adolescent friendly quality assessment tools [afquats] · ms majella doherty, regional child and...
TRANSCRIPT
Developed by: Programme of Action for Children [PAC], HSE 2006
Materials prepared by:Ms Caroline Cullen Assistant Director PAC and Ms Mary Roche Project Manager Adolescent Health, PAC
Thanks are due to the following people:Ms Martina Coen, Student Intern DCU, who prepared the groundwork for the development of the toolsMs Elaine Groarke, PAC, Sligo who provided administrationMs Deirdre Fullerton, Independent Consultant and Researcher, who carried out feasibility studies and consultations Members of the project team:Ms Carmel Cummins, Training and Development Officer, PAC, Ms Majella Doherty, Regional Child and Adolescent Health Development Officer, SHB and Ms Jean Kilroe, Research Officer, PAC
Dr V Chandra Mouli, Department of Child and Adolescent Health and Development, WHO, Geneva who offered invaluable advice and guidance
Copies will be available for download from www.hse.ie
© HSE 2006 This document is copyright. It may be produced in whole or in part for the purposes of service review, evaluation, planning, training or study.
design x LERMAGH :: www.lermagh.com
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Tableofcontents Introduction....................................................................................................................................................................................2
Aim ..............................................................................................................................................................................................2
Definition.........................................................................................................................................................................................2 ThenumberofadolescentsinIreland..................................................................................................................................3
ExplainingtheTools.......................................................................................................................................................................4 Whatarethequalityassessmenttools?...............................................................................................................................4 Whydevelopqualitytoolsforadolescenthealth?................................................................................................................4 Initialsteps............................................................................................................................................................................4 Theprocess..........................................................................................................................................................................4
UsingtheTools..............................................................................................................................................................................5 IssuesforconsiderationwhenplanningtouseAFQuATs....................................................................................................5 AdolescentFriendlyQualityChecklistToolAFQuATA.........................................................................................................5 Asample..............................................................................................................................................................................7 AdolescentFriendlyQualityAuditToolAFQuATB...............................................................................................................8 Furtherresources..................................................................................................................................................................8 FurtherdevelopmentoftheAFQuATs...................................................................................................................................8
TheTools.........................................................................................................................................................................................9 Form1AFQuATA.................................................................................................................................................................9 Form2AFQuATB..............................................................................................................................................................16
FurtherResources.......................................................................................................................................................................29 GeneralResources..............................................................................................................................................................29 SexualHealthResources....................................................................................................................................................30 DataCollectionandmeasurementinstruments.................................................................................................................31
Appendix1FeasibilityStudy.......................................................................................................................................................32
ReferenceSection.......................................................................................................................................................................33
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AdolescentFriendlyQualityAssessmentTools[AFQuATs]
This is a working document developed to date by the Programme of Action for Children. Further changes will be incorporated as it moves into its implementation phase.
Introduction GetConnected-DevelopinganAdolescentFriendlyHealthService,NationalConjointChildHealthCommittee,2002describedthe
importanceofaddressingadolescenthealthservicesanditsrecommendationsformthebasisforthedevelopmentoftheAdolescentFriendlyAssessmentTools[AFQuATs]citedhere.
AccordingtotheWorldHealthOrganisation[WHO],keyhealthchallengesduringadolescenceareinjuries,sexualandreproductivehealth,unhealthybehaviourslinkedtotheuseofsubstances,todietandphysicalactivity,andmentalhealth.Youthfriendlyhealthservicesareneededtoadequatelyaddressthesechallengesandtopromotebesthealthforyoungpeople.
Accesstohealthcareforyoungpeopleiscentraltopromotinghealthandwellbeing.Youngpeople,regardlessofsocio-economicclass,havethepotentialtobecomemarginalisedwhenitcomestoaccesstohealthservices.Internationalresearchfrombothdevelopedanddevelopingcountrieshighlightstheimportanceofcreatingaccessibleservicesthatareacceptabletoyoungpeople,iftheirhealthandwell-beingaretobemaintained1,2.Althoughtheliteraturesuggeststhatsomeyoungpeoplemaybemoreatriskofnotaccessinghealthcare3,researchalsoshowsthatyoungpeopleofbothgendersandfromallsocio-economicgroupsexperienceverysimilarbarrierstoaccess.Personalbarrierssuchasembarrassmentandfearsaboutconfidentialitycanbeamajorobstacleforyoungpeopletousingservices.Consultationwithyoungpeoplehasconsistentlyhighlightedtheimportanceofadolescentfriendlyservicesandyouthparticipationinservicedevelopment4.
Aim TheAdolescentFriendlyQualityAssessmentTools[AFQuATs]aredesignedtoprovideamethodforhealthserviceprovidersand
plannerstoassessthequalityofservicesforyoungpeopleinrelationtoadolescentfriendlyqualitystandards.
TheToolsidentifykeyareasforconsiderationinreviewingservicesforyoungpeopleandaredesignedtoencourageachievablestandardsinnewandexistingservices.
Definition Youth,youngpeopleandadolescentsaredefinedindifferentways.Adolescentsforthisdocumentarebroadlydefinedasyoung
peoplebetweentheagesof12yrsand18yrs.Thecutoffpointat18yrsisinlinewiththeoperationaldefinitionoftheHealthServiceExecutive[HSE],[ChildCareAct1991].Itisacknowledgedhoweverthatkeepingyoungpeople‘atthecentre’ofserviceplanninganddeliveryissueswillmeanthatflexibilityaboutagerangewillapply.Thetermsyouth,youngpeopleandadolescentsarethususedinterchangeablyinthisdocument.
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ThenumberofadolescentsinIreland Table:NumberofadolescentsexpressedasapercentageofTotalPopulation
Age in years Persons Males Females
12years 56,627 28,911 27,716
13“ 56,677 29,013 27,664
14“ 59,474 30,325 29,149
15‘’ 60,882 31,369 29,513
16“ 61,682 31,495 30,187
17“ 63,039 32,575 30,464
18“ 63,009 32,212 30,797
TotalPop12-18yrs 421,390
TotalPopulation 3,917,203
No12-18yroldsas%totalpop. 10.76%
Source:2002CensusData
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ExplainingtheTools Whatarethequalityassessmenttools? Thetoolsprovideguidanceontheassessmentandreviewofservicesforyoungpeople.Theycontainquestionsthatitisusefulto
askabouttheserviceinorderthatitcanbecomeasfriendlyaspossibletoyoungpeople.Actionsorwaystoimprovetheplanningandprovisionofservicescanbeputinplaceandchangescanintimebeassessedagain.Acontinualcycleofqualityassuranceisthusputinplace.
Whydevelopqualitytoolsforadolescenthealth? Qualityservicesmeansdoingtherightthing,attherighttime,intherightwayfortherightpersonhavingthebestpossibleresults.
Ifservicesforadolescentsaretoachieveapositivenethealthbenefittheyneedtobeofahighquality.Toensurethatqualitystandardsinservicesareachievedforadolescentsitisimportantthatasystemormethodtoassessthisaccordingtoagreeddimensionsisavailable.AstherewasnosuchtoolinexistenceforexaminingIrishservicesitwasconsideredimportanttobegintheprocess.
