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From face-to-face to virtual services: a success story during COVID19

When COVID19 hit Australia early this year, it left many health services scrambling to find the best virtual solution for their usual face-to-face services. One organisation, however, has been ahead of the curve having commenced the virtual delivery of some of their services over two-and-a half years ago.

In 2017, Karitane began their digital transformation strategy by looking at transforming existing programs into virtual models of care. They initially selected two models which academic research has since shown to be highly successful.

Toddler Behaviour Clinic (I-PCIT)

The first model to be trialed as a virtual model of care was the Toddler Behaviour Clinic which delivers an evidence based program called Parent Child Interaction Therapy (PCIT). This program focuses on the importance of familial relationships and strengthening these relationships early on.

Extensive research indicates that PCIT is one of the most powerful interventions for addressing behaviour concerns in children age 2-7 years. Karitane applied for funding through the NSW Mental Health Innovation Fund and were successful to embark upon a study of moving PCIT to a virtual delivery model.

Karitane CEO, Grainne O’Loughlin

Grainne O’Loughlin, CEO Karitane explains that they chose PCIT as it was only available as an in-centre therapy program in their clinics in South West Sydney and they wanted to increase accessibility and reach families across NSW, particularly in rural and regional Australia.

“Part of our concern was that parents had to come to our clinic for 12 weeks as part of the program and this was hampered by a range of issues, such as geography and transport.”

50 families participated in the original trial of the I-PCIT program with research showing extremely positive outcomes. Over 70 percent of children showed positive treatment response, 50 percent no longer met the criteria for disruptive behavior disorder and has effect score of 1.72 which is two and half times more effective than medication.

“I-PCIT is not just a video call. It’s not just a chat. It’s a rigorous evidence-based program that has been traditionally delivered in clinics but we have successfully transformed to a virtual experience,” says O’Loughlin.

Feedback from parents have echoed the positive outcomes from I-PCIT:

“We were shocked because there was just no aggression anymore. It was amazing, like a miracle. It has helped in so many ways,” said one parent of the program.

“The results were immediate. I’ve got new skills that I can use in situations rather than not knowing what to do” said another parent from I-PCIT.

Karitane is now in scaling and sustainability negotiations following excellent efficacy studies and widely published findings in peer-reviewed journals internationally.

Virtual Home Visits

Drawing on the success of I-PCIT, Karitane began to look at what other models of care they could transform into a virtual service to help even more families.

With long waiting lists for Parenting Centres and Residential Units, the idea of Virtual Home Visits provided by the Child & Family Health team was an obvious starting point.

“Virtual Home Visits focus on providing help for parents with young babies around breastfeeding, sleep and settling as well as general parenting support,” explains O’Loughlin.

“As we realised the significance of the digital transformation of our work, we connected the I-PCIT and Virtual Home Visit work and, with the help of the NSW Minister for Health, officially launched Karitane’s Digital Health Hub in February 2019.

And then COVID-19 came along!

Using their experience with creating successful virtual services, Karitane saw the urgent need to keep parents, babies and staff safe and were able to rapidly transform 100 per cent of their services into a virtual format. They now offer a range of services from Karitane Careline to Virtual Residential Unit offering a virtual continuum of care for families needing services from brief interventions to complex support.

“The Virtual Residential Unit (VRU) admissions have been highly successful,” explains O’Loughlin.

In this service families would traditionally stay in a Residential facility for four to five days receiving intensive support from a range of health professionals including GPs, Paediatricians, Psychologists, Allied Health staff and Nurses. However, COVID-19 rendered this a potentially unsafe model due to fears of increased community transmission amongst asymptomatic patients and in spite of best efforts to screen families for risk factors. The clinical redesign to shift the model to a new virtual format commenced rapidly.

“Families still receive the same level of intensive support they would have in the Residential Unit. They receive up to three virtual consultations a day, morning afternoon and evening from our team of health professionals. While  this is a significant departure from the traditional model, it still demonstrates positive clinical outcomes and excellent feedback from families and staff. A hundred percent of families said their knowledge improved, eighty nine percent of families found the service extremely or very helpful and the client satisfaction has been exceptional with a net promoter score of 89.” she says.

“Being able to access this support from our own home was a significant contributor to the overall success of this service. With the assistance of your very skilled, professional and compassionate team we were able to achieve our goals as a family,” said Lauren, Virtual Residential Unit client

Karitane’s swift response to virtual services has attracted international attention with organisations from the UK, USA & NZ seeking to learn from their example.

With the uncertainty around COVID19 and the need for physical distancing likely to continue for the foreseeable future, it seems that Karitane is well placed to continue the delivery of virtual services to families across NSW and beyond whilst supporting other organisations to create the blueprint for digital transformation.

By Linda Music