Caregiver and Clinician Experience With Virtual Services for Children and Youth With Complex Needs During COVID-19.
Laura Theall, Kim Arbeau, Ajit Ninan and 5 others
PMID 36307282WHAT IT FOUND
Caregivers of children with complex needs were more positive about virtual appointments than clinicians: 80% said goals were met, while only 48% of staff felt they could meet clinical goals.
Direct observation and physical exams remained hard.
Key findings
01Caregivers reported more positive experiences than staff: 80% said virtual services met their goals and expectations, and 87% were confident they could follow clinical recommendations, while only 48% of staff said they could meet clinical goals.
02Operational data showed the average wait for first service decreased by 3.2 weeks, but referrals fell by an average of 23 fewer outpatient and 8 fewer inpatient clients per month, and service duration increased by an average of 12 weeks.
03Staff and caregiver comments most often focused on wanting direct observation or help, and comprehensive assessments requiring direct observation, testing, or physical examination were difficult to complete virtually.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
This was a quality-assurance survey, not a controlled study, and it had no comparison with in-person services. Responses came from 245 staff survey responses and 155 caregiver survey responses, and the paper says individuals may have been counted more than once, so the number of unique people is unclear. The surveys started months after the urgent move to virtual care, so early problems may have been missed. Caregivers without technology, non-English-speaking caregivers, and families who waited for in-person care may not be represented. Caregivers and staff were not blinded, and more engaged or satisfied people may have been more likely to respond. Findings are not separated by discipline, so they do not show how virtual care worked specifically for physical therapy, occupational therapy, speech-language pathology, or nursing.
The easy way to misread this
Do not read this as proof that virtual services are as effective as in-person services for children with complex needs. It was a quality-assurance survey, not a controlled comparison, and only a third of caregivers and very few staff said virtual services were just as effective.