Exploring the skill level of the Occupational Therapy Allied Health Assistant workforce: The need for a competency framework

Megan Rumble1, Jessie Duncan1, Josh Scott1, Majella Campbell1
Central Gippsland Health1

ABSTRACT

Background or Problem/ Issue:

Due to an increase in demand for occupational therapy services, it is important that Occupational Therapy Departments are providing an efficient service. Allied Health Assistants (AHAs) can play a vital role in delivering efficient clinical service to clients. It is important to ensure that Occupational Therapy Allied Health Assistants (OT AHAs) have the appropriate clinical skills to provide intervention to clients. Discussions from within the Occupational Therapy Department at Central Gippsland Health (CGH) identified that AHAs were been used in a more administrative capacity than a clinical capacity.

Method or What you did?

A benchmarking survey was sent out to like for like healthcare organisations to determine how their AHA workforce was used both clinically and non-clinically and if a credentialling or competency framework was used regarding the AHA’s clinical skills.

Occupational Therapists (OTs) and OT AHA’s at Central Gippsland Health (CGH) were surveyed regarding the AHAs skill level at completing a range of clinical and non-clinical tasks across the inpatient, community and paediatric setting.

Results or Outcomes:

Three like for like organisations completed the benchmarking survey and shared their credentialing/competency frameworks. All three of the organisations were using AHAs in an increased clinical capacity compared to CGH. Only one of the three organisations competency framework included observation of the AHA’s clinical skills by the OT, whereas the other two were based on self-report of the OT AHA.

There were significant discrepancies between the OT’s and the AHA’s perception of skill level of the AHA’S. The AHAs working within the Occupational Therapy Department self-rated their skills in the moderately high to very high skill range on 97% of occasions compared to the OT’s rating of only 23%. The OTs tended to rate the AHA’s at a higher skill level in completing administrative related tasks compared to clinical tasks.

Conclusion and Implications for Practice

The major discrepancy between AHA self-rated and OT rated scores regarding skill level was of significant concern and could potentially be associated with the decreased use of AHA’s in a clinical capacity. Given this discrepancy, the CGH OT department developed a competency framework based on observation of the AHAs clinical skills rather than self-rated scales alone. The scoring system was based on observation using the SPEF scoring framework to ensure consistent scoring across the OT’s.

The competency framework is currently been trialled with the OT AHA’s. Review of the competency framework is required to determine if it has resulted in improvement in clinical skills of the AHAs and the OT’s confidence in the AHAs clinical skills.


BIOGRAPHY

Megan is an Occupational Therapist working at Central Gippsland Health across inpatient, adult community and NDIS. Megan has over 10 years experience working in public health and has a passion for supervision and teaching.

Development and implementation of the Basic Assessment Model to address long waiting lists in Occupational Therapy at Latrobe Community Health Service

Alyssa Mills1, Alice Davey1, Erin DiCorleto1, Georgia McDonald1, Laura Telling1
Latrobe Community Health Service1

ABSTRACT 

Background

The Basic Assessment Model (BAM) was developed by the occupational therapy team at Latrobe Community Health Service (LCHS) to address high demand and an increasing waitlist. The occupational therapy team at LCHS receives between 40 and 70 referrals per month, (on average 60 in 2017, 55 in 2018 and 54 in 2019). Prior to the implementation of BAM, the waitlist was increasing; reaching 196 in early 2018. To manage the increasing demand, the BAM was developed.

Method

An Occupational Therapist screens all referrals and, using inclusion/exclusion criteria, deems a client suitable for a BAM assessment. Allied Health Assistants conduct first section of the BAM with clients over the phone prior to an Occupational Therapist completing an initial assessment. Following the screen, the Occupational Therapist can complete their assessment in a shorter period of time, allowing assessment of more clients on one day.

