Coaching in an Acute Pediatric Setting: A Qualitative Approach to Understanding the Perspectives of Occupational Therapists

Abstract

Aims

To identify barriers and enablers to implementing coaching in acute pediatric settings from the perspective of occupational therapists and develop an implementation plan to address the identified barriers at a large metropolitan hospital.

Methods

Participatory Action Research was used, and two stages of focus groups were conducted with 17 occupational therapists working in an acute pediatric hospital. Reflexive thematic analysis was employed for data analysis.

Results

Stage one themes; (1) Lack of clarity around coaching definition, (2) Acute setting barriers to coaching, (3) Family acceptance and appropriateness, and (4) Enablers for coaching. Stage two themes; (1) Addressing skepticism about coaching, (2) Logistics and approvals, and (3) Implementation strategies for coaching. In Stage Two, participants and researchers developed an implementation plan.

Conclusion

Occupational therapists perceived coaching as hard to implement in acute pediatric settings due to acuity of caseloads and traditional medical models. The six-step implementation plan aims to enhance therapist knowledge and motivation as well as reduce environmental barriers, with the aim of embedding coaching into acute pediatric settings.

Keywords:

• Acute
• children
• coaching
• hospital
• occupational therapy
• pediatrics

Acknowledgements

The authors would like to acknowledge the contribution of Denise Luscombe and her support and guidance throughout the research. The authors would like to acknowledge the occupational therapists from Perth Children’s Hospital who participated in this study. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

Ethics approval was obtained from the Child and Adolescent Health Service, Safety and Quality Department (Quality Improvement #39181). Reciprocal ethics was obtained from Curtin Human Research Committee (HRE2021-0058). All participants provided written, informed consent.

Author contributions

MH, ST, PXL, TCSW, PYBN, HCCY, IP, JC contributed to the design of the study. PXL, TCSW, PYBN, HCCY collected the data. MH, ST, PXL, TCSW, PYBN, HCCY analyzed the data. MH, ST, PXL, TCSW, PYBN, HCCY wrote the manuscript. IP, JC reviewed and edited the manuscript. All authors read and approved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Pei Xuan Lee

Pei Xuan Lee Pei is an Occupational Therapy Honors student at Curtin University. She completed several practical placements in the area of pediatrics whilst studying her degree. She has also completed volunteer work with children with disabilities and led holiday occupational therapy programs for children.

Tsz Ching Sabrina Wong

Tsz Ching Sabrina Wong is an Occupational Therapy Honors student at Curtin University. She completed several practical placements whilst studying her degree. She has also completed volunteer work in the pediatric ward in a hospital in Hong Kong.

Pei Yun Beatrice Ng

Pei Yun Beatrice Ng is a new graduate Occupational Therapist. She previously worked as a support worker to provide support for a child on the autism spectrum. She has also completed volunteer work supporting children with disabilities.

Hau Ching Camilla Yuen

Hau Ching Camilla Yuen is a new graduate Occupational Therapist. She has completed a number of practical placements in the area of pediatrics. She has completed volunteer work with children with disabilities, including a coding program for children on the autism spectrum. She also worked as a support worker to provide support to the children with special needs.

Isabelle Pontre

Isabelle Pontre has worked as a pediatric Occupational Therapist for 10 years. Isabelle has previously been based in the community setting, and now works primarily within Pediatric Rehabilitation at the Perth Children’s Hospital. Isabelle works in Spinal Rehabilitation and Acquired Brain Injury, and has also worked extensively in Early Intervention. Isabelle has been involved in several Quality Improvement projects in various areas of the hospital and sees the importance of these in improving the quality and effectiveness of the services and interventions provided within the hospital.

Joanna Craig

Joanna Craig has worked as an Occupational Therapist across community and acute settings, including Child and Adolescent Mental Health Services (CAMHS), private practice pediatrics, adult hospital and pediatric hospital settings. Joanna has been in her current role at Perth Children’s Hospital since 2012 and has worked across a range of clinical areas including Infants and Neonates, Complex Airway Team, Oncology and Hematology, General Medicine and Early Intervention. Joanna is passionate about utilizing her training and skills in infant mental health, child development, infant feeding and developmental care to support families with their journey through the hospital system. Joanna is committed to evidence-based practice, ongoing professional development and quality improvement as part of her role as an Occupational Therapist.

Susan Taylor

Susan Taylor, PhD, has been an Occupational Therapist in the area of hospital-based research since 2012. Susan has developed outcome measures for somatosensory function and guidelines for sensory evaluation in children with neurological conditions, provided research capacity building opportunities for frontline clinical staff, and validated outcome domains for the measurement of health, wellbeing and quality of life in aged care. Over the past 10 years she has worked in senior research positions embedded within hospital and community organizations to inform healthcare decision making. Susan currently works as the Occupational Therapy Research Coordinator at Perth Children’s Hospital, Senior Policy Officer at the Western Australian Department of Health, and as a University Associate, School of Allied Health, Curtin University. The combination of roles allows Susan to be at the forefront of pressing issues in health care. Susan’s career purpose is to facilitate consumer directed policy relevant research in healthcare for people across the lifespan and find solutions that benefit all stakeholders.

Megan Hatfield

Megan Hatfield, PhD, is a Teaching and Research Academic at Curtin University in the Curtin School of Allied Health. Megan has a passion for research in the areas of pediatric occupational therapy, including topics such as mindfulness, autism, transition planning, self-regulation, assistance dogs, and coaching. Megan developed the Better OutcOmes for Successful Transitions for Autism (BOOST-A) program, one of the first autism specific online transition planning tools to support adolescents to prepare for leaving school. Megan is a registered Occupational Therapist, who has experience working in the disability sector, specializing in supporting children to participate in home, community, and school environments. Megan teaches pediatrics for the undergraduate and graduate entry masters Occupational Therapy courses.