Background
KidsAbility moved quickly to virtual appointments, or telerehabilitation, during the early days of the COVID-19 pandemic. These appointments allowed families to continue receiving support from their therapists. As we transitioned back into the clinic, KidsAbility recognized the value of retaining virtual care for certain types of appointments.
The Problem
Between 2022 and 2023, 14% of telerehabilitation appointments were missed, comparable to 15% of in-person appointments during this same time. This represents 456 virtual appointments that were missed without prior notice, limiting opportunities for clinicians to effectively use that client time. This data shows us that families continue to experience barriers to service use, even when offered virtually, and we need to look at innovative ways to improve access and engagement in telerehabilitation.
The Solution
Meaghan Reitzel, a previous occupational therapist at KidsAbility, undertook her PhD research with McMaster University and KidsAbility. This work was funded through a Canadian Institute of Health Research Canada Graduate Scholarship and a MITACS Accelerate Internship. Under the supervision of Dr. Michelle Phoenix, previous speech-language pathologist at KidsAbility, Meaghan used an Experience-Based Co-Design (EBCD) methodology to engage families, clinicians and managers from KidsAbility in a collaborative design process to identify and address barriers to telerehabilitation. The findings from this research highlighted 3 key areas that are pivotal in influencing the engagement of families in telerehabilitation before, during and after appointments. We call these the 3C’s:
1. Communication: Strategies for consistent and clear information dissemination between clinicians and families were developed, including video tutorials and text-based resources to help families understand and navigate telerehabilitation services.
2. Connection: Establishing and maintaining a trust-based relationship between clinicians and caregivers was emphasized. Solutions such as pre-telerehab meetings between clinicians and caregivers were proposed to build rapport and align expectations, ensuring a smoother and more effective therapy experience.
3. Consistency: Solutions aimed at providing consistent experiences across different clinicians were developed. This included standardized communication protocols and flexible service options, allowing families to choose between in-person and telerehabilitation appointments, thus accommodating their preferences and needs.
Meaghan Reitzel’s research has significantly contributed to the field of pediatric rehabilitation by demonstrating the efficacy of a collaborative, user-centered design approach. The integral involvement of KidsAbility in every phase of the project ensured that the solutions developed were both practical and effective in real-world settings. As the project moves towards implementation and evaluation, it promises to further enhance organizational practices and user experiences in pediatric telerehabilitation, setting a benchmark for future initiatives in this field.
Some of the tangible products of this work can be seen in the videos below. These videos are available to all KidsAbility families as a way of preparing them for virtual care. A bank of resources has been created for clinicians to improve their ability to provide effective virtual care, and support parents.
