adolescent friendly quality assessment tools [afquats] · ms majella doherty, regional child and...

Adolescent Friendly QualityAssessment Tools [AFQuATs]

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

design x LERMAGH :: www.lermagh.com

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

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.

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

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.

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

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.

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? √

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

TheTools

Form1 ADOLESCENTFRIENDLYQUALITYCHECKLISTTOOLA(AFQuATA)

Service name:

Quality Project Team Members:

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

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)

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

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

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:

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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

*MysteryShopperisameasurementtoolexplainedindetailinFurtherResources–DataCollection&MeasurementTools

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Servicesshouldbeaccessible(continued)

Physical/Structural

Environment

Thereshouldbe….. Provisionof…….. Measuredby….

Appropriatefacilitiesavailableforusebythephysicallydisabled

Wheelchairfriendlypremisesbothexternally(entrance,exitandparking)andinternally(doorways,toilets,lifts)

Surveyofpremises/facilitiesConsumersatisfactionquestionnaireMysteryshopper

Adequatespaceandcomfortableconditionsinwaitingareas

Largeareasforwaiting,appropriateventilation,heating,lighting,seating,refreshmentsetc.

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

Administration

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

Servicesshouldbeflexible(continued)

PhysicalEnvironment

Anappealing-serviceforyoungpeoplethatacknowledgesayouthcultureandrecognisestheethnicityofyoungpeopleusingservices

Appealingdecoration,displays,music,interactions,ambiencefacilitiesforinformationprovision

Surveyofpremises/facilitiesConsumersatisfactionquestionnaire

Awelcomingenvironmentforaccompanyingfriend,partnerorparent

Appropriateandappealingwaitingareasandconsultationareasforaccompanyingperson

Varietyof

Services

Aholisticmodelofhealthadoptedinprovidinghealthcareservicesandtreatmentstoyoungpeople

Acomprehensiverangeofhealthcareservicesandtreatmentsforphysicalandmentalproblems

Healthpromotionadvice,counsellingandreferralservices

Alternativestoin-patientcare

Serviceproviderquestionnaire

Specialservicesforindividualswithspecialneeds

Aninterpreterfornon-nationals,deafetc,whenrequiredInterventionstoovercomeliteracyproblemsforinformationissuesandprescriptiondirections

ListsServiceproviderquestionnaireMysteryshopper

Anappropriateprovisionofstafffortheproblempresentedandthepatientattending

Peercounsellorsforadviceonsensitiveissues

Healthcareprofessionalsfortechnicaldiagnosisortreatmentasappropriate

Bothmaleandfemalestaffforadolescentpreferences

Trainingcertificates

Reviewofdocuments/servicesprovidedDatabaseofinformation

Maximumusemadeofthecontacttimewithyoungpeopletominimisemissedopportunities

Healthpromotioninformationinadditiontoathoroughassessmentofthepresentedproblem

ServiceproviderquestionnaireDatabaseofinformationConsumersatisfactionquestionnaire

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Servicesshouldprovidetraininginthecorecompetenciesforstaff

CoreCompetencies-

Technicalaspects

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)

Asysteminplacetopreventanymissedopportunitieswiththeyoungpeoplewhoattendtheservice

Guidelinesinrelationtocarryingoutanadequatepsychosocialandphysicalassessmentofyoungpeople:

• Anappropriatehistorytakenoftheyoungperson.

• Anappropriatephysicalexaminationandinvestigationsaccordingtothecasemanagementguidelines/protocols.

• Assessmentsundertakenwithconsiderationbeinggiventothecomfort/dignityandmodestyoftheadolescent.

• Acomprehensiveassessmentofyoungpeople’shealthneedsandrisksensuringthatnoopportunityismissed.

• Appropriatemedicaloptionsortreatmentsatthediscretionofthecareprovideraccordingtotheageandmaturityofthepatiente.g.,Fraser(Gillick)Principles.

Development&presentationofdocuments/policies/reports

Refreshercoursestokeepstaffmembersinformedandtheirskillscurrentandopportunitiesfor‘onthejob’and‘offthejob’sessionstoallowforminimumdayslost

Appropriatetrainerstogothroughtheprocedureandgivetheproviderstheopportunitytoaskquestions

Aninformalseminarweekly/fortnightlytobringclinicalquestionsforwardfordiscussionandprovideanopportunityforcolleaguestooffersupportandadviceaboutanydifficultiesstaffencounter.

