Novita Research Report January 1999 - Novita Children's Services

Clinical pathway for voice output communication aid recommendation
and training for adults with disabilities
Parimala
Raghavendra
Manager,
Clinical Research
Roslyn Ferris
Senior Speech
Pathologist
Adriana Rapagna 1
Speech Pathologist
Michael Bebb 1
Speech Pathologist
Michelle Hardy 1
Speech Pathology
Assistant
Fiona McDonald 1, 2
Quality Assurance
1
Communication and
Therapy Services, now part
of Adult Therapy Services
at the Independent Living
Centre
2
Currently Quality
Coordinator, Ashford
Hospital
Objective
Clinical pathway is a plan of care, that reflects best clinical practice and the expressed needs of customers.
Because an enormous amount of time, effort, money and on-going support is needed in voice output
communication aid (VOCA) prescription and use, it was decided to streamline the process and develop a pathway
for consumers and external agencies involved in the process to ensure maximum efficiency and effectiveness.
Method
Information for the pathway was collected from adults with severe physical/multiple disabilities (consumers
of Communication and Therapy Services- CTS), their families, support workers, CTS staff, staff of Assistive
Technology unit of Regency Park Rehabilitation Engineering and an Options Co-ordinator (community case
manager) through questionnaires, interviews, and focus groups. The central theme that was addressed was the
current practices and expectations of VOCA prescription, training, support, use and follow-up. Two consumers of
CTS who use VOCA and access workers from various accommodation and day activity centres were invited to be
part of the project steering committee. Information from the above methods was used to develop a pathway at a
macro level, which presented the various steps in the process of device prescription and training.
Results
A booklet containing simple text, pictures, Picture Communication Symbols, (Johnson, 1994) was used to
illustrate each step in the process, the time frame and the agencies or individuals who can be involved. An initial
evaluation of the booklet showed that the response to referrals were within the current set time of 10 working days
and assessment was completed for the majority within a month. The period required for trialling varied amongst
consumers. Several consumers were waiting for funding to be organised. Some comments regarding the pathway:
“I was impressed with the booklet. It would have helped me with difficulties I had with obtaining a previous device”
(Client), “excellent idea, It will help in keeping track of the process and to train other staff” (support worker 1),“some
of the time frames are questionable” (support worker 2).
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Implications
With the use of the booklet,
1) that the process for VOCA prescription and support is clear to VOCA users, their support workers,
staff at CTS and all other stakeholders;
2) that there is reduction in communication breakdowns; and
3) that issues which interfere with VOCA prescription and support are identified and addressed.
Project completed in 2000
Novita Children’s Services Incorporated • Research Report January 1999 – June 2004