Childrens Safety

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Childrens Safety Best Practices in Risk Reduction
Catherine OLeary, OT Reg. (Ont.)
COTA Health
SYMPOSIUM 2008 Working Together for Kids Teens
with Disabilities
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What is Risk?
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• What is risk? (not so obvious)
• Long wait time
• Wrong information provided
• making a risky situation worse
• sending funding letters to the wrong funding
  sources
• not finishing the job
• lack of knowledge

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Why Address Risk?

• In home referrals for children with safety
  issues
• Service Providers who were hesitant to take on
  these referrals due to lack of experience/
  knowledge
• Pediatrics needs were different than adults in
  the variety of equipment, need for ongoing
  support and changing nature of the service
• Need to ensure consistency across the
  organization

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Purpose

• To provide a best practice assessment and
  management guidelines for Occupational Therapists
  for use with paediatric clients with issues
  relating to safety in their home and community.

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Why is Best Practice Important?

• To ensure appropriate information is provided in
  a timely manner to address current and future
  needs. This information should include researched
  support for its use or be considered the most
  common and gold standard treatment.

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Lets Play with Risk

• Balloon Play
• You be the Therapist, understanding the role of
  the therapist and how the system currently works.

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What Safety Concerns? Where? Whos concerns?
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OH MY GOD Thats not safe.
Obvious child safety issues in a home.
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Obvious child safety issues in a home.

• Children with developmental and/or sensory issues
  are at higher risk in the home.
• So are their parents!

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Discharge or Pre-Discharge visits HOME

• .

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Families living with a disability

• Caregiver Stress
• High Fall Risk
• Back problems

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Increasing Safety Quality of Life
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End of Life Comfort Care
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Identifying Issues

• Not enough information (referral)
• Not the correct supports or forms to support
  quick and efficient support of familes
• Therapists fearful of equipment issues (What if I
  am wrong?)

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Identifying Roles

• Who is responsible for what?
• Who supports whom?
• Who addresses funding?
• How do we effectively communicate?
• How will this be funded?

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OT Role (not the ADP Authorizor)

• Explain the prescription process (roles, risks
  and benefits, release of information, vendor
  involvement, funding options)
• Risks include falls, injuries to client or
  caregiver if equipment used incorrectly due to
  lack of training (CCAC loaner equipment or
  equipment not set up properly)
• Education of current and future safety needs
• To prioritize and set goals with the client and
  family (for interventions and equipment)
• Assess client and family to establish equipment
  parameters to meet needs
• To liaise with authorizing therapist to determine
  trial equipment
• To liaise with preferred vendor to arrange
  equipment trials
• To provide letters and forms for funding not
  covered by ADP
• To work with family and community agencies to
  negotiate the health care system including access
  to funding and in-home service providers
• To identify when external resources are required
  (e.g. ADP Authorizer, Universal Design
  Consultant, contractor, vendor, social worker,
  case manager, physiotherapists etc.)

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ADP Authorizer Role

• Connect with therapist to collect pertinent
  information (i.e. pediatric safety and equipment
  assessment)
• Meet with client, family, primary therapist and
  preferred vendor to perform physical and
  environmental assessment and determine trial
  equipment
• To explain the role of ADP and to provide a list
  of vendors
• To act as a resource during equipment trials
• To finalize the prescription of the equipment
• To complete ADP prescription form, submit for
  funding, and photocopy ADP form and place on
  client record
• To provide follow up once final equipment is
  dispensed (visit, phone call, fitting with
  vendor as appropriate)
• To ensure COTA consultation note is completed and
  placed on clients health record

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Vendor Role

• To match identified client parameters with
  available equipment
• To support the therapist and family in the
  equipment prescription process (education,
  equipment trials, equipment choices etc.)
• To provide accurate and timely quotations
• To notify prescribing therapist when equipment
  dispensed or service has been completed in the
  home
• To bill appropriate funding agency (e.g. ADP)
  only for equipment dispensed
• To provide manufacturers with feedback regarding
  equipment uses and unmet needs
• To provide ongoing technical service to families
  as requested

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Shared responsibilities

• Education on safety
• Communication between partners
• Share appropriate information with partners
• Training on specific equipment to all caregivers
• Identify need for team lead to coordinate a
  meeting (for services outside of CCAC)

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Best Practices

• Identified the pathway in best practice to
  address equipment and safety issues in the home.
• Identified key pieces of information for the
  following groupings
• General Child Proofing a home
• Pre-Discharge assessment
• Rehab equipment needs
• Home accessibility (minor and major)

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Equipment and Safety Assessment

• Provides all forms needed for any area of safety
  and accessibility
• Is modeled on the ADP form, to increase comfort
• Has information included that is needed for the
  ADP authorizer
• Cues the OT to consent, release and to give out
  the ADP vendor list when required
• Identifies appropriate safety mobility and
  accessibility goals
• Identifies options and priorities needed in home
  accessibility

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Decision Trees

• Were put together by the Task force and experts
  (Educators from Vendors, Contractors and
  Consultants)
• Clearly defines the roles of the therapists,
  vendors, CCAC and Family
• Were to guide a therapist in helping the family
  make decisions

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Our Partners

• Motion Specialties, Toronto
• EZ Access Design Consultants
• Shoppers Home Health Care, Home Renovation
  Division

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Questions?