Customised Home Modifications Education Achieving Best practice Standards & Functional Environments for clients Alison Finney Calvary Health Care Kogarah April 2016
OT & Home modifications Plays a role in maximising independence in ADL s Training is often not funded or specific to area policies OT skill levels & access to training varies, having a OT skill levels & access to training varies, having a direct impact on accuracy & patient outcomes
OT Services in SESLHD
Home Modifications Working Party Formed in 2012 Representatives from three sites across the LHD Calvary Health Care Kogarah, The Sutherland Hospital & The St George Hospital. To provide a consistent approach to provision of home modification prescription for clients across the LHD.
Determining Current Practice Review of existing policies & procedures across individual sites Inconsistencies identified between sites Business processes OT skill levels Training exposure Frequency of HMODS prescription and Resources available e.g. manuals and skilled peers
Objectives Business rules to ensure consistency Documentation template Minor home modifications manual Customised minor home modifications training program
Developing standardisation in business processes Business Rules developed Follow up of home modifications Release of Information
Business Rules Follow Up Details the required processes for reviewing minor and major home modifications Home Modifications Follow Up Form produced
Business Rules Release of Information Details the required process for releasing information to builders, client s and/or relatives Ensure appropriate information is provided to private builders, clients and/or relatives wishing to carry out minor or major modifications independently
Minor Home Mods Template Letter head Client details Location of modification OT contact details Date Photo with dimensions Written Specifications Drawing not to scale Disclaimer Page Number
Minor Home Modifications Manual Standards AS1428 Grabrails Assessment Process Toilet rails Shower rails Bath rails Handrails and Stairs Ramps Waterproofing Electrical Standards Documentation
Determining training requirements Staff surveys across the four sites were conducted to determine: OT training needs Previous courses attended Topics to be included in future training Method of training, frequency & duration
Are training needs being met?
Would therapists attend training if provided?
Program Content Application of the Australian Standards OT / Builder responsibilities Handrails/grabrails Threshold & steps ramps
Program Content Electrical Standards Miscellaneous Modifications Documentation Introduction to template Scope of work examples Referrals processes (e.g. under 65 years & over 65 years)
Program Content Alternatives to home modifications Business Processes Follow up Release of Information
Program Content 2 local Service Providers Intro to service Referral requirements Expectations of OT s Funding available Q&A Demonstration of frequently used materials
Program Content Practical Sessions Handrails Grabrails Case studies Documentation & referral example
Pilot Program Piloted in November 2014 20 therapists attended Varying levels of experience Full day session Affordable and accessible
Training Program Feedback
Training Program Feedback
Ongoing training Additional two courses run Refinement of program content & resources Support from Heads of Department Expectation that all new staff attend
Training Program Feedback
Where to from here? Ongoing minor modifications education Ongoing review of best practice guidelines to ensure relevance and accuracy Survey of clients and local service providers
Major Bathroom Modifications Training Major Bathroom Modifications Manual Major bathroom modifications training program Clinical reasoning Report writing Diagram specifications
Training Program Benefits Positive impact on patient outcomes Accuracy and effectiveness of minor modification recommendations Cost effectiveness for clients Consistency across LHD in relation to local policies and procedures
Training Program Benefits Increased collaboration across sites & with external service providers Therapist empowerment by having access to education & resources Mutual respect for each others roles and professional boundaries