Opportunistic adolescent health screening of surgical inpatients

Wilson, Hayden; Bostock, Nancy; Phillip, Nicola; Shannon, Penny; Payne, Donald; Kennedy, Amy

doi:10.1136/archdischild-2012-301835

Cited by 17 publications

(17 citation statements)

References 8 publications

(9 reference statements)

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“…In comparison to a group of adolescent surgical inpatients at our institution, the refugee cohort reported a much higher frequency of health risk behaviours requiring intervention (75% vs 30%) 14. In keeping with a study of adolescents seen in a child protection unit, the current data demonstrate that use of the questionnaire leads to the identification of previously unrecognised health concerns 15.…”

Section: Discussionsupporting

confidence: 70%

Identification of health risk behaviours among adolescent refugees resettling in Western Australia

et al. 2017

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Section: Discussionsupporting

confidence: 70%

Identification of health risk behaviours among adolescent refugees resettling in Western Australia

et al. 2017

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“…Using HEEADDSS screening has been shown to be helpful in identifying concerns in up to one-third of patients. 28 Adult physicians might feel that they do not have all the answers for this age group. Depending on the issue identified providing information and signposting young people to local services or relevant websites (such as www.teenagehealthfreak.org and www.youthhealthtalk.org) may be sufficient.…”

Section: Psychosocial Screening and Health Promotionmentioning

confidence: 99%

‘Everybody’s business’: transition and the role of adult physicians

2012

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-The outcome of transition from paediatric to adult care is often judged by what happens after transfer. Young people at the point of transfer are reported to have low levels of knowledge and independence. These observations could be interpreted in one of two ways: either that the transition process before transfer is inadequate or that the transition process needs to continue into young adulthood and therefore adult care. The second interpretation is further supported by brain development continuing into the third decade. There is also growing evidence for the effectiveness of young adult clinics in the process of transition. To optimise transition, adult physicians need not only to work with paediatricians to achieve continuity during transfer, but also to look critically at their service as to how it can be changed to meet the needs of young people. In addition, they need to develop knowledge, skills and attitudes to communicate effectively and address a young person's developmental and health needs.KEY WORDS: transition, adolescents, young adults, age appropriate care Introduction Transition has been described as 'a multi-faceted, active process that attends to the medical, psychosocial and educational/vocational needs of adolescents as they move from child-centred to adult-orientated care' . 1 There is evidence that optimal transition is not being achieved for a significant proportion of young people. The recent report from the Children and Young People's Health Outcome Forum (CYPHOF) states that transition services in the UK need to adopt 'an approach combining both a pull (from adult care) as well as a push (from paediatrics)' . 2 Adult physicians need to know how to 'pull' effectively to provide a service that meets the needs of young people transferring into their care (Fig 1). Transition does not end at transferTransition is a process and, although most literature focuses on the process up to transfer to adult services, it is after transfer that outcomes of transition are judged. Studies have shown that young people drift away from adult care and suffer deteriorating health. We suggest that it is time to focus on the transition process continuing beyond transfer, into young adulthood. This approach is further supported by evidence from neuroscience that the brain continues to develop into the third decade, with implications on thought processing and risk taking. 3 The extension of transition into young adulthood allows additional time for young people to become autonomous in their healthcare and achieve their full adult potential, the latter potentially delayed or disrupted by growing up with a chronic condition. Adult physicians need not only to aim for continuity of care with paediatric colleagues, but also to adapt their skills and services to meet the young person's changing needs. Working with paediatriciansA recent survey of paediatric and adult gastroenterologists found differing perceptions of whether young people were prepared at the time of transfer; the main areas of concern were la...

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“…It is time consuming, taking on average 30 minutes per interview [10] and furthermore it requires skill, knowledge, and a comfort level by HCPs to address sensitive issues. Reviews of inpatient psychosocial screening in a pediatric inpatient setting determined documentation rates of only 50% [11], and as low as 19% in a surgical setting [12]. Despite the low uptake in a surgical ward, screening resulted in a 30% increase in referrals, highlighting the value of HEEADDSS in uncovering new health issues [12].…”

Section: Introductionmentioning

confidence: 99%

Co-Creation With TickiT: Designing and Evaluating a Clinical eHealth Platform for Youth

Whitehouse¹,

Lam²,

Balka³

et al. 2013

JMIR Res Protoc

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BackgroundAll youth are susceptible to mental health issues and engaging in risky behavior, and for youth with chronic health conditions, the consequences can be more significant than in their healthy peers. Standardized paper-based questionnaires are recommended by the American Academy of Pediatrics in community practice to screen for health risks. In hospitals, psychosocial screening is traditionally undertaken using the Home Education, Eating, Activities, Drugs, Depression, Sex, Safety (HEEADDSS) interview. However, time constraints and patient/provider discomfort reduce implementation. We report findings from an eHealth initiative undertaken to improve uptake of psychosocial screening among youth.ObjectiveYouth are sophisticated “technology natives.” Our objective was to leverage youth’s comfort with technology, creating a youth-friendly interactive mobile eHealth psychosocial screening tool, TickiT. Patients enter data into the mobile application prior to a clinician visit. Response data is recorded in a report, which generates alerts for clinicians, shifting the clinical focus from collecting information to focused management. Design goals included improving the patient experience, improving efficiency through electronic patient based data entry, and supporting the collection of aggregated data for research.MethodsThis paper describes the iterative design and evaluation processes undertaken to develop TickiT including co-creation processes, and a pilot study utilizing mixed qualitative and quantitative methods. A collaborative industry/academic partnership engaged stakeholders (youth, health care providers, and administrators) in the co-creation development process. An independent descriptive study conducted in 2 Canadian pediatric teaching hospitals evaluated the feasibility of the platform in both inpatient and ambulatory clinical settings, evaluating both providers and patient responses to the platform.ResultsThe independent pilot feasibility study included 80 adolescents, 12-18 years, and 38 medical staff-residents, inpatient and outpatient pediatricians, and surgeons. Youth uptake was 99% (79/80), and survey completion 99% (78/79; 90 questions). Youth found it easy to understand (92%, 72/78), easy to use (92%, 72/78), and efficient (80%, 63/79 with completion rate < 10 minutes). Residents were most positive about the application and surgeons were least positive. All inpatient providers obtained new patient information.ConclusionsCo-creative design methodology with stakeholders was effective for informing design and development processes to leverage effective eHealth opportunities. Continuing stakeholder engagement has further fostered platform development. The platform has the potential to meet IHI Triple Aim goals. Clinical adaptation requires planning, training, and support for health care providers to adjust their practices.

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Opportunistic adolescent health screening of surgical inpatients

Abstract: Consideration should be given to offer adolescent health screening to all surgical inpatients. Further research should involve the participation of young people and should focus on the outcomes, feasibility, acceptability and resource implications of such screening.

Cited by 17 publications

References 8 publications

Identification of health risk behaviours among adolescent refugees resettling in Western Australia

Identification of health risk behaviours among adolescent refugees resettling in Western Australia

‘Everybody’s business’: transition and the role of adult physicians

Co-Creation With TickiT: Designing and Evaluating a Clinical eHealth Platform for Youth

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