Is it Working? Outcomes from a Collaborative Practice Model Review in Pediatric Rehabilitation

Holland Bloorview Kids Rehabilitation Hospital (HBKRH) is a pediatric teaching rehabilitation hospital providing Inpatient and Ambulatory services to children with disabilities. HBKRH was one of the first (early 2000’s) in Toronto to implement a collaborative practice model. This review sought to co-design an optimized practice structure to support Health Discipline Professionals (HDPs) and meet the evolving needs of clients. By acknowledging evolving needs of our clients, families, and systems, the ways we support our HDPs must also evolve. The results of this review will be used to enhance our collaborative practice & clinical education structure.Implementation: We engaged an external consultant (University of Toronto’s Centre for Advancing Collaborative healthcare and Education) and used an iterative process that engaged the internal hospital community through intra and interprofessional focus groups, an environmental scan, and literature review.Evaluation plan: The objectives were to 1) review current collaborative practice and clinical education model; 2) understand best practice for interprofessional models of care within and outside HBKRH; 3) highlight strengths and opportunities for change to meet current and future needs.

A six-step thematic analysis approach was used (Kiger & Varpio, 2020). The consultation team reviewed all focus group reports, discussed overall findings, trends, impressions, and reflections. Each focus group was coded by one consultation team member and reviewed with other team members for consensus building to identify similar coding between reports. Overarching themes were developed, defined, and refined, and were shared with HBKRH project leads for validation.Outcome(s) and significance: There were four main themes 1) Improve role clarity of Collaborative Practice Leader; 2) Support health discipline representation and voice 3) Nurture collaborative practice and interprofessional education 4) Develop and retain people.

An advisory group with representation from regulated and unregulated health disciplines, collaborative practice, and leadership formed to review the findings and advise on implementation of the recommendations.