Engaging young people to attend a Transition Clinic – - PowerPoint Presentation

Slide1

Engaging young people to attend a Transition Clinic – an idea in action – Dr Shelagh Watts & Dr Emily Betts, Clinical Psychologists, Buckinghamshire Hospitals NHS TrustSlide2

BPT means that is recognised that young people are just as in need of focussed care up to 19 yearsData clear that YP need care as metabolic control deteriorates and patients are lost to follow up in this group (Pacaud et al 2005)Data shows engagement in a clinic is as much about the therapeutic relationship than other factors,(Allen 2010;Watanabe 2010),non judgemental, honesty & knowledgeNeed to keep sight of patients

Model of clinic needed that nurtures and develops their autonomy, not just letting them go

Transition in DiabetesSlide3

Patients seen in their own allocated clinic 16-21yrs by Adult TeamYP seen on their ownOpportunities for discussion with MDT about age related lifestyle issues; driving/university life/alcohol.BUT Low attendance rate and a feeling that YP not engaged with clinic and staff; are they missing the structure, expectations & familiarity of paediatric input?

Bucks Hospital Trust Young Persons Clinic & Transition ClinicSlide4

How to engage the YP in the clinic- particularly in the first year of transition 16/17 years to set up expectations of clinic careHospital environment poor, no grouped set of clinic rooms or user friendly waiting areaModel of care? with/without parents, paediatric team and/or adult team, seen by team or individual professionals ?Need to do SOMETHING to get going Education Workshop for new group of 16yr olds transferring to the YP/transition clinic?

YP Business MeetingsMDT including psychologySlide5

FromToHow could this work?

Small YP survey suggested YP feeling scrutinised in clinic & wanting more information but not adverse to meeting other YP.

AIM to

c

hange Young Persons perceptions of their clinic appointments through the workshop attendance.Slide6

Agenda to introduce /familiarise YP to the clinic staff and environment Allow YP to be apart from their parentsRaise topics that could be discussed in future clinicsReassure parents about the next level of careEncourage YP to communicate with each otherConfidence and technique for marketing the workshop borrowed from Paediatric Diabetes PlanningSlide7

All MDT involved in delivery of workshopMessage of importance and expectation ‘first Transition Clinic appointment’Timing important, eg at a transition point when wanting informationSmall groups that move from topic to topicTake away informationNumbers- expect 50% attendance .

Transition clinic; 17 families with 16 yr olds invited –all due to move up to clinic in the next 3-6 months –.

Previous Experience from PaediatricsSlide8

Introduction to families and agenda setting Young Peoples Groups Hospital walk about (reduce worries about finding the place, talk to staff and each other)Biology lesson/information packs (meet staff & give structure that allows group discussion)Myth Busting (peer group and staff/YP discussion)3. Parents discussion. Reassure in the consistency of care offered across the clinics.

Format with the ‘communication’ AgendaSlide9

Facilities far from ideal- borrowed Staff Education centre, lookouts needed to find familiesPerformance Anxiety of StaffDoubts about the agendaON THE SPOTNumbers attending 8 YP 10 parents – rejig groupsHouse keeping, refreshments!Parents Group 50/50 mum/dadReluctance to finish by parents and YP- no break out space

Reality on the DaySlide10

Introduction (to team and agenda for the session)Orientation (to the hospital and adult Diabetes Centre) Would this be difficult to engage the young people in?Biology (overview of diabetic patient vs. non diabetic patient). Previously used in groups with success.Myth busting (range of diabetes “myths” developed by staff). Encouraged the young people to vote true or false and facilitated discussions. Eg ‘My BG levels affect my mood & concentration, I have to do a BG test whenever I drive, insulin makes you fat; my diabetes won’t be affected if I take drugs’

WorkshopsSlide11

Designed brief evaluation formCompleted after the session-just by patientsRated venue, each workshop and meeting other young people. Given room for comments on what was helpful/not necessaryEvaluationSlide12

Venue - “good” by all 8 patientsOrientation – range 6-10 in the “very useful” range. Basic biology – range 7-10 in the “very useful” range. Myth busting – range 7-10 in the “very useful” range.Meeting other young people – range 8-10

Patient FeedbackSlide13

What did you find helpful about the afternoon?“Meeting the team, learning about the changes”“I found the discussions with the team and doctors useful for understanding the transition and more about adult life with diabetes”“Meeting new team and finding out where I need to go”“Hearing other people’s opinions and facts on diabetes-helped to give a better insight”“Understanding which myths were true and false”

“Socialising with the staff and other young people”“Myth busting and getting to talk to other people the same age”“Knowing about some things I didn’t know

!

Was there anything you thought that wasn’t necessary today?

“no” or no comment

Any other comments?

None

Patient FeedbackSlide14

Unplanned group discussion with parents occurred –psychological discussion about keeping their children on board with diabetes care. At times it was very emotional, but different members of the team available to facilitate the discussion (Psychologist, Dietician and Medic). Could the clinics be held on another day? Most felt this was a really useful session for them as well as their child.

Parent’s feedbackSlide15

This was the first info session we had run for new patients transitioning from paediatrics. Overall felt beneficial- the families were as anxious as staff about transitionWe need an additional activity to take place during the orientation slot as this was completed very quickly.Has

enabled a trial of a more flexible model of care in clinic – All patients have turned up so far!Further plans about communicating with this group using Assistive Technology

We will review the

leaflets in the

pack

When is the ideal time to run this session

?

Doing

Something better than talking about it!

Team debrief and reflections