The RIPES Time is here – Piloting an inter-professional student education model

Ms Laura Page1, Mr Steve Cadell1

1Central West Rehabilitation Service, Longreach, Australia

Abstract:

Problem: Traditional student placement models promote discipline-specific clinical reasoning reducing exposure to skill-sharing and inter-professional practices

Setting: A rural inter-professional education and supervision program (RIPES) was piloted by the Central West Rehabilitation Service, in collaboration with the Cunningham Centre. This pilot studied the efficacy and knowledge base post execution of this innovative inter-professional education (IPE) model.

Key measures for improvement: Increased knowledge of IP scope of practice, holistic patient-centred treatment plans, improved discharge planning and cohesiveness in collaboration between students/health professionals.

Process of gathering information: Separate Clinical Educator (CE) and Student focus groups facilitated by the Cunningham Centre.

Analysis and interpretation: Identification of ceiling effect of current discipline specific student marking criteria.

Strategies for change: A standardised IPE program facilitating skill-set sharing and delegation foundations in adherence with frameworks such as the Calderdale may increase workforece readiness.

Effects of change: Improvement in comprehensive discharge planning from admission with predicted decreases in length of stay and increased patient satisfaction/clinical outcomes, increased referrals/assessments in line with skillset sharing.

Lessons learnt: The readiness for students to participate in IPE, clinical experience, maturity, university grades and the ability to work within a team were significant contributing factors to the success of the program. Future development may benefit from a review of how personality inventory indices effect inter-disciplinary team dynamics and skill-sharing. A further review into proficiency measures for tertiary students completing such a placement is warrented in order to reduce ceiling effects. Optimal lengths for consolidation of IPE and skill-sharing proficiency requires further investigation.


Biography:

Steve Cadell is the Team Leader and Advanced Physiotherapist for the Central West Rehabilitation Service. Steve completed both his Bachelor of physiotherapy and graduate diploma in rehabilitation studies through James Cook University. Currently, he is working towards a research masters in the field of persistent pain specifically in relation to the treatment and management of fibromyalgia related pain. Steve’s passion for physiotherapy resides across a diverse spectrum of mental health, neurology, dementia care and persistent pain management. Steve thoroughly enjoys working in Central West Queensland and since arriving in Longreach 2017, he and his team have established an allied-health led persistent pain management clinic in combination with the current rehabilitation service which too is consolidating and expanding across the Central West Hospital and Health Service.
Steve is an active advocate for rural health and currently represents Central West Hospital and Health Service on numerous projects and steering committees inclusive of the AHPOQ Transition2subacute, Tele-handover project/collaborative and the Statewide Persistent Pain Management Steering Network. In Steve’s spare time he trains in the Thompson River and Longreach Aquatic Center in preparation for swimming the English Channel in 2020 to raise funds for rural dementia care.

Get them while they are young! A Student Health Academy Promoting Careers for Rural High School Students

Mrs Kathryn Fitzgerald1, Ms Jodi Ullrich1

1WA Centre For Rural Health, Geraldton, Australia

Abstract:

The Student Health Academy (SHA) is a strategy to assist in a long term approach to ensuring a strong future rural health workforce by providing high school students with information and experiential learning about health careers. Based on the principles of the rural health pipeline, the WA Centre for Rural Health (WACRH) has delivered an immersive 2-day program to over 250 rural high school students in year 10 who have shown an interest in a health career. It is designed to include all key professions and allied health professions are integral to this. Academy members interact with local health professionals and students on clinical placement with WACRH and the program includes simulated learning with a focus with participants completing eight skills sessions from our suite of twenty-six. While the feedback from the six school partners and the participants is positive, in 2018/19, the SHA program has been expanded to provide a greater long term relationship with the high school students and schools, with a student health cadets program commencing from year 7. The aim of this is to focus on key student groups, and to develop a 6 year relationship with high school students in the Academy Program along the pipeline commencing with health literacy in the cadets program (year 7-9), careers information and learning in year 10, and support with academic choices and directions in years 11 and 12. This presentation will outline the development of the SHA so far and the development of the expanded program.


