Improving access to compression garment services through service and workforce redesign

Fiona Hall1, Julie Hulcombe2, Catherine Stephens3,Susan Gordon4

1Allied Health Professions’ Office of Queensland, Clinical Excellence Division, Department of Health, Queensland Government, P.O. Box 5607, Cairns, 4870, Fiona.Hall@healgh.qld.gov.au
2Allied Health Professions’ Office of Queensland, Clinical Excellence Division, Department of Health, Queensland Government, PO Box 2368, Fortitude Valley BC, Qld 4006, Julie.Hulcombe@healgh.qld.gov.au
3Allied Health Professions’ Office of Queensland, Clinical Excellence Division, Department of Health, Queensland Government, PO Box 2368, Fortitude Valley BC, Qld 4006, Catherine.Stephens@healgh.qld.gov.au
4School of Health Sciences, Flinders University, Clinical Teaching and Education Centre at ViTA , 17 Rockville Avenue, Daw Park, South Australia, 5401 sue.gordon@flinders.edu.au

Background

The implementation of a Health Service Directive that supported equitable access for clients across the state, with an ongoing need for compression garments to manage lymphoedema, prompted Queensland Health stakeholders to examine the scope of compression garment selection, fitting and supply that can be safely and effectively delivered by generalist occupational therapist and physiotherapists, particularly those in smaller regional, rural and remote locations to improve local access to this service for community members.

Methods

A trial of compression garment selection, fitting and monitoring provided by generalist occupational therapists and physiotherapists with the support of lymphoedema therapists via telehealth coaching and the provision of an education program, and implementation resources was undertaken.

Results

Seven HHSs enrolled in the telehealth supported compression garment selection, fitting and monitoring service model trial.  There were 69 referrals and 58 garments provided during the 12 month trial. The evaluation demonstrated that delivery of compression garment selection, fitting and monitoring by generalist occupational therapists and physiotherapists supported by defined training, supervision and governance processes l is safe, effective and positively evaluated by clients and health professionals.

Discussion

The service model has provided clear and consistent processes for clinicians and improved access to care for patients. The service model provides a sustainable workforce and service solution. If the full benefits of the service model is to be realised, the implementation will require significant cultural change to increase service capacity and to expand the number of generalist physiotherapists/occupational therapists and facilities who are able to provide compression garments.

Biography

Fiona has worked as a counsellor and clinical psychologist in educational, community and hospital settings in rural, remote and metropolitan locations in Australia. Fiona lives in North Queensland and works for the Allied Health Professions Office of Queensland, where she manages statewide workforce planning and policy development activities and provides leadership to allied health professionals in the Torres and Cape Hospital and Health Service of Queensland Health.