The Children’s Hospital at Westmead’s multidisciplinary feeding clinic uses videoconferencing to provide care, remotely, to children across NSW with various feeding difficulties. This Spotlight on Virtual Care report demonstrates how virtual care has enabled better care provision than in-person appointments, with children able to demonstrate natural behaviours in their home environment. The complementary Spotlight on Virtual Care short film showcases the enhanced patient and clinical experiences, as well as outlining the system benefits of the remote feeding clinic for the Sydney Children’s Hospitals Network (SCHN).
Complex feeding difficulties, such as swallowing incoordination, oral motor and sensory problems, or those experienced during the transition from non-oral to normal feeding patterns, can impact a child’s growth, oral motor skills and nutritional wellbeing. It is important to diagnose and treat these issues in a timely manner to support a child’s developmental outcomes. Aligned with the first 2,000 days framework, early treatment and diagnosis has been shown to positively impact life experiences well beyond developmental years.
In some circumstances, the expertise required to diagnose and treat feeding difficulties can be accessed locally through allied health professionals, general practitioners (GPs), paediatricians and child and family health nurses. When this is not available or when children are faltering in their development, referral to the specialist multidisciplinary service may be required.
SCHN offers feeding and dysphagia services at both The Children’s Hospital at Westmead and Sydney Children’s Hospital, Randwick to manage ongoing feeding concerns that cannot be addressed locally. Children may be referred from across NSW to either the Westmead or Randwick service, based on the referring clinician’s location and parent or guardian preference.
The feeding and dysphagia service at The Children’s Hospital at Westmead, is made up of three outpatient clinics:
- multidisciplinary feeding clinic
- dysphagia and nutrition clinic
- feeding service – speech pathology
This report focuses on the multidisciplinary feeding clinic, supporting patients with feeding difficulties associated with medical conditions such as cardiac, renal and mild-to-moderate disability. The multidisciplinary team provides assessments of feeding and nutrition, treatment consultations and reviews, with input from a paediatrician, speech pathologist and dietitian. The care includes feeding observations, which previously required parents or guardians to prepare and transport food for their child to take part in the examination at Westmead.
In March 2020, the multidisciplinary feeding clinic transitioned all consultations to virtual delivery to mitigate the risks of COVID-19 transmission, as well as adhere to physical distancing restrictions.
Offering care virtually enhanced the timeliness and accessibility of the service and improved the quality of care. Observing children in their own home, eating familiar food in a natural environment, increased the reality of observations and accuracy of assessments. Virtual care also minimised disruption to the lives of children and their families.
Following the success of virtual delivery, the multidisciplinary feeding clinic continues to offer this modality, with two thirds of consultations taking place virtually.
The service overview in this document summarises elements of the virtually-delivered consultations. Some elements are applicable across specialties and are not specific to a paediatric setting. Virtual care in a consumer’s home enables clinicians to see the home environment, enhancing care across a number of specialities.