Initialsteps Theinitialstepsinthedevelopmentofthetoolsdescribedherewereasfollows.In2002GetConnected-DevelopinganAdolescent
FriendlyHealthService,NationalConjointChildHealthCommittee,reviewedthekeyissuesrelatingtohealthservicesforthe12–18yearoldagegroupandproposedanagendaforadolescenthealthinthe21stcentury.Thecoreconceptofthestrategydescribedtheneedfordiscreetstandardsinhealthservicesforadolescents.
AnadolescentfriendlyqualityframeworkprojectwasproposedaspartoftheProgrammeofActionforChildren’s[PAC]businessplanin2004andwasaresponsetothesestrategicrecommendations.Itproposedthedevelopmentofaqualityframeworkunderpinnedbyqualitytoolstoenableserviceprovidersandplannerstogetstrategyintoaction.
Theprocess TheprocessfortheinitialdevelopmentoftheAFQuATs:
• Drewoninternationalresearchandpromisingpractice[Au2,7,NZ5,Ca6,USA8,UK9,10]
• ConsultedwiththeWorldHealthOrganisation[WHO]
• Heldfocusgroupswithyoungpeople
• CommissionedaFeasibilityStudywithserviceproviders.
Thedrafttoolsweretestedbyanindependentresearcherinanumberofadolescenthealthservicesettingsandwitharangeof
providers,youngpeopleandparents.Thetoolsandresourceinformationwerefurtherrefinedandenhancedthroughthisfeasibilitystudy.FurtherdetailsoftheFeasibilityStudyarepresentedinAppendix1.
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Usingthetools Twotools,andresourcereferencesareoutlinedinthissection
1. AdolescentFriendlyQualityChecklistTool[A]
2. AdolescentFriendlyQualityAuditTool[B]
3. Furtherresources
IssuesforconsiderationwhenplanningtouseAFQuATs Itwillbeusefulifthefollowingquestionsareconsidered:
• Haveyougotmanagementbuy-inforareviewprocess?
• Whoarethekeypeoplethatshouldbepartoftheprojectteamorworkinggrouptobeinvolvedintheaudit?
• Haveyouthoughtofawaytoinvolveserviceusersorotheryoungpeopleintheprocess?
• Willyousharetheresultswithstakeholders,plannersandpartners?
• Howdoyouplantousetheresultse.g.toinfluencetraining,policydevelopment,resourceneeds?
• Howoftenshouldthisbedonesoyoucancompareoutcomesovertime?
• Haveyouidentifiedcriteriathatarenotrelevanttoyourserviceorsettingandspecifiedwhy?
AdolescentFriendlyQualityChecklistToolAFQuATA Theprocessofassessingtheadolescentfriendlinessofahealthservicewillbedifferentforeachservice.Thechecklisttoolisideal
forstartingofftheprocessofassessingqualityinaservicefromanadolescentfriendlyperspective.Whenforexampleyouwant:
• Totestthereadinessforafulleraudit
• Toassesstheserviceacrossthe6dimensions
• Toprovideinformationforscopingaproject
• Todevelopanactionplanforqualityimprovement
• Toplanservicedevelopment
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Thequalitydimensionscloselymatchthose,whichweredevelopedinGetConnectedandarecolourcodedacrossthechecklistandaudittoolasfollows:
QualityDimensions
AccessibilityofService
FlexibilityofService
StaffTraining
QualityInformationforYoungPeople
PartnershipApproach
ConfidentialityandPrivacy
Eachofthesedimensionsisbrokendownfurtherintoassessmentcategories.Thefulllistofthesecategoriesisasfollows: Administrative,Geographic,Economic,Access,PhysicalStructure,VarietyofServices,Staffing,Interpersonalrelations,
Typeofinformationprovided,Howtheinformationisprovided,Youngpeople,Parents/Carers,Otherrelevantagencies. Theseassessmentcategoriesareappliedtoeachdimensionaccordingtotheirrelevance.
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ASample Asampleofhowthedimensionsmightbeassessedfollows.
Servicesshouldbeaccessible
Yes No Actionforimprovement?
Administration Doesyourservicehaveareasonabletimeperiodwhenwaitingforfirstappointment? √
Thisneedsmonitoring:Aislingtocheckmonthly.
Aretheserviceoperationalhourswelladvertisedinavarietyoflocationsandthroughavarietyofmedia? √
Advertisetheserviceopeninghoursinlocalyouthcentresandschools.
Istheserviceavailableinconvenientandappropriatesettings?(e.g.dropincentreoroutreach/mobileservice) √
Outreachinlocalprimarycarecentreisbeingdiscussed.
Geography Istheservicelocatedclosetowhereyoungpeoplelive(orcanitbeaccessedthroughpublictransport)? √
Doestheservicehaveadequatespaceandcomfortablewaitingarea? √
Nochanceofextendingspacebutyouthmagazinesandcushionswillmakeitmorefriendly.
Economic Istheserviceprovidedatfreeoratlowcost? √
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AdolescentFriendlyQualityAuditToolAFQuATB Theaudittoolisamorecomprehensivetoolandisidealforevaluatingtheservicemorefully,orforunderstandingthedetailbehind
thechecklisttool.Youwillnoticethefollowingiconsattributedtothekeyareasforinvestigation
u TheStandards,whichdescribewhatshouldbeinplaceundereachdimension.
l TheProcessIndicators[PI]describeshowtoensurethatthestandardisachievedineachcase
TheMeasurementInstrument,whichdescribeawayforthePItobemeasured
Usefulapplicationswouldbe:
• Toaudittheyouthfriendlinessoftheservice• Togetamoredetailedunderstandingoftheservicepossibilities• Toidentifyplanningforaction• Touseasatemplatetoengagewithpartners• Toprovideinformationforatraininganalysis• Touseasastandardtoolforindependentevaluation
Furtherresources Furtherresourceslistsseparatelythemeasurementinstrumentswhicharesuggestedintheaudittool.Wherepossible,examples
havebeensourced.Inthecourseofthedevelopmentofthesetoolsusefulresourceshavebeenfoundandexamined.Thesearecitedwhereavailableinthissection.
IfyouwouldliketofocusonstrategicdirectionyouwillfindtheGetConnected-DevelopinganAdolescentFriendlyHealthService,NationalConjointChildHealthCommittee,2002,reportcurrentlyonlineatwww.pacirl.ie[archive]Itwillbepossibletolocatethisonlineatwww.hse.ieinthenearfuture.
Thepositionpaper,whichgivesmorebackgrounddetailonthequalityframeworkforadolescentfriendlyhealthservices,willbeavailableonlinealso.Thesuiteoftoolsareoutlinedbelow.TheyareavailableinCDformatandonline.
FurtherdevelopmentoftheAFQuATs
Itisenvisagedthattheseresourceswillbedevelopedfurthertoincludetestedmeasurementinstrumentsastheycomeonstream.Otherareasfordevelopmentmaybethefutureprovisionofaqualitymarkforexcellenceinserviceprovision.
