The Living Independently and Fully Engaged (LIFEspan) clinic is a coordinated, client-centred service delivery model spanning pediatric and adult rehabilitation services run in partnership between Holland Bloorview Kids Rehabilitation Hospital and the Toronto Rehabilitation Institute. A key feature of the LIFEspan clinic is a multi-disciplinary clinical team consisting of a nurse practitioner, life skills coach, social worker, and youth facilitator with cross-appointments at the pediatric and adult hospitals. As the LIFEspan clinic reached its 10-year milestone in 2018, the clinic undertook an exploratory rapid redesign project from October 2018 to March 2019 to review and enhance existing transition-support services. The rapid redesign framework involves implementation of new ideas in a short period of time, tracking of trials and errors, and continuous discussion and reflection on progress and challenges. Based on feedback from LIFEspan clients, families, and staff four innovative ideas were implemented during the rapid redesign period: 1) pre-appointment phone calls to clients and families; 2) generative questions informed by a Solution-Focused Coaching approach; 3) referrals to free legal services (a Pro Bono lawyer) at Holland Bloorview; and 4) appointments held via the Ontario Telemedicine Network (OTN). A robust mixed-methods formative evaluation was conducted to document client, family, and staff experiences of the 20-week rapid redesign. As a team and with clients and families, we integrated and refined new service delivery ideas and developed recommendations to improve the LIFEspan service for clients and families.
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