Implementation of an Advanced Practice Physiotherapy Vestibular Assessment Clinic (PVAC) within ENT Specialist Clinics Philippa Pearce Acknowledgments: • Victorian Government Department of Health and Senior Clinician Physiotherapist Human Services – Advanced Practice in Allied Health Grant Program 2015-16. Ballarat Health Services • QLD Health (RBWH and PCH) • Ballarat Health Services – ENT Department
Background Objectives/Aims To evaluate the acceptability and feasibility of an Advanced Practice Physiotherapy Vestibular Assessment Clinic (PVAC). No Delayed Dedicated 203% diagnosis & Clinic Increase Treatment. in referrals 32% Prevalence of dizziness in 50+yrs Duplication of referrals 383 Day Advanced wait time to Practice see ENT successful elsewhere Images: 1. “Questions” Created by Marek Polakovic from the Noun Project 2. “Speech bubble” Created by Aldric Rodríguez from the Noun Project
Intervention Development and Implementation of PVAC Dec 2017 Project Oct 2016-March Complete Business Case 2017 Submitted Oct 2016 Physiotherapists Complete Clinic May/June 2016 Competency Commenced training package Engage (Fortnightly) Feb 2016 stakeholders/ Competency Framework Steering Physiotherapy Funding • Clinical skills 2015-16 Committee Application assessment • modules (x4) Clinical (DHHS) • Pre-intervention Gait and mobility • Observation (by ENT Governance Data Collection • Balance Specialist) Documents • Increased Oculomotor/vestibular • • Discussion with ENT Clinic processes referrals to function • staff competencies • Falls Clinic Review of a pure tone • Documentation Audit for advanced and Sub-Acute audiometry practice role. Outpatient PT.
Outcomes • 54 Patients • Further investigation (e.g., CT/MRI) • ENT Intervention (Prescription of Meds) • Average Wait time reduced 383 to 82 days “Women” Created by Milinda Courey from the Noun Project
Outcomes • 9.89/10 rating for positive experience • 98% “Very Satisfied” “The trial has been very successful and “I feel much has made a material better about my difference to the condition.” “I felt very safe, management of vestibular patients comfortable and in the region”. understood during my appointment.” Images: 1. “Speech bubble” Created by Gregory Radek from the Noun Project 2. “Dizziness” Created by Priyanka from the Noun Project 3. “Doctor” Created by Delwar Hossain from the Noun Project
Ensuring Long Term Success • Excessive wait times Identify need • Duplication of referrals • Pre-existing relationship with Build relationships • Over-reliance on 1-2 senior staff Senior ENT Specialist • Lack of space to expand • Determine available Staff with appropriate skills • • resources Difficult to demonstrate cost Equipment • effectiveness Room availability Establish framework for • • Growing demand for service Hand picked Steering development and Committee implementation Develop succession plan
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