Haddad Mesa County Developmental Services Jeanie Larsen, Service Coordinator Adjourn

NICU Consortium Partnership Members Updates and Announcements

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Judy Delaware, OTR/L, CLC Pediatric Occupational Therapist and Feeding Specialist, Certified Lactation Counsellor Boulder, Colorado

• Dr. Becki Cohill

Assistant Professor at the University of St. Augustine Occupational Therapy Program San Marcos, CA.

Making Meaningful connections

An introduction to telehealth

Learning Objectives:

• Understand the service delivery model of

telehealth.

• Illustrate the benefits of telehealth as a

service delivery model in family centered early intervention.

• Diagram a proposed model to integrate tele

health into current early intervention process.

• Differentiate when tele health may be an

appropriate model for service delivery.

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Learning Objectives

• Evaluate current technology available based
• n HIPAA and family needs.
• Integrate telehealth information into a case

example for infants transitioning from NICU

• Measure outcomes of tele health program and

caregiver satisfaction.

Mentimeter

What is Tele health?

Telehealth is a collection

• f means or methods for

enhancing health care, public health and health education delivery and support using telecommunications

• technologies. Telehealth

encompasses a broad variety of technologies and tactics to

deliver virtual medical, health, and education services (cchpca.org, n.d.)

(Hu, n.d.)

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The Elephant in the Room Mentimeter

• “I became a healthcare provider to work

with people”

• “How great…I can sit at Starbucks and

facetime!”

• “Sounds good, but is it HIPPA compliant?”
• “But technology…UGH!”
• “Telehealth is a specialty service”

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Regulations

• Licensing/portability
• Ethics
• Compliance
• Reimbursement
• Legal

Technology considerations

We are living in a time of rapid and unpredictable change. Advances in knowledge and technology have made our lives more interconnected and complex” (Hinojosa, 2007, p. 629). (Birth2Work, n.d.)

Technology Considerations

• Considerations
• Confidentiality (security, privacy)
• Integrity (information protected from unauthorized users)
• Availability (information, services)
• Cost/benefit ratio
• Socio –economic considerations
• Using existing infrastructure
• Technology connection requirements
• Sound and image quality
• Accessibility of equipment
• Provider/ and user comfort ad expertise with technology

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Telehealth and Early Intervention Telehealth in early intervention

• Ability to provide services in natural

environment

• Tele health model utilizes coaching method of

service delivery

• Using telehealth allows for routines based

intervention

Benefits of tele health

• A review of evidence indicates that outcomes

for a tele health service delivery model are the same or higher than of traditional methods. It is also of significance that multiple studies, across multiple age groups indicate a high level of caregiver satisfaction with the tele health service delivery model (Cason, 2014;Cottrell et al, 2018)

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Provider Benefits

• Decreases travel constraints
• Reduces health-related cancellations
• Facilitates access to interpreters
• Increases use of family-centered coaching

strategies

• Supports family involvement goals
• Provides access to qualified providers
• Provides opportunities to work as a team

Benefits for Families

• Increased child responsiveness to parent
• Increased skills of family members
• Improved child language development and

listening skills

• Increased confidence in promoting childs skills

Coaching

• The mission of early intervention and the

purpose of effective help giving practices is to build the capacity of parent, support and enhance parent confidence and competence and assist parents and other care givers in sustained achievement of desired outcomes

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Reflection

• Type of questions

– Awareness – How did that work for you? Why? – Analysis- What did you do that got that outcome? – Alternative- What different things could you have done? – Action- What do you plan to do next time? Why?

• Question Content

– Knowledge and understanding (what you know) – Practice ( What did you do) – Outcome ( What was the result) – Evaluation ( what about the process)

Tele health in action

• Video

Case example

• Baby was born at 23w2d. Age at discharge 4

months, corrected age at discharge 44weeks 2

• days. DX: LBW < 1200 grams, good bottle feeder,

02 1/32, ROP, IVH, GERD, difficulty with sleep

• routine. Family has infant digital scale, Dr. Brown

bottle preemie nipple system. Family concerned about travel outside of the home due to mom primary caregiver to maternal grandmother who lives with this family. How can EI thru Telehealth be helpful and where to start?

