Publications by authors named "Joanna Soscia"

Article Synopsis
  • The study focuses on aiding Children with Medical Complexity (CMC) as they transition to adult healthcare, addressing gaps in support and coordination that negatively impact their care.
  • PITCare is a randomized controlled trial involving 154 CMC and their caregivers, assessing an intensive transition support program that connects patients with a multidisciplinary team for two years post-18.
  • Outcomes will include successful care transition rates and patient satisfaction, with qualitative interviews to gather insights on the experience of various stakeholders, while ethics approval has been secured for the study.
View Article and Find Full Text PDF
Article Synopsis
  • Children with medical complexity (CMC) require specialized care due to chronic conditions and often face challenges like fragmented care.
  • A randomized clinical trial compared the effectiveness of the Complex Care for Kids Ontario (CCKO) program, which emphasizes intensive care coordination, to usual care over two years.
  • Results showed significant improvements in the use of care planning tools for families in the CCKO program after 12 months, although the coordination of care scores did not differ significantly between the groups.
View Article and Find Full Text PDF

Introduction: A provincial strategy to expand care coordination and integration of care for children with medical complexity (CMC) was launched in Ontario, Canada in 2015. A process evaluation of the roll-out examined the processes, mechanisms of impact, and contextual factors affecting the implementation of the Complex Care for Kids Ontario (CCKO) intervention strategy.

Methods: This process evaluation was conducted and analyzed according to the United Kingdom Medical Research Council (UK-MRC) process evaluation framework.

View Article and Find Full Text PDF

Objectives: Parents of children with medical complexity are often expected to implement complicated plans of care, such as enteral tube feeding, to support the health of their child. Enteral feeding can have psychosocial implications for the parent, child, and family. Blenderized tube feeding (BTF) refers to the administration of pureed food and drinks through a feeding tube.

View Article and Find Full Text PDF

Background: Complex Care for Kids Ontario (CCKO) is a multi-year strategy aimed at expanding a hub-and-spoke model to deliver coordinated care for children with medical complexity (CMC) across Ontario.

Objective: This paper aims to identify the facilitators, barriers and lessons learned from the implementation of the Ontario CCKO strategy.

Method: Alongside an outcome evaluation of the CCKO strategy, we conducted a process evaluation to understand the implementation context, process and mechanisms.

View Article and Find Full Text PDF

Background And Objectives: Caregivers of children with medical complexity (CMC) face many stressors related to their child's medical condition(s). Financial stress and its impact on housing has been reported to be a challenge among this population. However, unique housing challenges specific to CMC, including disability accommodations in the home and housing space and layout, have yet to be examined in the literature.

View Article and Find Full Text PDF

Introduction: Technological and medical advances have led to a growing population of children with medical complexity (CMC) defined by substantial medical needs, healthcare utilisation and morbidity. These children are at a high risk of missed, fragmented and/or inappropriate care, and families bear extraordinary financial burden and stress. While small in number (<1% of children), this group uses ~1/3 of all child healthcare resources, and need coordinated care to optimise their health.

View Article and Find Full Text PDF

Proton pump inhibitors (PPIs) are commonly prescribed to infants and children for managing gastroesophageal reflux disease (GERD). Recently published literature illustrates conflicting evidence on the efficacy of PPIs in infants and children. Randomized controlled trials and systematic reviews have demonstrated a lack of efficacy of PPIs, specifically in young infants.

View Article and Find Full Text PDF

Gastrostomy (G) and gastrojejunostomy (GJ) tubes are commonly used to enhance nutrition and hydration, and facilitate the administration of medications to children with medically complex conditions. They are considered to be safe and effective interventions for the medical management of these patients; however, they are not without risks. There are common complications associated with G and GJ tubes.

View Article and Find Full Text PDF