Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report

Area of Science:

• Healthcare Management
• Pediatric Rehabilitation
• Service Delivery Systems

Background:

• Children with complex needs often encounter significant barriers accessing multiple healthcare services.
• A central intake system was implemented in Winnipeg, Manitoba, Canada, in 2008 to improve service coordination and access for pediatric rehabilitation.
• This study specifically examines the implementation and impact of central intake for pediatric physiotherapy.

Purpose of the Study:

• To evaluate the process and impact of a central intake system for pediatric rehabilitation.
• To assess changes in wait times, referral volumes, and caregiver satisfaction.
• To identify factors facilitating successful implementation of a central intake system.

Main Methods:

• A mixed methods instrumental case study design was employed.
• Qualitative data were gathered through interviews with 9 individuals.
• Quantitative data on wait times, referral volume, and caregiver satisfaction were collected for 1,399 children with complex needs and 3,901 children with orthopedic concerns.

Main Results:

• Central intake implementation led to more streamlined processes, with improved wait times for children with complex needs (from 12.3 to 8.0 days for contact, 29.8 to 24.3 days for appointment).
• Referral volumes remained consistent for the complex needs group, while increasing for the orthopedic comparison group, which also saw a slight increase in wait times.
• Caregiver satisfaction remained high throughout the implementation period.

Conclusions:

• The central intake system successfully streamlined processes and improved access to pediatric physiotherapy by decreasing wait times for children with complex needs.
• Key facilitators for successful implementation included stakeholder agreement, dedicated coordination, government financial commitment, and leadership.
• Further research is recommended to explore the impact of central intake across multiple pediatric therapy disciplines.