Starting a conversation: Regional community members’ awareness of and engagement with speech pathology

Ms Tina Janes1, Associate Professor, Dr. Barbra Zupan1, Associate Professor, Dr.  Tania Signal1, Associate Professor, Dr. Megan Dalton2

1Central Queensland University, Rockhampton North, Australia, 2Australian Catholic University, Sydney, Australia

Background:
Speech pathology has a history of low public awareness in Canada (Breadner et al., 1987) and Australia (Parsons et al.1983). Although these authors advocated for increased public awareness efforts, no data exists to determine if this has occurred and/or whether awareness of what speech pathologists do has increased. The continued rollout of the NDIS reinforces the need for increased consumer cognisance so that people can be empowered to make informed decisions about their health care. If NDIS participants and providers are uncertain of speech pathologists’ scope of practice, it may negatively impact service access and potentially health outcomes.

Aim:
To assess the public’s awareness and knowledge of speech pathology in regional/rural Australia.

Method:
An online survey using snowball sampling was conducted. Questions included self-reported knowledge of the profession, identification of patient populations that fall within the speech pathology scope of practice and case studies.

Results:
Ninety percent of the 208 respondents indicated they had heard of speech pathology. Of these, 75% had at least some knowledge of speech pathology, which translated in significantly better identification of the types of patients speech pathologists work with, F(1, 205)=13.66, p<.001. In comparison to identifying patient types, all respondents’ were significantly worse at identifying cases speech pathologists should be involved in [t(203)=22.27, p<.001], even respondents who had indicated knowledge of speech pathology, t(182)=21.03, p<.001.

Conclusion:
Whilst community members may have heard of the profession, an appreciation of the varied roles speech pathologists assume is limited. The NDIS/A espouses empowering people with disability to be confident consumers and independently choose services. If speech pathology is to be a service choice, awareness of and engagement with the profession is essential.


Biography:

Tina Janes is a senior lecturer in Speech Pathology at CQUniversity. Tina’s qualifications include a teaching degree; a Graduate Diploma of Aboriginal and Islander Education and Bachelor of Speech Pathology with Honours in Audiology. Prior to arriving at CQU, Tina has taught and practised speech pathology in a variety of interprofessional and cross cultural settings for over 30 years. Tina is currently enrolled in a PhD at CQU on speech pathology in mental health.

The digital age of occupational therapy home visits

Tamzin Brott1, Amanda Bishop1

1Waitemata District Health Board, North Shore City , New Zealand

Introduction
Home visits for occupational therapists in an inpatient setting are time intensive and removes the occupational therapist from the ward, reducing their availability to see other patients.  An average home visit can take a total of 3-4 hours.

Objectives
The benefits of this project include:

  • providing the best care for our patients via utilisation of resourses and technology effectively
  • clear guidelines indicating when a home visit is required, and the use of technology to offer an alternative option to a home visit, resulting in completion of home visits by a therapist for high complexity patients only .

Methods
A pre-trial and post questionnaire was completed to gather the therapist’s perceptions of this new way of working.  A four month trial of an occupational therapy environmental questionnaire was completed.   The patients family/friends completed the form and took photographs and measurements of the home environment.  The number of environmental questionnaires being completed was captured and how many negated the need for a home visit based on the photographs and measurements provided.

Results
At completion of 4 months: 95 environmental questionnaires have been completed and 14 home visit replacements identified in Trendcare.  Potential savings of 42 hours (when average home visit is 3 hours), $1625.04 in staffing costs and infrastraucture savings over this time.

Conclusion
Occupational therapists reported they felt it improved patient and family involvement in discharge planning, improved the timeliness with which therapy is provided and the environmental questionnaire increased the amount of time they can directly spend with patients.


Biography: 

Tamzin Brott is the Executive Director Allied Health, Scientific and Technical (AHST) Professions at Waitemata DHB, providing strategic, professional, clinical and quality leadership for AHST Professions across the organisation. An Occupational Therapist by professional background, Tamzin also holds an MHSc (Hons) and MBA (Hons). Tamzin is passionate about the development of data and digital systems and tools to support, and raise the visibility of, the AHST workforce, leading to better outcomes and enhanced patient experiences for the communities we serve.

A retrospective study of the low FODMAP diet in children with a functional gastrointestinal disorder

Mrs Stephanie Brown1, Professor Andrew  Day2, Professor Richard Gearry2, Professor Kevin Whelan3

1University of Otago, Christchurch, New Zealand, 2University of Otago, Christchurch, New Zealand, 3King’s College, Nutritioal sciences division, London, United Kingdom

Background: Functional gastrointestinal disorders (FGID) such as Irritable bowel syndrome (IBS) are increasingly more common in children (1) and affect 20% of children worldwide (2). The aetiology  combines genetic, environmental and psychological factors, with no clear organic cause (3). Symptoms are recurrent,  including abdominal pain, diarrhoea, constipation, alternating stool patterns, excessive gas production and abdominal distension (4). FGIDs are associated with a reduced quality of life, school absences and psychological challenges (5). Treatment options are variable due to the heterogeneity of FGIDs.

