A co-design project to develop a fresh person-centred self-management approach and training programme in Children and Young People Services
Southern Health and Social Care Trust, Northern Ireland
Children with lifelong conditions have to continuously weigh up their clinical against their social needs as they move through different life stages . While building capacity to adjust to ever-changing life situations is critical for these children and their families, the medical notion of fixing problems still restricts the scope of paediatric rehabilitation to date .
- To jointly develop with practitioners, children, young people and their parents, the first dedicated training programme for AHPs that moves beyond a therapy-led approach in Children and Young People Services, to one in which shared knowledge, shared decision making and building capability is at the centre of the service
- To get to the heart of what matters most to children/young people and their families quicker
- To move away from a focus on impairments towards supporting children/young people and their families to explore their potential and find their own way of living the best life possible with a health condition
- To reduce dependency on services.
What We Did
Discovery: we held five focus groups with children, parents and staff to refine the project aims, collect real life stories from children and parents for training material and co-developed evaluation methods.
Knowledge Zone 1: we held a full-day bespoke workshop with twenty-five Allied Healthcare Professionals (AHPs) who worked across the specialist child health & disability teams at the Southern Health and Social Care Trust. The workshop was tailored with audio clips and stories from children and their parents from the Discovery phase.
Transform: AHPs implemented their action plans from Knowledge Zone 1 and the focus points for change included: consider your first impression, improve communication with children/parents, a two-way partnership, parent/peer support, improve communication between services and interventions and evaluate the changes.
Knowledge Zone 2: AHPs returned for a half-day follow-up workshop in which they were guided to reflect on successes and challenges and jointly build plans for ongoing sustainability and dissemination.
Onwards: practitioners are continuing to develop and refine Bridges for their service and service users, and they are helping us to deliver more training workshops for teams and practitioners working in Children and Young People Services.
- We held five focus groups with a total of eight children aged 7-12 years, six young people aged 13+ years, twenty parents, and ten AHPs
- We delivered one workshop to twenty-five AHPs
- Practitioners filmed their experiences and learning from implementing Bridges, which are being used within our new workshops for practitioners in paediatric services.
What We Learned
- AHPs valued the Bridges approach as an overarching multi-disciplinary framework that made them feel liberated to work differently and get to the heart of what is important to children and their families quicker – achieving more meaningful therapy outcomes with existing resources
- Engaging children and parents in co-developing new ways of working and engaging them in a more mutual relationship is feasible and was well received
- Change can be best achieved by focusing on small changes that AHPs can easily combine with existing practice helping them to build their own confidence and embed Bridges routinely into their everyday practice
- Considering sustainability from the outset by focusing on integrating Bridges principles into team processes and documentation appeared critical
- Changing underlying values to service delivery requires ongoing support and mechanisms to enable joined reflection and continuous re-adjustment of the chosen aims and actions beyond the time frame of this project
- Embedded evaluation methods are key to legitimise this different way of working.
Heide Pöstges, Director of Innovation and Training, Bridges Self-Management
Aisling Mitchell, Occupational Therapist
Links and Downloads
1 Sattoe, J.N.T.; Bal, M.; Roelofs, P.D.D.M., Bal, R.; van Staa, A.; and Miedema, H.S. (2015). Self-management interventions for young people with chronic conditions: A systematic overview. Patient Education and Counselling, 98 (6): 704-715.
2 King, G.; Imms, C.; Stewart, D.; Freeman, M.; and Nguyen, T. (2017). A transactional framework for pediatric rehabilitation: Shifting the focus to situated contexts, transactional processes and adaptive developmental outcomes. Disability and Rehabilitation. 23 (3-4): 1-13.