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Telehealth Wheelchair Seating Consultation and Mentoring

Telehealth Wheelchair Seating Consultation and Mentoring. Calgary Health Region (Rural) Jacquie Bryce BSc.P.T., MHS Betty Whitney B.S.R. Doug Gorin B.Sc. P.T. Presentation Overview. Background/history of w/c clinics Telehealth project highlights & milestones

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Telehealth Wheelchair Seating Consultation and Mentoring

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  1. Telehealth Wheelchair Seating Consultation and Mentoring Calgary Health Region (Rural) Jacquie Bryce BSc.P.T., MHS Betty Whitney B.S.R. Doug Gorin B.Sc. P.T.

  2. Presentation Overview • Background/history of w/c clinics • Telehealth project highlights & milestones • Results & Key Learning within project • Discussion of need to integrate sustainability planning to ensure future service

  3. Background/History of Clinic • HR clinic 1st level one clinic approved in rural Alberta, AADL program • Eventually became a regional service • Most clinics (approximately 12 annually), occurred at HR site • Therapist’s travel time limited access to service for other area sites • Team felt that clients’ needs not met

  4. INDIVIDUAL CLIENT -Informed participation in goal setting and decision making -Outcome evaluation from client perspective -Effective communication -Family involvement -Comfort, skin, mobility, swallowing, pulmonary, visual field, hand function Colt (2001) SERVICE / SYSTEM LEVEL -Interdisciplinary approach** -Coordination / continuity** -Accessibility** -System evaluation from service perspective** -Response to client feedback** ** areas where current system might be improved Client Centered Rehabilitation

  5. From...

  6. To…

  7. Telehealth Wheelchair Seating Project Goals • Improve access to wheelchair seating prescription • Enhance learning and skill among practitioners • Build system capacity and ability to better manage complex seating needs

  8. Description • Videoconferencing is being used to enhance the availability of seating services within the rural area of Calgary Health Region (Didsbury, Canmore, Strathmore, Black Diamond, Vulcan, Claresholm, Okotoks, High River) • Expertise is being shared from the High River site to the remote referring sites

  9. Project Highlights • Infrastructure (process) developed • Inventory of existing resources and gaps • Hiring of temporary program assistant • Mock Clinic Day: eleven therapists and three technicians (vendors) trained in use of telehealth equipment and assessment process • Cabling of referring rehabilitation service sites • Purchased equipment (pressure mapping, camera, tripods, lighting) • Two therapists attend AADL seating course; one therapist to attend national conference • Project evaluation developed with U of C Telehealth Faculty of Medicine

  10. Results and Key Learnings • Since first telehealth clinic on April 1st, 2004, we have assessed 30 new clients by telehealth • Energy • Synergy • Everyone benefits

  11. Results and Key Learnings • OVERALL IMPROVED EFFICIENCY ACCESSIBILITY • IMPROVED CLIENT ACCESS AND THROUGHPUT (>#’S, LESS SYSTEM REQUIREMENTS) • TIMELY MANAGEMENT OF COMPLEX CASES (<WAIT TIME) • PROCESS ESTABLISHED IN REGION • INCREASED RESOURCES (EQUIPMENT & SUPPORT)

  12. Results and Key Learnings • OVERALL IMPROVED SERVICE • BETTER ENGAGEMENT AND COLLABORATION (referring therapists/ family/ vendors) • IMPROVED CLINICAL EVALUATION PROCESS (experts able to concentrate solely on the evaluation; therapists ‘energized’ by process) • INCREASED VOLUME OF CLIENTS MEANS DEVELOPMENT AND MAINTENANACE OF EXPERTISE AMONG CLINICIANS • RURAL TO RURAL SERVICE MODEL ALLOWS FOR IMPROVED JOB SATISFACTION AND FLEXIBILITY IN MEETING UNIQUE ATTRIBUTES OF RURAL PRACTICE

  13. Results and Key Learnings “And of Course There Will be Surprises…… And Perhaps Even a Few Dust Ups”

  14. Results and Key Learnings • AMBITIOUS GOAL SETTING PROJECTIONS TOO HIGH - REVISED ESTIMATE OF NUMBERS OF CLIENTS TO BE SERVED; ORIGINAL NUMBERS TOO HIGH; NOT REALISTIC (time line very tight for grant proposal, original estimate called for an increased capacity of threefold)

  15. Results and Key Learnings • BUILD BETTER SUPPORT FOR PROJECT MORE CONSULTATION WITH STAKEHOLDERS • TIGHT TIME FRAME BETWEEN CALL FOR GRANT PROPOSALS AND SUBMISSION MADE ADEQUATE CONSULTATION CHALLENGING. This created a few “bumps” along the way; • Addressed concerns raised by AADL program regarding scope of project and integration with their processes • Concerns with human resource use at sites (booking, preparation for clinics, using referring site staff) • Increased hours by “experts”

  16. Key Messages • Grant has fulfilled its seed role, telehealth wheelchair seating clinics proven a viable option • Sustainability of service will require ongoing support • Clinical rehabilitation applications using telehealth significant; good potential for further development

  17. Future? What happens after grant runs out? • SUSTAINABILITY OF VIDEOCONFERENCING FOR SEATING NEEDS • REPLACEMENT STAFF AT HR SITE • ONGOING TRAINING NEEDS • ONGOING EVALUATION OF SERVICE (DATA COLLECTION AND ANALYSIS) • REFERRING SITES, SUPPORT FOR BOOKING AND CLINIC SET-UP

  18. Thank you Questions

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