Workforce redesign to improve access to compression garments services in rural facilities
Workforce redesign to improve access to compression garments services in rural facilities Conference Paper
14th National Rural Health Conference: A World of Rural Health
- Author(s): Hall, Fiona, Hulcombe, Julie, Stephens, Catherine, Gordon, Susan
- Secondary Author(s): Coleman, Leanne
- Published: 2017
- Publisher: National Rural Health Alliance
Abstract: Background: Delivery of malignancy related lymphoedema services including provision of compression garments in rural and remote Queensland has been difficult due to staff and skill shortages. Consumers have undertaken lengthy, expensive travel to metropolitan centres to access services. The service barriers and access issues have prompted Queensland Health stakeholders to examine the scope of compression garment selection, fitting and supply that can be safely and effectively delivered by generalist occupational therapist and physiotherapists in smaller regional, rural and remote locations to improve local access to this service for community members. Methods: A new service model involved an evaluated trial of compression garment selection, fitting and monitoring provided by generalist occupational therapists and physiotherapists (i.e. physiotherapist or occupational therapist who had not completed a formal lymphoedema training program (e.g. Level 1 or 2 course), but had undertaken, an on-line education program with support of lymphoedema therapists, supported by telehealth, implementation resources and governance processes. The service model included a training model that paired generalist occupational therapists and physiotherapists in rural areas with a lymphoedema therapist The online education program covering pathophysiology, assessment and management of lymphoedema, compression garment prescription, monitoring and care accompanied one-on-one telehealth delivered coaching sessions. Telehealth was used to support the supervised practice stage of the training program and was used if required in the post-training phase if generalist clinicians required support from their lymphoedema therapist coach. Results: Seven rural and remote health facilities have implemented the telehealth supported compression garment selection, fitting and monitoring service model. There were 69 referrals and 58 garments provided during a 12 month trial period. Evaluation demonstrated that the delivery of compression garment selection, fitting and monitoring by generalist occupational therapists and physiotherapists supported by defined training, supervision and governance processes is safe, effective and positively evaluated by consumers and health professionals. Discussion: The service model has provided sustainable workforce and service solutions and improved access to care for consumers in rural and remote Queensland. Phase two of the service model implementation is underway and will promote and expand the model for the provision of compression garments for the treatment of lymphoedema.
- Urls: http://www.ruralhealth.org.au/14nrhc/sites/default/files/Hall%2C%20Fiona_C1.pdf Available from, http://www.ruralhealth.org.au/14nrhc/program/concurrent-speakers Download site
- Publisher Location: Cairns