Background/ Why Is This Important?
Out-reach teams provide access for children to expert sub-specialist services in their home communities. Through the delivery of care close to home, resources are optimized while providing leading edge care. The geography of BC can be very challenging, costly and disruptive to children and families who need to seek care. Children miss school, parents miss work, siblings are impacted and costs of travel can be a significant burden. Out-reach clinics build partnerships with the health care team in the community providing care to children close to home.
For the past ten years Child Health BC has supported and strengthened the growth of Outreach clinics by championing a Tiers of Service framework to deliver care. Over the past two years, outreach patient visits by the BC Children’s Hospital sub specialty teams supported by Child Health BC increased by over 30 per cent. This translates to over 5400 patient visits delivered by the team in areas such as cardiology, neurology, nephrology, endocrinology, rheumatology, gastroenterology, surgery-ophthalmology, dermatology, hematology/oncology, surgery-ENT, biochemical diseases and surgery-orthopedaedics.
Virtual Care including telehealth is another transformational strategy for eliminating barriers to access to sub specialty care, and enabling care proximity in children’s home or community. Virtual care will enable children to be seen in their homes or communities integrating it seamlessly as part of the care plan.
What Actions Have Already Been Taken?
Outreach team members can include sub-specialty physicians, nurses, physiotherapists, echo sonographers and dieticians; depending on the needs of children they serve. Clerical support for the outreach activities has also been an important part of the service. The development of standardized roles and processes has allowed improvements of service delivery in the regional health authorities.
The *below table provides the breakdown of the 436 sub-specialty outreach clinics that occurred throughout the province between March 2017 and March 2018:
|Sub-specialty||# of Clinics||Sub-specialty||# of Clinics|
|Cardiology||114||Surgery - Ophthalmology||24|
|Endocrinology||54||Surgery - ENT||10|
|Gastroenterology||38||Surgery - Orthopaedics||2|
Where Are We Going Next?
Over the next few years pediatric sub-specialty outreach will grow to new communities, and add new clinical programs enabled by new telehealth capabilities which means improved access to children and their families. This will enable specialized health services to be provided to children at home or close to home and eliminate the impact on families. Telehealth and virtual care have the potential to reach children in their communities providing health care value, while sustaining the system, reducing costs and maintaining high quality care. These technologies have the potential to decrease wait-times to see sub-specialists, complete follow up care after hospital discharge and provide support in schools. All of which enhance care for children.