Results

Since the implementation of BAM, the occupational therapy team has seen a decrease in the waitlist and a significant decrease in the time clients were waiting for services. Average wait times were reduced by 26 days (25%). The reduction in waitlist time was achieved by using the existing numbers of staff;. It was found that the demand could be met even when staffing levels were low (such as leave or staff turnover) and while new staff were in supernumerary positions. EFT between pre and post data was reduced by 27%, however an additional two clients were seen each month. A quantitative study was completed and this model was found to have a statistically significant result in reducing the time a client spends on the wait list for occupational therapy services.

Conclusion

This model was shown to reduce the wait times for occupational therapy clients in a regional community-based health service in Victoria. Other services with a long wait time for community-based occupational therapy may benefit from implementing a similar model.


BIOGRAPHIES

Laura completed her degree in Occupational Therapy in 2009 and who has since worked in Latrobe Valley and Wellington shire areas. Laura currently works in the adults Occupational Therapy team at Latrobe Community Health Service providing community based services to people in Latrobe Valley.

Alyssa completed her Bachelor of Occupational Therapy (Honours) degree at Monash University in 2015. Alyssa secured a new graduate position at LCHS in early 2016 and has since developed her skills in the community setting working with a range of clients including clients with neurological conditions and palliative diagnosis.

Beyond COVID-19: Where to next for tribunals?

The coronavirus pandemic has required all organisations to reassess how they operate. Tribunals are no exception, introducing a range of procedural and other changes in a short space of time to continue to deliver services. This session offers an opportunity to look beyond the immediate effects of the pandemic. Three tribunal leaders – Judge Gerard Phillips, Deputy President Malcolm Schyvens and Registrar Sian Leathem – will discuss what COVID-19 may mean for tribunals in the longer term.


Presenter biographies:

Judge Gerard Phillips

Judge Gerard Phillips was appointed President of the Workers Compensation Commission of NSW and a judge of the NSW District Court in January 2019. On 26 August 2020, he was appointed as inaugural President of the Personal Injury Commission of NSW which will be established on 1 March 2021. Prior to these appointments, Judge Phillips enjoyed over 30 years’ of legal experience as a solicitor. He was a partner at the global private law firm K&L Gates and was a board member between 2011 and 2017. He practiced extensively in every state in Australia and the United Kingdom across a range of criminal, civil, personal injury, industrial relations and employment matters. Judge Phillips is Vice Convenor of the NSW Chapter of the Council of Australasian Tribunals.

Malcolm Schyvens

Malcolm Schyvens was appointed a Deputy President of the NSW Civil and Administrative Tribunal and Division Head for the Guardianship Division on 1 January 2014. He was appointed Deputy President of the NSW Guardianship Tribunal in October 2008 and was subsequently appointed President of that Tribunal in September 2011. Malcolm is a past president of the Law Society of Tasmania, having been in private practice in Hobart for 11 years. He was also a part-time member of the Tasmanian Guardianship and Administration Board and the Forensic Tribunal. Malcolm holds degrees in law and commerce. He is currently the Chair of the Australian Guardianship and Administration Council and National Secretary of the Council of Australasian Tribunals.

Sian Leathem

Sian Leathem was appointed Registrar and Chief Executive of the Commonwealth Administrative Appeals Tribunal in April 2015. She has over 15 years’ experience in tribunal management. She led the project team responsible for merging 22 tribunals into the NSW Civil and Administrative Tribunal and performed the role of Principal Registrar of that amalgamated tribunal. Prior to that, Sian was the Registrar of the Workers Compensation Commission of NSW for 5 years. She holds a Bachelor of Laws (Hons), a Master of Arts (Merit) and an Executive Masters in Public Administration from the Australian and New Zealand School of Government.

Privileges: When they arise and how to handle them

From legal professional privilege to public interest immunity and the privilege against self-incrimination, privilege issues arise from time to time in tribunal proceedings. This session will provide a refresher on the key common law and statutory privileges tribunal members, registrars and practitioners need to be aware of. It will also offer practical tips on how to handle them – whether raised by counsel, a self-represented party or by the tribunal itself – using examples from practice.


