An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders: The Optimus Co-design Project that has Made it to Regular Care

Int J Integr Care. 2021 Apr 15;21(2):3. doi: 10.5334/ijic.5494.

Abstract

Introduction: Multiple neurodevelopmental problems affect 7-8% of children and require evaluation by more than one profession, posing a challenge to care systems.

Description: The local problem comprised distressed parents, diagnostic processes averaging 36 months and 28 visits with 42% of children >4 years at referral to adequate services, and no routines for patient involvement. The co-design project was developed through a series of workshops using standard quality improvement methodology, where representatives of all services, as well as parents participated.The resulting integrated care model comprises a team of professionals who evaluate the child during an average of 5.4 appointments (N = 95), taking 4.8 weeks. Parents were satisfied with the holistic service model and 70% of children were under 4 at referral (p < 0.05). While 75% of children were referred, 25% required further follow-up by the team.

Discussion: The Optimus model has elements of vertical, clinical and service integration. Reasons for success included leadership support, buy-in from the different organisations, careful process management, a team co-ordinator, and insistent user involvement.

Conclusion: Evaluating multiple neurodevelopmental problems in children requires an integrated care approach. The Optimus care model is a relevant showcase for how people-initiated integrated care reforms can make it into usual care.

Keywords: co-design; neurodevelopment disorder; preschool children; quality improvement; team care.

Publication types

  • Case Reports

Grants and funding

The study was funded by Forte Vinnvård Fellow clinical quality improvement grant # 2017-02565. The funder had no role in interpretation and reporting of the study. The funder’s role in design and implementation support comprised a fellowship, using the NHS blueprint for quality improvement fellows. Thus, apart from paid time to conduct the project, AS also underwent continuous training and mentoring in change leadership and quality improvement methods.