My goals, my guide

Dr Susan Waller1, Dr Alison  Beauchamp1, Mrs Nicole McFarlane2

1Monash University, Warragul, Australia, 2Latrobe Community Health Service, Morwell, Australia

Aim: This innovative model categorises clients according to ability to self-manage their condition. The categories provide a structured, multidisciplinary approach to care, within which clients participate in goal-setting. This project aimed to embed Guided Care into CDM service delivery and evaluate outcomes.

Methods: Study design: quasi-experimental. Setting: rural community health service. Participants: clients with diabetes and respiratory conditions enrolled in GCM. Process: care plans are completed for new clients to identify health goals. Baseline assessment includes scales from the Health Literacy Questionnaire (HLQ) and the health education impact Questionnaire (heiQ). Clients are categorised according to level of support needed to reach their goals; this determines multidisciplinary team input and follow-up frequency. Outcomes: changes in the HLQ/heiQ and goal attainment at 6-months. Clinicians were interviewed to identify factors influencing uptake of GCM.

Results: Baseline data from n=162 clients shows 20% required a high level, and 57% a moderate level of self-management support. At 6-month review (n=50) significant increases in all HLQ/heiQ scales were seen. 68% reported achieving their goals. Clinicians viewed GCM as a holistic, client-centred approach. Challenges and enablers to its implementation were also identified.

Significance for Allied Health: The GCM supports clients to build self-management capacity and offers AHPs a structured approach to planning intervention that meets the client’s need. AHPs are better able to support person centred management by actively partnering with the client to understand where they are in their chronic disease journey.


Biography:

Susan is a Senior Lecturer in Monash Rural Health, Monash University. Susan is responsible for nursing and allied student placement support in the MRH footprint, facilitating the interprofessional simulated student clinic at Latrobe Community Health Service and teaching on the Masters of Advanced Healthcare Practice.

Start-up strategies for accelerating growth in Allied Health research culture, capacity and translation

Dr Olivia King1,2,3, Mr  David Meade1, Ms Kait  Brown2, Dr  Rosalie  Boyce1,2

1University Hospital Geelong, Barwon Health, Geelong, Australia, 2South West Healthcare , Warrnambool, Australia, 3Monash Centre for Scholarship in Health Education , Clayton, Australia

Background: Strategies to embed allied health (AH) research clinicians in health services are premised on the notion that research-active health services produce higher quality patient outcomes. High-performing allied health services in urban centers of several Australian jurisdictions have been first-movers to establish research infrastructure over the past decade. Higher self-ratings in individual research skills have been associated with more senior, metropolitan-located clinicians.

In this presentation we track and explore the start-up strategy and accelerator tactics deployed in a unique greenfield research infrastructure initiative funded as part of the 2018 Victorian research investment program. The case site partners a university hospital in one health service with a rural health service that jointly bid for a single position that subsequently staffed the position with a job-share working in an integrated model across both health services.  The start-up and accelerator strategies were designed to produce a framework to guide the activities and identification of research priorities, capacity development needs and translation opportunities.

Method: The framework was informed by a review of the literature related to the implementation of clinician researcher and research capacity-building roles; and engagement with key shareholders through face-to-face individual and group meetings.

Results: A strategic framework was developed to guide the research, capacity-building and sustainability-enhancing activities of the AH research and translation co-leads. The framework consists of four program streams:

  1. AH research capacity-building
  2. AH workforce and governance research
  3. Engagement with Victorian Research Community of Practice
  4. Contribution to the region’s research and healthcare innovation strategy.

Within these macro-level program streams, meso and micro-level activities are detailed. These reflect higher-level expectations of the roles, the regional context and the unique characteristics and needs of the two key health services.

Discussion: Given the novelty and breadth of inaugural roles, due diligence must be paid to ensuring maximum research impact and community benefit. Previous research has focused on the individual, organisational and system-level enabling and inhibiting factors for research culture and capacity-building. This study adds value to the evidence base through its specific focus on a rural-urban partnership setting and the start-up implementation and accelerator strategies in a greenfield setting.


Biography:

Olivia is a qualified podiatrist and credentialled diabetes educator. She completed her PhD (Health) which explored the role boundaries and differences in the scopes of practice of diabetes educators of allied health and nursing background, in 2018. She has recently been appointed (with Dr Rosalie Boyce) as Regional Allied Health Research and Translation Co-Lead for the Barwon South West region. She also holds an adjunct research associate role with the Monash Centre for Scholarship in Health Education. Her research interests include the allied health workforce, sociology of the professions and healthcare education.