Forfurthercopiespleasecontact:
TheChildrenYouthandFamilyDirectorate 1UpperHartstongeStreet,Limerick.Tel0035361310437 PopulationHealth,ChildrenandYoungPeople’sTeam 3rdFloor,BridgewaterHouse,RockwoodParade,Sligo.Tel00353719174780
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TheTools
Form1 ADOLESCENTFRIENDLYQUALITYCHECKLISTTOOLA(AFQuATA)
Service name:
Quality Project Team Members:
Date:
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Servicesshouldbeaccessible
Yes No Actionforimprovement?
Administration
Doestheservicehaveareasonable*timeperiodwhenwaitingforfirstappointment?
Doestheservicehaveareasonabletimeperiodwhenwaitingforfollow-upappointment?
Aretheserviceoperationalhoursclearlyadvertisedinavarietyoflocationsandthroughavarietyofmedia?
Istheservicetailoredtoyoungpeople’sneeds?(ordoestheservicehaveasubsectiontailoredtotheneedsofyoungpeople?)
Istheserviceavailableinconvenientandappropriatesettings(e.g.dropincentreoroutreach/mobileservice)?
Geography Istheservicelocatedclosetowhereyoungpeoplelive(orcanitbeaccessedthroughpublictransport)?
Economic Istheserviceprovidedatfreeoratlowcost?
AccessDoestheservicehavenon-discriminatoryaccessregardlessofminoritystatus(e.g.Wheelchairaccess,childcareforteenageparents,translationservices)?
*Thetermreasonablewillvarydependingonthenatureoftheserviceprovided.Servicesarerequiredtodetermineanacceptablestandardforthisdimension.
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Servicesshouldbeflexible
Yes No Actionforimprovement?
Administration
Doestheservicehaveoperationalhourssuitableforyoungpeople(e.g.afterschool,weekends)?
Doestheservicehavesuitableappointmentallocationforneedsofyoungpeople(e.g.sufficienttimetoassessproblem,extratimeforcomplexconsultations,appointmentstosuityoungpeopletravellinglongdistances)?
Isthethereamulti-serviceapproachwherebyarangeofservicesareavailableforyoungpeople(e.g.hospitals,healthcentres,youthcentresone-stop-shopetc.)?
Aretherevariouspointsofcontact(e.g.healthcentreorsportscentres,outreach)?orIsitatailoredservicewithintraditionalprovidersetting?
Physical/Structural
Doestheservicehaveadequatespaceandcomfortablewaitingarea?
Istheserviceappealingforyoungpeopleinthatitacknowledgesayouthculture(e.g.appealingdecoration,displays,musicetc)?
Doestheservicesupporttheyoungpersontohaveafriendorotherpersonwiththemwhenreceivingtheservice?
Varietyofservices
Isaholisticmodelofhealthadoptedintheprovisionofhealthcareservicesandtreatmentstoadolescents(rangeofservices,healthpromotionorsignpostingtootherservices)?
Arethereservicesforindividualswithspecialneeds(e.g.youngpeoplewithlearningdisabilityorlowliteracy,translationsfornon-nationals,signingfordeafetc)?
Doestheservicehaveappropriateprovisionofstafffortheproblempresentedandthepatientattending(e.g.peercounsellors,healthcareprofessionalsfortechnicaldiagnosis,maleandfemalestaff)?
Ismaximumusemadeofthecontacttimewithadolescentstominimisemissedopportunities(e.g.healthpromotionadviceetc)?
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Staffing(CoreCompetenciesandTraining)
Yes No Actionforimprovement?
Staffing
Haveallstaffreceivedtheessentialtrainingrequiredforthisservice?
Haveallstaff(includingsupportstaff)everreceivedanydiscreettrainingforworkingwithyoungpeople?
Arestafftrainedtopreventanymissedopportunitieswiththeadolescentswhoattendtheservice?
Isthereongoingtrainingforstafftokeeptheminformedandtheirskillscurrent?
Isthereamultidisciplinaryandmulti-agencyapproachtakenbystaff?
Inter-personalrelations
Arestaff(includingsupportstaff)trainedinappropriatecommunicationskillswhendealingwithadolescents?
Doestheserviceusehaveappropriatecriteria-basedinterviewingintherecruitmentoftraineesorthosewhowillworkwithorsupervisestafftoworkwithadolescent’s(e.g.informedattitudes,qualifications,interpersonalfactors)?
Doestheorganisationhaveamemberofstaffappointedtodevelopandoverseetheadolescentfriendlinessoftheservice?
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QualityInformation
Yes No Actionforimprovement?
TypeofInformation
provided
Havestaffreceivedadequatetrainingintheinformationwhichisrequiredbyadolescentse.g.:- Availablehealthandsupport?- Accessingappropriateservices?- Options,rights&entitlements?- Backupservicesandafterhoursnumbers?- Generalhealthissues?- Healthpromotionandadolescenthealthissues?- Processformakingcomplaints(e.g.Ombudsmanfor
Children)?
Doestheservicehaveasystemwhereparentsarebriefedinrelationtoinformationandservicesofferedforadolescents(e.g.,informationonthehealthissue,adolescentsneedsforconfidentialservices,rightsofparentalconsent)?
Howtheinformationis
provided
Doestheservicehaveanagreedformatontheprovisionofinformationforyoungpeople(e.g.,accurate,ageappropriate,complete,eye-catching,languageappropriate,relevant,tailoredforspecialneeds,throughavarietyofmedia,updated)?
Doestheserviceprovideopenaccesstomedicalrecords?
Istheinformationcompleteandareallrecordspresentintheservice?
Doestheserviceprovideinformationthroughattractiveandappealingmedia(e.g.Interactivetools/computers/DVDs,telephonehotlinesbytrainedcounsellors,contemporarydesignedleaflets,throughavarietyofpointsofcontact)?
Doestheserviceprovideaone-stop-shopapproachtoprovisionofinformation:• ontheserviceprovided?• onotherrelevantservices?• ongeneralhealthinformationforadolescents?
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APartnershipApproach
Yes No Actionforimprovement?
YoungPeople
Doestheserviceofferopportunitiestoinvolveyoungpeople?
• Intheplanningofservices(e.g.throughfocusgroupsorinvolvementinmanagementcommittees)?
• Inthedeliveryofservices(e.g.peers-ledormentoringprojects)?
• Intheevaluationofservices(e.g.consumersatisfactionquestions,orinmysteryshoppingetc)?
• Inappropriateconsultationwithestablishedgroups?• Inthedevelopmentofnewgroups?
Parents/Carers
Doestheserviceinvolveparents/carersintheplanning,deliveryandevaluationofservicesasappropriatethrough
• Theplanningofservices?• Theevaluationofservices?
OtherRelevantAgencies
Doestheserviceinvolveotherrelevantagenciesintheplanning,deliveryandevaluationofservices?
Hastheserviceformedallianceswithotherrelevantorganisationse.g.localschools,youthorganisations?