Presenter biography:

Joanna Davidson was admitted to practice in 2004 and called to the Bar in 2012. From 2012 to 2014 she served as Counsel Assisting the NSW Solicitor General and Crown Advocate. She has advised and appeared in a range of public and commercial law matters in the High Court, Federal Court and NSW superior courts as well as tribunals and inquiries. Joanna previously worked in the Administrative Law Group at the NSW Crown Solicitor’s Office and spent several years in commercial litigation practice. She has taught Administrative Law part time at the University of NSW law school since 2009. She is a Centre Fellow of the Gilbert + Tobin Centre of Public Law. Joanna has a Master of Laws from Harvard Law School.

Reality testing: Helping people move forward

Reality testing is a core technique used in ADR processes that is equally applicable in many hearings. This fast-moving and interactive session will look at how people make decisions, what influences decision making and why reality sometimes means different things to different people. Dispute resolution specialist Nina Harding will provide thoughts and tools on helping people to narrow issues in dispute, see a different perspective, make a decision or accept an outcome and move forward.


Presenter biography:

Nina Harding has over 25 years’ experience in resolving business and public interest disputes. A law graduate with a Master of Laws, she is a nationally accredited mediator. She is a member of numerous mediation panels, including with the Workers Compensation Commission of NSW, and is the Australian Film Code Conciliator. Nina is a recognised expert in the area of dispute resolution and has taught thousands of people how to negotiate more effectively and resolve conflict. She has lectured at universities in Australia and overseas. She is currently a Visiting Senior Lecturer at The University of Hong Kong.

Work place threats at an educational facility – a case study by the Mental Health Forensic Assessment and Consultation Team (MH-FACT)

Carmen Cilmi1

1Monash Health

Our intention for the poster presentation is to provide an overview of the service enhancement role of the Mental Health Forensic Assessment and Consultation Team (MH-FACT). Our service works collaboratively with the Victorian Fixated Treats Assessment Centre (VFTAC), and accepts referrals from the VFTAC of identified individuals who pose a risk of engaging in behaviour indicative of pathological fixation and grievances. These individuals have been identified by the VFTAC as having a high potential for grievance fuelled violence and who also have identified mental health needs.
The Department of Health and Human Services (DHHS) and Victoria Police have established a Victorian Fixated Threat Assessment Centre (VFTAC), which brings together police and mental health capability to respond to threats of violence posed by high-risk persons with complex needs.
In addition to establishing VFTAC, further funding was provided to enhance specialist mental health and drug and alcohol services to engage with individuals referred to VFTAC. MH-FACT is a ‘systems enhancement’ service that will either work directly with the individual to assist them to mobilise supports, who then are further supported by MH-FACT. As well as this, a large part of our work is supporting Area Mental Health Services (AMHS) to work with identified individuals to mitigate risk. MH-FACT is one of two, State service enhancement programs which reports directly to DHHS.
To this end, we have created a poster to showcase the types of service enhancement that MH-FACT provide. The poster has three sections:
1. We explain who MH-FACT are
2. Outline a range of service enhancement interventions, including the referral pathway
3. Outline a MH-FACT case example of workplace grievance fuelled violence within educational facility.
This poster illustrates an example of ‘work place grievance fuelled violence’ and how the MH-FACT service enhanced an AMHS, as well as providing direct clinical support to the individual to mitigate the risks that he posed to an educational facility.


Biography

Carmen Cilmi (BSW (Hon), MSW & Accredited MHSW) is a senior mental health clinician/ social worker currently working with the Mental Health Forensic Assessment and Consultation Team (MH-FACT). Carmen has over 20 years’ experience in public mental health, having worked within a range of community settings and in senior clinical roles. Some of which include case management, Crisis Assessment and Treatment Team clinician (CATT) and Emergency CATT, homelessness, as well as having undertaken leadership and project roles within a number of Area Mental Health Services. She has also worked for a period of time within Victoria Police.

