Transcript Youth and Provider Meetings - Health Transition Wisconsin

Wisconsin Youth Health Transition Learning
Community
Youth and Family Engagement: Transition and
Transition QI
Presented by 2014 Transition Quality Improvement
Grantees
March 5, 2015
1
2014 Grantee Presenters
• Children’s Hospital of Wisconsin
• Julie Turkoske
• UW HIV Comprehensive Care Program
• Sheryl Henderson MD
• UW and AFCH Hospital Medicine
• Ryan Coller MD, MPH, Sarah Ahrens MD
Engaging Youth
•Recruiting
•Supporting
•Encouraging
Julie Turkoske, Information & Referral Specialist
https://www.youtube.com/watch?v=UAySTI9GSds&sns=em
Recruiting
• Project SEARCH
– Youth are already on campus and are interested in
learning about the hospital operations
• Youth Advisory
– Youth patients and siblings meet monthly to plan
events and provide feedback on hospital
operations
• Engaged Parents
Supporting
Meet with youth ahead of time
• to explain the committee goals and processes
• to ask what they hope to gain from
participating
Meet with youth after the meeting
• Find out what went well
• Learn what questions they have
• Provide encouragement and positive feedback
Encouraging
• Appreciate their thoughts!
• Show interest in their personal life
• Provide some sort of reward (gift card, “logo”
item, etc.)
Youth Healthcare Transition
UW HIV Comprehensive Care
Clinic
Sheryl L. Henderson, MD, PhD and
the UWHIV Healthcare Transition
Team
Setting—
Clinic Based QI Project
• UW HIV Comprehensive Care ClinicPediatrics/Adolescent Program
• 30 HIV infected youth (ages 3-24)
• 10 are ages (18-24)
• Primarily perinatally infected
• One half live in the Madison area
• Clinic is shared with the adult HIV clinic
It’s a Team!!
• Young Adults and
Parents
• Patient Advocate
• UW Pediatrics
– Jody Belling, RN, MSN
– Kirstin Carlson, Med,
RN
– Joseph McBride MD
– Teri Meyer, RN, ACRN
– Solomy Ntambi, MSW
– Sheryl Henderson,
MD, PhD
• Waisman Center
–
–
–
–
Kristina Jones, MPH
Amy Lyle, MSSW
Colleen Moss
Amy Whitehead, MPA
• UW Adult Medicine
– Rachel Luzbetak, MSW
– Lisa Baker, PhD
– Shufang Sun
Approach
• PDSA cycle to:
– Determine the skills needed for current youth to
successfully transition and
– Identify the best means of patient education and
skill development
Approach
• Family/Youth/Adult Provider
Engagement to
– Develop transition policy
– Identify areas to target to improve transition
process
– Understand best tools for working with youth on
education and skill development
Clinic Baseline Survey of Readiness
• Presented to six young adults at clinic visit
• Assessed knowledge of:
– Their CD4 counts/viral load
– Their medications
– How to contact social worker
– Health insurance
– Arranging transportation independently
– Scheduling appointments
Clinic Baseline Survey of Readiness
• Presented to six young adults at clinic visit
• Assessed knowledge of:
– Their CD4 counts/viral load
– Their medications
– How to contact social worker
– Health insurance
– Arranging transportation independently
– Scheduling appointments
Follow Up
• Action: Intentional discussion of lab values,
reasons to know. Increased use of visual aids
in teaching
• Provider survey (physician, nurse, pharmacist)
•
Assess mode of teaching
• Patient survey
•
Assess knowledge of lab values and
medications
Youth and Provider Meetings
•
•
•
•
•
•
•
•
•
Scheduled for a clinic day
Personal email and phone call invitations (no response
to written invitation)
Youth and parents invited
Dinner Meeting
Funds for transportation and honoraria
Case managers and social workers assisted with
arranging transportation
Icebreakers
Young patient advocate as facilitator for discussions
Discussions and evaluations informed the content and
process of future meetings
Youth and Provider Meeting
August
• Small group discussions (separated youth
and providers)
– What is working well in the clinic around transition
and what is not working well?
– Fears and concerns about transition to adult care
– How do youth best learn about their health?
Two Action Items
1. Educate in a manner that is visual, graphical, animated.
Use technology for medication and appointment reminders.
•2. Youth asked to meet with adult providers as a group
(they wanted to get to know their personalities)
Second Meeting October 2014
• Large group discussion with six youth, patient facilitator,
pediatric and adult providers and one parent.
• Some topics of discussion,
• The culture of the adult clinic,
• Parent’s role in transition,
• Peer counseling and support
• Joint clinic visit with peds and adult providers
Third Meeting December 2014
• Transition Policy review by providers, youth
and parent
• Format of discussion—anonymous questions
answered by anyone in attendance
• Formulated ideas for a youth retreat and
mentor program
Current Plans
• Continue developing readiness tools to
include younger ages.
• Exploration of electronic tools for HIV
education and assessment of transition
readiness
• Addressing needs of peer support and
education by holding a retreat
• Continued involvement of adult providers
in the transition policy and process
Family Engagement Resources
CYSHCN Regional Centers
Family Voices of Wisconsin
Parent 2 Parent of Wisconsin
NICHQ Patient and Family Engagement
UW Center for Patient Partnerships Patient Engagement in Redesigning Care Toolkit
21