Your presenters today…… Siobhán Ward Lynch Aoife MhicMhathúna Rosemary Kavanagh Eilís Dignan Avril Mullane
Transition to video-enabled care March-October 2020 Access to information Focus on via shared Basic drive hardware + well-being of VPN staff Phone appointments Regular staff meetings to review practice and policies Video platforms: Telehealth guidelines Attend Anywhere, Policies and Webex Procedures
Promoting Person-Centred Care Using a solution focused approach Cisco Webex Eilís Dignan Senior Speech and Language Therapist Community Health East, Dublin South East eilis.dignan@hse.ie
There are lots of references to person- centred care in HSE documents
Here is the definition of person-centred care that I like…. Person-centredness ….. recognises the uniqueness of every individual whether availing of or providing a service. This approach is possible through the development of relationships that enable everyone to achieve their personal best and flourish. A National Framework for Person Centred Planning in Services for Persons with a Disability (HSE 2018)
What is a solution focused approach ? It is a particular way of having conversations with people It is applicable to any situation where people want to work towards change
Some solution focused questions What has been What are your better since we best hopes What difference last met? from us talking would that make? together? What have you heard What have you yourself say in our been doing that conversation that has helped those could end up being changes to useful to you? happen?
Some background information Our SLT team in Dublin South East use a solution focused approach. There is a lot of interest nationally. Since 2014 some of my colleagues and I have facilitated 24 workshops nationally to 565 SLTs in a variety of settings. These workshops take time – preparation time and travel time. So we have often had to turn down requests to facilitate workshops. COVID 19 is providing us with an opportunity to think differently about how we might promote solution focused practice. Here are two initiatives we are trying………
1 . Solution focused practice- online forum We contacted everyone who attended our solution focused workshops over the past 6 years and invited them to a solution focused online forum. Using the cisco webex platform, we had our first hour-long meeting in July and our second in October. We plan another one for early 2021. This online platform allows SLTs from different work-settings and different parts of Ireland to discuss solution focused practice, to share ideas and to discuss cases.
1 . Solution focused practice- online forum It's great to have this opportunity to share solution focused I valued hearing ideas perspectives from other SLTs outside of our team. One thing I have found I like the mix of cases and since starting to ask the also the video yesterday was question regarding best really helpful. I would love to hopes is that it has hear from others who are completely changed the successfully using solution- SLT/school relationship in focused therapy in addition to the SLT/family challenging circumstances relationship.
2. Online workshops Within our SLT team in Dublin South East, I have experimented with the flipped classroom concept. I recorded two 10-minute webinars for colleagues to watch in their own time. I then followed up with a one- hour online discussion linked to the content of those videos. It was targeted particularly to colleagues new to solution focused practice although other colleagues found them useful . It went well and I plan to record some more short webinars based on the feedback that they gave me. I have been in contact with SLTs from 4 different teams who are interested in trying this type of workshop-delivery with their team.
• Using an online platform is time efficient • Broadband connectivity is unreliable at • There is no travel involved times. When I want to host a group, I • It is cheaper - no room rental or work from home and use my VPN • I miss the informal face-to-face chatting teas/coffees /travel expenses • It is much easier to have mixed groups that onsite groups allow. • You need to be very familiar with the from different teams and different parts of the country features of the platform and still be • Breakout rooms are now available in prepared for IT glitches to happen. webex which is a very useful feature
Video-Enabled Drop-in Clinic Rosemary Kavanagh Primary Care, Dublin South East Rosemary.kavanagh1@hse.ie
Drop-in clinic pre-covid • Monthly in 3 paediatric primary care clinics • Function: to decide if a referral is necessary, general advice • Format: No appointment necessary, 15 minute conversation with an SLT • Well attended and positive feedback on usefulness and accessibility • Advertised by poster in preschools, schools, GP surgeries and via PHN
Video-enabled drop-in clinic Links and Trialled on 30 th Pre-registration guidelines emailed required September the day before Attend 30 minute 10 families Anywhere timeslot attended Cisco Webex
Format of video calls Conversation Observation Observe the child in play with What are your best hopes from parent or alone – device choice our conversation today? mattered! What concerns do you have? Screen speech (age dependant) What are you already doing that’s Finish conversation with Next helping Steps. Email follow-up in some cases
Pitfalls…
Service user feedback Anonymous feedback questionnaire via Survey Monkey We asked… • How well did the drop-in session meet your needs? Scaling question 1-5 • What did you find useful? • How did you find the amount of time you had to speak with the speech and language therapist? • Any other comments? • 4 of the 10 parents completed the survey
Service user feedback • Meeting the person’s need on a scale of 1 -5 Scale 1 (not at all) 2 3 4 5 (very well) Responses 1 person 1 person 2 people • All 4 respondents were happy with the length of the video call (30 minutes)
Service user feedback- comments Specific to video- enabled drop in General comments ✓ Happy with format as an ‘initial Child in his own environment consultation’ Relaxed, able to play with his ✓ Short waiting time own toys ✓ Clear information Able to chat to the therapist without the child noticing ✓ Follow-up email Because parent was holding the phone she couldn’t interact with the child herself
Learning • Drop-in clinic could be replicated using video-enabled care and could become another ‘business as usual’ part of our service • Think about ways to let parents know about the clinic • Streamline the registration process • Discuss best hopes with parents in advance
Little Lámh workshop on Attend Anywhere platform Avril Mullane CHO 5 Kilcreene Children’s Services, Kilkenny avril.mullane@hse.ie
Background • Lámh is a manual sign system which was developed for children and adults with intellectual disability in Ireland in the early 1980s • The Little Lámh workshop is for parents and families of the very young child (approx 6m to 2 years) to introduce them to Lámh and to set up a Lámh environment at home at an early age
Background • Workshop scheduled for March 20 - Cancelled due to Covid-19 • End of July 20 - Permission from Lámh office to run a pilot of the Little Lámh workshop on the AA platform • August Contacted the parents – phoned and shared info about AA • Ran 2 workshops virtually in September and October 20 • Workshop – 90 minutes, adapted PowerPoint presentation and teaching of 26 Lámh signs
Outcomes • Workshop 1 - invited 5 parents and 3 attended • Workshop 2 – invited 3 and 1 attended • Workshop 2 attendee – needed to reschedule to do signs face to face as we had issues with connection • 3 participants at a time was enough as there were connection issues, lower numbers than if face to face • My feedback as Lámh tutor – PowerPoint presentation was ok but couldn't see them while they could see me • Enthusiasm for the training • Satisfying piece of work • Delay and resulting mismatch with audio and visual made teaching and checking signs challenging
Outcomes continued • Parent feedback: 2 written feedback forms received - mixed feelings “I would still prefer to do workshop in person, you can see better and ask questions without laptop being slow and waiting for answer especially when all us mums had issues virtually it delays class” “even with a slight time delay due to my wifi I learned all signs and was signing with my baby that day. Cant wait to do the next one!” Both rated the workshop 5 (scale 1-5) as being very helpful
Barriers and enablers • Internet connection and equipment being used outside of my control • Lower numbers in each workshop so takes longer to complete the training and address the caseload needs • All need to be comfortable with tech • Literacy issues • Patience required from all and to recognise when it is not working and go to plan b! • ?barriers for those who did not attend, are they the same as for face to face?
Student Placements using Video-Enabled Care Siobhan Ward Lynch CHO 1, Donegal Aoife Mhic Mhathúna CHO 6, Dublin South East
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