Autism Therapy Providers and Families Benefit from Grand Rounds at Hopebridge
December 02, 2020
December 02, 2020
Those in the medical field – as well as those who watch “Grey’s Anatomy” or “The Good Doctor” – are likely familiar with the concept of grand rounds. For those who may not have this “insider” knowledge, we’ll give you the scoop. Not to be confused with the daily “rounds,” clinicians use grand rounds to present challenging patient cases to an audience of experts and students as a way to collaborate, train junior colleagues and increase learning in areas outside of their core practices.
While traditionally reserved for the medical industry, the concept of grand rounds can have a major impact on treatment and education in other areas of healthcare as well. Our leadership team at Hopebridge Autism Therapy Centers created its own version of grand rounds that has helped us bring a higher quality of care to children with autism spectrum disorder (ASD) for many years.
At Hopebridge, this process consists of an interdisciplinary clinical review team designed to assist our behavior analysts, occupational therapists and speech-language pathologists struggling with specific patient programs. Topics could include challenges around a reduction in maladaptive behaviors or gaining new skills.
Any senior-level clinician can submit cases to review, but the learning does not stop with them. Once cases are selected, the requesting board certified behavior analyst (BCBA) or therapist participates, along with their center manager and any RBT fellows involved in the team. The registered behavior technician (RBT) and any other therapists who directly treat the child may also join.
Grand rounds are conducted virtually, which allows us to hand-select the most qualified experts to serve as assets to the therapy team without concern over their geographic location. Participating professionals may include Hopebridge psychologists, applied behavior analysis (ABA) leadership, and BCBAs at the doctoral level (BCBA-D). Pediatricians and other physicians may also be called upon if the child experiences additional medical conditions and we need to refer to experts in those areas.
Before diving in, the team first reviews the autism diagnosis, possible comorbid diagnoses, the reason for referral and any current medications that could play a factor. Parents are always informed when their child’s case is discussed, and they may be invited to follow-up sessions, depending on the outcome and recommendations.
Hopebridge’s grand rounds are held weekly, though we also have the opportunity to call for them on an emergency basis. We review three to four cases, then schedule follow-ups for each, as needed, so there are multiple occasions for discussion.
How does grand rounds set Hopebridge apart from other autism therapy centers?
Our large network of professionals across the nation provides our therapy teams with access to experts in the field with whom they may not normally have the opportunity to work alongside. They can use them as a resource for additional recommendations and to assist in analyzing data and information in ways that may have not yet occurred to them.
“We have a lot of budding BCBAs on our team who are young in their careers, and our leaders want to harness their excitement and energy for the field while also building upon their education,” said Hopebridge Director of ABA Melissa Chevalier. “Grand rounds is an opportunity for newer behavior analysts to pull on the experiences and knowledge of seasoned BCBAs and other veteran clinicians to help them problem solve.”
In addition to the internal team, our BCBAs and therapists are connected to Hopebridge’s external consultants, including Dr. Adam D. Hahs, BCBA-D of Arizona State University and Dr. Teresa Cardon, CCC-SLP, BCBA-D of The Chicago School of Professional Psychology. As opposed to only providing guidance to our executive teams and management, our network of specialists provides direct feedback to those who may benefit from it the most. Often times, the clinical experts available to our organization are not only practitioners, but they are well-known educators, professors and leaders in research.
“The Hopebridge approach to care has always focused on treating the whole child – not simply a diagnosis – which is why our programming combines complementary therapies,” said Melissa. “In the same realm, we participate in grand rounds as a way to view the bigger picture.”
Grand rounds are used to review cases that need more support, often due to challenges far more complex than those surrounding communication and social skills or repetitive behaviors. We have reviewed patients who present with behaviors that may fall outside the diagnosis of autism.
For instance, Hopebridge professionals have used grand rounds as a means to collaborate over the case of one child who often engaged in significant, dangerous behaviors like aggression and self-injury. This particular child had a physical disability that posed a greater risk during these scenarios and made some of the more common treatment options difficult.
During grand rounds, the therapy team learned there were possible comorbid diagnoses and a recent in-patient hospitalization that could have impacted behavior. The team was able to ask questions about medication dosages and the details of the hospitalization as it could relate to in-center and at-home behaviors.
“The more we asked probing questions, the more information we discovered. Until that point, the child’s clinician was not able to envision how it all tied together,” said Melissa. “By utilizing the combined knowledge of our experts during grand rounds, the therapy team was able to create a better plan of action.”
The group discussed how to manage the behaviors and various strategies. As a result, they decided to update the Functional Behavior Assessment to make sure it is correctly targeted to the right function of behavior. They talked about having conversations with parents around safety concerns that may occur in the home environment and how the team could provide additional assistance in those instances. The therapy team also walked away with recommendations for different antecedent strategies and how to set up the environment for success before behaviors ever occur.
Because of grand rounds, this child and family now have a greater chance for safety and independence.
Grand rounds is just one of the many opportunities available to our employees for continuing education at Hopebridge. A benefit to new and seasoned team members – as well as the children we serve – grand rounds is often mentioned as one of the top perks of the job from our BCBAs.
If learning experiences like grand rounds sounds interesting to you, consider joining our team of Hopebridge heroes. Check out our open positions in autism therapy centers across the nation to continue to build your career with Hopebridge.
*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC.