No one likes having to scramble to coordinate a ton of appointments and find all the medical help they need. This is what motivated the Dre Sara Long-Gagné, pediatrician at the Montreal Children’s Hospital, to put together a team that helps families navigate the complexities of the health care system. We speak with her about the genesis and achievements of the Intermediate Complexity Coordination and Navigation Service (CONCI).
CONCI is a support service for parents of young patients who have multiple health problems, but who do not benefit from the comprehensive care already offered by the Complex Care Department of the Montreal Children’s Hospital, reserved for the most severe cases. For the Dre Sara Long-Gagné and her mentor, Dr.re Hema Patel, who heads the division of general pediatrics, it was illogical to ask the families of these “intermediate cases” to follow up with three, four, five specialist doctors, or even more, and to obtain the results themselves. access to the various services from which children could benefit.
A service like CONCI is a game-changer for families. Imagine that you have a five-year-old child with multiple disabilities who must be followed by a nephrologist, a neurologist, a surgeon, a pediatrician, an occupational therapist, a physiotherapist and nurses, all several times a month.
“Before the creation of CONCI, services were offered in silos for moderately complex cases, which meant that everything rested on the shoulders of the parents; This is also what gave us the idea of hiring care coordinators who could meet their needs,” explains the Dre Long-Gagne.
Although the usefulness of CONCI is obvious, its financing was not easy. “We made the request in 2015,” she continues. Everyone thought it was a good idea, but we had difficulty finding funds. The project ended up unblocking with the pandemic. Due to the confinement, the hospital administration, which feared seeing waves of patients with multiple disabilities landing in the emergency room because their families had not been able to obtain an appointment, agreed to assume the services of two people to launch the project. That’s all we needed to get our foot in the door. Once the service was launched, there was no going back. Today, our team numbers around twenty people, not to mention external specialists. »
An initiative that benefits patients and the entire health system
Funding for CONCI is not provided by the Ministry of Health, but rather by philanthropic organizations. “At the moment, we are supported by the Montreal Children’s Hospital Foundation and the Opération Enfant Soleil foundation, which together managed to raise $4 million,” emphasizes Dre Long-Gagne. Our funding is assured until 2029 only. We want someone within the health network to understand that this service is necessary and that it absolutely must be supported. »
However, the positive impacts of CONCI are clear and clear. Care coordination allows patients to have easier access to pediatric specialists, schedule appointments based on parental availability, and simplify overall healthcare management. The service can also help families sign up for programs and grants they may not even have known existed. All with the aim of lightening the burden on families.
As the pediatrician explains, the repercussions on the health system are just as conclusive. “The hospital, outpatient clinics and the rest of the network benefit when the patient is better taken care of. This avoids duplication of procedures and reduces the need for emergency services when a patient cannot obtain an important appointment. »
The CONCI effect
Concretely, each child or adolescent cared for by CONCI is assigned a care coordinator, who acts as a direct point of contact with the family. This pivotal resource organizes medical visits, tests, therapies and medical procedures, in accordance with the availability and preferences of parents. Consultations are also offered with pediatricians, nurse practitioners and clinical nurses at the CONCI clinic.
“A service like CONCI is a game-changer for families,” says the Dre Long-Gagne. Imagine that you have a five-year-old child with multiple disabilities who must be followed by a nephrologist, a neurologist, a surgeon, a pediatrician, an occupational therapist, a physiotherapist and nurses, all several times a month. Very quickly, the health system becomes like the house that drives you crazy in The 12 Labors of Asterix. For a simple blood test, for example, parents must take time off work. Without the CONCI, they could have learned a few days later that another specialist doctor had requested a different blood test, even though all of this could have been done at the same time. There are parents who are on the verge of a nervous breakdown, and our service is there to help them. »
A concrete example of success? The Dre Long-Gagné mentions the case of a young patient suffering from a syndrome which predisposes her to quickly gain weight. “Elsewhere in Canada, she was followed by a multidisciplinary team which included, among other professionals, a nutritionist. At the Montreal Children’s Hospital, services were offered, but not in the context of an integrated team, since the patient did not meet certain specific criteria. We consulted CLSCs, which could not support her due to the complexity of her case. In the meantime, the young girl had gained a lot of weight since her arrival in Quebec and she was no longer able to function normally. One of our pediatricians found a private interdisciplinary clinic and one of our coordinators identified a subsidy that could apply to his situation, for which we applied. » Result: the young patient, finally taken care of, is doing better and better.
The keys to success
“Pediatricians and other specialists in disciplines such as surgery, neurology and community social pediatrics, as well as nurses, care coordinators and all healthcare staff at the Montreal Children’s Hospital, including occupational therapists and physiotherapists are all very involved in this initiative. In fact, they are doing significantly more than was originally expected,” she concludes. It is true that, since its creation, the success of CONCI has been based on the principles of compassion, collaboration and consultation. Without forgetting the direct involvement of dozens of specialist doctors who are always attentive to the needs of their young patients and their families – like Dr.re Long-Gagné –, who are fully invested in improving health care in Quebec.
About the FMSQ
The Federation of Specialist Physicians of Quebec (FMSQ) defends and supports the approximately 10,000 doctors working in one of the 59 medical specialties recognized in Quebec. The FMSQ also promotes the provision of high-quality care and services for the Quebec population.
This content was produced by the Special Publications team at Duty in collaboration with the advertiser. The editorial team of Duty had no role in the production of this content.
To find out more about the Federation of Specialist Physicians of Quebec
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