Stepping up to developmental challenges – Allied Health led system change

Ms Bernadette O’Connor1, Ms Adrienne Fosang1

1The Royal Children’s Hospital, Parkville

A Stepped Care Approach to Developmental Care is a 2 ½ year project which was launched after identifying numerous barriers when referring children for developmental concerns to the Royal Children’s Hospital (RCH) in Melbourne. Difficulties included the wide variability in eligibility criteria for different RCH departments as well as inconsistent triage processes and varied service structures. These inconsistencies resulted in increased waiting times for an initial appointment, inefficient use of clinician time, frustration on the part of families and clinicians and an inability to ensure children with developmental challenges were identified as early as possible and given a pathway to appropriate interventions.

This presentation will outline the design of the clinically based and Allied Health led triage process, which is centrally based and applies a stepped approach to identifying the family’s needs as well as determining the appropriate triage pathway. Outcomes to date will show the “value add” of using this approach for the organization, as well as highlighting the value of utilizing the clinical knowledge of Allied Health clinicians in this process. Ensuring that families experiencing vulnerability are not “lost” in the process is inherent in the program and we will provide data about the benefits that have ensued for clinicians, but more importantly, for families and children.


Adrienne Fosang is a senior physiotherapist with 30 years’ experience at RCH. She has worked as a clinician and team leader in the acute, community, rehabilitation, and gait laboratory settings with a focus on children with neurodevelopmental disability. She has a Masters in the use of Botulinum Toxin for children with cerebral palsy and is passionate about focusing interventions on goals that are meaningful for children and families. The Stepped Care project is a natural extension of this with its focus on matching family needs with service provision.

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