Adopting a transdisciplinary approach has helped KK Women's and Children's Hospital's (KKH) Department of Child Development (DCD) integrate patient care and free up capacity for the wider system, where families work with just one Allied Health Professional as the key worker.
Allied Health Professionals (AHPs) have traditionally played unique roles in therapeutic care for patients, keeping within their respective specialties.
In the area of child development, Occupational Therapists help children who have physical, sensory, or cognitive problems gain the skills needed for everyday living and Speech and Language Therapists treat communication and feeding difficulties. Meanwhile, Psychologists conduct diagnostic assessments of neurodevelopmental conditions, provide interventions for children with emotional or behavioural difficulties, and make recommendations for intervention, educational placement, and transition to primary school.
Previously, when children with developmental delays and autism were concurrently referred to the various AHPs for intervention, the multiple visits were stressful for parents.
At KKH DCD, it is much different these days. AHPs are being upskilled with transdisciplinary training from their colleagues from a different specialty so that each patient is seen by just one key AHP, and everyone—from the parents to the AHPs and the doctors on the cases—are all the happier.
Ms Mok Tse Ling, Senior Occupational Therapist from KKH DCD shares, "Operating this way has really helped us improve the quality of patient care on all fronts, for an overall better experience for both patients and parents. I am now a lot more confident to manage my patients in a more seamless and holistic manner too."
Transdisciplinary framework to optimise patient care
Doctors and AHPs in KKH's DCD embarked on a mission to optimise patient care and address on-the-ground feedback by parents to improve and streamline the treatment process.
Their solution was to band together to collaborate across their disciplines, to offer children – such as those with social interaction deficits and language delays – a therapist who could meet most, if not all, of their needs.
Now, children are offered an intervention package much sooner—within two to three months —with any one of the key workers within the transdisciplinary team, after their initial needs are assessed.
To ensure that the AHPs have the skills to see through their patients' holistic treatment plans, they had to undergo cross-training from each other's disciplines.
For example, Ms Mok had learnt the picture exchange technique from her Psychologist colleagues to communicate with her non-verbal patients. "I've also showed my colleagues how to use play as a technique to engage their patients—a method right out of my Occupational Therapy playbook," said Ms Mok.
With this, the child is only referred onward to an AHP from another discipline if he or she has a specific developmental need that cannot be addressed by the key worker handling his or her case.
She explained, "There is less cross-referral to our other colleagues, as we now have the skills to help. Our patients now have a smoother and faster treatment experience."
Boosting staff capabilities with the transdisciplinary approach
Adopting the transdisciplinary approach six years ago did not only benefit the patients—the DCD AHPs and doctors have gained a lot too.
The most evident benefit to the AHPs is the expanded skillsets they have gained. This has made their work much more effective in many aspects, even though it may initially seem like a heavier responsibility to be the sole key worker attached to a patient.
"With my newly acquired transdisciplinary skillsets, I feel more equipped and confident to help my young patients and support their families holistically," explained Ms Mok.
Perhaps even more crucially, being the sole key worker has resulted in better rapport and stronger connections forged between the AHP, the patients, and their families.
Ms Mok shared, "This, coupled with the fact that we can progress more meaningfully with each subsequent session with less repetition, fewer information gaps, and a deeper follow-through, have resulted in patients showing greater improvement in a shorter time."
As for the DCD doctors, they have benefited from the time saved from needing to only read one comprehensive report per patient each session now, rather than three separate ones in the past.
"As a department, we've definitely become more agile and efficient, with less waiting and repetition than before," said Ms Mok. "Frequent patient discussions, problem-solving, and training sessions have helped to build trust within the team, bringing the team closer together!"
Bringing transdisciplinary benefits to the community
Seeing how a transdisciplinary approach has brought such rich gains to both patients and staff alike, the core team at KKH DCD are working to bring this collaborative effort to the community, in the hopes of reaching more people.
To this end, the DCD AHPs are working closely with the Ministry of Social and Family Development (MSF) on their new community programme that trains caregivers of children with developmental needs, providing professional consultation and sharing their invaluable experience from what's been done at KKH so far.
"By taking the programme into the community and enlisting the help of even more parents at an earlier stage—we hope that children with developmental delays or autism will be able to get the help they need even more quickly, starting in their own homes."