 

Update relating to the Novel Coronavirus (2019-nCoV)

Update relating to the Novel Coronavirus (2019-nCoV)

The 2020 APATAP conference is going ahead as planned. There is a wonderful program in place which offers great professional development and learning opportunity for everyone: www.conferences.com.au/2020apatap/program

Information about the Novel Coronavirus
We continue to monitor and follow the advice of the Australian Government Department of Health, and Victorian Department of Health and Human Services regarding the 2019 Novel Coronavirus. For the latest information we encourage delegates to refer to the following resources.

https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov
https://www2.health.vic.gov.au/about/news-and-events/HealthAlerts/2019-Novel-Coronavirus2019-nCoV
https://immi.homeaffairs.gov.au/
https://www.smartraveller.gov.au/

Delegates travelling from mainland China from 1 February:
Australian citizens/permanent residents who have been to mainland China since 1 Feb 2020 are advised to self-isolate and should not attend APATAP.

Non-Australian citizens/permanent residents who have been to mainland China since 1 Feb 2020 will NOT be permitted to travel to Australia at this time.

For further information visit the Department of Home Affairs website: https://immi.homeaffairs.gov.au/

Delegates travelling from Hubei province within the last 14 days:
In line with the precautionary advice from the Australian Government and Victorian Department of Health and Human Services, people who have been in Hubei province within the last 14 days are advised to self-isolate and should not attend APATAP.

For further information please visit the DHHS website: https://www.dhhs.vic.gov.au/novelcoronavirus

Should you be unable to attend APATAP due to the above circumstances, please contact mail@conferencedesign.com.au.

Ga Yao (add oil), an overview of Hong Kong protests and radicalisation

Totti Karpela1
1Peace Of Mind, Hong Kong

The presentation will give an overview of the events that have taken place in Hong Kong from June 2019 tills January 2020 and provide insight into the change of attitude and mentality within demonstrators. How certain events impacted the overall attitude towards the HK SAR and police response and how different radicalisation elements can be seen in the process. We will look at the impact of social media, age structure of the participants and various push- and pull factors in the radicalisation.


Biography:

Mr. Karpela, a graduate of Finland’s Police University College, has a 20-year career in the National Police of Finland where he worked as a unit supervisor and subject matter expert. During his career, Mr. Karpela was part of a team that specialized in managing threats that were directed towards law enforcement and judicial officials. He also spent nine years as a member of the hostage negotiator team in the National SWAT team. For the majority of his career, Mr. Karpela also worked at the National Police University, teaching management of aggressive behavior and conflict resolution skills.

In his current role in the private sector, Mr. Karpela has worked with presidential candidates, celebrities, media companies, banks and insurance companies, aviation industry, educational facilities as well as multi-national corporations specializing in threat assessment and case management. He provides behavioral and security consultation in numerous global corporations on a weekly basis.

Mr. Karpela has worked as a subject matter expert since 1986, consulting and coaching government organizations and corporations on five continents in the prevention of violent crime, security issues, conflict resolution, and risk mitigation. Mr. Karpela is the only person outside of the United States to hold a CTM-accreditation, professional accreditation for security professionals related to the assessment and management of violent behavior. Mr. Karpela is also accredited to provide consultation and training related to the European equivalent, CETAP. He holds numerous professional certifications related to violence risk assessment. Mr. Karpela’s vast experience with threat management is clearly demonstrated in cases where analysis is put into practice, how multi-disciplinary teams of professionals are coached and how to manage low to median and high-risk cases related to violent behavior.

Mr. Karpela is a graduate of U.S. Secret Service Threat Management Program, Gavin De Becker threat management academy and he has done numerous other professional training programs with the FBI Behavior Analysis Unit.

Other relevant NGO responsibilities: Subject matter expert for the European Council and O.S.C.E. in crime prevention projects. Totti is also a member of the Merrick & Company’s Global Biosafety & Biosecurity Consulting Advisory Board since 2017. President for the Association of European Threat Assessment Professionals (AETAP). He is also a senior research fellow at the Association for Counterterrorism and Security Professionals – Centre for Security Studies.

Mr. Karpela has done numerous security audits specifically related to the prevention of violence in educational facilities, health care service providers and manufacturing and production facilities. The audits have covered regions in Europe, South- and Central America as well as the Middle East and Africa.

