Abstract
Although the implementation of new treatment models can be a challenging process for
health care services, the outcomes can be greatly beneficial to patients and service
providers. This article describes the process of change experienced within our multidisciplinary
specialist eating disorder service when we implemented a new evidence-based model
of care focusing on outpatient family-based treatment (FBT). Clinical outcomes were
positive, including a 56% decrease in admissions, a 75% decrease in readmissions,
and a 51% decrease in total bed days. Of families referred to FBT, 83% completed treatment
and 97% of completers achieved >90% of their expected body weight. Despite these gains,
many challenges were experienced, including misgivings about the suitability of FBT
and difficulties in adhering to changes in professional roles. We describe these challenges,
describe how they were overcome, and review factors perceived to be critical to the
program's success, including integration of medical and mental health services, communication,
and training.
Key Words
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Biography
Elizabeth K. Hughes, Research Fellow for Eating Disorders, The University of Melbourne Department of Paediatrics and The Royal Children's Hospital Centre for Adolescent Health; Honorary Research Fellow, Murdoch Childrens Research Institute, Melbourne, Australia.
Biography
Daniel Le Grange, Professor of Psychiatry, The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL.
Biography
Andrew Court, Consultant Child and Adolescent Psychiatrist, The Royal Children's Hospital Consultant and Liaison Psychiatry Mental Health Team, Melbourne, Australia.
Biography
Michele Yeo, Paediatrician, The Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.
Biography
Stephanie Campbell, Clinical Nurse Consultant for Eating Disorders, The Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.
Biography
Melissa Whitelaw, Clinical Specialist Dietitian, The Royal Children's Hospital Centre for Adolescent Health and Department of Nutrition and Food Services, Melbourne, Australia.
Biography
Linsey Atkins, Senior Clinical Psychologist, The Royal Children's Hospital Integrated Mental Health Program and Centre for Adolescent Health, Melbourne, Australia.
Biography
Susan M. Sawyer, Director and Paediatrician, Royal Children's Hospital Centre for Adolescent Health; Chair of Adolescent Health, The University of Melbourne Department of Paediatrics; and Honorary Research Fellow, Murdoch Childrens Research Institute, Melbourne, Australia.
Article info
Publication history
Published online: September 20, 2013
Footnotes
This work was supported by The Baker Foundation, The Butterfly Foundation, and the Victorian Government's Operational Infrastructure Support Program.
Conflicts of interest: Daniel Le Grange receives royalties from Guilford Press and Routledge and consultant fees from the Training Institute for Child and Adolescent Eating Disorders.
Identification
Copyright
© 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.