Simcoe/Dufferin Ballroom

Missed appointments are problematic because they can negatively impact children’s progress and make inefficient use of organizational resources and clinician time. In an attempt to balance finite resources and manage waitlists, many agencies use policies and service delivery models which discharge families from services after missing a specified number of appointments. Terms such as “no shows” and “hard to reach” inadvertently place blame on the family without knowing the reason why appointments are missed. It’s important to also consider how aspects of current organizational structures, such as service models and policy, make services hard to reach and impede families’ engagement.

This presentation will discuss an innovative service delivery model and considerations for policy development aiming to enhance equitable access and service continuation for families who would like to receive them.

3 Key Takeaways
1.    Missed appointments frequently occur in children's rehabilitation services, limiting opportunities to provide support to children, take children off the waitlist, and using clinician time to prepare, wait, and follow-up
2.    The reasons for missed appointments may occur at the level of the child (e.g. frequent hospitalizations), the family (e.g., parents have challenges organizing appointments) and the organization (e.g., do not provide flexible appointment times). 
3.    Policies often direct clinicians to discharge families after missed appointments, but this raises ethical concerns. The Readiness Support Program replaced discharge policies and was able to support families who have a history of missed appointments, improving their access to care, and reducing the rates of missed appointments at the centre 
 

Michelle Phoenix, Assistant Professor, McMaster University, CanChild Centre for Childhood Disability and Adjunct Scientist Holland Bloorview Kids Rehabilitation Hospital
Meaghan Reitzel, Occupational Therapist + PhD student, McMaster University, KidsAbility, Centre for Child Development, CanChild Centre for Childhood Disability
Sue Simpson, Executive Director, Waterloo Region Family Network
Gabrielle Shiry, Social Worker and Intake Program Manager, KidsAbility Centre for Child Development