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Providing value-added care for individuals with autism

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Dr. Donna Murray, director of Clinical Services, and co-director of the Division of Developmental and Behavioral Pediatrics at the Kelly O’Leary Center for Autism Spectrum Disorders in Cincinnati, OH, spent a busy afternoon with the faculty and staff of the MU Thompson Center last Thursday, February 17. While small group discussions consumed most of her afternoon visit, Murray completed her visit with a presentation about the Kelly O’Leary Center’s recent journey toward quality improvement in the delivery of treatment for individuals with autism.

The Kelly O'Leary Center for Autism Spectrum Disorders at Cincinnati Children's Hospital Medical Center is a collaborative parent and professional program that provides diagnostic, treatment and support services. It was established when families advocated for a response to the needs of children with autism and their families. The makeup of the center was determined largely by family input. Based in the Division of Developmental and Behavioral Pediatrics at Cincinnati Children's, the center opened in 1999. When the center first opened, the demand for autism diagnosis and treatment was growing and providers at the center found it hard to keep up.

Murray says, “Many families told us that it was almost worse that they knew about the clinic and that the clinic did good things because they couldn’t get into the clinic for services.”

With this in mind, the center’s leadership and staff sought the help of consultants to reorganize the way they deliver services so that individuals with autism spectrum disorders (ASD) would have greater access to services.

“We had to rethink our service model.” Murray says. “The way we were delivering treatment wasn’t keeping up with the increase in diagnosis. We were using the traditional model of one doctor and one patient, rather than the newer model of an interdisciplinary team.”

To make the new model work, Murray and her colleagues chose to replace their traditional practice of scheduling one patient with one doctor with 12 week therapeutic. These sessions include an individual evaluation of the child’s needs at that time, appropriate group intervention, periodic consultative treatments and referral to appropriate therapists. After the session is complete, the child “graduates” from the groups and other therapies they are receiving and is re-evaluated to determine what, if anything, they need next.

“This program makes visits ‘value added’,” says Murray.

The 12-week sessions have allowed the clinic to increase the number of individuals who access the clinic by 25%.

“We have increased access while maintaining quality,” Murray adds.

While the program shift has been a successful one, implementing the new model of service hasn’t been easy.

Says Murray of the transition, “Sometimes, it is hard to get families used to the 12-week model.”

She also noted that reorganizing the schedule to accommodate the model change took time and commitment.

“But, it was worth it.” She added.

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