Biography:

Kathryn Fitzgerald has worked in rural and remote areas as an Allied Health professional in clinical practice, in policy and program development and in health professions’ education for over 30 years, and has been involved with SARRAH since the organisation’s early days. She currently works as the Clinical Education Manager for the WA Centre for Rural Health based in the Midwest of Western Australia.

Evaluation of health service student programs in a primary health and culturally responsive framework: Service learning in Mt Magnet, Western Australia

Mrs Kathryn Fitzgerald1

1WA Centre For Rural Health, Geraldton, Australia

Abstract:

Allied Health students undertaking clinical placements with the WA Centre for Rural Health have the opportunity to live in the remote town of Mt Magnet for periods of 2 -14 weeks and work with community agencies, providing services to the community. Students in 2018 based in Mt Magnet include Exercise Physiology, Speech Pathology, Occupational Therapy and Social Work.
Students work in the community, partnering in areas of under-represented services and community expressed need. Students participate in cultural orientation as well as practical sessions about clinical yarning prior to the placement and, in additional to clinical and interprofessional supervision, participate in regular cultural mentoring throughout their time in Mt Magnet.
The aim of this project is to evaluate the students’ work in terms of the services they provide in the context of culturally responsive practice as described in Indigenous Allied Health Australia’s Cultural Responsiveness in Action: An IAHA Framework (2015) within a framework of knowing, being and doing.
This project aims to evaluate services within the context of the IAHA key capabilities from the perspectives of the community agencies, community leaders, the students and clinical supervisors. Clients/ patients and family members will be invited to participate also.
This project is ongoing through to 2019 and the outcome will provide guidance on how to continue to develop service learning opportunities for allied health students clinical placements in rural and remote Australia.


Biography:

Kathryn Fitzgerald has worked in rural and remote areas as an Allied Health professional in clinical practice, in policy and program development and in health professions’ education for over 30 years, and has been involved with SARRAH since the organisation’s early days. She currently works as the Clinical Education Manager for the WA Centre for Rural Health based in the Midwest of Western Australia.

Checking out the landscape: the experiences of a Grade 1 physiotherapists from a major tertiary Hospital rotating through a remote hospital and the positive impact on recruitment

Ms Sally Barrett2 Ms Annie Farthing1, 2, Ms Lenore Block2     

1Centre for Remote Health, Alice Springs, Australia, 2Alice Springs Hospital, Alice Springs, Australia

Abstract:

In 2010 Alfred Health signed an agreement with the Alice Springs Hospital (ASH) to have Grade 1 physiotherapists complete a four month rotation at ASH. Since the program commenced, Twenty seven physiotherapists have chosen to complete a rotation in Central Australia. Seven staff members have returned to take up P2 positions at the Alice Springs Hospital within a year of completing their rotations in Alice Springs – currently, four of the nine physiotherapists employed by ASH are former employees of Alfred Health and all of these staff were first introduced to remote healthcare through the Alice Springs rotation.

This presentation will explore the experiences of the therapists who have chosen to take up a career in remote health through this process. It aims to highlight some of the lessons learned by staff at Alice Springs Hospital as well as from Alfred Health, and will propose key factors which have supported and challenged the project.


Biography:

Sally is very lucky to have started her physiotherapy career with Alfred Health. She took the opportunity to “check out” the landscape in Alice Springs on a rotation through the grad program, fell in love with the place and came back to continue her career in Central Australia.

Telerehabilitation: Supporting Change in SA Health

Mr Chris Leung1

1SA Health, Bedford Park, Australia

Abstract:

SA Health need to meet increasing demands for rehabilitation services across the state, improve consumer access and enhance clinical safety and quality. This paper explores the implementation of telehealth in rehabilitation (telerehabilitation) as a service modality across SA Health to enhance care pathways.

Supported by growing national and international evidence for telerehabilitation, SA Health committed to embed telehealth in rehabilitation services across the state, investing significantly in new roles and technology.