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SummaryTableofchecklistactions
Dimension ActionsRequired/Comments
AccessibilityofService
FlexibilityofService
StaffTraining
QualityInformationforYoungPeople
PartnershipApproach
ConfidentialityandPrivacy
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TheTools
Form2 ADOLESCENTFRIENDLYQUALITYAUDITTOOLB(AFQuATB)
Service Name:
Audit Project Members:
Date:
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Servicesshouldbeaccessible
STANDARDu PROCESSINDICATORl MEASUREMENT
Administrative
Thereshouldbe…. Provisionof…. Measuredby….
Areasonable,maximumtimeperiodestablishedforyoungpeople,whenwaitingforafirstorreferredappointment
Anagreedstandardwaitingperiod,basedonconsultationswithrelevantpartnerse.g.,Serviceproviders,youngpeopleetc
DatabaseofinformationConsumersatisfactionquestionnaireMysteryshopper*
Areasonable,maximumwaitingperiodestablishedforyoungpeople,whenattendingforscheduledfollow-upappointments
Anagreedstandardwaitingtime,basedonconsultationswithrelevantpartnerseg.Serviceproviders,youngpeople
DatabaseofinformationConsumersatisfactionquestionnaire
Aservicewheretheoperationalhoursandlocationofservicesarewelladvertisedbothinternally&externally
Awelladvertisedserviceinavarietyoflocationsandthroughavarietyofmedia
ListsConsumerreportsMysteryshopper*
Aserviceorasubsectionoftheservicewhichistailoredspecificallyfortheneedsofyoungpeople
Aspecificdesignatedaspectoftheserviceoraservicecompletelydedicatedtoyoungpeople
Mysteryshopper
Acomprehensiveregister/databaseofinformationabouttheyoungpeoplethatusetheservice
Aregularlyupdatedregisterwithyoungpeoplepriortoconsent
Databaseofinformation
Geographic
Adolescenthealthservices+/orinformationonhealthservices,availableinconvenientandappropriatesettingsalreadyusedbyyoungpeople
Servicesinconvenientlocations,outreachservices,mobileservices,drop-inservicesandservicesincommunitysettingseg.Youthcentres,shoppingmalls,schools,adolescent/teenclinics
SurveyoflocationofservicesDatabaseofinformationMysteryshopper
Healthserviceslocatedwithinareasonabledistancewhereyoungpeoplelive
Serviceswithinaspecifieddistancefromwhereyoungpeopleliveparticularlyinrural,remoteordisadvantagedareas(basedonconsultationswithrelevantpartnerse.g.,Serviceprovidersandyoungpeople)
SurveyoflocationofservicesConsumerreportsFocusgroups/interviews
Transportwherepossible,iftheserviceisnotonapublictransportroute
ConsumersatisfactionquestionnaireMysteryshopper
Anagreedratioofhealthserviceprovidertoyoungpeopleingivenarea
Databaseofinformation
*MysteryShopperisameasurementtoolexplainedindetailinFurtherResources–DataCollection&MeasurementTools
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Servicesshouldbeaccessible(continued)
STANDARDu PROCESSINDICATORl MEASUREMENT
Physical/Structural
Environment
Thereshouldbe….. Provisionof…….. Measuredby….
Appropriatefacilitiesavailableforusebythephysicallydisabled
Wheelchairfriendlypremisesbothexternally(entrance,exitandparking)andinternally(doorways,toilets,lifts)
Surveyofpremises/facilitiesConsumersatisfactionquestionnaireMysteryshopper
Adequatespaceandcomfortableconditionsinwaitingareas
Largeareasforwaiting,appropriateventilation,heating,lighting,seating,refreshmentsetc.
Surveyofpremises/facilitiesConsumersatisfactionquestionnaireMysteryshopper
Economic
Healthservicesofnoorlowcosttoadolescentwhereappropriate
Free/subsidisedservicesandproductswhereappropriatee.g.,Healthclinics,contraceptives,prescriptiondrugs
DatabaseofinformationMysteryshopper
Optionsforappropriatepaymentmethods CreditorflexiblepaymentoptionsforyoungpeopleDevelopmentandpresentationofdocument/policy/report
Non-DiscriminatoryAccess
Non-discriminatoryaccessforeachoftheadolescentminoritygroups(travellers,homeless,refugees,asylumseekers,educationaldisadvantage,teenageparents,chronicphysicalillnessanddisability)
Apolicydocumentintheorganisationwhichaddressestheneedsofminoritygroupsandthedisadvantaged
Servicestopromotenon-discriminatoryaccesseg.Childcarefacilitiesforadolescentparents,interpretersetc.
Developmentandpresentationofdocument/policy/reportDatabaseofinformationConsumersatisfactionquestionnaireMysteryshopper
Genderspecificaspectsofthehealthserviceandalsosharedhealthserviceaspects(genderproofing)
Acomprehensivepolicydocumentincorporatinggenderperspectives
Developmentandpresentationofdocument/policy/report
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Servicesshouldbeflexible
STANDARDu PROCESSINDICATORl MEASUREMENT
Administration
Thereshouldbe….. Provisionof…….. Measuredby….
Convenientoperationalhoursoftheserviceforyoungpeople
Servicesoutofschoolhoursandatweekends
ListsConsumersatisfactionquestionnaireMysteryshopper
Suitableappointmentallocationfortheneedsofyoungpeople
Sufficienttimetocarefullyassessthepresentedsymptomsanddiagnosethepatientcorrectly
Extratimefordifficultorcomplexconsultations
Convenientandflexibleappointmentschedulingforyoungpeopletravellinglongdistancesorbypublictransport
ServiceproviderquestionnaireConsumersatisfactionquestionnaireConsumersatisfactionquestionnaireMysteryshopper
Setting/Approach
Amulti-serviceapproachtakeninserviceprovisionwherearangeofservicesettingsareavailableforyoungpeople(hospitalshealthcentres,communitysettings,youthcentres,schools,telephonehelplinesetc.)
Healthservicesinconvenientlocations
Variouspointsofcontacte.g.,Healthcentresinrecreationalorsportscentres
Outreach/mobileservices
Specificallydesignatedservicesforyoungpeopleorserviceswithinatraditionalprovidersetting
SurveyoflocationofservicesDatabaseofinformationConsumersatisfactionquestionnaireSurveyoflocationofservicesMysteryshopper
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Servicesshouldbeflexible(continued)
STANDARDu PROCESSINDICATORl MEASUREMENT
PhysicalEnvironment
Thereshouldbe….. Provisionof…….. Measuredby….
