What About Me?

Children with differences do not need to be fixed or cured or pitied. Children are valuable simply for the person they are and will be. Schools and school districts have sought to remediate the weaknesses of children with disabilities without focusing on or utilizing the strengths and interests of children with disabilities as the basis for individual education programs (IEP). Beginning with a pre-referral process that focuses on parent or teacher concerns for children, driving an evaluation that focuses on a child's weaknesses, leading to an IEP built on remediating weaknesses that often ignore an individual's strengths and interests, the process and end product are focused on deficits in children. This chapter will present an alternative to this model, an alternative focused on identifying and utilizing a child's strengths and interests in the development of IEPs.

Retrospective Analysis of Intra-Departmental Requests for Consultation To Hematology Department

Aim: To investigate how much information a specialist hematologist receives at the time of initial assessment of referred patients through a referral letter. Study design: Retrospective study Place and duration of study: Haematology department BVH, October 2020 to February 2021 (5 months) Methods & Results: Among the 96 referral letters received, Majority 45 (47%) was referred from medicine department. Most common reason for referring the patient was evaluation of Pancytopenia n=19 (19.8%), Request for bone marrow biopsy n=14 (14.6%), being the second most common. The reason for referral was not properly stated in n=9 (9.4%) of patients in our study. Majority of referred patients were above 46 years of age n=22 (22.9%). CBC was mentioned only in n=35 (36.5%). Conclusion: Our study concludes that quality of referral letter was well below the acceptable standards. A well-documented protocol for referral letter is the need of hour to improve the quality of a referral process. Keywords: referral letter, pancytopenia, bone marrow, hematology clinics

Optimising access and provision of interventional radiology service to patients by utilising a new referral system

Objective: Implementing a streamlined interventional radiology (IR) service in the UK has been a challenge. This study aims to review a set of changes introduced in IR at a tertiary centre, including a new referral process and the designation of IR clinical nurse specialists. Methods: A new process of referring patients to IR using a single generic referral pathway was implemented, replacing an order dropdown-based system. A qualitative survey was designed and distributed as a single-use web link in order to assess the satisfaction and impact of this new process. Responses were based on Likert scale and pertained to perceived qualities of the new referral process. Data analysis was performed to identify specialty and grade-specific trends and possible differences amongst groups. Results: Findings from 98 respondents revealed a strong overall satisfaction with the new referral method and support for its continuation. Subgroup analysis by specialty, concluded medical specialties rated the new referral system more favourably than surgical specialties across all aspects: time efficiency, ease of use, periprocedural support and overall user experience. The new system also increased departmental productivity with an increase in the number of patients treated by 11.2%. Conclusion: Micropolicy changes within individual IR departments such as the replacement of a request-based referral system to one which puts IR in control of vetting and patient flow is one of many changes that reinforce the transformational phase of this specialty. Advances in knowledge: Micropolicy changes within IR departments are key in the progression and widespread recognition of the specialty.

EP.TU.673Optimising the referral process to the Surgical Emergency Clinic through mutual education of primary and secondary care teams: an audit cycle

Aims The Surgical Emergency Clinic (SEC) in our Hospital facilitates access to General Surgical consultant-led emergency assessment. Anecdotally, referrals are often (likely inadvertently) inappropriate and / or incomplete, which may delay assessment by the correct specialist. We audited the quality of GP referrals to the SEC against four standards: Methods Retrospective analysis of 50 GP referrals to the SEC between November - December 2017, after recording data pertinent to the above standards in a spreadsheet. Results were presented at a local GP development day, a re-designed referral form incorporating GP feedback received was uploaded onto the Trust’s intranet and an email inbox created for e-referrals. 50 further referrals between September - November 2018 were analysed. Results Full completion of the referral form increased from 0% (initial audit) to 29% (re-audit), and appropriateness of referrals from 62% to 90%. The proportion of patients having had specified blood and urine tests in advance improved overall also. Conclusions Our experience demonstrates that primary and secondary care teams actively communicating and working closely together can improve the referral process for both parties, and most importantly enhance patient access to timely, appropriate specialist care.

Pregnancy and parenting experiences of women with twin-to-twin transfusion syndrome: a qualitative study

Background Qualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support. Methods A semi-structured interview method was used to assess the pregnancy and parenting experiences of women with TTTS. Colaizzi method was used for data analysis. Results Eighteen women participated in the study. We found that women with TTTS during pregnancy experienced persistent worry about their children’s health from the disease diagnosis to the subsequent parenting processes, even in case of minor changes in their children’s health. The lack of an efficient referral process and health information increased their uncertainty about their children’s health. Conclusion In addition to the children’s health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Clinicians in the first-visit hospital and foetal medicine centre should improve the referral process and establish a follow-up system to provide women with health information and psychological support.

Identifying Clinical Patterns in OT Referrals for Concussion Management: An Evidence-Based Approach

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This descriptive study examined OT referrals in an interdisciplinary concussion clinic. Data analyzed show that patients referred to OT presented to clinic evaluation further out from injury; had missed more days from school, work, and physical activity; were lacking a routine; and were not socially active. These results provide variables that indicate the need for OT assessment, guide clinicians in the referral process, and advance the role of OT in concussion management. Primary Author and Speaker: Shannon S. Westerberg Additional Authors and Speakers: Madison Harris Contributing Authors: Samia Rafeedie, David McArthur, and Christopher Giza