THE MEDICAL POST
May 06, 2008

Network helps special-needs kids access care

Joe McAllister

ORILLIA, ONTARIO. -- Dr. Nicky Jones-Stokreef has one young patient on a Baclofen pump who used to travel almost weekly to the Bloorview Kids Rehab Hospital to have his medication delivery system adjusted. Not a minor thing when the child with cerebral palsy—and a parent—had to travel from their home in Orillia, Ont., to Toronto. The journey, including a 90-minute drive each way, takes a full day.

Now, partly thanks to the Children’s Treatment Network (CTN), a not-for-profit agency serving York Region and the County of Simcoe north of Toronto, the boy just has to be taken around the corner to see Dr. Jones-Stokreef.

Dr. Nicky Jones-Stokreef, a developmental paediatrician with Children’s Treatment Network of Simcoe York, assesses Aydan Graham, a Barrie, Ont., child with cerebral palsy.

Before the introduction of the CTN, pediatric patients in a vast swath north of Toronto had access to some of the best children’s medical services in the world—but getting to the Bloorview, the Hospital for Sick Children or other services involved navigating Toronto’s sprawling streets and choked highways. That was a daunting experience for the parents of developmentally delayed children who need specialized services.

In 2003, consensus started building in Simcoe and York to find a better way to bring those services to children. In other regions of Ontario, such services are often delivered via a centralized clinic. “Before government approved this program, there was a community movement to get better services for special-needs kids,” said Dr. Jones-Stokreef. “We wanted to bring those services to patients,” not found a new clinic, she noted.

“Rather than developing a building, the community decided to go a different route and develop the CTN,” said Dr. Darcy Fehlings, physician director of the child development program at Bloorview. She was familiar with Dr. Jones-Stokreef’s work, a developmental pediatrician who completed a fellowship at Bloorview as part of her training, when the CTN launched.

Dr. Gerald Friedman, chief of pediatrics at York Central Hospital said, “Essentially, the whole concept is to co-ordinate service close to the family and close to the patient,” he said, adding the buzz-phrase they use is “one-point-of-contact.”

The concept revolves around “a single plan of care,” he explained. “Families put in one phone call and they get a co-ordinated plan.”
The Simcoe and York CTN serves an estimated 4,500 children with physical disabilities and developmental delays from birth to age 19.

After parents contact the agency, a case worker helps them pull together the services that are offered to meet the needs of children with cerebral palsy, autism, severe brain injury and severe developmental disabilities.

The agency is also responsible for providing some professional training for doctors and allied health providers such as physiotherapists, who may feel they need to better deliver care to developmentally delayed children.

For cerebral palsy patients, for instance, spasticity is a problem. The CTN not only helps doctors with issues such as medication, but has also been involved, through Bloorview, in training doctors to give Botox injections to patients in need of this treatment.

Although still a work in progress, the CTN is attempting to pull together and manage all aspects of treatment for these needy children. Besides physical and occupational therapy, doctors’ services and sub-clinics, they are also attempting to bring the one-treatment-plan idea into institutions such as schools through teacher’s aides and language instructors. This, too, is intended to be co-ordinated and accessed by a single case worker at the CTN for the patients and their families.

All the information about a patient is accessible to team members through a single plan-of-care record which is online and accessible for every team-member with a password. The program is using specialized software that Dr. Jones-Stokreef said “allows people from various agencies to co-ordinate care.”

“We are all every much behind building capacity in the community,” said Dr. Fehlings. “There is a lot of room for exciting developments.”


PROGRAM AT A GLANCE

Program: Children's Treatment Network
Where: York Region and Simcoe County, Ontario
What it does: Provides services locally for special needs children
Phone: 1-866-377-0286
Website: www.ctn-simcoeyork.ca