Anappealing-serviceforyoungpeoplethatacknowledgesayouthcultureandrecognisestheethnicityofyoungpeopleusingservices
Appealingdecoration,displays,music,interactions,ambiencefacilitiesforinformationprovision
Surveyofpremises/facilitiesConsumersatisfactionquestionnaire
Awelcomingenvironmentforaccompanyingfriend,partnerorparent
Appropriateandappealingwaitingareasandconsultationareasforaccompanyingperson
Surveyofpremises/facilitiesConsumersatisfactionquestionnaireMysteryshopper
Varietyof
Services
Aholisticmodelofhealthadoptedinprovidinghealthcareservicesandtreatmentstoyoungpeople
Acomprehensiverangeofhealthcareservicesandtreatmentsforphysicalandmentalproblems
Healthpromotionadvice,counsellingandreferralservices
Alternativestoin-patientcare
Serviceproviderquestionnaire
Specialservicesforindividualswithspecialneeds
Aninterpreterfornon-nationals,deafetc,whenrequiredInterventionstoovercomeliteracyproblemsforinformationissuesandprescriptiondirections
ListsServiceproviderquestionnaireMysteryshopper
Anappropriateprovisionofstafffortheproblempresentedandthepatientattending
Peercounsellorsforadviceonsensitiveissues
Healthcareprofessionalsfortechnicaldiagnosisortreatmentasappropriate
Bothmaleandfemalestaffforadolescentpreferences
Trainingcertificates
List
Reviewofdocuments/servicesprovidedDatabaseofinformation
Maximumusemadeofthecontacttimewithyoungpeopletominimisemissedopportunities
Healthpromotioninformationinadditiontoathoroughassessmentofthepresentedproblem
ServiceproviderquestionnaireDatabaseofinformationConsumersatisfactionquestionnaire
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Servicesshouldprovidetraininginthecorecompetenciesforstaff
STANDARDu PROCESSINDICATORl MEASUREMENT
CoreCompetencies-
Technicalaspects
Thereshouldbe….. Provisionof…….. Measuredby….
Suitablyqualifiedandtechnicallycompetentstaffintheirareaofspecialisation,employedintheserviceeg.GP/PHN/supportstaff
Staffwhohavethebasicqualificationsrequired,asoutlinedbytherelevanttraininginstitute,topractice
Trainingcertificates
Traininginthecorecompetenciesforallstaff(includingsupportstaff),withadditionaltrainingforspecialisedstaffasappropriate
Trainingcoursesforstaffwhichincludetraininginthefollowingareas:
• Traininginthehealthworkersspecialisationarea,inrelationtothemostup-to-dateadvances,treatmentsandrecommendationsandinformationofup-to-dateservicesavailableinthearea
• Traininginthegeneraladolescentdevelopmentarea,inrelationtotheirknowledgeandawarenessofspecificadolescenthealthissuesandstagesofyoungpeople’sdevelopmentandmaturation(physical,mentalandsocial),andalsoinunderstandingthecultureandthecontextofyoungpeople’slivesparticularlyamongtheadolescentminoritygroups
• Trainingofselectedstaffforspecialneedspatientseg.Aidesforthevisuallyororallyimpaired,languageinterpreters
• Traininginthetechnicalaspectsinrelationtorunningtheserviceeg.Theappropriateuseofup-to-dateequipment,indatabaseandrecord-keeping,managementofre-orderingandcontinuousstockingofdrugs,suppliesandequipmentfortheneedsofyoungpeople
DatabaseofinformationServiceproviderquestionnaireConsumersatisfactionquestionnaireDevelopmentandpresentationofdocuments/policies/reportsTrainingcertificates
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Servicesshouldprovidetraininginthecorecompetenciesforstaff(continued)
CoreCompetencies–
technicalaspects(cont)
STANDARDu PROCESSINDICATORl MEASUREMENT
Thereshouldbe….. Provisionof…….. Measuredby….
Asysteminplacetopreventanymissedopportunitieswiththeyoungpeoplewhoattendtheservice
Guidelinesinrelationtocarryingoutanadequatepsychosocialandphysicalassessmentofyoungpeople:
• Anappropriatehistorytakenoftheyoungperson.
• Anappropriatephysicalexaminationandinvestigationsaccordingtothecasemanagementguidelines/protocols.
• Assessmentsundertakenwithconsiderationbeinggiventothecomfort/dignityandmodestyoftheadolescent.
• Acomprehensiveassessmentofyoungpeople’shealthneedsandrisksensuringthatnoopportunityismissed.
• Appropriatemedicaloptionsortreatmentsatthediscretionofthecareprovideraccordingtotheageandmaturityofthepatiente.g.,Fraser(Gillick)Principles.
Development&presentationofdocuments/policies/reports
Serviceproviderquestionnaire
Refreshercoursestokeepstaffmembersinformedandtheirskillscurrentandopportunitiesfor‘onthejob’and‘offthejob’sessionstoallowforminimumdayslost
Appropriatetrainerstogothroughtheprocedureandgivetheproviderstheopportunitytoaskquestions
Aninformalseminarweekly/fortnightlytobringclinicalquestionsforwardfordiscussionandprovideanopportunityforcolleaguestooffersupportandadviceaboutanydifficultiesstaffencounter.
Development&presentationofdocuments/policies/reports
Serviceproviderquestionnaire
CoreCompetencies–
InterpersonalRelations
Traininginappropriatecommunicationskillswhendealingwithyoungpeople,forallstaff(includingsupportstaff)asappropriate
Trainingcoursesforstaffwhichincludetraininginthefollowingareas:
• Positivecommunicationskills,provisionofapositiveandappropriateatmosphereforyoungpeople
• Positiveattitudestowardsyoungpeople(welcoming,considerate,non-judgemental,friendly,empathetic,respectful,customercare)wherethey‘seeadolescentsaspeopleandnotasaproblem’
Consumersatisfactionquestionnaire
Serviceproviderquestionnaire
TrainingCertificates
Mysteryshopping
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Servicesshouldprovidetraininginthecorecompetenciesforstaff(continued)
Recruitment
STANDARDu PROCESSINDICATORl MEASUREMENT
Thereshouldbe….. Provisionof…….. Measuredby….
Criteriabasedinterviewingintherecruitmentoftraineesorthosewhowillworkwithorsupervisestafftoworkwithyoungpeople
Appropriateselectionofstaffwhohavesomeexperienceofworkingwithyoungpeopleorwhohavethecorecompetenciesrequired(attitude,qualifications,interpersonalfactors)toworkwithyoungpeople
Reviewofdocuments/services
AnAdolescentFriendlyDevelopmentOfficerinplaceintheservice.
Amemberofstaffappointedtodevelopandoverseetheadolescentfriendlinessoftheservice
Evidenceofpolicyimplemented/actionstakenReviewofdocuments/servicesprovided
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Servicesshouldprovideyoungpeoplewithqualityinformationto
ensurethattheyarewellinformedinhealthcareaspects
STANDARDu PROCESSINDICATORl MEASUREMENT
Typeofinformation
provided
Thereshouldbe….. Provisionof…….. Measuredby….