A cultural journey: Papua New Guinea to a North Queensland tertiary hospital

Ms Julie Watson1, Ms Chris Fox, Ms Elisabeth McColl

1Townsville Hospital And Health Service, Townsville, Australia

Background:  Each year an increasing number of patients arrive at the Townsville Hospital Intensive Care Units (adult, paediatric and neonatal) via Queensland Health Retrieval Services from Papua New Guinea.   The social, emotional and cultural issues for these patients and their accompanying family member/s are significant.  Papua New Guinea is one of the most ethnically diverse and complex countries in the world. Patients arriving at The Townsville Hospital (TTH) are primarily from small coastal villages in some of the remotest areas of Papua New Guinea.

Allied Health teams managing these patients at TTH have developed a wealth of knowledge, networks and innovative solutions in helping patients through to recovery and eventually a safe return to their homelands.

Method:  A review of a cross section of these patients presenting to TTH over a four year period has established a range issues impacting the patient and family including language barriers, cultural concerns, border security issues and personal safety on home returns.

Results:  This paper will outline key areas of learning from the review, highlighting the training and education needs of staff working with Papua New Guinea patients and health system improvements to better support this client group.


Biography:

Julie Watson is Director of Social Work at The Townsville Hospital (TTH).   She is a James Cook University (JCU) graduate and has worked primarily in the areas of disability and health throughout her career.  She has interests in rural and remote health, workforce planning and professional development for Allied Health Professionals.

Leading the way in consumer engagement with victims of sexual assault

Ms Julie Watson, Ms Liana  Schnierer, Ms  Trudi  Contarino

1Townsville Hospital and Health Service, Townsville, Australia

Sexual assault is an issue of profound consequence, the impacts of which are far reaching.   The recent establishment of a collaborative ‘Sexual Assault Response Team’ (SART) within Townsville, North Queensland, has innovatively sought to increase and improve the engagement with victims of sexual assault in their model of care.  The support and care provided to victims (consumers of the service) by a specialised team has resulted in increased engagement with victims and a clear and supportive pathway for survivors of sexual assault.

The complex nature of sexual assault and the number of organisations with which a victim commonly must interact with, particularly at the time of crisis, typically characterises a daunting and confusing process. The process itself is often intensified, by involved organisations continuing to work in isolation, merely attempting to join up operationally when necessary. Such an approach ultimately places victims at a heightened risk for inappropriate, inadequate and potentially harmful intervention, with limited access to essential services and specialist sexual assault support. The need for greater interagency cooperation and service coordination in the provision of responses to victims of sexual assault has long been plainly apparent within the local Townsville community, and indeed more broadly across the State.

SART is a multidisciplinary, specialist team that comprises social workers, detectives, forensic nurses, and emergency department staff, that aims to provide a 24 hour coordinated crisis response, that is holistic, timely and trauma informed.   Guided by the perspectives of victims of sexual violence, the organisations involved acknowledge that individual healing and recovery, necessitates direct service delivery responsive consumer needs.  Moreover, organisations acknowledge that various systems with which survivors invariably engage, necessitate cultural and broader policy reform, in order to safeguard the rights, confidence and trust of victims.  Ultimately, SART remains committed to fostering change, for both individual survivors of sexual assault, and the local Townsville and broader Queensland community.


Biography:

Julie Watson is Director of Social Work for the Townsville Hospital and Health Service (THHS), based at the Townsville Hospital.   She has had a strong interest in rural and remote health, workforce planning and professional development for Allied Health Professionals.

Working for Queensland Health for most of her career, Julie commenced work as a social worker at the Townsville General Hospital in 1987.  She has since worked in a range of roles that have involved project management, planning, training, community engagement, management and clinical work.

Julie is a strong advocate for community and consumer input in the health setting and is currently on the Board of the Townsville Hospital Foundation (THF).   She has been involved in a range of projects including some significant telehealth projects and the redevelopment of the Townsville Hospital.   She was responsible for facilitating consumer input and community engagement throughout these projects.

Her research interests have included utilising e-health in the clinical setting, improving services for Papua New Guinea patients at TTH, and discharge against medical advice in the TTH Emergency Department.

A multidisciplinary model of chronic disease care for potentially preventable hospitalisations in a regional Indigenous community

Sharon Woods1

1Mackay Hospital & Health Service,

It is well known that there exists a gap in health equality between Aboriginal and Torres Strait Islander people and other Australians.  With higher rates than non-indigenous Australians of chronic disease, morbidity and mortality, access to primary healthcare for indigenous people living with chronic disease is crucial.  At a regional North Queensland local hospital over 50% of acute admissions for indigenous people that are potentially preventable are attributed to chronic disease.  Of those, the highest rates are in patients with complications of diabetes (27.6%), respiratory disease (16.3%), and cardiac conditions (9.8%).  In response to growing concerns that existing services were not meeting the community needs, a community based service with a multidisciplinary care model was introduced.  The aims of the service were to improve care coordination and access to allied health and specialist services for indigenous people with chronic conditions living in the local area, and to provide prevention and early detection activities for the wider indigenous community.   In view of the high rates of potentially preventable hospitalisations due to diabetes complications, cardiac and respiratory conditions, clinic based and home visiting services for dietetics and podiatry were the first allied health services to be implemented.  The purpose of this presentation is to share the challenges and successes of the Potentially Preventable Hospitalisations Team, and to highlight potential future opportunities for improving access to chronic disease care for indigenous people in regional communities.


Biography: To be confirmed

Growing together – improving job satisfaction and utilisation of scope of practice within a Dietitian Assistant workforce through a dietitian-led training and assessment program.

James Bartholomew1, Tegan Dalla1, Julie McFarlane1

1Central Coast Local Health District, Gosford, Australia

Background: The introduction of an electronic nutrition risk screening process resulted in a 440% increase in referrals to the Dietitian and a 38% reduction in referral response rate. Many of these referrals were ‘false positives’ and reduced the efficiency of dietitians in diagnosing and treating patients with malnutrition. To address this, a modified screening process was developed by Nutrition Services using the scope of practice of a Dietitian Assistant (DA) workforce, with the goals of increasing efficiency in referral management processes and the delivery of better integrated patient care.

Methodology: The aim was to maximise utilisation of the DA scope of practice. This included development of a modified nutrition risk management pathway led by the DA, a training and assessment program to support implementation and a Departmental supervision framework to support new learner sustainability. The primary outcome measure was response time to referrals, with qualitative data collected on job satisfaction, implementation success and staff acceptability of the training and assessment program.

Results: Implementation of the pathway resulted in a 50% decrease in referral response time by dietitians (39 hours from 79 hours P<0.05) and a 321% reduction in inappropriate referrals being actioned. Implementation success scored moderate-high among both dietitians and DA’s and staff reported increased job satisfaction, empowerment and utilisation of their knowledge and capabilities post-implementation.

Discussion: A training and assessment pathway is an effective and accepted way to develop task capability within a DA workforce. This can positively contribute to the workload management of clinical dietitians and reduce response time to referrals which leads to efficient patient nutrition care. Integrated education and training is well received and can effectively support learning within a DA team as well as empower dietitians to take a leadership role in delivering integrated training and assessment. Sustained, supervisory sessions can ensure learners feel supported, and leads to better job satisfaction and commitment to excellence within an Allied Health Assistant workforce.


Biography: 

Tegan Dalla is a Senior Diabetes Dietitian working in the Central Coast Local Health District, and recently completed her Masters of Healthcare Leadership with Southern Cross University. Tegan has ten years of experience across a range of clinical areas in dietetics, specialising in diabetes for the past two years. With a special interest in education and training, she is passionate about lifelong learning and supporting early career staff development. Tegan has been involved in several quality improvement activities resulting in improved patient outcomes, and she led the development and implementation of the training and assessment pathway presented at this conference.