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Mentimeter Case Example

• 6 month old child with Spina Bifida and

bilateral club feet. Receiving service coordination and occupational therapy

• services. Child has 3 caregivers during her

week, what are some ways the telehealth program can improve communication between parents and caregivers?

Mentimeter

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Case examples

• Case study two:
• Baby born at 31.5 weeks, Turner syndrome, low

muscle tone, weak suck, possible vision concerns.

• Baby is 4 months old and struggling with weight

gain, and delayed gross motor skills.

• Family has two older children, live in rural

situation, and are two and a half hours from the nearest Pediatric Therapy Center.

• How can we help this family thru Telehealth?

Mentimeter Outcome Measures

Interview and observation-based assessments is the best match for telehealth service delivery model.

• RBI/SAFER
• Parent Satisfaction Survey
• COSF
• Interview based

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QUESTIONS?

(technotparent, n.d. )

Mentimeter References

• Benzies, K., Magill-Evans, J., Hayden, K., & Ballantyne, M. (2013). Key components of early

intervention programs for preterm infants and their parents: a systematic review and meta- analysis. Pregnancy and Childbirth, 13, 1-15

• Cason, J. (2014). Telehealth: A rapidly developing service delivery model for occupational
• therapy. International Journal of Telerehabilitation, 6(1), 29-36. doi:10.5195/ijt.2014.6148
• Center for Connected Health Policy. (n.d.). Retrieved from https://www.cchpca.org/
• Clawson, B., Selden, M., Lacks, M., Deaton, A. V., Hall, B., & Back, R. (2008). Complex pediatric

feeding disorders: Using teleconferencing technology to improve access to a treatment

• program. Pediatric

Nursing, 34, 213-216.

• Cottrell, M. A., Hill, A. J., O’Leary, S. P., Raymer, M. E., & Russell, T. G. (2018). Clinicians’

perspectives of a novel home-based multidisciplinary telehealth service for patients with chronic spinal pain. International Journal of Telerehabilitation, 10(2), 81-88. https://doi-org.prx- usa.lirn.net/10.5195/ijt.2018.6249

• Hinojosa, J. (2007). Becoming innovators in an era of hyperchange. American Journal of Occupational

Therapy, 61, 629-637.

• Kelso, G., & Olsen, S. (2009). The feasibility of virtual home visits to provide early intervention. Infants &

Young Children, 22, 332-340.

• Little, L. M., Wallisch, A., Pope, E., & Dunn, W. (2018). Acceptability and cost comparison of a

telehealth intervention for families of children with autism. Infants & Young Children, 31, 275- 286. Retrieved from http://prxusa.lirn.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsgin &AN=edsgcl.560648317&site=eds-live

• Rush, Dathan D., Shelden, M’Lisa L. (2011). The Early Interventions Coaching Handbook, Paul

Brooks Publishing, Baltimore Md.

• Special thank you to CB for the use of his video

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Break – Save the Dates

September 20, 2019

NICU Consortium Partnership Annual Meeting

November 1, 2019 Celebrating World Prematurity Month “Creating a Community of Support for Babies and Their Families After Discharge from the NICU”

Families Perspectives of Telehealth in Early Intervention

Moderator: Beth Cole Provider Relations Manager Early Intervention North Metro Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee, Service Coordinator Nancy Haddad, Service Coordinator Mesa County Developmental Services Jeanie Larsen, Service Coordinator

North Metro

Missy Oiler Service Coordinator

7/30/2019 13 Mesa County Developmental Services

Jeanie Larsen Service Coordinator

• Families served by TV1
• Families receiving private OT
• Families receiving private SLPA
• Families served through Alliance

primarily for speech

The Resource Exchange

Lisa Bisbee Service Coordinator Nancy Haddad Service Coordinator

Early Intervention

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What is Early Intervention?

• Services and supports that are available to babies

and young children with developmental delays and disabilities and their families.

