WCMT-Melissa-Kelly

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able to provide formal examinations and reported that this goes a very long way to remove the fear, if higher learning or complete retraining is required. Of absolute importance, was connecting everyone involved both in the multi-disciplinary group, inter-vocational support and external in supporting the person to either return to school, return to work or to return to an entirely new environment. Job coaching begins early, as does employer engagement. The teachers expressed the need to look at the practical versus theory post-injury, commenting that the higher level of injury tetraplegia group provided a greater challenge, as often more time was required. Vocational Consulting Patient X “In the first moment you came to my bed I could have murdered you because I was thinking about relationships, life, toilets and my injury. But when I left the hospital I understood why you came so early; it was necessary and I thank you forever. Initially I couldn’t deal with work issues if they arose, it would be too much.” The return to work rate for the Swiss population is 55-60% (in 2012 it was reported at 58%). The following statements from the vocational consultants attribute to the success of the patients outcomes and strongly echo our experience at Kaleidoscope: o We make communication with the employer very early on. o The patients are consulted about the vocational team contacting their employers. o Having a vocational consultant early and prioritised, the patients report “It is one problem less, no need to worry about work.” o An appointment is made with the employer, initially to visit the hospital and then the consultants visit the workplace and conduct a worksite assessment, if geographically possible. o An objective is to remove the fear of workplace modification costs from the employer. o A message delivered to the patients is, “we will try and find a solution together; it may be different now, but there is a future.” o We link patients with peers in the community working in the same job, if the patient wishes for this to occur. <strong>WCMT</strong> Research Fellowship 19
o It is so important to reintegrate the person into their community and provide vocational services. In saying this, it is equally important is to build self-image, confidence and selfefficacy. o SCI is normalised and an example of this is school children using the SPC swimming pool, community groups visiting and tours of the institute and allowing the community to access the large cafeteria and dine with inpatients. The funding model in Switzerland is not dissimilar to New Zealand, whereby if it is an accident the person receives accident insurance, and an injury at work will entitle them to insurance of incapacitation (90% of salary). For spinal illnesses, the person will receive the pension and an invalidity benefit. There is further insurance, whereby if the person is injured by another person i.e. hit by a car or stabbed, and then they will receive 100% lifetime compensation; however this is a lengthy process, with lawyers involved, and can be very hard on the patient. The general unemployment rate in Switzerland is 3%; the government expects and also supports employers to return disabled persons to work. At the time of discharge, and when a patient is returning to work, they conduct a work-capacity assessment for a period of three months; in NZ this is referred to as a ‘work trial’ or ‘graduated return to work’. The vocational consultants conduct a three month post-discharge reassessment interview, examining how the patient has adapted to their vocational setting, life adjustment and medical wellness; this is conducted again at six months post-discharge. I was encouraged by the conversations and the time I spent with the vocational counsellors to learn that we essentially operate in parallel, despite being over the other side of the world. Also, what they value as integral in the ‘early intervention’ work with patients is identical to Kaleidoscope. Vocational Workshop and Computer laboratory I have to be honest and say that upon walking into the workshop and computing area my immediate comments were “Is that a 3D printer, hold on do you have a CAD machine?” For a vocational rehabilitation department to have these two pieces of machinery is quite astonishing. My immediate thought was how fantastic for the patients to leave their rehabilitation trained or, <strong>WCMT</strong> Research Fellowship 20
Page 1 and 2: Specialist Spinal Vocational Rehabi
Page 3 and 4: Contents Executive summary Page 3 I
Page 5 and 6: 3. Ability Awareness Learning Exper
Page 7 and 8: is specialist spinal vocational reh
Page 9 and 10: Four specialist centres were select
Page 11 and 12: with change and uncertainty; the ne
Page 13 and 14: Work Readiness and Job Skills Train
Page 15 and 16: such as buses and trains. The servi
Page 17 and 18: the result of a water incident and
Page 19: physical and social aspects such as
Page 23 and 24: Stoke Mandeville’s Approach to Re
Page 25 and 26: Following targeted support, the att
Page 27 and 28: for patients, including those not r
Page 29 and 30: the open cafeteria area, in which p
Page 31 and 32: The topics covered will be: • Bas
Page 33 and 34: • Informal talks with NZST staff
Page 35 and 36: My fellowship will contribute to th
Page 37 and 38: Appendix 1. Model Explanation of
Page 39 and 40: Whilst Kaleidoscope’s core role i
Page 41 and 42: Appendix 4. Winston Churchill Memor
Page 43 and 44: Friday, May 16 Time Appointment Whe

WCMT-Melissa-Kelly

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