111 Kids Rock Janeway Pediatric Conference Oct 5 th 2014 Lisa Knisley and Carly Leggett

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Kids Rock Janeway Pediatric Conference

Oct 5th 2014

Lisa Knisley and Carly Leggett

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Share the TREKK story http://youtu.be/aj-ugBEZkTQ

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Up to 85% of children in Canada who need emergency care are treated in general emergency departments that are not part of a children’s hospital.

As many as 40% of these children do not get treatments for which clear evidence exists and up to 20% get a treatment which is of no benefit or may be harmful.

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What is TREKK?

Network of researchers, clinicians, health consumers and national organizations.

Want to increase health professionals’ knowledge, skills and confidence in caring for very ill and injured children in general EDs.

Accelerate the speed at which the latest knowledge in children’s emergency care is put into practice in every general ED

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TREKK Vision

To deliver the highest standard of care to every child, whether they choose to seek treatment

in a pediatric or general ED

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The TREKK TeamDirector Dr. Terry Klassen

• University of Manitoba, • Manitoba Institute of Child Health

Co-Directors Dr. Shannon Scott, Needs Assessment

• University of Alberta Dr. Lisa Hartling, Knowledge Synthesis

• University of Alberta Dr. David Johnson, Implementation

• University of Calgary Dr. Mona Jabbour, Implementation

• University of Ottawa

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Newfoundland teamPERC RepDr. Robert Porter

• Janeway Children’s Health and Rehabilitation Centre

TREKK CoordinatorDebbie Harnum

• Janeway Children’s Health and Rehabilitation Centre/MUN

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Carbonear General Hospital ~70 bed, in-patient facility Range of services, inc ED TREKK rep: Dr. Chris Patey

Western Memorial Regional Hospital 192 bed facility offers secondary services to about 80,000 people

in the western region of NL and Labrador ED open 24/7 TREKK rep: Dr. Dennis Rashleigh

Newfoundland TREKK Sites

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Three Phase Plan

1.Needs Assessment 2.Mapping current evidence 3.Share knowledge and practical tools with health professionals, parents and other stakeholders

Longer term: plan to expand beyond initial sites & continued innovation

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Needs Assessment

Purpose: determine the knowledge needs & preferences among our receptor communities (HCP & HC)

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Needs Assessment Team

• Shannon Scott, RN, PhD (PI) – University of Alberta

• Lisa Given, PhD (Co-I) – Charles Sturt University (CSU), Australia

• Lauren Albrecht, MEd (Project Coordinator) – University of Alberta

• TREKK coordinators for data collection• TREKK sites (32)

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Needs Assessment Process

Survey data collection (32 TREKK sites) Coordinators visited TREKK sites to collect data via

iPads Healthcare professionals & healthcare consumers were

invited to participate Surveys completed in French & English Data collection took place from May 15, 2012 –

October 2013

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Survey Findings

Healthcare professionals: 1,471 surveys included in final analysis (1471/2575 = 57% response rate)

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HCP: Primary Professional Role

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HCP: How do you normally find information you need in order to work with children seeking care in the ED?

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HCP: Which electronic devices do you use to look for new information at work?

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HCP: What type of information do you need (that you currently do not have) in order to provide the best care to

children in the ED?

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HCP: For which of the following childhood conditions do you require more clinical information to provide the best

care to children in the ED?

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HCP: How would you like to receive new information about providing care to children

in the ED?

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Survey Findings

Healthcare consumers: 897 surveys included in final analysis

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Consumers: Why did you bring your child into the emergency department today?

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Consumer: What is the medical reason for coming to the ED today?

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Consumers: How do you normally find health information needed to care for your child?

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Consumers: Did you look for info before coming to ED today?

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Consumers: Where did you look for information before coming to the ED?

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Additional Methods in Needs Assessment

Focus group data collection at 7 TREKK sites• Sites selected for maximum variation

Remote/Rural/Urban Size (Based upon reported # of Pediatric Visits/Month) 2 sites in NL

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Additional Methods in Needs Assessment

• Shared preliminary survey findings and asked for feedback

• Focus group questions centred around Review key survey questions Whether HCP had procedural skill needs (rather than

clinical information needs)

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Identified Conditions Survey top 10

Unperceived Need

Focus Groups KM Round

Multi System Trauma ✓ 3

Severe Head Injury ✓ 3

Meningitis ✓ ✓ 3

Congenital Heart Disease (first presentation)

✓

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Status Epilepticus ✓ 2

Sepsis ✓ ✓ 2

Diabetes Ketoacidosis ✓ ✓ ✓ 2

Croup ✓ ✓* 1

Asthma ✓ ✓* 3

Intussusception ✓ 4

Gastroenteritis ✓ ✓ 1

Bronchiolitis ✓+ ✓* 1

Procedural Sedation ✓ ✓ 1

Fractures (musculoskeletal injuries) #11 ✓ 4

* respiratory illness + top 3 for allied health professionals

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What’s next?

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Professional development at TREKK sites

How will this benefit health care professionals?80.3% of HCP want new info on caring for children in the ED through PD opportunities

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Professional development at TREKK sites

Local level:

• Face-to-face education sessions• Simulation-based training sessions• Webinars • Focus on priority topics

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Professional development at TREKK sites

National level:

Emergency Medicine CasesCanadian Pediatric Simulation Network (CPSN)

- national HPS curriculum for outreach training- increase HPS at TREKK sites where possible

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Create online resource repository

How will this benefit health care professionals?Over 60% of health care professionals want evidence based protocols/treatments, info on new diagnoses and treatments and clinical pathways/practice guidelines Qualitative data and verbal feedback suggests need for a website with easy to access & download summaries

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Create online resource repository

How will this benefit health consumers?52 % use internet search engines to find child health info47% identified the need for explanation of conditions and 42% want more info about treatments 74% prefer to get health info by talking in-person with a health care professional

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Connect with TREKK

Trekk.ca Twitter @TREKKca YouTube - trekkca E-update Blogs Central admin team: (204) 789 3323

trekk@mich.ca

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Thank you

Questions?

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