In adults with diagnosed IBS, a low FODMAP diet is an effective dietary strategy to alleviate symptoms (6). FODMAPs are short-chained carbohydrates, poorly absorbed by the gastrointestinal tract due to their increased osmotic activity and excess gas production from the bacterial fermentation process. Currently, there is a paucity of data examining dietary interventions that restrict carbohydrates in children with IBS. The aim of this study was to assess the efficacy of the low FODMAP diet in children with a FGID.

Methods: A retrospective cohort study of children with a FGID managed with FODMAP-free diet was undertaken. Subjective measures and a survey were used to assess diet efficacy.

Results: Of the 29 children included in this study, 16 subjects (55%) experienced complete resolution of symptoms by the end of the four-week diet. Twenty-eight percent of subjects had partial resolution and 13% experienced no symptom relief. Complete resolution of gastrointestinal symptoms were observed for 75% of those with distention, 62.5% of those with diarrhoea and 58% of those with abdominal pain. Fructans were the most common symptom-causing fermentable sugar.

Conclusion: The low FODMAP diet is an efficacious dietary treatment strategy for children with FGIDs. This  study adds to the small body of evidence supporting FODMAP dietary interventions in children with FGID. Further prospective studies are required.


Biography:

Stephanie Brown is a paediatric gastroenterology dietitian at Christchurch Hospital. She is part of a MDT responsible for the nutritional management of children who require dietetic input. Stephanie is completing her PhD with a focus on Nutrition and paediatric IBD. She is married with two young children and loves the outdoors.

Supporting the provision of evidence-based care – developing a national ACS capability framework

Bianca Miras1, Dr Karen Page2, Prof David  Brieger3

1Alfred Health, Caulfield, Australia, 2National Heart Foundation of Australia, Melbourne, Australia, 3Concord Hospital, Sydney, Australia

Background
The provision of safe quality patient care depends on the capability of the health service. The National ACS Capability Framework outlines health system requirements needed to implement evidence-based patient-centred care articulated in the ACS clinical guidelines and new Clinical Care Standard.

Objective
The framework’s purpose is to ensure there is capability to deliver evidence-based care for those experiencing an ACS event no matter where they live in Australia. This paper provides an overview of the framework development; the model and service categories; and implementation strategies.

Method
An expert consensus approach facilitated by the Heart Foundation was used to develop the framework. Extensive consultation and a comprehensive literature review were undertaken to inform an expert roundtable discussion, which identified content and format for the resource.

Results
Expert consensus was reached on the following key elements:

  1. A framework model organised into service categories that reflect the key components of ACS care and system linkages. Four service categories, including one pre-hospital and three in-hospital care categories, which reflect the type of health facilities that receive patients with chest pain and/or symptoms suggesting ACS.
  2. Health system requirements for service categories outlining recommended services, workforce, support services and linkages necessary to deliver care to patients with varying degrees of complexity.

Conclusion
The capability framework, for launch in August 2015, will support the implementation of the ACS Clinical Care Standard. It will be an invaluable advocacy tool recommending system requirements that are practical and achievable.


Biography:

To be confirmed

Domestic Violence Initial Assessment Form: A brief structured psychosocial assessment and intervention tool

Ms. Alexandra Miller1, Ms Julie  Greathouse1

1St Vincent’s Hospital Sydney, Darlinghurst, Australia

Routine screening for domestic violence of women attending health services has been established as a key strategy for early identification and response to domestic violence. St Vincent’s Hospital Sydney recently participated in a multi- site pilot introducing routine screening for domestic violence in the Emergency Department. Where studies have reported on the benefits or not of the screening process, they have historically focussed heavily on the process of identification, ignoring the significance of the intervention that follows and the influence that that next stage of intervention has on outcomes. This paper will report on the implementation of a structured intervention for women who identified they were experiencing DV.  We developed a Domestic Violence Initial Assessment Form (DVIAF), along with an extensive education package, to ensure consistency in the content of initial brief psychosocial assessment and intervention with patients identified through a screening program. The DVIAF was informed by the NSW Health Policy and Procedures for Responding to Domestic Violence, the WHO’s Clinical and policy guidelines for responding to intimate partner violence and sexual violence against women , as well as studies reviewing the evidence about screening and psychosocial interventions. Intervention protocols reviewed in the development of this tool included an assessment of danger; helping to develop safety plans, provision of emotional support, and facilitation of referrals to local advocacy programs.