• May include speech therapy, occupational therapy,

physical therapy, and other types of services based

• n the needs of the child and family (15 types of

services!)

• Can have a significant impact on a child’s ability to

learn new skills and overcome challenges and can increase success in school and life.

• All services are individually based and provided in a

natural environment (home or other location that typically developing children visit)

Who we serve:

• Infants and toddlers

with at least a 25% delay in development

• Children with

established conditions which places them at high risk for developmental delays (i.e. low birth weight, Trisomy 21, hearing loss)

• Infants and toddlers

The Natural Environment – Wherever children typically are – lots of variety!

7/30/2019 15 Key principles of early intervention

• Infants and toddlers learn best in everyday

experiences and interactions

• All families, with supports and service, can

enhance their child’s learning

• The Early Intervention process must be

dynamic and individualized to reflect family priorities, learning styles and cultural beliefs

• Outcomes should be functional and based on

the family’s priorities

• Services are based on evidenced-based practice

Trans-disciplinary approach during the Individual Family Service Plan (IFSP)

• A team approach that crosses

disciplinary boundaries is used, with the family as an integral part of that team.

• TRE uses the coaching model to

encourage and support the family and reflect on current practices, apply new skills, give feedback and problem solve challenging situations.

• A primary service provider works closely

with the family and Service Coordinator to facilitate the delivery of services and to manage the links within the transdisciplinary team

Clinical staff are licensed or accredited in their field. Average years of experience with children with developmental disabilities is 26 years!

• Physical Therapists – 19
• Occupational Therapists - 21
• Speech Pathologists - 36
• Dieticians - 2
• Developmental Interventionists – 29

Early Childhood Special Educators, Licensed Professional Counselors

• Psychologists and Social Workers - 4
• Nursing – 1
• Teachers of the Blind – 3
• Hearing Specialists – 8

Total of 123 Providers!

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Geographic teams, Specialty teams, and Discipline

Specific teams

• Autism
• Feeding
• Assistive Technology
• Early Childhood Mental

health

• Child and Parent

Psychotherapy

• 8 Geographic teams

Weekly or Monthly meetings to address best practice, identify standards and collaborate on difficult cases

Specialty programs

• Power of Peers – play based program for

children with Autism embedded in a natural day program (before they are old enough for preschool)

• Positive Solutions for Families Parent

training to promote positive strategies to manage child behavior

• GoBabyGo – building modified ride-on

cars for toddlers to promote mobility for those children with movement difficulties

Families Perspectives of Telehealth in Early Intervention

Moderator: Beth Cole Provider Relations Manager Early Intervention North Metro Missy Oiler, Service Coordinator The Resource Exchange Lisa Bisbee, Service Coordinator Nancy Haddad, Service Coordinator Mesa County Developmental Services Jeanie Larsen, Service Coordinator

7/30/2019 17 NICU Consortium Partnership

Leadership Council

Leadership

Chair Petora Manetto-Spratt Co-chair Lisa Hymes Secretary Carolyn Kwerneland Treasurer Beth Cole

Community Representatives

Parents - Amber Minogue JFK Partners - Renee Charlifue-Smith Physicians - Sharon Langendoerfer

Committee Chairs/Co-chairs Mental Health - Emily McNeil NICU Consortium Planning Committee - Kristin Frank Family Support Programs - Natalie Gates Safe Sleep Going Home – Mekida Wilson NICU Outreach - Open 2019 Once Day Conference – Barbara Deloian 2020 Interdisciplinary Institute - Open

Please contact Barbara Deloian at specialcare@sk-sc.org if you would like to participate on one of the Committees

Special Kids, Special Care Update

Please use our website: www.specialkids-specialcare.org

• Announcements about our education programs, the NICU

Consortium Meetings and our newsletter Family Support Programs

 NICU Outreach: Safe Sleep Going Home Program:

 Wearable Sleep Sac Blanket and safe sleep parent education materials provided to the hospital NICU staff and public health nurses

 Family Support Grant

 Infant cribs  In-home lactation consultation support  Respite care