Adequatetrainingprovidedforhealthworkersintheinformationwhichisrequiredbyyoungpeople
Traininginthefollowinginformationarea:
• Availablehealthandpersonalsupportservices
• Accessingappropriateservices• Options,rightsandentitlementsofyoung
peopleintheuseofhealthservices (e.g.Medicalcard)• Informationprovidedtoyoungpeopleabout
back-upservicesandafterhourstelephonenumbers
• Generalhealthissues,healthpromotioninformationandspecificadolescenthealthissues
• Understandingofdiagnosisandwhataction/treatmentisrequiredandwhen
• Followupinformationonfurthertreatmentsorcareetc
• Availabilityofcompleteandaccuratemedicalrecords
• Processformakingacomplaint(OmbudsmanforChildren)
DatabaseofInformationServiceproviderquestionnaireDatabaseofInformationConsumersatisfactionquestionnairesListsConsumersatisfactionquestionnairesDevelopment&presentationofdocuments/policies/reportsEvidenceofpolicyimplemented/actionstaken
Asystemwhereparentsarebriefedinrelationtoinformationandservicesofferedforyoungpeople
• Informationonadolescenthealthissuesandthetypeofservicesoffered
• Adviceforparentsinunderstandingyoungpeople’sneedsinrelationtoconfidentialservices
• Informationinrelationtotheirrightsofparentalconsent
Parentalsatisfactionquestionnaires/commentcards
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Servicesshouldprovideyoungpeoplewithqualityinformationto
ensurethattheyarewellinformedinhealthcareaspects(continued)
STANDARDu PROCESSINDICATORl MEASUREMENT
Howtheinformation
isprovided
Thereshouldbe….. Provisionof…….. Measuredby….
Anagreedformatthattheinformationprovidedtoyoungpeopleshouldtake,toincreaseitsappealandunderstandingforyoungpeople`
Informationthatis:
• Accurate• Age-appropriate• Complete• Eye-catching• Languageappropriate• Relevant• Tailoredforspecialneeds• Throughavarietyofmedia• Updated
ListsDevelopment&presentationofdocuments/policies/reportsObservationsConsultationandresearchwithyoungpeople(questionnaires,focusgroups,interviewsetc)MysteryShopper
Anopenandhonestapproachtakenintheprovisionofinformationtoyoungpeople
Appropriateaccesstomedicalrecordsshouldbeinplace,theinformationmustbecompleteandtherecordsmustbepresentintheservicefacilityatalltimes
Consumersatisfactionquestionnaires
Aninnovativeapproachtakeninprovidingyoungpeoplewithinformationandaccesstothisinformationshouldbethroughavarietyofpointsofcontact
Informationthroughattractiveandappealingmediawhichyoungpeoplefrequentlyuse:
• Interactivetools(computerbasedhealtheducationprogram,adolescentwebsites,CDROMS,DVD’s)
• Telephonehotlines(fromservicesitebytrainedcounsellors)
• Contemporarydesignedleaflets• Throughcommunitycentresorservice
centresinformationcontacts
Reviewofdocuments/servicesprovided
Consumersatisfactionquestionnaires
Aone-stop-shopapproachtoprovisionofinformationontheserviceprovided,+/orotherrelevantservices,+/orgeneralhealthinformationforyoungpeople
Aspecificdesignatedaspectoftheserviceoraservicecompletelydedicatedtoyoungpeoplethathasallyoungpeople’sinformationneeds
Consumersatisfactionquestionnaires
Serviceproviderquestionnaire
MysteryShopper
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Servicesshouldadoptapartnershipapproachwithyoungpeople
andkeystakeholders
STANDARDu PROCESSINDICATORl MEASUREMENT
YoungPeople
Thereshouldbe….. Provisionof…….. Measuredby….
Aninvolvementofyoungpeopleintheplanning,deliveryandevaluationofservices
Opportunitiesforyoungpeopletobeinvolved:
• Theplanningofservices,inrelationtohealthissuestobeaddressedandtheneedforspecificservices,e.g.,youngpeople’sviewssoughtthroughfocusgroups,representationonrelevantcommittees
• Thedeliveryofservicese.g.,throughpeer-ledapproaches,mentoring
• Theevaluationofservicesthroughe.g.,consumersatisfactionquestionnaires,representationonrelevantcommittees
• Appropriateconsultationwithestablishedgroups+/ordevelopmentofnewgroupsasrequired
Evidenceofpolicyimplemented/actionstakenConsumersatisfactionquestionnairesDevelopment&presentationofdocuments/policies/reportsFocusgroups,InterviewsServiceproviderquestionnaireDatabaseofinformation
Parents/Carers
Aninvolvementofparents/carersintheplanning,deliveryandevaluationofservicesasappropriate
Opportunitiesforparents/carerstobeinvolvedin:
• Theplanningofservices,inrelationtoinformationprovidedtoyoungpeoplee.g.,throughrepresentationonrelevantcommittees
• Theevaluationofservicese.g.,throughparentalsatisfactionquestionnaires
Parentalsatisfactionquestionnaires/commentcardsFocusgroups/interviews
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Servicesshouldadoptapartnershipapproachwithyoungpeople
andkeystakeholders(continued)
STANDARDu PROCESSINDICATORl MEASUREMENT
HealthProfessionals/
RelevantAgencies
Thereshouldbe….. Provisionof…….. Measuredby….
Aninvolvementofdiversehealthprofessionals(inlinewithanholisticapproachtohealth)intheplanning,deliveryandevaluationofservices
Opportunitiesforhealthprofessionalstobeinvolvedin:
• Theplanningofservicesandhowinformationisdisseminatedfromhealthprofessionaltohealthprofessionalaboutnon-compliantyoungpeoplewithattendanceandmedication
• Thedeliveryofserviceswherereferralprotocolsareinplacetoensureamultiagency/multidisciplinaryapproachisadoptedinthetransitionorcontinuityofcarewithin(paediatrictoadultcare)andbetween(departments,disciplinesandservices)services
• Theevaluationofservices
Evidenceofpolicyimplemented/actionstakenDatabaseinformationConsumerreportsServiceproviderquestionnaireDevelopment&presentationofdocuments/policies/reports
Alliancesestablishedwithotherrelevantorganisationse.g.,localschools,youthorganisations
Opportunitiesforotherrelevantorganisationstobeinvolvedin:
• Theplanningofservicesandawarenessraisingofhealthprogrammesandhealthservicesavailablelocally
• Thedeliveryofservicesandopportunitiesforjointtrainingofstaffasappropriate
Development&presentationofdocument/policies/reports
Serviceproviderquestionnaire
ResearchinAdolescentHealth
Anevidencebasedpracticeimplementedintheservice
Evidencebasedplanninginrelationtoadolescenthealthneeds
Opportunitiesforinvolvementinresearch
Development&presentationofdocument/policies/reports
Serviceproviderquestionnaire
Amultidisciplinary/multi-agencyapproachtakeninthetrainingofstaffasappropriate
Opportunitiesfortheinvolvementofhealtheducators,guidancecounsellors,teachers,schooladministrators,familycourtjudges,staffinyouthorientedcommunityprogrammes
Databaseofinformation
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Servicesshouldbestructuredsothattheconfidentiality
andprivacyoftheyoungpersonisrespected
STANDARDu PROCESSINDICATORl MEASUREMENT
Physical/Structural
Thereshouldbe….. Provisionof…….. Measuredby….
