Problem
The care team at McMaster Children’s Hospital wanted to identify & manage those patients whose outcomes were at risk due to the psychosocial interplay between lifestyle and IBD
Lifestyle and overall health have a significant impact on long-term outcomes for adolescents with chronic disease (1). One such chronic disease, Inflammatory Bowel Disease (IBD), a condition characterized by recurring chronic inflammation of the digestive tract, is particularly susceptible to psychosocial stressors (2). The care team at McMaster Children’s Hospital wanted to identify & manage those patients whose outcomes were at risk due to the psychosocial interplay between lifestyle and IBD. While they had a psychologist on their team there was no mechanism for identifying those at risk, and staff depended on patients self-identifying to access psychological care. The team was concerned that the lack of comprehensive data to consistently assess the emotional and social issues in their population was impeding their ability to make objective care decisions at the clinical level and to determine their resource utilization for psychological support at an operational level.
Solution
To systematically assess psychosocial risk amongst young patients with IBD, the care team at McMaster utilized the gold standard screening tool – the HEEADSS assessment (Home, Education, Eating, Activities, Drugs, Sexual health, Suicide), administered on Tickit’s interactive and patient-centric platform.
Tickit was chosen based on it’s contemporary, graphically-based, Digitally Empathetic design that resonated with youth. The ability to self administer the questionnaire allowed teens a greater sense of confidentiality regarding sensitive topics, increasing responsiveness and data quality. Summary of results was available in real-time to attending physicians, highlighting and/or alerting areas of concern and maximizing physician’s effectiveness during consultation regarding issues that required extra attention
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Of the 53 questionnaires administered on Tickit there was a 99% completion rate, supporting the hypothesis that a patient-centric survey tool engages respondents and provides comprehensive population data capture.
Outcomes
- Of the 53 questionnaires administered on Tickit there was a 99% completion rate, supporting the hypothesis that a patient-centric survey tool engages respondents and provides comprehensive population data capture.
- 11% of patients indicated suicidal thoughts in the past three months or provided a history of self-harm, supporting the value of screening to identify risk
- 63% of patients indicated a concern regarding where they would receive care beyond the age of 18, indicating current education materials regarding transition needed upgrading for better knowledge transfer
- 92% of patients found the questions easy to understand
- 94% of patients were comfortable with the content of the questions
- 92 % of respondents thought the survey would be helpful to doctors and nurses caring for them
The Conclusion
Digital Empathy HEADSS Validated at McMaster Children’s: the additional, more consistent information obtained from patients has enabled the McMaster team to find opportunities to improve their existing programs. The use of the Tickit-enabled HEADSS assessment proved to be very beneficial to obtain confidential and sensitive information from adolescents and empower the care team to efficiently meet their needs. The data captured proved sensitive in identifying patients at risk of suicide or self-harm, streamlining navigation of appropriate referrals to the psychologist. It also identified opportunities for staff to improve program management through identifying the need to better educate patients about their transition to adult care after the age of 18.
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Acknowledgements
Authors: Isseman, R. and Odeh, S.V. McMaster Children’s Hospital, Hamilton ON, Canada. Department of Pediatrics, McMaster University, Hamilton ON, Canada.
About HEEADSSS Assessment: Adolescence is a challenging time when many emotional and physical changes take place. HEADSSS is a screening tool to assess risks that can be used for all adolescents. It provides a systematic approach to the adolescent interview progressing from the least threatening topics to the most personal and sensitive subjects. The acronym stands for: Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, and Safety. This interview format is flexible and can be catered to all adolescents. The HEEADSSS review of systems is an effective way for care providers and social workers to engage in dialogue with teens and address many of the challenges faced by this age group. Learn more about HEEADSSS here
About McMaster’s Children Hospital: Located in Toronto, Mc Master’s Children Hospital is home to the fastest-growing kids-only emergency department in Ontario, one of Canada’s most advanced neonatal intensive care units, and a range of programs and clinics with unique expertise in a number of areas including children’s cancer, digestive diseases, and mental health.
About Tickit Health: Tickit Health houses the expertise to help organizations elevate their performance by harnessing the power of Digital Empathy. The flagship product, Tickit®, is an interactive proprietary digital surveying software that captures the unique needs of an individual and collects high-fidelity data for organizations to effectively manage their populations. Tickit Health has demonstrated the success of this tool in various industries, healthcare, market research, insurance and education across the US, Canada, and Australia.
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