Consults for Medical Professionals

How can consultative rounds help my team?

If you support a child or youth struggling with incontinence, The Vermont Continence Project will work with your team to gain a deeper understanding of incontinence and of the challenges you are facing. We offer you strategies and resources, help you craft a plan to address the incontinence, and support you in crafting a plan.

What do consultative rounds look like?

There are two phases of consultative rounds.

Phase 1: Guided Resource Access

The Vermont Continence Project has a large Resource Library that addresses most of the questions we commonly receive and guides you through a plan that can address most incontinence cases. However, we recognize that providers may need modifications or clarifications to apply to your client/student/patient. In Phase 1, we address those questions.

During Phase 1, you follow a treatment checklist, which includes videos handouts, and data sheets. This checklist emphasizes two things:

  • Thorough medical treatment
  • Reducing or eliminating pressure on the child related to their incontinence

We find that — by addressing these two factors — most cases of incontinence get significantly better.

If other members of the team want to ask questions, they must also follow the treatment checklist.

During Phase 1, our consultants are available by email or phone call to answer your questions about the steps in the treatment checklist. Some examples include:

Diagnosis and treatment

  • Understanding presentations of functional constipation and other functional gastrointestinal disorders
  • How to support parent understanding of diagnosis and implementation of treatment plan
  • Choosing medications and supplements for elimination health
  • Dietary management of elimination health

Participation & Behavior

  • Decreasing stress and refusal
  • Improving parent-child relationships related to toileting
  • Positioning and equipment
  • Planning toileting for a person with a disability

Yes. Consultative rounds are for any professional. However, we know that medical treatment is absolutely necessary for most cases of incontinence, and we will still emphasize that. We will provide resources to help you to communicate incontinence concerns to the child’s medical provider, and answer your medical questions about incontinence.

We will also support you to answer non-medical questions related to the checklist.

 

Phase 1 will continue through implementation of the steps in the checklist. We estimate this will take at least two or three months.

After implementing this checklist, you will decide with the VCP director if you wish to continue consultation.

Phase 2: Individualized Team Support

Sometimes, managing incontinence needs a more specialized plan, due to developmental, medical, or social factors. In Phase 2, the VCP will meet with your local team to craft an individualized, multi-disciplinary plan.

During Phase 2, we complete an interdisciplinary intake, which can take up to 90 minutes. We support the team to set goals, and establish roles related to toileting. After our intake, we create an action plan, and set a timeline to check in on that plan.

After our initial team consultation, we may:

  • Plan follow up consultation related to one or more topics from intake
  • Create and share resources for your student/patient

All referrals go through Phase 1, as this is a part of the treatment process for incontinence.

We have found that even children with a high level of developmental complexity often make huge gains when we meet their medical needs and reduce stress. We will help you customize your plan for this child.

Phase 2 requires more coordination of team, family, and resources.

After completing Phase 1 with the VCP, we will ask you to complete the following steps:

  • Identify a point person for your team: The point person will be responsible for coordinating with VCP and local team to schedule meetings, communicate with VCP team by email, provide VCP team with up to date team contact information, disseminate content from VCP to local team.
  • Organize your local team: The team must include representatives from primary care, education, and social services (if any social services are involved), and can include other disciplines you feel are relevant. The referral must provide email contacts for all team representatives, or your point person is exclusively responsible for communicating with that person.
  • Organize needed family support: Some families require intensive implementation support. If the family has significant social complexity, such as homelessness, caregiver disability, or language access needs, we will discuss these in Phase 1.

 

Consultative Rounds FAQs

At this moment, we are building the registration platform. If you are interested in consultative rounds, please email us at continence.project@uvm.edu.

Any professional member of a team (including physicians, educators, school nurses, mental health professionals, or administrators) can register for consultative rounds if they want support following our treatment checklist. A “team” is defined as all of the relevant professionals who support a specific child across medical, social services, and educational services.

Please note, register for consultation only if the professionals on your team want support from the Vermont Continence Project. We cannot not communicate with the parents or child for you, and we do not meet with families without a provider present.

We are a team of consultants. We do not provide any evaluations or treatment.

We also believe strongly in family-centered care! Our role on a team is to equip the providers with the tools and knowledge to implement a plan for this child and family, and for those who come in the future. We have found that it is better for famliies to keep teams smaller and have the providers who know them offer intervention. Sometimes, parents are included in consultation after the first meeting.

All of our meetings are remote using Zoom. The VCP team will set up the link.

The number of consultations can vary. After the first meeting, our director will meet with the point person to identify additional goals and steps. We can then arrange future steps.

The VCP is part of the Center on Disability and Community Inclusion (CDCI) at the University of Vermont. We are not part of any medical center and cannot access EPIC. At present, we do not have access to a fax machine.

We suggest that any confidential documents are sent through UVM’s File Transfer Service: filetransfer.uvm.edu with director Chayah Lichtig (chayah.lichtig@uvm.edu) as the recipient.

If you need to mail a hard copy, please email Chayah Lichtig to tell her. We are in the office very infrequently, and we will not receive your documents in a timely way unless we know they are coming.