Anenvironmentrespectfultoconfidentiality
Purposebuiltspacesthatfacilitateadolescentconfidentialityensuringthat
• Otherpeoplequeuingcannotoverhearwhatisbeingsaid
• Otherpeopledonotwalkinandoutduringtheexamination
• Theadolescentisaskedfortheirconsent(andallowedtorefuse)ifmedicalstudentsaretoobserve
• Anadolescentwhoneedstoundresscandosoinprivateandthattheprivacyoftheadolescentisrespectedduringtheexamination
• Confidentialinformationiscommunicatedinaprivatemannerthroughdirectcontact,bytelephoneorelectronically
ConsumersatisfactionquestionnaireServiceproviderquestionnaireSurveyofpremisesMysteryshopper
Appropriate,userfriendlysignagethroughoutthepremises
Internalandexternalsignpostingofservices,andspecificaspectsofservicesinauserfriendlyformatthroughappropriatetextandvisualdesignsandtheuseofgenericterms(non-stigmatic)
SurveyofpremisesMysteryshopper
Staff
Anon-judgementalapproachtakenbystaffindealingwithyoungpeople/Staffshouldbetrainedtorespecttheconfidentialityofyoungpeople
Stafftrainingdealingwithconfidentialityissuesandpractices
TrainingcertificatesServiceproviderquestionnaires
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FurtherResources Furtherinformationonresources,toolkitsandguidanceonbestpracticefordeliveryofyoungpeoplefriendlyservices
GeneralResources
Australia
Bartik,W.,Maple,M.,MasseyP.,(2001)YouthFriendlinessAssessmentToolNewEnglandAreaHealthService,NSWAU. http://www.ruralhealth.org.au
TheAustralianYouthFriendlinessAssessmentTool(Y-FAT)wasdesignedtoprovideareviewmethodforHealthServicesintheNewEnglandAreaontheissueofimprovingyouthhealth.Itidentifiesthekeyareasofyouthhealthforahealthservicetobereviewedagainstwiththesebroadlygroupedintoaccess,physicalenvironmentandhealthservicepolicy.Italsocontainsaresourcesectiontoprovideideasofhowthehealthservicecanbeimprovedtohaveapositiveimpactonthehealthofyoungpeopleinthearea.Thekeyareashavebeendesignedtobeachievableratherthansuggestinghigh-costalternativesthatmayneverbeimplemented.Thetoolkitalsoincludesaselfassessmentyouthfriendliness(SAY)checklisttoassessserviceprovidersyouthfriendliness.WithmodificationthismightbeadaptedtotheIrishcontextasaperformanceindicatortomeasuresomeofthestaffingstandards.
England
TheDepartmentofHealth(2005)You’reWelcomequalitycriteria–Makinghealthservicesyoungpeoplefriendly.London,DeptofHealthwww.dh.gov.uk
TheYou’reWelcomeQualityCriteriasetoutprinciplestohelphealthservices(includingnon-NHSprovision)becomeyoungpeoplefriendly.Itcoversareastobeconsideredbycommissionersandprovidersofhealthservices.Contentisbasedonexamplesofeffectivelocalpractice.
RoyalCollegeofGeneralPractitionersandRoyalCollegeofNursing(2002)GettingitRightforTeenagersinYourPracticeLondon,DeptofHealth
www.rcn.org.uk
Theaimoftheleafletisfortheprofessionalorganisationstoencouragetheirmemberstoimproveyoungpeople’saccesstoadviceonarangeofhealthissues,includingpregnancyandsexualhealth.ThisshortdocumentincludesaquizHowdoesyourpractice‘score’withteenagers?whichmightbeausefulnon-threateningtoolforengagingserviceproviders.
RoyalCollegeofNursing(2004)AdolescentTransitionCare–RCNGuidanceforNursingStaffLondon:RoyalCollegeofNursing.
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SexualHealthResources
InternationalResources
IPPF/WHR(20O5)MakingservicesyouthfriendlywithlimitedresourcesSpotlightonYouth(Jan2005) http://www.ippfwhr.org
PathfinderInternational(2003)ClinicassessmentofYouthFriendlyServices:AToolforRapidAssessmentandImprovingReproductiveHealthforYouthWatertown,MA:PathfinderInternational
www.pathfind.org/publications
Nelson,K.,MacLaren,L.,Magnani,R.(2000)AssessingandPlanningYouth-FriendlyReproductiveHealthServicesFocusToolSeries2:JanuaryWashington,DC
http://www.futuresgroup.com Thistoolkitwasdesignedtohelpprogrammanagersassesstheextenttowhichtheirfacilityisalreadyreachingyouth,andwhat
characteristicsoftheirprogramdiscourageyoungpeoplefromaccessingservices.Theguideincludesworkbooks,datacollectiontools&instrumentsandplanningworkbooks.
Thistoolhelpsprogrammemanagersandcliniciansdeterminetheextenttowhichcurrentreproductivehealthservicesareyouth-friendly.Resultsfromthetoolcanbeusedtotailorservicestobettermeettheneedsandpreferencesofyoungpeople.
http://www.pathfind.org
COPE®,whichstandsfor“client-oriented,provider-efficient”services,isaprocessthathelpshealthcarestaffcontinuouslyimprovethequalityandefficiencyofservicesprovidedattheirfacilityandmakeservicesmoreresponsivetoclients’needs.COPEprovidesstaffwithpractical,easy-to-usetoolstoidentifyproblemsanddevelopsolutionsusinglocalresources,anditencouragesalllevelsofstaffandsupervisorstoworktogetherasateamandtoinvolveclientsinassessingservices.ThroughCOPE,staffdevelopacustomerfocus,learningtodefinequalityinconcretetermsbyputtingthemselvesintheirclients’shoes.Theprocessalsoenablesstafftoexplorethestrengthsoftheirworksite.
http://www.engenderhealth.org
AGuidetoMonitoringandEvaluatingAdolescentReproductiveHealthPrograms AdamchakS,BondK,MaclarenL,MagnaniR,NelsonK,SeltzerJ(2000)FocusonYoungAdultsTool(part1andpart2) http://www.pathfind.org
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DataCollectionandMeasurementTools
Outlinedbelowisalistofdifferentdatacollectioninstrumentsthatmightbeusedtomeasurestandards
1 ConsumerSatisfactionQuestionnaires 2 ParentalSatisfactionQuestionnaires/CommentCards 3 ServiceProviderQuestionnaire 4 Surveyoflocationofservices 5 SurveyofFacilitiesandPremises 6 AuditsofTraining/Accreditation 7 Databases 8 Consumerreports 9 Lists 10 Developmentandpresentationofdocuments/policies/report 11 Evidenceofpolicyimplementation 12 MysteryShopper 13 ReviewofDocumentsandServices
FurtherinformationandguidanceonthedevelopmentandimplementationofconsumersatisfactionsurveysandotherdatacollectionmethodsisavailableintheHealthBoardsExecutive(2003)PatientSatisfactionSurveys–Guidelines
http://www.hebe.ie
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Appendix1-FeasibilityStudy Thefeasibilitystudy,undertakenbyanindependentresearchconsultant,consistedoftwodistinctstages.Stageoneofthestudyinvolved
interviewswithserviceprovidersfromthreedistinctadolescenthealthservicesacrossthecountry.Thefirstservice,locatedinStJames’HospitalDublin,isanestablishedadolescentsexualhealthservicedeliveredaspartoftheadultGUIDE(sexualhealth)clinic.Thisdrop-inserviceisdeliveredbyamulti-disciplinaryonaweeklybasis.Aspartofthefeasibilitystudytheresearchermetwiththenursepractitionertotalkherthroughthetoolandtodescribethedifferentqualitydimensions,thestandardsandassociatedperformanceindicatorswithinthetool.ThenursepractitionerthendistributedacopyofthedraftAFQuATtohercolleagues.Afterasixweekperiod,theresearcherinterviewedfivemembersoftheteamusingsemi-structuredinterviewstoexploretheirviewsonthetool,andtoidentifyitsstrengthsandweaknesses,andthepotentialusesofthetool.
