A case study of program implementation and quality improvement - Establishing a national CAPD program for children at Australian Hearing Alison King 1, Karin Gillies 1, Helen Glyde 2, Sarina Sanna 3, Sharon Cameron 2, Simone Punch 4, Meagan Ward 4, Harvey Dillon 2 1 Australian Hearing, Box Hill Centro, Victoria, Australia 2 National Acoustic Laboratories, Sydney, NSW, Australia 3 Australian Hearing, Melbourne, Victoria, Australia 4 Australian Hearing, Sydney, NSW, Australia World Congress of Audiology, Brisbane, 2014

The issues Dispersed network –Service offered through ~50% of sites New clinical service –Controversial field –New clinical skills –Different clientele

Clinical Program Clinical case note & report Proformas Nationally Consistent Protocols developed, documented Timely, Coordinated Implementation Phased Rollout Train-the- trainer Knowledge & Clinical Skill Single training package developed by expert Post-course evaluation Link No. clinicians trained to caseload (consolidation)

Quality Improvement - Clinical Service Delivery Support and data collection Post Course evaluation Clinical Support –Core group of experts networks, phone support, teleconferences, F2F Client results data –Monitor for trends, errors Clinical audit

Impact on Program Regular monitoring enabled concerns to be addressed quickly via a range of avenues –Newsletter, teleconferences, individual assistance Training program revised and updated to forestall future difficulties Over time, reduced number of trainers –Avoid dilution of knowledge transfer and variability

Service Delivery Network Education program for all staff Nationally Consistent Centrally coordinated rollout Appropriate appointments Centralised contact Front counter resource Correct information for enquiries Identified specialist to take all early enquiries Central phone number Resources – info sheets & presentation, website updated

Quality Improvement – Service Delivery Support and data collection Hearing centres and central contact provided –Demographic data –Referral sources – client and professionals –Clients who decided not to proceed with appointment – reasons, help assess if access problems –Client concerns and issues Collected 3 times during the first 12 months Support network – , phone

Impacts on service delivery Identified ways to improve the information provided to clients –Common questions and referral types analysed Need to be diligent about age of child at appointment Questions about testing ADHD, Autism Best time of day to offer appointments –Improve information resources

Keeping the momentum going Monitoring results and referrals, fed back to the network Regular teleconferences with clinicians to discuss research, clinical practice issues and success stories Regular teleconferences with Managers to address uncertainties about the program, lessons learned

What have we learned When field is new, identify a small group of people who can build expertise quickly DATA-DATA-DATA Monitor rigorously in early stages –Take prompt action to help individuals, use knowledge to build system changes –The nature of support changes as skills develop –Remember to keep supporting new people Success involves the whole team –Share successes, feed back progress

Contact Australian Hearing Thank you for listening