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Business Name: Dunstan Pediatric Services
Client Name: Christopher Dunstan
Websitehttp://dunstanpediatric.com/
SBDC Advisor: Rita Toth

WHAT IS YOUR BUSINESS? WHAT DO YOU DO?

Dunstan Pediatric Services is a school-based related services provider supporting schools and families in central and northern New Hampshire. The scope of services involves, but is not limited to, occupational therapy, speech therapy, nursing, and a teacher of the visually impaired.

WHEN THE SHUTDOWN BEGAN, WHAT WAS THE IMMEDIATE IMPACT ON YOUR BUSINESS?

On March 13, 2020, I was away at the New Hampshire Association of Special Education Administrators (NHASEA) conference in Portsmouth. We were informed that the universities were closing. Some districts even started calling their employees back from the conference. That afternoon, I reached out to my staff and told them to bring their computers, contact information for families, and all the therapy resources they could fit in their cars, unsure of when they would be able to return to school. As it turned out, that weekend all schools closed down.

The following Monday, March 16, I created my first Zoom meeting and invited my staff to join me.  We did not ask the governor if we were essential, we simply decided that we needed to figure this out quickly or the children we serve would be without therapy.  Over the course of the next 4 days, we built the framework that would be the cornerstone of our teletherapy program.

By March 23, 2020, we were already contacting parents to schedule our therapy sessions. During the next 3 months, we became a functional telehealth company providing regular therapy sessions, and meeting as a team every week. We were essential to the success of educating students, along with every other member of the school community.

HOW WERE YOU ABLE TO ADAPT DURING THE FIRST FEW MONTHS OF THE PANDEMIC? 

Dunstan Pediatric seemed to pivot on a dime and simply create a new paradigm for intervention.  Children were at home and there was direct evidence that something uncomfortable was beginning to occur. Almost immediately, the DCYF reports of child abuse plummeted. As we opened up Zoom meeting after Zoom meeting, we started to see into the lives of the children we were servicing. Some families were able to make the transition smoothly, while others did not.

One of the first protocols we put into place was how to respond to instances of suspected child abuse or neglect. Two of my staff members, Brian Walsh and Tyler Santucci, reached out to DCYF and asked for support. We learned what to look for, what questions to ask, and how to report.  As the owner, I shared the protocol with the SAUs that we worked in hoping to provide important information to special education teachers and other service providers.

One of the biggest challenges was to keep spirits high and encourage everyone to believe in themselves and the therapy they were providing. I learned that my staff not only has the capacity to show innovation, but they also have grit. We worked together, supported each other, and tried to offer a sense of hope.  

ONCE BUSINESSES WERE ABLE TO OPEN IN NH, HOW DID YOU ADAPT YOUR BUSINESS, SERVICES, PRODUCTS, AND/OR PHYSICAL SPACE?

I reached out to NH SBDC during the summer months and began speaking directly with Rita Toth.  My concern was that my business could face significantly challenging obstacles if schools closed in the fall and my staff of 13 were unable to work. I had questions, as well, about the PPP loans I had been hearing about.

Rita offered initial direction on what was involved in the process and how it was carried out. She then began to ask more probing questions like, “How will you meet the needs of your clients if you stay in a remote setting?” and “How will you ensure your company growth continues even under this adversity?” These questions, though challenging to face, inspired a transformation.

We began to depart from the dialog relating, specifically, to therapy and started to find mutual understanding around business concepts. I quickly understood the wisdom that Rita was sharing and the unique opportunity that NH SBDC was offering. Truth be told, I did not initially believe that Rita would understand what pediatric therapy entailed and was dubious of her recommendations. I humbly admit I was mistaken.

HOW HAS SBDC HELPED YOU AND YOUR BUSINESS, ESPECIALLY IN THE LAST YEAR?

During this initial conversation over the summer, Rita made several important recommendations.  The first was her challenge for me to anticipate what my customers would need in the coming months and year, and then invest in ensuring I could deliver what was needed. I predicted that they would need reliable telehealth services and looked to find quality therapists that had the versatility and personality to make a new service successful. As it turned out, I was able to hire five therapists to manage telehealth services.