Development&presentationofdocuments/policies/reports

CoreCompetencies–

InterpersonalRelations

Traininginappropriatecommunicationskillswhendealingwithyoungpeople,forallstaff(includingsupportstaff)asappropriate

Trainingcoursesforstaffwhichincludetraininginthefollowingareas:

• Positivecommunicationskills,provisionofapositiveandappropriateatmosphereforyoungpeople

• Positiveattitudestowardsyoungpeople(welcoming,considerate,non-judgemental,friendly,empathetic,respectful,customercare)wherethey‘seeadolescentsaspeopleandnotasaproblem’

Consumersatisfactionquestionnaire

TrainingCertificates

Mysteryshopping

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Servicesshouldprovidetraininginthecorecompetenciesforstaff(continued)

Recruitment

Criteriabasedinterviewingintherecruitmentoftraineesorthosewhowillworkwithorsupervisestafftoworkwithyoungpeople

Appropriateselectionofstaffwhohavesomeexperienceofworkingwithyoungpeopleorwhohavethecorecompetenciesrequired(attitude,qualifications,interpersonalfactors)toworkwithyoungpeople

Reviewofdocuments/services

AnAdolescentFriendlyDevelopmentOfficerinplaceintheservice.

Amemberofstaffappointedtodevelopandoverseetheadolescentfriendlinessoftheservice

Evidenceofpolicyimplemented/actionstakenReviewofdocuments/servicesprovided

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Servicesshouldprovideyoungpeoplewithqualityinformationto

ensurethattheyarewellinformedinhealthcareaspects

Typeofinformation

provided

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

��

Servicesshouldprovideyoungpeoplewithqualityinformationto

ensurethattheyarewellinformedinhealthcareaspects(continued)

Howtheinformation

isprovided

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

Aone-stop-shopapproachtoprovisionofinformationontheserviceprovided,+/orotherrelevantservices,+/orgeneralhealthinformationforyoungpeople

Aspecificdesignatedaspectoftheserviceoraservicecompletelydedicatedtoyoungpeoplethathasallyoungpeople’sinformationneeds

MysteryShopper

��

Servicesshouldadoptapartnershipapproachwithyoungpeople

andkeystakeholders

YoungPeople

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

��

Servicesshouldadoptapartnershipapproachwithyoungpeople

andkeystakeholders(continued)

HealthProfessionals/

RelevantAgencies

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

ResearchinAdolescentHealth

Anevidencebasedpracticeimplementedintheservice

Evidencebasedplanninginrelationtoadolescenthealthneeds

Opportunitiesforinvolvementinresearch

Development&presentationofdocument/policies/reports

Amultidisciplinary/multi-agencyapproachtakeninthetrainingofstaffasappropriate

Opportunitiesfortheinvolvementofhealtheducators,guidancecounsellors,teachers,schooladministrators,familycourtjudges,staffinyouthorientedcommunityprogrammes

��

Servicesshouldbestructuredsothattheconfidentiality

andprivacyoftheyoungpersonisrespected

Physical/Structural

Anenvironmentrespectfultoconfidentiality

Purposebuiltspacesthatfacilitateadolescentconfidentialityensuringthat

• Otherpeoplequeuingcannotoverhearwhatisbeingsaid

• Otherpeopledonotwalkinandoutduringtheexamination

• Theadolescentisaskedfortheirconsent(andallowedtorefuse)ifmedicalstudentsaretoobserve

• Anadolescentwhoneedstoundresscandosoinprivateandthattheprivacyoftheadolescentisrespectedduringtheexamination

• Confidentialinformationiscommunicatedinaprivatemannerthroughdirectcontact,bytelephoneorelectronically

ConsumersatisfactionquestionnaireServiceproviderquestionnaireSurveyofpremisesMysteryshopper

Appropriate,userfriendlysignagethroughoutthepremises

Internalandexternalsignpostingofservices,andspecificaspectsofservicesinauserfriendlyformatthroughappropriatetextandvisualdesignsandtheuseofgenericterms(non-stigmatic)

SurveyofpremisesMysteryshopper

Anon-judgementalapproachtakenbystaffindealingwithyoungpeople/Staffshouldbetrainedtorespecttheconfidentialityofyoungpeople

Stafftrainingdealingwithconfidentialityissuesandpractices

TrainingcertificatesServiceproviderquestionnaires

��

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.

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

��

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

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