A Case Study Implementing a Social Needs Screening Process and a Family Navigation Hub at Holland Bloorview Kids Rehabilitation Hospital.

Identifying and addressing clients' and families' most pressing social determinants of health needs are integral to quality healthcare. Healthcare leaders and front-line clinicians have long recognized the connection between unmet essential resource needs, such as food, housing and transportation and health outcomes. As a component of broader organizational efforts to improve equitable access to services, a social needs screening (SNS) initiative was introduced, along with a Family Navigation Hub providing navigation interventions.

Health status and health care utilization profiles of adolescents with disabilities.

Background: Adolescents with physical disabilities of childhood often require a transition from pediatric to adult systems as part of life-long, comprehensive health care once they reach 18 years of age. The process of transition can be complex, challenging, and influenced by health-related factors and availability of health care resources.

Objective: To provide a baseline profile of health-related quality of life, health management, social participation, and health care utilization for adolescents 16 years of age with spina bifida (SB), acquired brain injury (ABI), or cerebral palsy (CP) in Toronto, Canada.

Integrating lived experience into clinical practice: a case study of young peer providers in pediatric rehabilitation.

Purpose: Youth Facilitators (YFs) are peer service providers (SPs) with childhood-onset disabilities working in pediatric rehabilitation teams. This study explored the YF role focusing on what work YFs do, the perceived facilitators and challenges pertinent to the role integration process, and the evolution of the role over the study period.

Methods: A longitudinal, qualitative case study approach was used to gather data over a total period of 14 months through interviews, focus groups, workload logs, and observations.

Bridging Pediatric and Adult Rehabilitation Services for Young Adults With Childhood-Onset Disabilities: Evaluation of the LIFEspan Model of Transitional Care.

LIFEspan ("Living Independently and Fully Engaged") is a linked transition service model for youth and young adults with childhood-onset disabilities offered via an inter-agency partnership between two rehabilitation hospitals (one pediatric and one adult) in Toronto, Canada. The objective was to evaluate healthcare outcomes (continuity of care and healthcare utilization) for clients enrolled in LIFEspan. A prospective, longitudinal, observational mixed-method study design was used.

The Value Filter: A Novel Framework for Psychosocial Adjustment to Traumatic Upper Extremity Amputation.

Purpose Upper extremity traumatic amputation due to work injury is a devastating injury with poor outcomes. As it does not appear to follow existing theories of psychosocial adjustment to injuries and illness, we sought to understand this problem by asking those who have sustained the injury, how they try to adjust. Methods Qualitative methods were used to interview 11 participants within 3 years of their accident.

Perceived Impacts of Solution-Focused Coaching Training for Pediatric Rehabilitation Practitioners: A Qualitative Evaluation.

Aims: This qualitative evaluation study assessed perceived impacts of a solution-focused coaching (SFC) training rolled out in a Canadian pediatric rehabilitation hospital from the perspective of clinical service providers.

Methods: Thirteen clinical service providers were interviewed six months after receiving 2-day SFC training. Participants retrospectively described perceived impacts of the training and benefits and challenges pertinent to the implementation of the SFC approach.

Impact of Solution-Focused Coaching Training on Pediatric Rehabilitation Specialists: A longitudinal evaluation study.

Fostering successful interprofessional collaboration remains a challenge in pediatric rehabilitation. A coaching approach can enhance client-centered care and provide a transdisciplinary framework for collaboration. The purpose of this longitudinal study was to evaluate the impact of Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds) training on pediatric rehabilitation practitioners from multiple disciplinary backgrounds.

Clinical Documentation in an Era of Increasing Transparency: The Impact of Electronic Portals on Care.

Electronic health records (EHRs) and consumer health portals have implications for improving the quality and cost-effectiveness of healthcare and make it much easier for patients and families to access health information in a timely and convenient manner. However, the accessibility of information afforded by EHRs and health portals changes the dynamic of control over health information in very significant ways. Institutions and their clinicians have typically been the caretakers of these documents; therefore, the introduction of portals represents a major cultural shift in healthcare.

Supporting Client and Family Engagement in Care Through the Planning and Implementation of an Online Consumer Health Portal.

Web-based portals and electronic health records are making it easier for clients and families to access health information. This improved transparency and access to information has the potential to promote activation and improve outcomes, but to realize these benefits, the information needs to be valuable, meaningful, and understandable. Engagement of the end users in the planning and implementation will ensure that the product meets the needs of the consumers.