Mr. Karpela has also authored three books on police operations with organized crime, personal security and case management guide for stalking cases. He has also authored a chapter on the use of social psychology in counter-terrorism operations as well as management guide on persistent and vexatious complainants.

The Girl Behind The Face

The Girl Behind The Face

Mui Thomas

“The remarkable story of Mui Thomas might bring a tear to your eye.” The Guardian newspaper.
Cyberbullying put all three of us where we never wanted to be: on the front pages of a newspaper.

Our family story is a real life narrative. While preparing to start a new life in Australia, Tina and I met an abandoned baby girl in a hospital playroom. Mui was then hidden away on the fringes of Hong Kong society because she was born with an appearance altering skin disease, Harlequin Ichthyosis. Tina was just twenty-six years old.
Doctors made clear to us Mui would die in infancy; the authorities insisted we acknowledge the medical prognosis; they insisted on our silence. People told us to walk away.
We fought so hard, Mui rose so high… she thrived, she inspired, we celebrated. Cyberbullying destroyed all of that. Discrimination has cut to the quick.
As parents, we doubled down. Each time, and with resilience and determination the three of us have rebuilt.

Twenty-five not entirely uneventful years later, Mui is the world’s first rugby referee and yoga teacher with Harlequin Ichthyosis! A contagious smile lights up her face.
Mui is part of the first generation of survivors in the world with Harlequin Ichthyosis.
As a family, we have grown, we have learned and we continue to celebrate, and as a family – parents and daughter, two sides of one coin – we share our story.
We speak at schools, NGOs and corporates. We are committed to making a difference.
And still, cyberbullying impacts Mui and us; it still leaves invisible scars.

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Thank you for presenting at the 2020 APATAP Conference

Oral presentation guidelines

Presentation length and time keeping

  • Please check the program to confirm the time allocated and length of your presentation
  • To ensure the program runs to time, please keep your presentation to your allocated time. Your session chair will notify you with 5 minutes, 2 minutes and 1 minute remaining. If there is time remaining at the end or your presentation the chair will direct the questions.
  • Please go to your allocated room 15 minutes prior to the start time of the session to meet with the Session Chair (their name will be noted in the program) and familiarise yourself with the room and AV technicians and setup.

Presentation Format and slide ratio

  • The presentation computers use PowerPoint with Windows operating system. If you created your presentation using another program, on a Mac or require a specific or uncommon program, we suggest you bring your laptop as a backup.
  • Please bring your presentation files to the conference on a USB (embed any content such as audio or video – do not link to external files).
  • The slide ratio for your presentation should be set to 16:9

Photocopying

  • There are no facilities for photocopying at the venue. We suggest you bring a copy of your slides and any handouts with you (if desired)

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  • Please load your presentation files to the online folder by COB Friday 21 February 2020. Please name your presentation DAY-TIME-INITIAL.SURNAME e.g. TUES-1145-J.Smith
  • A speakers preparation room will be located XXXX
  • When you register at the venue you will be directed to the Speaker’s Preparation Area. An AV technician will load your presentation on to a central computer and network it to the appropriate room and session.
  • Please visit the speaker preparation room at least 2 hours before your scheduled presentation.
  • Speakers are to bring their presentation on a USB.
  • The speakers preparation area will be open at the below times;
    • TBC

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  • Please be seated in the front row so that you can move to the lectern quickly at the end of the previous presentation.
  • There will be AV technicians roaming between the session rooms to trouble shoot any technical issues should they arise.
  • The length of your presentation is noted in the program. During your presentation, please keep a strict eye on the time. There will not be question time at the end of your presentation. A Q&A session will be held at the end of each session.
  • At the end of your presentation the chair will ring a bell for you to conclude immediately.  At the conclusion of the session 15 minutes has been scheduled questions and discussion.
  • We do not want to embarrass you however the session chairs have been instructed to end all presentations after the allocated time, even if you are not finished, in order to keep the program to time.
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