Keeping culture at the centre of student support

Trevor-Tirritpa Ritchie

In early 2013, Indigenous Allied Health Australia (IAHA), a national not for profit, member-based Aboriginal and Torres Strait Islander allied health organisation, identified a need for targeted support for Aboriginal and Torres Strait Islander allied health students to enable them to complete their degrees and confidently enter the health workforce. This is particularly important for those students who wish to go back home to live and work in remote and rural locations upon graduation.

Since 2013 IAHA has held an annual HealthFusion Team Challenge (HFTC) specifically for Aboriginal and Torres Strait Islander health students – the first of its kind both nationally and internationally. The intensive two day event enables participants to engage with a diverse range of health disciplines, building valuable skills and knowledge in leadership, public speaking, collaborative team work and holistic person-centred care.

The IAHA HFTC is unique in that it is steered towards creating a culturally safe and responsive learning experience, where participants grow as future Aboriginal and Torres Strait Islander health professionals.   At university a participant may be one of very few Aboriginal and Torres Strait Islander people in their course, they find at the HFTC that they are in fact part of a vibrant and growing cohort of exceptional Aboriginal and Torres Strait Islander students across the nation.

Students from remote and rural areas are strongly encouraged and supported to attend the event, which holds culture as an essential component of Aboriginal and Torres Strait Islander health and wellbeing.  The IAHA HFTC is one way that IAHA contributes to building a workforce and a health system that is more effective, accessible and culturally responsive to the needs of Aboriginal and Torres Strait Islander peoples.

Biography

Trevor-Tirritpa Ritchie is a Kaurna man and an Occupational Therapist. He has previously worked in Corrections, Housing and Education. He is currently working at the University of South Australia as a Lecturer in Allied Health Aboriginal Health. He is also working in Paediatrics with Country Health SA providing services to remote communities on the far West South Australian Coast. He is a current board member for Indigenous Allied Health Australia.

Supporting interprofessional practice as a step to a resilient workforce

Kathryn Fitzgerald1, Maeva Hall2

1Western Australian Centre for Rural Health. PO 109 Geraldton WA  6531, Kathryn.Fitzgerald@uwa.edu.au
2Western Australian Centre for Rural Health. PO 109 Geraldton WA  6531, Maeva.Hall@uwa.edu.au

The Western Australian Centre for Rural Health (WACRH) is a University Department of Rural Health with a focus on education and research to meet workforce needs now and in the future.

To complement key learning and interprofessional practice, students participate in a 5 week paediatric clinic. We will outline the format and impacts for the client, students and clinicians.

The Clinic is a partnership between the Rural Clinical School, WACRH and Hospital. Students are form across the allied health disciplines and medicine.

The clinic format is:

  • Week 1: Orientation
  • Week 2: Case History
  • Weeks 3 and 4:  Interprofessional Assessment
  • Week 5: Feedback and written report

Students work in teams of 3-5, with 2 students leading the weekly consultation.  Each team has an experienced clinical facilitator, with access to of clinical advisors as required, including paediatrician, speech pathologist, occupational therapist, physiotherapist and social worker.

The lead students often are collecting data that would not normally be within their scope of practice.  Data collection is complimented by the other students observing the live steaming and supports the learning with and from each other that is central to interprofessional practice.

Clinics run for 3.5 hours with team briefings, tutorials, debriefing and the clinical consultation.  The debrief includes parent feed back to the students on their performance for a parent perspective.

This presentation will include video commentary from parents, students and clinical staff on their perceptions of the process and impact on learning. We will outline our plan for expansion to other types of interprofessional teaching clinics and how these fit in parallel with the more traditional placement delivery.

Biography

Maeva Hall, OT with over 30 years rural experience in public, private and tertiary sectors. Currently the Deputy Director of WACRH and lead of the Education Team with a focus on building health literacy, attracting people to health careers, providing high quality placement opportunities and supporting the clinicians in their rural activity and extension around evaluation, research and higher education as determined.

Making it up as we go: The tall and true story of Greater Northern Australia Regional Training Network (GNARTN) and Allied Health Rural and Remote Generalist (AHRRG)

SR Davis1, J Hulcombe, D Bianchini, R Moore

1Cairns director@gnartn.org.au

For a new organisation like GNARTN which is by virtue of its structure and funding a radical departure from the way government agencies collaborated, many said for GNARTN to “take on” Allied Health Rural and Remote Generalist was in the words of Humphry from “yes minister” a “Brave Decision”. GNARTN was established as a cross-jurisdictional network, established in 2013 to address a range of clinical workforce and clinical placement, education and training issues, via an agreement reached between Western Australia, Northern Territory and Queensland Health Departments through funding provided by the Commonwealth Department of Health Australia. A key objective of GNARTN was to drive innovative pragmatic and sustainable models to address workforce mal-distribution and improve patient outcomes.

This is the story, of GNARTN,as a new entity, and what role the organisation has played in supporting the development of the AHRRG constructs, and the emerging narrative around what this means for the future of the regional, rural and remote allied health workforce in the future.

Biography

Dr Scott Davis (PhD, MIPH) is the Executive Director of the Greater Northern Australia Regional Training Network (GNARTN). Over the past 20 years, Scott has held a range of senior executive leadership and practice roles within the health sector internationally and within Australia.

An online Allied Health Palliative Care resource

Deb Rawlings1, Jennifer Tieman2

1Palliative & Supportive Services, Flinders University, GPO Box 2100, Adelaide, 5001 South Australia deborah.rawlings@flinders.edu.au
2Palliative & Supportive Services, Flinders University, GPO Box 2100, Adelaide, 5001 South Australia Jennifer.tieman@flinders.edu.au

Background

CareSearch is an online evidence – based palliative care resource. It features an Allied health ‘Hub’ to recognise their vital role within multidisciplinary care. Hubs consolidate the knowledge base/practice issues for those involved in seeing people with palliative care needs. It provides easily accessible information for Allied Health Professionals that can help empower, motivate and educate in palliative care.

Methods

An advisory group supports ongoing development, providing feedback on the content, design and organisation of the hub as well as user testing. Pages are created within a knowledge translation framework and include summaries of the issues as well as practical resources that include DVDs, policy documents and weblinks. There are sections on clinical considerations, education, areas of practice, quality policy standards, interdisciplinary teams, and working with patients and consumers. There are also pages for consumers on the roles of allied health professionals.  Each page is peer reviewed.

In addition, there are PubMed topic searches specific to Allied Health, each featured discipline and to rural and remote issues.

Results

The Allied Health hub had 164,000 page views in the 2 years to November 2015.

Each member of the advisory group leads an edition of the bi-monthly newsletter focusing on their discipline. This includes a case story and a profile of someone working in palliative care. There are over 1,000 subscribers to this.

Discussion

CareSearch contributes to increasing the evidence base for palliative care for those working in Allied health with rigorous developmental processes to ensure currency and appropriateness of information.

Biography

Deb’s background is in Oncology and Palliative Care Nursing both in the UK and Australia. Deb is a lecturer in Palliative and Supportive Services, Flinders University and also works as a research fellow on CareSearch an evidence based website.

An intervention aimed at reducing the number of frequent attendances to hospital emergency departments

Jane George1, Lynne Briggs2

1West Coast District Health Board, Grey Hospital, PO Box 387, Greymouth, New Zealand jane.george@westcoastdhb.health.nz
2Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia l.briggs@griffith.edu.au

Background

A Health and Wellbeing Connection pilot study was undertaken by Richmond Services in partnership with Pegasus Health, Partnership Health, and the Canterbury District Health Board.

Objective

The aim of this study was evaluate an intervention program offered that assisted reduction of the number of frequent attenders to the Emergency Department at Christchurch Hospital.

Methods

The K10 Depression and Anxiety scale and the World Health Organization Quality of Life measure (WHOQOL) were administered to 105 people attending the Emergency Department repeated for the 53 participants who completed the intervention program.  Attendance rates at the Emergency Department and general practice were also recorded.

Results

The majority of the participants who completed the program had reduced their attendance at the Emergency Department significantly and all reported a decrease in psychological distress and an increase in their quality of life. There was no real change in their attendance rates at general practice centres.

Conclusion

While the number of participants in this study does not allow for robust analysis of efficacy it does indicate that there is merit in continuing to develop brief intervention case management models to support behaviour change programs for frequent attenders to Emergency Departments.

Biography

Jane George is Associate Director of Allied Health for the West Coast District Health Board.  She is a registered Social Worker, and has practiced in New Zealand and the United Kingdom.  Her research interests are centred on improving health outcomes for vulnerable populations in rural settings.  A primary goal is the use of strengths based leadership strategies to support staff to use innovation in response to change.  Jane is a Member of the Australasian College of Health Management, the Aotearoa New Zealand Association of Social Workers (MANZASW) and Health Informatics New Zealand (HINZ).

Social work approach on decreasing blood lead levels in Port Pirie

Emma Nunan1, Charlotte Dean2, Hannah Herrmann3

1 Environmental Health Centre, 117 Gertrude Street Port Pirie, SA 5540 emma.nunan@sa.gov.au
2 Environmental Health Centre, 117 Gertrude Street Port Pirie, SA 5540 charlotte.dean@sa.gov.au
3 Environmental Health Centre, 117 Gertrude Street Port Pirie, SA 5540 hannah.herrmann@sa.gov.au

Background:

The Port Pirie Environmental Health Centre (EHC) helps protect children from the harmful effects of lead in their environment. Port Pirie has a history of lead contamination resulting from more than 100 years of smelting in in the town.

The Social Work team’s responsibility at EHC is to provide comprehensive case management focusing on early intervention and collaboration with the families and local community to reduce lead exposure pathways. There is no ‘safe’ level of lead exposure and exposure should be reduced or prevented to keep blood lead levels as low as possible. Young children and pregnant women are most at risk from the health impacts of lead exposure.

Purpose:

EHC identified that children’s blood lead levels increased within the first two years of the child’s life. Due to this knowledge and the previous research on pathways in Port Pirie,early intervention strategies were identified as a plan forward to reduce children’s exposure to lead. The social determinants of health were recognised as an impact on children’s overall health, particularly their blood lead levels.

Method:

A review of services identified a need to refocus EHC service provision. A service plan proposal was developed utilising the analysis of blood lead levels technical paper, AEDC and child development knowledge, which was approved by senior staff members. Advocacy for additional resources, with two allied health FTEs employed, to expand the team’s ability to provide more intensive early intervention case management. Partnering with children and families is central to increase engagement and health outcomes for their children in Port Pirie.

Results:

Results will be discussed with reference to technical paper data and case examples.

Conclusion

Exploring case examples and utilising statistical data provides evidence that early intervention and prevention is the most proactive and efficient way forward in managing children’s exposure to lead in Port Pirie.

Biography

Emma is the senior social worker at the Environmental Health Centre, she also has a private social work practice. Previously Emma was employed by Families SA and UCWCSA. Emma is recognised as an Advanced Accredited Social Worker by the AASW. Emma has been the elected the chair of the Early Childhood Initiatives Group on two occasions; working with an interagency multidisciplinary group to develop plans for development of the Port Pirie community. During Emma’s roles she has engaged intensively with families to alleviate risks and implement client centred case plans; focusing on paediatrics and the dynamics of families.

Remote novice allied health professional workforce preparation, recruitment and retention: Personality as an influence

Narelle Campbell1, Diann S Eley2, Lindy McAllister3

1University of Queensland; Flinders Northern Territory. narelle.campbell@flinders.edu.au
2School of Medicine, The University of Queensland. d.eley@uq.edu.au
3Faculty of Health Sciences, The University of Sydney. lindy.mcallister@sydney.edu.au

Background

Attracting and retaining an allied health (AH) workforce in rural and remote areas is an ongoing issue. Key trends from medical and nursing have shown that personality factors play a role in recruitment and retention. However, there has been very little research aimed at understanding personality factors that might influence AH professional recruitment and retention. This paper will address the gap, with a particular focus on novice AH professionals in remote and rural positions.

Methods

This national mixed methods study of the AH workforce comprised two strands: an investigation of personality characteristics using an internationally validated personality inventory, and a follow up study using a structured interviews. This combination of data sought to uncover personality characteristics and factors that contribute to successful recruitment and retention in remote and rural areas.

Results

The results (n=562) showed that a sense of adventure (Novelty seeking) and acceptance of uncertainty (Harm avoidance) was a useful combination of personality traits for recruitment potential. Younger professionals had higher Harm avoidance. Retention in remote included factors beyond personality characteristics such as confidence in a ‘generalist’ role, and a sense of contributing to the health of individuals and the community. Younger AH professionals were significantly more challenged by practicing in remote and more likely to consider that their expertise was under-valued by colleagues and community members.

Discussion

Policy implications and practical outcomes related to recruitment and retention of novice remote AH professionals will be presented from the research. ‘The village’ approach to raising successful remote AH professional ‘children’ will be emphasised.

Patient driven radiotherapy information movies

Katelyn Williams1, Jenna Blencowe1, Melissa Ind1, David Willis1

1North West Cancer Centre, Johnson Street, Tamworth. NSW. 2340. Katelyn.williams@hnehealth.nsw.gov.au

Background:  Misconceptions about Radiotherapy processes can compound the anxiety patients experience at the commencement of treatment. In partnership with patients an information video program was initiated to counter this phenomenon and help patients explain treatment to family and friends. The project was conducted in a regional department where 45% of patients travel more than 100km for care.

Method: Patient consultation and a literature review informed video content. Footage of treatment processes was augmented with 3D software.  Videos were produced voluntarily by staff, outside clinical hours with loaned equipment.  Patient-approved videos were incorporated in information sessions and made available online and on DVD. An ethics-approved survey was conducted to assess how effectively the videos met patients’ informational needs.

Results: Patient feedback was overwhelmingly positive.  Patient engagement permitted iterative improvements and creation of multiple videos.  The program received professional recognition for both quality and originality. Surveyed patients reported that the video met one or more of the listed information needs (98% n=60) with 3D software explanations of complex concepts regarded as helpful (85%).   Fifty percent credited the videos with reducing anxiety.  Patients watched again at home (53%), primarily to explain treatment processes to loved ones (40%).

Discussion:  Collaboration and personal commitment to a shared goal has allowed patients and staff to produce high quality information resources with no budget. The 3D visualization software assisted in explaining dosimetry technicalities and treatment delivery in a range of patients. Standardised videos provided efficient and consistent information and permitted subsequent review at home.

Biography

Katelyn Williams is a Radiation Therapist with 10 years clinical experience, a Masters in Health Science (Medical Radiation Science) and is currently undertaking a Masters of Health Services Management. She began her career in metropolitan centres, prior to moving to Tamworth in 2013 as part of the Foundation team for region’s first Radiation Therapy service. Katelyn has a strong interest in the use of multimedia in patient information, holding key roles in video project teams in her previous workplace and in Tamworth.

No more dieting, Move Nourish Enjoy!

Esther Miller1, Amy Trengove2

1Port Pirie Regional Health Service, The Terrace & Alexander Street, Port Pirie SA 5540, esther.miller@sa.gov.au
2Clare District Hospital, Webb Street, Clare SA 5453, amy.trengove@sa.gov.au

Move Nourish Enjoy (MNE) is an evidence-based group piloted July-Sept 2015 in the Mid North ‘Village’, SA. It was initiated due to the high demand for dietetic services for weight management. MNE enabled peer support and education through an intensive weekly program, aiming to improve non weight related health outcomes through behaviour change and self-management. It focussed on active living, pleasurable and healthful eating and positive self-image, using Rick Kausman’s non diet approach to weight management.

Nine participants were recruited. Pre and post evaluation measured activity and nutrition health behaviours, knowledge and attitudes, and quality of life. Participants attended for 2hrs per week for 8 weeks with 45minutes of low impact movement and a 60min workshop. Process evaluation occurred at the end of each session and on completion of the program.

The waiting list decreased by 30%. MNE achieved an average attendance of 78%. The group reported a total increase in nutritious foods and decrease in discretionary choices. All increased their physical activity with a total increase from 1100min to 1190min per week.  Rate of perceived exertion decreased from a total of 24 (light to moderate) to 6 (nothing or very light).  Participants experienced a 2% overall decrease in BMI (not the focus).

100% of participants enjoyed the program and felt confident in their new skills to continue their health and wellbeing journey. MNE improved health outcomes and contributed to a reduced dietetic waiting list therefore two more groups are scheduled for 2016.

Biography

Amy Trengove is a Rural Generalist Dietitian in Mid North South Australia passionate about primary health care and supporting clients so they can care for themselves. Born & raised on a rural property, Amy always knew she would return to the country following university. She has been and is a member of many rural focused organisations including the Flinders University Rural Health Society, National Rural Health Students Network, National Rural Health Alliance, Future Health Leaders and SARRAH. She was a semi-finalist in the 2013 & 2014 SA Young Achiever of the Year Awards for her work with these organisations.

Let’s listen! Redesigning medication programs to suit the needs of Aboriginal and Torres Strait Islander people.

The Home Medicines Review (HMR) program has been found to raise awareness of medication safety, reduce adverse events and improve medication adherence. Aboriginal and Torres Strait Islander (Indigenous) clients are the most likely of all Australians to miss out on HMRs despite their high burden of chronic disease and high rates of hospitalisation due to medication misadventure.

This study investigated how pharmacists, through the HMR program, might better address the medication management needs of Indigenous people.  It explored the attitudes and perceptions towards medication review of clients, health professionals in Aboriginal Health Services (AHSs) and pharmacists.

Eighteen focus groups with 101 Indigenous clients, and 31 interviews with health professionals were conducted at 11 AHSs. Focus groups and interviews were recorded, de-identified and transcribed. Transcripts were coded and analysed thematically.  A cross sectional survey was used to gather demographic, qualitative and quantitative data from HMR accredited pharmacists.

Barriers to provision of medication review to Indigenous clients included paternalistic attitudes of health professionals, the GP-client relationship, and the need for more culturally responsive pharmacists. Onerous, inflexible HMR program rules were impediments to health professionals, pharmacists and clients alike.

Remodelling of the HMR program is needed to increase the awareness, accessibility, acceptability and effectiveness of the HMR program for Aboriginal and Torres Strait Islander people. Like many health programs, the HMR program was designed without consultation or input from Indigenous people.

This presentation will explore how research can result in changes in policy and increased consultation with Aboriginal and Torres Strait Islander people.