Exploring the ICF-CY as a framework to inform transition programs from pediatric to adult healthcare.

Objective: To explore the utility of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) for informing transition-related programs for youth with chronic conditions moving into adult healthcare settings, using an exemplar spina bifida program.

Methods: Semi-structured in-depth interviews were conducted with 53 participants (9 youth and 11 parents who participated in a spina bifida transition program, 12 young adults who did not, 12 clinicians, and 9 key informants involved in development/implementation). Interview transcripts were thematically analyzed, and then further coded using ICF-CY domain codes.

Connecting Families to Their Health Record and Care Team: The Use, Utility, and Impact of a Client/Family Health Portal at a Children's Rehabilitation Hospital.

Background: Health care portals have the potential to provide consumers with timely, transparent access to health care information and engage them in the care process.

Objective: The objective was to examine the use, utility, and impact on engagement in care and caregiver-provider communication of a client/family portal providing access to electronic health records (EHRs) and secure, 2-way e-messaging with care providers.

Methods: We conducted a prospective, mixed-methods study involving collection of caregivers' portal usage information over a 14-month period (from portal introduction in January 2015 to the end of the study period in March 2016), a Web-based survey for caregivers administered after a minimum of 2 months' exposure to the portal and repeated 2 months later, and focus groups or individual interviews held with caregivers and service providers at the same points in time.

Youth and parents' experiences of a new inter-agency transition model for spina bifida compared to youth who did not take part in the model.

Background: Young adults with spina bifida are underserved in health care and are at risk as they transition to adult health care. A pediatric rehabilitation hospital and an adult community health center partnered to help address this gap. Although some research has explored general transition experiences of youth with disabilities, little is known about their experiences in a transition model that involves an inter-agency partnership, continuous, age-appropriate, and client-centered care.

Implementing Patient-Oriented Discharge Summaries (PODS): A Multisite Pilot Across Early Adopter Hospitals.

Communication gaps when patients transition from hospital to either home or community can be problematic. Partnership between Toronto Central Local Health Integration Network (TC LHIN) and OpenLab addressed this through the Patient-Oriented Discharge Summaries (PODS) project. From January through March 2015, eight hospital departments across Toronto came together to implement the PODS, a tool previously developed through a co-design process involving patients, caregivers and providers.

Perspectives of school-work transitions among youth with spina bifida, their parents and health care providers.

Purpose Youth with disabilities encounter many challenges in finding employment and transitioning to post-secondary education. In this article, we explore the nature of school-work transitions for youth with spina bifida, which few studies have previously addressed. Method We conducted in-depth interviews with 44 participants (nine youth and 12 young adults with spina bifida, 11 parents and 12 clinicians).

Simulation for System Change: Holland Bloorview's Experience Using Simulation to Enhance the Use of Technology at the Point-Of-Care.

Simulation has the potential to invigorate teaching practices, facilitate professional development and impact client care. However, there is little literature on using simulation at the level of organizational change in healthcare. In this paper, the authors explore Holland Bloorview Kids Rehabilitation Hospital's experience using simulation to enhance the use of technology at the point-of-care.

Gender and Transition From Pediatric to Adult Health Care Among Youth With Acquired Brain Injury: Experiences in a Transition Model.

Objective: To explore gender and sex differences in experiences of transitioning to adult health care among young adults with acquired brain injury (ABI) who take part in a coordinated model of transitional care.

Design: Descriptive design using in-depth semistructured qualitative interviews.

Setting: Interviews over the phone and in person.

The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery.

Purpose: LIFEspan is a service delivery model of continuous coordinated care developed and implemented by a cross-organization partnership between a pediatric and an adult rehabilitation hospital. Previous work explored enablers and barriers to establishing the partnership service. This paper examines healthcare professionals' (HCPs') experiences of 'real world' service delivery aimed at supporting transitional rehabilitative care for youth with disabilities.

Longitudinal Evaluation of Transition Services ("LETS Study"): protocol for outcome evaluation.

Background: Because of advances in medical treatment, most children with physical disabilities can expect to achieve near normal life spans. Typically, coordinated teams of health care providers in specialized pediatric settings care for these children. As these children reach adulthood, however, the availability of services and expertise changes because the adult health care system has different processes designed to meet their specialized needs.