Access to specialist rehabilitation services in SA Health has been limited to 4 key metropolitan sites and 3 regional sites. Consumers are now able to loan SA Health iPads, or use their own technology, to connect with rehabilitation teams for consultations, assessments and therapy as well as utilise therapeutic apps to engage with extra goal-oriented activities, from their own homes.

A target was set for 5% of all IPHA Tier 2 rehabilitation activity to be provided by telehealth. Additional measures include: monitoring of incidents and sentinel events, establishing appropriate and relevant measures for technical issues impacting on clinical care, and continual monitoring of consumer, as well as clinician satisfaction.

The 70:20:10 learning and development model and various change management philosophies were used to introduce new concepts, skills and procedures to clinical staff.

In 10 months, telerehabilitation services have exceeded the 5% target for Tier-2 activity. The program has enabled unprecedented access to rehabilitation services for rural and remote patients.

The program team recognised and balanced the subjective and objective, individual and collective elements required for system-wide reform.


Biography:

Chris works for SA Health, as the Statewide Telerehabilitation Clinical Lead – Allied Health. Over the last 12 years, he has enjoyed various roles in clinical physiotherapy and allied health clinical governance, from metropolitan to country and rural services across SA and the NT. His clinical passions lie in serving the community as a general ruralist physiotherapist and in promoting greater access to quality services for rural and remote Australians. In his current role, Chris is proud to be serving as a bridge between ICT and clinical care, and to be planning, implementing and promoting statewide initiatives through technology.

The Northern Australia Research Network: Building evidence-informed services for Functioning, Disability and Health in northern Australia.

Mrs Kylie Stothers2, A/Prof. Ruth Barker1, Mr Andrew McGraw3, Mrs Jennifer Chamberlain-Salaun1, Ms Jennifer Carr1, Ms Renae Moore4

1James Cook University, Smithfield, Australia, 2Indigenous Allied Health Australia, Katherine, Australia, 3WA Country PHN, Broome, Australia, 4Top End Health Service, Darwin, Australia

Abstract:

The Northern Australia Research Network (NARN) was established in 2016 to conduct collaborative research in the area of Functioning, Disability and Health, to inform delivery of rehabilitation and lifestyle services in regional, rural and remote Northern Australia. Recognising the cultural and diverse needs, beliefs, practices and authority of Aboriginal and Torres Strait Islander peoples in northern Australia, in 2017 NARN partnered with Indigenous Allied Health Australia.

NARN is a small cross-jurisdictional collaborative network of researchers, clinicians, health managers, Primary Health Network managers and consumers from the Northern Territory, Western Australia and Queensland. Allied health professionals form the majority of the NARN membership with a range of other members who contribute to delivery of rehabilitation and lifestyle services. A Leadership Group and an Expert Research Advisory Group guide the following five Research Working Groups:
• Community engagement
• People-centred health care
• Skilled and responsive workforce
• Evidence-informed practice
• Evidence-informed investment
The objectives of NARN are to:
• Build an evidence base for services in the area of Functioning, Disability and Health in northern Australia.
• Respond to the needs of Northern Australians, particularly Aboriginal and Torres Strait Islander peoples.
• Build research capacity – community research partners, clinicians, student and early career researchers.
• Embed allied health professionals into the broader health research arena.
• Work with stakeholders across the health sector to identify needs, partnerships and resources.

This presentation will consist of an overview of NARN within the changing landscape of northern Australia and of the Disability sector.


Biography:

Kylie Stothers and Ruth Barker are the co-chairs of the Northern Australia Research Network.

Kylie Stothers is a Jawoyn woman, born and raised in Katherine within a large extended family with strong ties in Katherine and surrounding communities. She is a Social Worker and Workforce Development Manager for Indigenous Allied Health Australia (IAHA), the national peak body representing Aboriginal and Torres Strait Islander allied health professionals and students. Kylie has a central role in training allied health professionals on the IAHA Cultural Responsiveness Framework.

