There is no place like @home!: The value of home consultations in paediatric rehabilitation

• Published in: Child : care, health & development Vol. 44; no. 4; pp. 623 - 629
• Main Authors: Maren‐Suir, I., Ketelaar, M., Brouns, B., Sanden, K., Verhoef, M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2018
• Subjects: benefits; Best practice; Child Health Services - statistics & numerical data; Child, Preschool; Children; Chronic Disease - rehabilitation; Delivery of Health Care, Integrated; Disabled Children - rehabilitation; Early intervention; Experts; family‐centred services; Female; home; House Calls - statistics & numerical data; Humans; Infant; Infant, Newborn; Interviews; Male; Netherlands; paediatrics; Parents; Parents & parenting; Parents - psychology; Patient Satisfaction - statistics & numerical data; Pilot Projects; Referral and Consultation - statistics & numerical data; Rehabilitation; Semi Structured Interviews; Teams; Therapeutic Environment; Netherlands; benefits; paediatrics; family-centred services; rehabilitation; home
• ISSN: 0305-1862; 1365-2214
• DOI: 10.1111/cch.12573

Background
Family‐centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0–5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations.
Method
The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process.
Results
In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best.
Conclusion
By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre.