Capability and Competence to identify and respond to eating disorders

Ms Hilary Smith1, Ms Eliza Charlett

1National Eating Disorders Collaboration, Glen Iris, Australia

Abstract:

The National Eating Disorders Collaboration has developed a competency framework for safe and effective identification and response to eating disorders. This trans-disciplinary tool articulates the skills and knowledge requirements for practitioners at any point in the eating disorders continuum of care, from first responder through to inpatient services and recovery support.
This presentation will outline the competency framework with specific reference to the rural and remote allied health workforce and the unique needs of their clients. This will include exploration of the different roles that practitioners may be required to play within a multi-disciplinary team. Tools to support practice and avenues for further professional development and support will be discussed.
Eating disorders are serious, complex, diverse and treatable mental illnesses which affect 1 million Australians, from urban centres to the most remote parts of the country. In regional and remote Australia, people with eating disorders and their families can struggle to access services with the right level of capability in eating disorder management. This is not limited to acute settings.
Early identification and intervention in cases of suspected eating disorders can save lives. Despite this, the average wait between onset of illness and first attempt to seek help for an eating disorder is 7 to 10 years. Delayed help seeking can lead to significant and lasting mental and physical health complications. Improved skills across the health workforce in recognising warning signs and intervening at the earliest opportunity is a critical current workforce development need.


Biography:

Eliza Charlett is the Manager of the National Eating Disorders Collaboration (NEDC), and has extensive experience in building the capacity of professional networks and communities to identify and respond to eating disorders.

Hilary Smith is the NEDC Workforce Development Coordinator. Her role is focused on introducing specific competencies for safe and effective responses to eating disorders in health and other workforces across the country.

Robotic rehabilitation: A public regional health service model of care

Mrs Andrea Voogt1, Mrs Lisa Peters1, Mrs Bronwyn Connelly1

1Northeast Health Wangaratta, Wangaratta, Australia, 2Better Care Victoria, Melbourne, Australia

Abstract:

Rural Australians face distinct health challenges compared to their metropolitan counterparts. Factors contributing to such disparities include an allied health workforce lacking in specialist skills and lack of access to state-of-the-art technologies. Northeast Health Wangaratta (NHW) received philanthropic grants and community raised funds to purchase robotic equipment in 2017. Utilising robotics we aimed to provide consistent, intensive, repetitive and task specific rehabilitation to patients with motor deficits post neurological injuries.
Whilst trying to implement the new equipment we realised that there was no gold standard model of care (MOC) for Robotic equipment post neurological injury, let alone a publically funded MOC that would consider the unique needs of regional health in Australia. So, NHW completed a business case to Better Care Victoria (BCV) to undertake the development of a model of care for robotic based upper limb rehabilitation.
Systemic changes to our sub-acute ambulatory care service (SACS) were required to support the trials of intensive robotic groups. A detailed assessment about staff competence and confidence to use robotic equipment is being undertaken, as well as evaluation of the broader economic implications of having this technology available to regional patients.
We believe we offer a unique regional and public perspective of undertaking a quality improvement project of this scale and significance.


Biography:

Andrea Voogt is a senior physiotherapist at Northeast Health Wangaratta, where she speicalises in the management of complex neurological and cardiac clients.  Andrea has a wealth experience in service delivery planning and coordination and has recently commenced as a project coordinator for the robotics program. Andrea sees robotics as the way of the future and is excited to have the opportunity to have access to state of the are technology within a rural setting. Andrea is currently using her experience and knowledge to develop a model of care for upper limb robotics program within the public health system.

Strong Foundations – child, family, community and environmental toxins

Ms Emma Nunan1, Ms Hannah Herrmann1

1Environmental Health Centre, Port Pirie, Australia

Abstract:

The Port Pirie Smelter has been operating for over 100 years, leaving a lead legacy for the city. The Environmental Health Centre (EHC) works collaboratively with families to help protect children from the harmful effects of lead in their environment.

In conjunction with the Port Pirie Smelter Transformation in reducing lead exposure within the community, EHC’s service delivery model has changed to actively support pregnant women, children and their families during the first thousand days.
In Port Pirie, blood lead levels typically increase in the first two years of a child’s life. The first thousand days is also a period of rapid brain development. Children’s brains are particularly vulnerable to environmental toxins. “Exposures to substances such as lead that have minimal or no discernible impacts in adults can permanently alter brain development and function in a child” (Centre for Community Child Health, The First Thousand Days, 2017 p. 42).

As a result, early intervention strategies were identified to reduce children’s exposure to lead. A key feature of these strategies is to support families to have access to timely and appropriate prevention services.

A review and service plan proposal was developed utilising the analysis of Port Pirie blood lead levels, Australian Early Development Census and child development knowledge. The Social Work team has refocused on providing intensive early intervention strategies and partnering with pregnant women and children to help promote positive health outcomes within the community of Port Pirie. Early intervention and prevention is the most proactive and efficient way forward.


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 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.

Taking Tracheostomy Care across the Territory

Dr Carole Maddison1, Mrs Jaya Thomas1

1Clinical Learning Education and Research Services (CLEaRS), Top End Health Services, Darwin, Australia

Abstract:

Background and Aim/s:In 2014 the education program resulted from an identified need to enhance clinical skill and knowledge of tracheostomy care for all health care staff at Royal Darwin Hospital. This was driven by high staff turnover and the need to ensure an Interprofessional approach to learning and care delivery.
The seven hour program was collaboratively designed with medical, allied health and nursing input and a strong focus on the patient experience to inform practice.

Methods:Presenters include nursing, medical, speech pathology disciplines with an enthusiastic patient / consumer.
Delivery design comprises pre-session assessment, theory and practical skills undertaken in a simulated clinical setting.
The program has been extended to Alice Springs staff with theoretical sessions delivered via Videoconference and skills stations completed in the simulated clinical setting at each venue.

Results:In 2016-2017 six sessions were delivered with three videoconference-linked to Alice Springs.
There were 137 attendees from Nursing and Allied Health disciplines.
The program received commendation from the ACHS accreditation surveyors in August 2017 for innovation and the inclusion of the patient perspective.
Future inclusion of Katherine and Gove hospitals is planned.

Conclusion:The success of the program highlights the importance of engaging patients in the planning and delivery of education for clinicians. This program includes
• Patient centred care
• Interprofessional collaboration
• Simulation and practical skills
• Use of technology to reach geographically dispersed audiences

References: Available on request


Biography:

Jaya Thomas has worked in the CLEaRS (Clinical Learning Education and Research Service) team as Nurse Educator with the Graduate Nurse Program and Nurse Education Consultant delivering a range of programs across the Top End Health Service. She has experience in acute clinical nursing as well as an in-depth understanding of chronic disease management. She has completed a Master of Nursing and holds a Graduate Certificate in Education. Jaya has been integral to the development of the Tracheostomy Care program that has been delivered across the Northern Territory.

“Balancing health and farming: How farmers understand, maintain and make decisions about their health”

Miss Alexandra Humphrys1, Professor Megan Smith1, Associate Professor  Rylee Dionigi1

1Charles Sturt University, Albury, Australia

Abstract:

Farmers experience a lower standard of health than the general population, and are a consumer group with specific requirements of health services. This study provided new insights into how farmers understand, maintain and make decisions about their health. This knowledge enables better collaboration between farmers and rural and remote allied health professionals.
In-depth interviews were conducted with seven farmers in the Riverina, recruited by trusted referral. Data was analysed using inductive content analysis to generate new insights into the health values, maintenance behaviours, and decision-making processes of farmers.
The findings of this study were captured in three themes: farmers understand their health in relation to their role as a farmer, farmers actively aim to maintain health, and farmers base their health decisions on the values of productivity and self-sufficiency. It was found that farmers do not refrain from seeking the help of practitioners, however they have different triggers for help-seeking compared to other consumer groups.
What this means for allied health professionals is that farmers as a consumer group may use consultations for advice and maintenance strategies for multiple issues, rather than presenting with one specific issue. It also provides evidence that improving functionality at work, which is within the scope of physiotherapists and occupational therapists in particular, is the key to providing allied health services that address the specific needs of farmers as a consumer group.


Biography:

Alexandra Humphrys is a new graduate physiotherapist, who conducted this research as part of her Honours degree under the guidance of co-authors, Professor Megan Smith and Associate Professor Rylee Dionigi. Alexandra grew up in Echuca, and has always been interested in rural health, having travelled extensively in the Australian outback. She is inspired by rural practitioners, and aspires do her best to improve the health of rural communities.
Professor Megan Smith is a director of Three Rivers University Department of Rural Health. She has previously been the Head of School of the School of Community Health, physiotherapy course leader, Sub Dean of Workplace Learning for the Faculty of Science, and Acting Associate Dean for the Faculty of Science. Her current research interests are in the area of developing a future rural health workforce that can meet the health needs of rural communities, and she supervises PhD, Professional Doctorate, Masters and Honours students.
Associate Professor Rylee Dionigi is widely published in the fields of sport sociology, ageing and physical activity, health, exercise psychology and leisure studies. She has extensive expertise in qualitative research methodologies, and her research is recognised both nationally and internationally. In addition to her work at Charles Sturt University, she has ongoing external research collaborations in Canada, the United Kingdom and Australia.

Burns Occupational Therapy —providing burn rehabilitation to remote Indigenous patients in the Top End.

Mrs Jennifer O’Neill1

1Royal Darwin Hospital, Tiwi, Australia

Abstract:

The Royal Darwin Hospital Burns Unit has been committed to providing burn treatment and education across the Top End since its formation after the Bali Bombings in 2002. The Burns Unit caters to adult and paediatric inpatients and outpatients with minor to major burn injuries, and supports patients through their recovery from acute treatment to long term scar management.

The Burns Unit Scar Management Clinic delivers a high standard of care in accordance with evidence based practice guidelines in Burn Trauma Rehabilitation. The primary role of the Burns OT is to provide specialist scar education, treatment and management to prevent problematic scarring, contractures and skin breakdown post a burn, while maintaining joint function and improving overall cosmetic appearance and quality of life.

A significant proportion of the unit’s acute admissions are people from remote Aboriginal communities. The unique issues and challenges presented by this patient group demand adaptations to standard approaches to practice. Working with remote dwelling Aboriginal people offers opportunities to develop specific educational resources and interventions to meet the demand for culturally responsive care, and address the geographical and environmental challenges that come with living in the Top End.

Providing an effective scar management service to remote dwelling Aboriginal people is challenging, however the RDH Burns Unit continues to strive for best practice, utilising resources such as telehealth, adapting educational tools, and coordinating with community clinics.


Biography:

Jennifer O’Neill is an Occupational Therapist at the Royal Darwin Hospital (RDH). After graduating from the University of Queensland, Jennifer has spent the last 6 and a half years working in a wide variety of general and specialist areas at RDH, including caseloads in medical, surgical, neurology, oncology, orthopaedic, paediatric and the Emergency Department.
For the last four years Jennifer has been working in an outpatient caseload , specialising in hand therapy. She was the RDH lymphoedema therapist for two years until July 2017, when she moved into the speciality Burns caseload as the primary Burns Occupational Therapist.

TEHS Renal Service Occupational Therapy Role

Mrs Joan Crombie1

1TEHS Renal Service, Darwin, Australia, 2Occupational Therapy Acute Service Royal Darwin Hospital, Darwin, Australia, 3Occupational Therapy Australia , Fitzroy, Australia

Abstract:

Lightning Presentation ( visual message )

Representing OT Goals current activities and projects
– to provide inpatient acute service whist also addressing the
outpatient suburban , rural and remote population across
diverse cultural backgrounds and languages for CKD and ESRF
clients
– to ensure clients with renal disease continue to utilise the most
appropriate services for their specific issue including Remote
Services, GP’s Include existing services
– to support patients in their renal journey to be actively engage in
their own health care journey through meaningful dialogue,
through activity and with mutual respect through the Pathways
to My Home Program.


Biography:

An Occupational Therapist , British Diploma in Occupational Therapy 1977 ( Trained in Edinburgh Scotland)
Practised mainly in Australia ( Vic, WA, NT) across Acute inpatient Services, inpatient rehabilitation , domiciliary services, Community Health and within home based Enablement Programs. As a volunteer in India over extended periods I used my OT practices to empower and enable children and adults towards healthy living and healthy futures. Opportunities within Royal Darwin Hospital since 2013 in a senior rotational clinical role have led me to this exciting new OT position within the Top End Renal Service.

Kicking goals – goal setting within the remote Aboriginal community context

Miss Michelle Antoine1, Miss Kate Pollard1

1Northern Territory Government, Katherine, Australia

Abstract:

Identifying and setting goals within the remote allied health and disability sector is a challenge, however, when done correctly is rewarding and guides clients to better outcomes. In the complex context of remote Aboriginal health, the reasons for referral are often only a small part of someone’s life. The recognition of this along with differing cultural perspectives on health and disability, language barriers and competing priorities are essential to setting appropriate client-centred goals.
Our team of allied health professionals provide community health, disability and aged care services to individuals in remote Aboriginal communities across the Katherine region. We strive to provide client-centred and culturally safe services, a key component of which is the collaborative identification and formation of meaningful and achievable goals.
We are continually adapting our approach to goal setting based on positive client outcomes seen in practice. To be successful with goal setting within the remote Aboriginal community context requires consideration of; relationship and rapport building, engagement of the correct people, open discussion, use of visual supports, and flexibility of practice.


Biography:

Kate Pollard is a Speech Pathologist working as part of the NT Office of Disability, Top End remote (Katherine Region) team.

Enabling change through the key contact service delivery model in the Katherine region.

Miss Rebecca McGrath1, Miss Emma  Brady1

1Office Of Disability Katherine, Katherine, Australia

Abstract:

The Katherine Office of Disability’s key contact service delivery model has facilitated change in the professional skills of the allied health team, and improvement in the quality of service delivery and associated health outcomes for remote communities in the Katherine region. The key contact approach involves transdisciplinary upskilling and ongoing support of allied health professionals to provide a single point of contact for a community. This model encourages each allied health discipline to think outside the traditional boundaries of their profession and consider a more holistic approach to delivering health services in the remote context where resources are limited.
In particular this has been a huge transition for the physiotherapists on the allied health team, who previously worked in specialised areas of physiotherapy and now work in general practice across the lifespan, with the additional role as ACAT assessors. We have acquired increased knowledge, and a broader skill set that includes aspects of occupational therapy and speech pathology roles, that are traditionally outside our scope of practice.
Working in this role has not only altered our professional skills but also our perspective on the provision of culturally appropriate health services to remote communities, and the importance of acknowledging the social determinants of health.
Additionally this service delivery model has enabled the development of stronger relationships between the health service provider and the remote communities leading to increased client engagement, community empowerment to manage health needs, and generally improved health outcomes.


Biography:

Rebecca has worked with the Office of Disability in Katherine for nearly two years. She has extensive experience as a Physiotherapist working in a variety of clinical areas across diverse health care settings including non-government organisations, private and public health sectors in Australia and Internationally. Over 13 years’ experience working sensitively with diverse client groups, across the whole lifespan.

Massive Online Open Courses as a way of engaging rural health professionals and communities in open discussions about death and dying.

Dr Lauren Miller-Lewis1, Professor Jennifer Tieman1, Deb Rawlings1, Professor Deborah Parker2, Dr Christine Sanderson3

1College Of Nursing And Health Sciences, Flinders University., Adelaide, Australia, 2Faculty of Health, University of Technology Sydney, Sydney, Australia, 3Faculty of Health, University of Technology Sydney; and Calvary Health Care Kogarah, , Australia

Abstract:

Background: Massive-Open-Online-Courses (MOOCs) have changed the way in which geographically-dispersed health professionals and the community can engage with each other. MOOCs are freely available short online courses that make use of the digital environment to deliver educational content and create socially-constructed learning and exchange. CareSearch, an evidence based palliative care website, offered the Dying2Learn MOOC, which aimed to build community awareness and acceptance of death as a natural part of life.

Methods: The free five-week course provided the opportunity to discuss and collaboratively learn about issues around living, dying and palliative care. The platform enabled evaluation of participant engagement, learning gains and pre-post attitudinal change. Data was examined using mixed-methods.

Results: 1156 people joined the online course in 2016, and 1960 joined in 2017, demonstrating a need for online forums offering the chance to explore death and dying from social perspectives. In 2017, most MOOC participants resided in Australia, with 38% living in regional and rural areas. Over two-thirds of participants identified as health professionals (19% of which were in Allied Health), with the remainder being members of the general community. Both health professional and general community course participants reported feeling motivated and empowered, became more comfortable with talking about death, and reported high levels of satisfaction with the experience.

Conclusions:The Dying2Learn MOOC was well-utilised by health professionals and the general community in rural Australia. This highlights the potential of these innovative online digital platforms for increasing community awareness of death and palliative care, and for health professional education.


Biography:

Lauren’s background is in health and developmental psychology, with a PhD in this field. Dr Miller-Lewis is part of the CareSearch team at Flinders University. CareSearch is a website that aims to provide trustworthy information about palliative care to the Australian community, and the best palliative care research evidence to health professionals. In her position at CareSearch, Lauren brings experience in psychology, health research, and health professional education. Her role at CareSearch involves website content development, research, and facilitating online learning and engagement for health professionals and the community.

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