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An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders: The Optimus Co-design Project
Anna Sarkadi1, Anton Dahlberg1, Kajsa Leander1
1Uppsala University, SE.
Insights
The Optimus model streamlines neurodevelopmental evaluations for children, reducing wait times and improving parent satisfaction through an integrated care approach. This model demonstrates successful, people-led reform in healthcare delivery.
Area of Science:
- Pediatric Healthcare
- Neurodevelopmental Disorders
- Integrated Care Models
Background:
- 7-8% of children experience neurodevelopmental problems, necessitating multidisciplinary evaluations and presenting challenges to existing care systems.
- Current diagnostic pathways involve lengthy processes (36 months, 28 visits) and late referrals (42% >4 years), with limited patient involvement.
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.
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