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Rungan S, Gardner S, Liu HM, Woolfenden S, Smith-Merry J, Eastwood J. Ngaramadhi Space: An Integrated, Multisector Model of Care for Students Experiencing Problematic Externalising Behaviour. Int J Integr Care 2023; 23:19. [PMID: 38107833 PMCID: PMC10723013 DOI: 10.5334/ijic.7612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Behavioural and emotional disorders are a significant cause of morbidity for young people aged 10-19 years. School-based health care (SBHC) provides an innovative approach to addressing these issues within Australia. Description We describe an innovative and integrative SBHC model called Ngaramadhi Space (NS) based at a specialised behavioural school called Yudi Gunyi school (YGS) in metropolitan Sydney, Australia. NS was developed in partnership with the Aboriginal community to provide holistic, integrated, multidisciplinary child and family centred care to students experiencing problematic externalising behaviour. We contextualise the historical factors leading to the development of NS, highlighting the importance of effective partnerships between sectors, and providing the theoretical framework and key components underpinning the model of care. Discussion In Australia, schools are an under-utilised resource for the delivery of health and support alongside education. Collaboration between sectors can be challenging but allows a more coordinated approach to the management of complex social and health issues. By forming effective partnerships with schools and communities, the health sector has an opportunity to improve access to health and social care in a culturally safe and acceptable way. This is in line with national and international frameworks for improving health service delivery and addressing inequity. Conclusion The health sector can play a pivotal role in improving the wellbeing of children by forming effective partnerships with schools and communities. The NS model is a practice-based example of this.
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Affiliation(s)
- Santuri Rungan
- Sydney Local Health District, University of Sydney, Sydney Institute for Women, Children & their Families, AU
| | | | - Huei-Ming Liu
- The George Institute for Global Health, University of New South Wales, AU
| | - Susan Woolfenden
- Sydney Local Health District, University of Sydney, AU
- Sydney Institute Women, Children and their Families, University of New South Wales, AU
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy, Sydney School of Health Sciences, The University of Sydney, AU
| | - John Eastwood
- University of New South Wales, Sydney, AU
- Ingham Institute of Applied Medical Research, Liverpool, NSW, AU
- University of Sydney, Sydney Institute for Women, Children and their Families and Sydney Local Health District, AU
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Adams S, Beatty M, Moore C, Desai A, Bartlett L, Culbert E, Cohen E, Stinson J, Orkin J. Perspectives on team communication challenges in caring for children with medical complexity. BMC Health Serv Res 2021; 21:300. [PMID: 33794885 PMCID: PMC8015748 DOI: 10.1186/s12913-021-06304-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with medical complexity (CMC) require the expertise of many care providers spanning different disciplines, institutions, and settings of care. This leads to duplicate health records, breakdowns in communication, and limited opportunities to provide comprehensive, collaborative care. The objectives of this study were to explore communication challenges and solutions/recommendations from multiple perspectives including (i) parents, (ii) HCPs - hospital and community providers, and (iii) teachers of CMC with a goal of informing patient care. METHODS This qualitative study utilized an interpretive description methodology. In-depth semi-structured interviews were conducted with parents and care team members of CMC. The interview guides targeted questions surrounding communication, coordination, access to information and roles in the health system. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using thematic analysis. RESULTS Thirty-two individual interviews were conducted involving parents (n = 16) and care team members (n = 16). Interviews revealed 2 main themes and several associated subthemes (in parentheses): (1) Communication challenges in the care of CMC (organizational policy and technology systems barriers, inadequate access to health information, and lack of partnership in care) (2) Communication solutions (shared systems that can be accessed in real-time, universal access to health information, and partnered contribution to care). CONCLUSION Parents, HCPs, and teachers face multiple barriers to communication and information accessibility in their efforts to care for CMC. Parents and care providers in this study suggested potential strategies to improve communication including facilitating communication in real-time, universal access to health information and meaningful partnerships.
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Affiliation(s)
- Sherri Adams
- Division of Pediatric Medicine, SickKids, The Hospital for Sick Children, Toronto, Canada. .,SickKids Research Institute, Toronto, Canada. .,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
| | | | - Clara Moore
- SickKids Research Institute, Toronto, Canada
| | - Arti Desai
- Department of Pediatrics, University of Washington, Seattle, USA
| | | | | | - Eyal Cohen
- Division of Pediatric Medicine, SickKids, The Hospital for Sick Children, Toronto, Canada.,SickKids Research Institute, Toronto, Canada.,Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Jennifer Stinson
- SickKids Research Institute, Toronto, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.,Department of Anesthesia and Pain Medicine, Toronto, Canada
| | - Julia Orkin
- Division of Pediatric Medicine, SickKids, The Hospital for Sick Children, Toronto, Canada.,SickKids Research Institute, Toronto, Canada.,Department of Pediatrics, University of Toronto, Toronto, Canada
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