IF YOU RECEIVED A PPP LOAN, TELL US YOUR OWN AND YOUR EMPLOYEES' STORIES.

A second recommendation from Rita was to look at the mechanisms DPS had in place that were ineffective and to take the necessary steps to correct them.  By successfully applying for a PPP loan, I was able to keep one-third of my staff working by developing interval processes like data collection, based on best practices for therapy, as well as revamping an evaluation template to now include more robust assessments, such as assessment aimed at understanding executive functioning capabilities. I am so grateful to three of my staff including Alyssa Pattison, Ariel Gosling, and Alyson Messina for their commitment and exemplary work over the summer months to move these processes forward. Following Rita's advice and access to the PPP loan, DPS had positioned itself to continue to offer quality services to the disabled children we service.  

WILL YOU CONTINUE THE CHANGES AND ADAPTATIONS YOU HAVE MADE ONCE CONCERNS OVER COVID-19 ARE BEHIND US? ARE YOU PLANNING TO INSTITUTE MORE CHANGES IN THE NEAR FUTURE?

Late in the winter, I reached out again to NH SBDC to set up a consultation with Rita. We spoke at length about Key Performance Indicators (KPIs) and she provided me with additional knowledge about ways to improve marketing development, process development, people development, and product development. I fully intend to continue using the tools that NH SBDC has to offer as I’ve only seen successful outcomes as a result of time working with Rita.

ARE YOU COLLABORATING WITH OTHER BUSINESSES, MUNICIPALITIES, ORGANIZATIONS, ETC. FOR THE FIRST TIME OR DIFFERENTLY THAN IN THE PAST?

Each year the New Hampshire Association of Special Education Administrators meets to go over important initiatives to support all school districts in NH. This year, DPS sponsored their virtual conference event as one of their primary sponsors.  We created several videos that spotlighted all of our current service areas. Now that everyone understands the ease of using virtual meetings, I’ve been able to reach out to therapists, researchers, and professors from around New England and the country. I’ve been successful in coordinating these folks as guest speakers at our monthly staff meetings.  

I have employed two speech therapists as sub-contractors to provide ongoing remote therapy for the towns of Laconia, Henniker, and Lisbon. One therapist is in West Virginia and the other is on the NH seacoast.  Neither of them would be able to provide this service if not for the telehealth opportunities. Additionally, I have employed two occupational therapists as employees to provide continued remote therapy for the towns of Laconia, Henniker, and Lisbon.  One therapist is in Bedford and the other is in Scarborough, ME. One of the therapists supervises an OTA in Holderness and has provided mentorship for the other OT working from Maine.  All of this happened through the new use of the telehealth platform and virtual meetings.

IF YOU HAVE EMPLOYEES, HOW HAS YOUR WORKFORCE BEEN AFFECTED?  

As mentioned above, I was able to anticipate a service need and successfully increase the number of staff members. I do not anticipate the capacity will remain the same, however, since the use of telehealth platforms has transformed the ease of connecting with people across a distance.  I heard a wise comment towards the end of the 2020 school year in regards to the impact the pandemic has had on virtual meetings and services.  “We have learned more in the past 3 months than we could have learned in 10 years of continuing education.”

HOW ARE YOU COMMUNICATING WITH CUSTOMERS NOW? ARE YOU MARKETING IN THE SAME WAYS YOU WERE PRIOR TO COVID-19?

Our communication style hasn’t changed, but the medium through which we do so has taken on a slightly different shape. We believe in communicating with our schools and surrounding communities in a way that is honest and efficient. Like many other businesses, we have made more of a shift to the online space since the start of COVID-19. We have made many resources available to the communities we serve via social media and virtual classrooms designed by our therapists. Taking the advice of NH SBDC, we have been focusing on market development and looking to understand how our customers receive information. We now have a presence on Instagram, Facebook, and we are using LinkedIn more effectively.

This client story is part of NH SBDC's ongoing collection of COVID Creativity stories about businesses surviving and thriving during COVID-19.