This paper reports on a survey that found social workers using the (DVIAF) felt the quality of their interventions and assessments were improved and all felt the quality of their documentation improved. All surveyed stated that they would like to continue use of the tool and suggested only minor structural adjustments. For the future we intend to review records of psychosocial interventions prior to the introduction of the DVIAF which will provide objective comparison to records where the DVIAF has been utilized.


Biography:

Alex Miller is the Manager of Domestic Violence and Community Social Work at a large urban hospital and has qualifications Social Work and Child Welfare. She is responsible for strategic leadership in the area of domestic violence, development of policy and protocols, program implementation and staff management at St Vincent’s Hospital. Alex Miller has worked in the field of domestic and family violence in health care and community child protection for 16 years.

Domestic Violence Initial Assessment Form: A brief structured psychosocial assessment and intervention tool

Ms. Alexandra Miller1, Ms Julie  Greathouse1
1St Vincent’s Hospital Sydney, Darlinghurst, Australia

Routine screening for domestic violence of women attending health services has been established as a key strategy for early identification and response to domestic violence. St Vincent’s Hospital Sydney recently participated in a multi- site pilot introducing routine screening for domestic violence in the Emergency Department. Where studies have reported on the benefits or not of the screening process, they have historically focussed heavily on the process of identification, ignoring the significance of the intervention that follows and the influence that that next stage of intervention has on outcomes. This paper will report on the implementation of a structured intervention for women who identified they were experiencing DV.  We developed a Domestic Violence Initial Assessment Form (DVIAF), along with an extensive education package, to ensure consistency in the content of initial brief psychosocial assessment and intervention with patients identified through a screening program. The DVIAF was informed by the NSW Health Policy and Procedures for Responding to Domestic Violence, the WHO’s Clinical and policy guidelines for responding to intimate partner violence and sexual violence against women , as well as studies reviewing the evidence about screening and psychosocial interventions. Intervention protocols reviewed in the development of this tool included an assessment of danger; helping to develop safety plans, provision of emotional support, and facilitation of referrals to local advocacy programs.

This paper reports on a survey that found social workers using the (DVIAF) felt the quality of their interventions and assessments were improved and all felt the quality of their documentation improved. All surveyed stated that they would like to continue use of the tool and suggested only minor structural adjustments. For the future we intend to review records of psychosocial interventions prior to the introduction of the DVIAF which will provide objective comparison to records where the DVIAF has been utilized.


Biography:

Alex Miller is the Manager of Domestic Violence and Community Social Work at a large urban hospital and has

qualifications Social Work and Child Welfare. She is responsible for strategic leadership in the area of

domestic violence, development of policy and protocols, program implementation and staff management at St Vincent’s Hospital. Alex Miller has worked in the field of domestic and family violence in health care and community child protection for 16 years.

Domestic Violence Initial Assessment Form: A brief structured psychosocial assessment and intervention tool

Ms. Alexandra Miller1, Ms Julie Greathouse1

1St Vincent’s Hospital Sydney, Darlinghurst, Australia

Routine screening for domestic violence of women attending health services has been established as a key strategy for early identification and response to domestic violence. St Vincent’s Hospital Sydney recently participated in a multi- site pilot introducing routine screening for domestic violence in the Emergency Department. Where studies have reported on the benefits or not of the screening process, they have historically focussed heavily on the process of identification, ignoring the significance of the intervention that follows and the influence that that next stage of intervention has on outcomes. This paper will report on the implementation of a structured intervention for women who identified they were experiencing DV.  We developed a Domestic Violence Initial Assessment Form (DVIAF), along with an extensive education package, to ensure consistency in the content of initial brief psychosocial assessment and intervention with patients identified through a screening program. The DVIAF was informed by the NSW Health Policy and Procedures for Responding to Domestic Violence, the WHO’s Clinical and policy guidelines for responding to intimate partner violence and sexual violence against women , as well as studies reviewing the evidence about screening and psychosocial interventions. Intervention protocols reviewed in the development of this tool included an assessment of danger; helping to develop safety plans, provision of emotional support, and facilitation of referrals to local advocacy programs.

This paper reports on a survey that found social workers using the (DVIAF) felt the quality of their interventions and assessments were improved and all felt the quality of their documentation improved. All surveyed stated that they would like to continue use of the tool and suggested only minor structural adjustments. For the future we intend to review records of psychosocial interventions prior to the introduction of the DVIAF which will provide objective comparison to records where the DVIAF has been utilized.


Biography:

Alex Miller is the Manager of Domestic Violence and Community Social Work at a large urban hospital and has

qualifications Social Work and Child Welfare. She is responsible for strategic leadership in the area of

domestic violence, development of policy and protocols, program implementation and staff management at St Vincent’s Hospital. Alex Miller has worked in the field of domestic and family violence in health care and community child protection for 16 years.

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