This model introduces a number of health professionals into the current Developmental and Behavioural Paediatrics Pathway of Care to aid the paediatrician in the diagnosis, and ongoing management of patients. Valuable expertise will be provided by an Intake Child Psychologist (ICP), Developmental General Practitioner with Special interest’s GPwSI (D GPwSI) and Developmental Case Manager (DCM) in the patient journey.
Referral & Triage Phase
Rather than have a new GP referral passed into the general paediatric triage system, the referral is “picked up” & actioned by an ICP. The ICP will:
- contact the parents and conduct a phone interview using a standardised history taking tool
- request further information from collateral sources
- monitor receipt of information and ‘chase’ further information as necessary
- organise/conduct further assessments if needed
- triage the patient to a more appropriate service at any point in this initial phase after discussion with the patients’ GP as necessary
- suggest as necessary the commencement of a management plan and early intervention therapy supported by Medicare or NDIS
- collate all the above into a coherent formulation/summary
Assessment Phase
In this phase multiple health practitioners will engage with the child and their family. Activities in this phase include:
- ICP providing a coherent formulation/summary &/or consulting jointly with a Developmental General Practitioner with a Special Interest (D GPwSI) at the first appointment
- D GPwSI and ICP initiate or continue the intervention plan, if already in place as a result of triage phase.
- If the D GPwSI is unable to make a diagnosis the child is seen by a developmental paediatrician as a secondary consultation on the same day
- Support is provided by a paediatric pharmacist who can dispense psychotropic or other medication as required, and can be involved in the initial discussion and education phase with parents
Management Phase
If the management plan is unclear, complex or difficult, a case conference or direct review is scheduled with the developmental paediatrician and the patients GP. This phase is facilitated by a Developmental Case Manager (DCM) who:
- Facilitates rapid referral to the NDIS.
- Provides ongoing case management and health/disability system navigation for the patient and their families by monitoring progress of the management plan through liaison with parents and other involved care providers including schools, allied health and other non-government organisations e.g. Headspace, Kalwun Health Services.
- Consults (when there is deviation from the expected trajectory) with the D GPwSI +/-the ICP +/-the developmental paediatrician to modify management accordingly.
- This may include additional face-to-face or telehealth consultations with any member of the team, or advocacy to other agencies including the NDIS.
- Works with the patient’s regular GP to provide long term management with a view to discharge from the clinic
- Ongoing medication monitoring and management, including parent and GP liaison will be provided by the paediatric pharmacist