Episodic scheduling improves access to pediatric therapy services

Our therapists lovingly call their work with kids “play with a purpose,” because what better way to get the hard work done than by having fun while doing it? From occupational, physical and speech therapy to specialty services like feeding therapy and assistive technology, CHoR is the place to help kids of all ages learn or regain skills.

Now, a new scheduling model is helping our therapy team improve access and provide more care to kids when and where they need it. Our director of pediatric rehab services, Sallie Tidman, explains the episodic scheduling model and why CHoR and other top children’s hospitals are implementing it to ensure the best experience.

What is the episodic scheduling model?    

Episodic scheduling is built on an episodes of care model, which is the delivery of specific health care services for a specific medical problem or illness for a specific period of time.

In terms of therapy, children are scheduled for a defined period with a focus on specific goals. At the end of the specified period, performance and goals are re-examined. Depending on progress made during the episode, the child may continue therapy, begin a therapeutic practice period (child and caregivers continue working on therapy goals at home and in the community) or be discharged. As skills are mastered, the child can begin a new episode addressing their next set of goals or skills.

When an episode begins, the therapy frequency generally falls into one of four groups:

• Intensive – therapy sessions multiple times per week for immediate and/or complex needs
• Weekly – weekly sessions making continuous progress toward goals
• Periodic – monthly sessions, often with a goal of perfecting home education in preparation for discharge or a therapeutic practice period
• Consultative – one or two visits for specialty services or a specific need, such as an update of durable medical equipment or assistive technology

What are the benefits of episodic scheduling?

There are many positives associated with episodes of care therapy, including:

• Improved outcomes
• Improved participation in therapy appointments and home education programs and activities 
• Flexibility for families to continue using learned skills at home for a period before returning to therapy
• More appointment availability and flexibility

Can my child still get occupational, physical and speech therapy on the same day?

We always strive to schedule appointments that work best for kids and their caregivers, including scheduling appointments back-to-back when more than one type of therapy is needed. For some patients, though, consecutive appointments aren’t ideal. They may need a break between sessions, or even appointments on different days to make sure they have the endurance to get the most out of it. We’ll work with you to find the best balance for you and your child.

Why is CHoR shifting to an episodic scheduling model for therapy? Is it backed by research? 

Dosage – which includes when to start therapy, when to end therapy and ideal intensity for specific conditions – has been researched for some time by professional organizations for physical, occupational and speech therapy and the episodic scheduling model has proven beneficial. The research-backed approach is in use by several of our local therapy peer groups, along with leading children’s hospitals across the country.     

What changes can be expected when scheduling therapy appointments?

The process of scheduling appointments at all our locations across Central and Northern Virginia will look very much the same as it has in the past but wait times for these appointments will be lessened.   Appointments for time-sensitive situations, such as head injuries or recent surgeries, will continue to be scheduled as quickly as possible.

My child has a chronic condition that requires ongoing therapy. How will this new process impact my family?  

The episodes of care approach looks different for each patient. A child with a chronic condition may enter multiple episodes of therapy with different disciplines during their pediatric years with therapeutic practice periods between. Some of the episodes may be longer, and others shorter, or even include some consultative appointments for check-ins depending on the child’s needs. The therapists will work with you and your child throughout each episode, encouraging continued growth and achievements during practice periods through home programming and activities. 

My child is new to therapy. What is the best way to keep track of their care?

Signing up for VCU Health MyChart will allow you to review notes and goals for therapy. It provides quick, easy, 24/7 access to information to help your child get the most out of their therapy.

Learn more about all the therapy services offered at CHoR.