Thesecondteamofproviders,locatedinLetterkennyRegionalHospital,weredevelopinganewtransitionserviceforyoungpeoplemakingthemovefromapaediatricdiabetescareservicetotheadultdiabetescareservice.Theresearchermetamemberofthediabetescareteam(diabetesnurse)priortothedevelopmentoftheservicetodescribeanddescribethelongversionoftheAFQuAT.ThediabetesnurseinturnpresentedthedraftAFQuATtothediabetescareteamwhousedittodesigntheservice.Afterashortperiodthetransitionservicewasestablishedanddeliveredbyamulti-professionalteamonabi-monthlybasis.Afterthefirsttwoclinicstheresearcherinterviewedthetwodiabetesnursespecialiststoexploretheirviewsonthetool,andtoidentifythestrengthsandweaknessofthetoolinguidingthedevelopmentofanewservice,aswellasthepotentialusesofthetool.Inaddition,theresearcherconductedaninterview-administeredsurveywiththeyoungpeopleattendingtheclinicandtheirparents.Thequestionnaireexploredtheserviceusers’viewsonthesixqualitydimensionsusingexamplesfromthestandardsprovidedintheAFQUaT.
Thethirdserviceinthefeasibilitystudyisacommunitybasedyouthcafé(TheGaf)locatedinGalwaycity.Theserviceprovidesyoungpeoplewithopportunitytorelaxinasafeenvironmentwithdirectaccesstovariousservicessuchashealthadvice,peereducation,andmentoring.ThenursepractitionerfromthecentreagreedtoreviewtheAFQUaTandtoprovidefeedbackonthetool.Afterreceivinganelectronicversionofthetool,thenursepractitionerwasinterviewedusingasemi-structuredinterviewcoveringdifferentelementsofthetoolincludingherinitialresponsetotheAFQUaT,herviewsonthestrengthsandweaknessofthetool,andpossibleopportunitiestousethetoolwithinacommunitybasedyouthservice.
Afterthecompletionofallinterviewstheresearchercompletedathematicanalysisoftheresponsesfromthethreeservices.ThethemesfromthefeedbackincludedconcernsaboutthepresentationoftheAFQUaT(includinglayout,language,structure),thestrengthsandweaknessofthetool,andthepotentialusesforthetool.Allrespondentsalsohighlightedthechallengesandobstaclesexperiencedbyserviceprovidersinthedeliveryofadolescentfriendlyservices.Inresponsetothefeedbackonthepresentationofthetool,theresearchermadeanumberofamendmentstotheAFQUaTincludingpresentation(colourcoding)andlanguagechanges.InresponsetofeedbackcommentsonthelengthandlevelofdetailoftheAFQUaT,andtooneserviceprovider’ssuggestionsforthedevelopmentofashorterversion,theresearcherdevelopedashorterchecklistversionofthetool.
Thesecondstageofthefeasibilitystudyinvolvedaworkshopwithacross-sectionofprofessionalsinvolvedintheplanning/development,and/ordeliveryofadolescentservices.WorkshopparticipantsreceivedacopyoftheAFQUaTandtheshorterchecklistversioninadvanceofthemeeting.Attheworkshopparticipantsweretalkedthroughbothinstrumentsandwereaskedfortheirfeedbackonbothinstruments.Followingthemeeting,additionalchangesweremadetoboththeshortandlongerversionofthetool.Throughoutthetwostagesofthefeasibilitystudytheresearcherconductedinternetandliteraturesearchesforothernationalandinternationalexamplesoftoolsandbestpracticeinthedeliveryofadolescenthealthservices.
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ReferenceSection 1KangM,BernardD,UsherwoodT,QuineS,AlpersteinG,Kerr-RoubicekH,ElliottA&BennettD(2005). BetterPracticeinYouthHealth:Finalreportontheresearchstudy:AccesstohealthcareamongyoungpeopleinNewSouthWales: Phase2.NSWCentrefortheAdvancementofAdolescentHealth,TheChildren’sHospitalatWestmead. 2Bartik,W.,Maple,M.,MasseyP.,(2001)YouthFriendlinessAssessmentToolNewEnglandAreaHealthService,NSWAU. http://www.ruralhealth.org.au 3BurkeS(1999)YouthasaResource-PromotingtheHealthofYoungPeopleatRisk,DepartmentofHealth&Children,1999 4NorthWesternHealthBoard(2003)Alittlebitofrespect–consultationwithyoungpeopleparentsandprofessionals intheNorthWest GallagherK(2004)InvolvingYoungPeople–YourTurn,YourSay,YourService–SlainteAreporttoNWHBChildren’sServices
Planning 5YouthHealth(2002)AGuidetoAction,MinistryofHealthNewZealand,http://www.moh.govt.nz
6TheOpenDoor(1997)AProjectonYouthFriendlyCommunities,http://griffin.multimedia.edu/~mccreary 7Wilson,C.J.Fogarty.K.,Deane,F.P.(2002)TheEssentialYouthFriendlyGPkit:AnevidencebasedresourcetoincreaseGP
competencesfordealingwithyoungpeople.ProceedingsforYouthinMindConference,NationalAllianceofGeneralPractice,Brisbane,Australia.
http://www.uow.edu.au 8PathfinderInternational(2003)ClinicassessmentofYouthFriendlyServices:AToolforRapidAssessmentandImproving
ReproductiveHealthforYouthWatertown,MA:PathfinderInternational www.pathfind.org/publications 9TheDepartmentofHealth(2005)You’reWelcomequalitycriteria–Makinghealthservicesyoungpeoplefriendly.London,Deptof
Health, RoyalCollegeofGeneralPractitionersandRoyalCollegeofNursing(2002)GettingitRightforTeenagersinYourPracticeLondon, DeptofHealth RoyalCollegeofNursing(2004)AdolescentTransitionCare–RCNGuidanceforNursingStaffLondon:RoyalCollegeofNursing 10TheTASCAgency(2003)AllIwantReporttoHealthyRespectHealthDemonstrationProjectEdinburgh