Mealtimes matter: The development of a pilot program for families of children with complex sensory-based feeding problems

Ms Tracy Harb1, Ms Rebecca  Aherne1, Ms Anne  Embry1, Ms Pip  Golley1, Ms Tiffany  Peddle1, Ms Jane  Rogers2, Ms Shien Ee  Tan1

1Canberra Health Services, Women, Youth & Children’s Community Health Programs, Canberra/Belconnen, Australia, 2Child Development Service, Canberra/Holder, Australia

Introduction: Currently, the Child Development Service (CDS) offers assessment, referral and linkages for children aged 6 years and younger, which includes speech and occupational therapy. Children who require intervention are referred to a community-based NDIS partner. There are no dietetic services provided through the CDS. Children requiring dietetic support are often referred to Canberra Health Services without the benefit of an integrated interdisciplinary approach. This may limit the effectiveness of nutrition support for these families, since very often feeding problems result from complex sensory processing problems. The evidenced-based Mealtimes Matter pilot program represents a new service delivery model of care for families and is an interprofessional collaboration between the CDS and the Women, Youth, and Children’s Community Health Program (WYCCHP) Nutrition team.

Objectives: To develop an evidenced-based interprofessional approach to assisting families with complex sensory-based feeding problems.

Methods: A series of meetings and ‘round table’ discussions were held with the aim to improve access to interprofessional services for families of children with complex sensory-based feeding problems. The meetings were attended by dietitians from the WYCCHP and the Canberra Hospital (TCH) nutrition teams and resulted in the development of a gap analysis and project brief outlining options for evidenced-based programs. The evidenced-based Mealtime Matters approach was chosen since it focuses on capacity building and empowering parents to become their child’s ‘therapist’ within a supportive group setting. The WYCCHP nutrition team leader approached the manager at the CDS for occupational therapy input and to scope the potential for collaboration. The project received funding under Allied Health Research Grants and is planned for implementation as a pilot program throughout the 2019 calendar year.

Discussion and Implications: The Mealtime Matters program has the potential to reduce the burden on Canberra Health Services by empowering parents to confidently manage their child’s specific feeding difficulty.


Biography:

Tracy Harb is an Accredited Practising Dietitian specialising in maternal and infant/child nutrition; she currently works part-time for Canberra Health Services, Women, Youth & Children Community Nutrition. Tracy has many years’ experience in clinical practice in both public and private sectors, in addition to many years’ experience in Public Health Nutrition policy and program development for the Commonwealth Government. Tracy has also worked as a Public Health Epidemiologist for NSW Health. She has  completed a PhD at the University of Queensland’s, Faculty of Medicine, Child Health Centre; her research focused on functional gastrointestinal disorders in fully breastfed infants. Her PhD thesis is currently under examination.

The triple RRR recruitment program @ The Royal Melbourne Hospital Australia The Right fit, Right job and Right time a recruitment program for Allied Health clinical staff

Ms Genevieve Juj1, Dr Toni Withiel1, Ms Lucinda Marr1

1Royal Melbourne Hospital, Parkville, Melbourne, Australia

Background: Traditional approaches to recruitment in Australian health organisations typically prioritise competency-based outcomes over the cultural fit of prospective applicants. Research suggests that there is a correlation between person-to-culture fit and enhanced job satisfaction and organisational efficiency. However, much of this research focuses on nursing, thus limiting generalisability to other health care professionals, including allied health.The objective of this study was to evaluate the effectiveness of the RRR recruitment program on allied health staff attrition rates at the Royal Melbourne Hospital. The RRR recruitment program is a two-stage approach to recruitment including a brief telephone screen to establish clinical competency, followed by a face-to-face interview to explore behavioural competencies. The interview panel includes a consumer advocate.

Methods: This study utilised a prospective mixed-methods design at a single site. The primary outcome of interest was staff attrition rates, which was defined as the number of staff who ceased employment within the first 12 months. Baseline data were collected in the 12 months prior to commencement of the intervention. Staff and consumers who participated in the interview panels were surveyed for their overall satisfaction with the new model.

Results: The recruitment model was used for 204 new allied health positions.  Descriptive analysis revealed that there was a decrease in the overall staff attrition rates following the introduction of the new recruitment model. Survey data revealed that interviewers rated the new recruitment strategy as more effective than traditional approaches

Discussion: The findings from this study suggest that this new approach to recruitment can improve staff retention rates. Furthermore, the inclusion of a consumer advocate on the interview panel enabled a more holistic evaluation of candidate suitability. Together, the findings suggest that prioritisation of cultural competencies can improve the quality of allied health staff.


