New learning program sees guardianship matters fast tracked

Mrs Sue Steele-Smith1

1Health Education And Training Institute Nsw, Gladesville, Australia


In 2016, NSW Health identified an issue with the process of appointing guardians for people who were considered unable to make their own decisions. Lack of understanding and awareness about guardianship matters among staff resulted in patients experiencing lengthy hospital stays. Patients were waiting on average 83 days before discharge from hospital, for a decision to be made through the guardianship process.

The NSW Whole of Health program, in collaboration with the Local Health Districts and Specialty Health Networks, developed new guardianship application guidelines. The goal was to ensure patients who do not need to be in hospital were placed in the most suitable setting as quickly as possible. To support the effective implementation of the new guidelines, HETI developed and delivered a training package that would educate staff about the new guidelines throughout NSW.

This is the first training program focussing on guardianship, conducted within NSW Health. As an educational intervention, the program resulted in a reduced length of stay in hospital from 83 days (prior to the guidelines and training) to 27 days post implementation.  The results demonstrate that this was achieved through the successful roll out of both the e-learning and the face to face training package. The increased confidence and knowledge of staff in this area, resulted in faster decision-making and the right care being provided in the most appropriate setting as quickly as possible. Effective workforce development in this area, supported both improved practice and practice change.


Sue Steele-Smith has worked for more than 30 years as an Occupational Therapist in a range of clinical settings and has a Masters of Health Science Education. She has also worked as an education consultant and RTO manager which involved training more than 500 allied health assistants, both in NSW and nationally.  She was involved in developing the Allied Health Assistant Framework.  Following her move to HETI she has been involved in the development, implementation and evaluation of Allied Health specific training programs.  This has included Lymphoedema, Allied Health Assistant supervisor training, Clinical supervision, the Allied health Governance guide and more recently Guardianship application training workshops.

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