Ruth Barker is a physiotherapist and researcher with expertise in stroke rehabilitation and innovative models of service delivery for rural, remote and Indigenous communities of northern Australia. Over the past decade, Ruth has attracted funding of more than $16 million to design, pilot, implement and evaluate community rehabilitation services in Townsville and Mt Isa with outreach services to surrounding communities. In her current position, Ruth is focused on building research capacity across Allied Health disciplines by supporting, mentoring and advising a raft of PhD students and clinician researchers across the health professions.

“Working in a bubble”: the experiences and meaning of professional isolation from the perspective of health professionals working in rural and remote Western Australia.

Ms Jodi Smith1, Professor  Sonya Girdler1, Doctor Petra Wagman1

1Curtin University, Bentley, Australia

Abstract:

Objective:To understand the experience and meaning of professional isolation (PI) from the perspective of health professionals working in rural and remote Western Australia.

Design: A qualitative, grounded theory approach was used. Semi‐structured interviews were completed with 32 theoretically selected health professionals. Data were analysed using a constant comparative method to provide detailed descriptions of the experience of PI.

Results:Three core themes emerged from the data. The first theme “Professional isolation means working in a bubble” described the feeling of working alone without outside influence or connection. The second core theme was “it could be worse if you were way out Woopwoop” describing the variations in opinions on if geographical isolation was directly linked to PI. The third core theme was “I choose not to feel professional isolation”, described how some participants recognised the need to avoid PI and had put strategies in place to counteract it. Participants saw PI as leading to negative outcomes for the client, the health professional and the community. Whilst participants universally viewed PI as negative, some participants acknowledged that there could be positive gains including personal and professional creativity, learning new skills and networking opportunities.

Conclusions:Participants were interviewed described diverse, complex situations and clinical issues that led to them feeling PI. Health professionals viewed PI as involving multiple features, being potentially present in all workplaces and leading to poor work performance stress and burnout. Participants also described PI as something they felt they could manage with experience, knowledge and networks.


Biography:

Jodi Smith is an Occupational Therapist of far too many years experience, with decades of this experience working in rural and remote settings in WA, SA and NT. Jodi is currently studying for a PhD and this research is part of a larger study looking at defining the term professional isolation.

Bottom-Up Schools: Using technology in rural and remote schools to support child regulation for improved learning and social outcomes

Ms Dagney Hopp1, MS Rebecca Hammond1, Ms  Kim  Casburn1

1Royal Far West, Manly, Australia

Abstract:

Every year, hundreds of country children with limited access to local allied health services benefit from Royal Far West (RFW)’s multi-disciplinary model of care for behavioural, learning and mental health disorders.

Because of the challenges in accessing consistent allied health services in some country areas, strengthening capacity of rural and remote communities to support child development is a key strategic pillar of RFW’s work. Schools, and in particular teachers, are increasingly playing a role in this day-to-day support. Technology is an invaluable modality for ensuring equity of access to professional development opportunities for rural and remote schools.

RFW’s specialist multi-disciplinary paediatric team have developed a NSW Education Standards Authority (NESA) accredited, technology delivered Capacity Building Program. The modules are based on latest evidence and include live feedback sessions with senior Allied Health Professionals to build learning and practice in key areas of child development, behaviour and mental health. One of the most successful Capacity Building packages are Occupational Therapist-led Regulation modules. These modules focus on regulation including sensory, emotional, environmental and relationship mechanisms that impact and underpin child behaviours and outcomes in school. RFW’s Senior OTs work with school staff to identify what they are doing well, as well as thinking through new strategies and techniques to apply across the whole school. These strategies can support schools to build safe and supportive school environments with a bottom-up approach to supporting children at all developmental stages.

Presenters will share about the development and success of the Occupational Therapy Regulation modules.


Biography:

Dagney Hopp is a Senior Occupational Therapist and Team Leader of Occupational Therapy, Dietetics and Orthoptics at Royal Far West. She works as a clinical lead in the multi-disciplinary paediatric team, providing both in-person and telehealth assessment, therapy and capacity building services for children, families, schools and communities in rural and remote Australia. Dagney’s paediatric specialisation has been developed through her previous roles as Senior Occupational Therapist at a number of mutli-disciplinary paediatric health and education practices. Dagney’s skills as a collaborative, multi-disciplinary team provider have a strong focus on addressing childhood trauma and regulation issues.

Developing viable allied health service and workforce development models in rural and remote Aboriginal communities.

Ms Donna-Maree Towney1

1Indigenous Allied Health Australia, Deakin West, Australia

Abstract:

Indigenous Allied Health Australia (IAHA) is a member-based organisation with over 1,400 members, made up of allied health students and professionals. We acknowledge and respect the critical role both the allied and Indigenous health workforce plays in improving health and wellbeing for Aboriginal and Torres Strait Islander peoples. IAHA advocates for systemic improvements to better enable health professionals to achieve this.

Working in collaboration with community and key stakeholders, IAHA are leading a project to develop an Indigenous allied health workforce in remote and rural Australia.

The project has identified two locations that have access to the National Disability Insurance Scheme (NDIS), with a high population of Indigenous people with disability:
• Tennant Creek, NT,
• Palm Island, QLD; and
Aboriginal and Torres Strait Islander people with disability are more disadvantaged and generally do not access health care for a variety of reasons.
IAHA has progressed this project to determine there is a significant and critical need for consistent allied health care within remote and rural locations.

By developing an Indigenous allied health workforce, we are:
Providing opportunities for Indigenous peoples with employment and career pathways
Providing sustainable employment which will improve the economy;
Providing communities consistent person and family centred care that is culturally appropriate and safe; and
Increasing health outcomes for Indigenous peoples who cannot easily access health care

Workshop participants will consider key recommendations from the final RIAHP report and discuss practical solutions of ensuring viable allied health services and workforce development can be sustained.


Biography:

Donna-Maree Towney is a Gunditjmarra woman.
Donna-Maree worked in the Australian Public Service (APS) for 15 years and proudly joined the IAHA team in May 2017 and is currently working on the Remote and Rural Indigenous Allied Health Workforce Development Project (RIAHP).

Whilst in the public service, Donna-Maree worked with several government agencies to develop strategies to employ and retain Aboriginal and Torres Strait Islander people in the Australian Public Service, as well as boost government departments’ knowledge of cultures and value of employing Aboriginal and Torres Strait Islander peoples.

Culturally safe and accessible service development; An Occupational therapy and Home and Community Care partnership

Ms Robyn Glynn1, Mrs Moira Mau2

1Torres and Cape Hospital and Health Service, Thursday Island, Australia, 2Northern Peninsula Area Regional Council , Bamaga, Australia

Abstract:

The gap in health status between Aboriginal and Torres Strait Islander (Indigenous) Australians and non-Indigenous Australians remains unacceptably wide. One of the factors in improving health care is ensuring services are culturally responsive and safe to optimise access and effectiveness.

In a quality improvement activity, using a case study approach, two service providers, one Indigenous Home and Community Care (HACC) Service coordinator and one non-Indigenous occupational therapist, reflected on their five years of collaboration to make the outreach occupational therapy service culturally safe. The challenges and strategies were identified and were then compared with the literature on culturally responsive and safe occupational therapy practice.
The challenges, mostly consistent with the literature, were categorised thematically. These included cultural safety of Indigenous clients when receiving a home assessment service from a non-Indigenous clinician, difference in priorities between clinician and client, communication and the impact of cultural roles on therapy interventions and outcomes. The strategies identified from the case study included activities not documented in the literature.

Two key conclusions were that:

  • Partnership between Indigenous and non-Indigenous service providers can enable implementation of culturally safe and competent health professional practice that is consistent with research and service quality standards requirements.
  • Service hours need to be allocated to establish partnership and processes for culturally safe services

Biography:

Moira Mau:Coordinator of the Northern Peninsula Area Home and Community Care Service. Has worked 16 years as a care support worker to acting supervisor now coordinator. Is committed to supporting people both from her Torres Strait Islander and Aboriginal cultures to feel culturally safe to connect with visiting services
Robyn Glynn: Currently working primarily as an allied health manager with a component of clinical practice. Prior to this has worked for nearly 20 years in remote Australia providing occupational therapy services in Aboriginal and Torres Strait islander communities.