Biography: To be confirmed

Supporting Allied Health professionals to find and use reliable mental health apps and online programs with their patients

Ms Heidi Sturk1, Dr Ruth Crowther1, Professor David Kavanagh1

1Queensland University Of Technology, South Brisbane, Australia

There is fast-growing interest in the use of apps and online programs for mental health and wellbeing. Many allied health professionals are keen to recommend these to their patients but are unsure where to start and how to integrate into their practice.  We can feel overwhelmed by the large amount of online resources available so it is important to know how to find those which are evidence-based and reliable.

Many people do not receive face-to-face help for their mental health for a variety of reasons. Digital mental health resources can provide an easily accessible method of help and can be effective for people who have mild to moderate mental health issues or are going through difficult times. These resources also cover a range of health topics that impact wellbeing such as managing chronic pain or parenting support.

The Australian Government has funded the E-Mental Health in Practice (eMHPrac) project to raise awareness of digital mental health resources. The project provides free nationwide training and support to health practitioners about digital mental health and how to use these resources with clients. This training includes face-to-face workshops, awareness presentations and online webinars and modules. The project is led by Queensland University of Technology in collaboration with Black Dog Institute, Menzies School of Health Research and University Centre for Rural Health, University of Sydney.

This presentation will outline how to find and assess apps and online programs and resources to support the mental health and wellbeing of patients. It will also present features of the new Head to Health website which links people to trusted online and phone mental health services. There are some excellent resources available and the presentation will give some examples and also discuss how to integrate them into practice.


Biography:

Heidi Sturk is the Deputy Director of eMHPrac (e-Mental Health in Practice) at Queensland University of Technology. Heidi delivers national training and support on digital mental health resources to GPs, allied health practitioners and service providers working with Aboriginal and Torres Strait Islander people.  She has a Masters in Organisational Psychology and 25 years’ experience in applied mental health research. Her areas of interest include how to integrate appropriate digital technologies into health care, rural and remote mental health, and wellbeing of health practitioners.

Hidden talents: The multiple career backgrounds of allied health professionals

Professor Susan Nancarrow1, Dr Rosalie Boyce3,4, Dr Anna Moran2

1Southern Cross University, Coolangatta, Australia, 2University of Melbourne, Albury / Wodonga, Australia, 3University Hospital Geelong, Barwon Health and Southwest Healthcare, Geelong and Warrnambool, Australia, 4University of Queensland, Brisbane, Australia

The 21st Century career is sometimes described as encompassing “portfolio careers”, involving multiple interruptions, different roles and multiple employers. However, allied health professions (AHP) are largely examined from a linear perspective, ignoring the potential for previous roles and the skills and expertise these may bring to the workforce.

This paper reports on the previous careers of 7399 AHPs from 11 disciplines (occupational therapy, physiotherapy, psychology, allied health assistants, social work, audiology, medical laboratory science, exercise physiology, dietetics, sonography and speech pathology) who participated in Victorian Allied Health Workforce Research project, a three year project commissioned by the Victorian Department of Health and Human Services from 2015-18.

An important goal of the study was to understand AHP career pathways. To explore this, we asked all survey respondents whether they had worked in a previous career, defined as having worked full-time for more than 6 months in another role, and asked about the nature of this role. This paper describes the scale and diversity of the previous careers of AHPs.

The results show that AHPs come from enormously diverse backgrounds. The most diverse workforces, with more than 50% of respondents reporting a previous career, were exercise physiology, social work, psychology, allied health assistants and sonography. Between 20 – 50% of the physiotherapy, medical laboratory science, dietetics, audiology, occupational therapy and speech pathology workforces reported a previous career. Physiotherapy was the least diverse (22%), while 69% of psychologists reported previous careers, the largest proportion of whom had come from teaching backgrounds; and 80% of allied health assistants.

This paper explores the rich diversity of the AHP workforce, and looks at ways that the structure of work, alongside the growth of technologies such as E-credentialing and micro-credentialing may enable these skills to be recognised and embedded into existing allied health careers.


Biography:

Susan is Professor of Health Sciences at Southern Cross University. Susan has nearly 20 years’ international experience as a health services researcher with expertise in health workforce reform, service delivery and organisation. In particular, she works with health services to help them think differently about how they organise and deliver care to provide solutions to enhance health care from the patient’s perspective. She is particularly committed to regional and rural health issues, community health, and capacity building. Recent research projects have explored the use of the NBN to provide telehealth to keep older people independent at home; primary health care integration; the use of social media to engage with health service users; and the recent Victorian Allied Health Workforce Research Project.

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