Report No. 024-12

TO: Chair and Members of the Board of Health
FROM: Graham L. Pollett, MD, FRCPC, Medical Officer of Health
DATE: 2012 February 16

Interagency Protocol for Family Service Coordination in the Region of Thames Valley

Recommendation

It is recommended that Report No. 024-12 Interagency Protocol for Family Service Coordination be received for information.

Background

Over the past year, the Interagency Protocol for Family Service Coordination in the Region of Thames Valley was developed in response to a need for a more integrated, effective system of service provision for families who have children with special needs. The protocol is a revision and integration of the London-Middlesex Community Service Coordination Framework (2001) and the Oxford County Interagency Protocol for Service Coordination for Families with Children 0-6 Years (2007) (Appendix A). The protocol works in conjunction with the high risk infant protocols for children birth to 2 years that already exist in Middlesex and Elgin Counties.  The vision as stated in the protocol is “All families can provide coordination of services for their children through an integrated system of service provision in the Thames Valley region.”

The committee of service providers, who developed this protocol, also developed and implemented a staff training module across the region.  The committee meets regularly to oversee training, support, evaluation and sustainability of the service coordination system.  Presently the committee is chaired by Ms. Debbie Shugar, Manager, Family Health Services (FHS). Ms. Suzanne Vandervoort, Manager, FHS and Martha Kirkwood, PHN, Healthy Babies Healthy Children (HBHC) program also sit on the committee. The Committee membership is attached as Appendix B.

Interagency Protocol

Too often families who have more than one service provider find that each service operates in isolation of the other. Families are asked to complete individual plans with each provider, repeat their stories multiple times and may receive conflicting information. This new protocol uses a service coordination

model to ensure that service providers work together with the family in an integrated and community oriented manner. The protocol outlines the roles and responsibilities of a Family Team Coordinator, documents all the service providers, describes the service coordination and decision making process and provides a template for the Family Team Plan (Appendix A). In the past, service coordination has been used effectively for small pockets of families and usually only those with the highest of needs. This protocol expands the use of the service coordination model to any family who has more than one service provider e.g. a Speech Language Pathologist from tykeTALK provider and a Public Health Nurse from HBHC both working with the same family.

Training

Community service providers have varying skill levels in working within a service coordination model. In order for the model to be successful, a specific skill set is needed. Training helps service providers learn to support and coach families to provide coordination of services for their children to the best of their ability. Families can then experience a consistent approach from all service providers with whom they have interaction.

Three, one-day training workshops took place in London, St. Thomas and Woodstock in late fall of 2011 and early winter of this year. All regional service providers that support families of pre-school children were invited. The majority of front line service providers from the Health Unit’s HBHC program, the tykeTALK program and the Infant Hearing and Blind Low Vision programs participated in the training. Training focused on strengthening facilitation skills and including families in the planning and participation of the treatment. The workshop introduced the protocol by focusing on the art and skill of relationship-centred practices useful for supporting families in coordinating their care. Four key areas addressed included hearing from a panel of families about their service coordination experiences, exploring the art and skill of listening and responding to families, strengthening facilitation skills when asked to lead a coordinated meeting with other community partners and supporting families as they develop and strengthen their own service coordination skills.

Evaluation and Outcomes

Evaluation tools have been developed to evaluate the impact of the workshop and to establish a baseline from which to track experiences of families and professionals over time. Key outcomes will include:

• consistent implementation of the protocol by service providers.
• development, coordination and monitoring of one integrated and individualized family team plan of services and informal support for children and families.
• increase in families skills in coordination of their services.
• increase in facilitation skills of service providers, specifically with respect to the role of Family Team Coordinator.

Champions in each service provider agency will support colleagues in using the protocol and in training new colleagues who join their agency as well as in evaluation of the effectiveness of the model in providing better care for families.

This report was prepared by Ms. Debbie Shugar, Program Manager, Family Health Services.

Graham L. Pollett, MD, FRCPC
Medical Officer of Health

This report addresses the following requirement(s) of the Ontario Public Health Standards: To promote the health of children and youth
and
Area of Focus: Facilitate the effective and efficient implementation of the Ontario Public Health Standards (OPHS) at the Middlesex-London Health Unit.