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Rehabilitation Clinician Network

Rehabilitation is an area which has been identified as a service which would benefit from a more structured clinician network, given the multidisciplinary nature of the specialty; the diverse and complex case mix and the broad professional core competencies required. Many rural clinicians are professionally isolated due to lack of networks for education and training, peer support and mentoring / supervision.

The Rural Clinician Network Support Project aims to establish a structured framework for a rural clinician network for rehabilitation clinicians across rural NSW. A Project Officer was appointed for 12 months in October 2006 to engage rural clinicians (medical, nursing and allied health) and develop recommendations for developing and piloting capacity building networks within and across Area Health Services.

ACHIEVEMENTS

State-wide rural rehabilitation clinician consultations, focus groups and interviews were conducted November and December 2006.

• Report on findings

A clinician satisfaction survey and education needs analysis was completed January 2007

• Presentation of survey results

Based on these initial findings, the project adopted 4 main aims: Education, Networks, Raising the profile of rehabilitation and Establishing partnerships / Researching Managed Clinical Network Models.

AIM 1: EDUCATION

To review existing rehabilitation education delivery models and provide evidence-based rehabilitation education to clinicians

Organisation	Existing Programs	Capacity to value add	Outcome
Area Health Services (AHS)	Nil	Collated education surey distributed to AHS Learning & Development Units	Rehab workshops introduced: Sexuality and Disability, Cognitive Assessment, Loss and Grief in Disability, Goal Attainment, Assessment for acquired Apraxia, Paediatric Rehab Assessment
Australasian Faculty of Rehab Medicine (AFRM)	Global Telehealth, Comprehensive Registrar Program	Bought into Electroboard which reduced the cost of telehealth	All rehab disciplines invited to participate with medical colleagues. Trial 2007.
Rural Heatlh Education Foundation (RHEF)	Pain Management/ Arthritis Only	Develop 2 rehabilitation programs for satellite broadcast	In progress
Australasian Rehab Nurses Association (ARNA)	Annual study day for members held in Sydney	Invite rural membership	Survey rural clinicians Oct 07. Commence rural annual study day 2008.
Royal Rehab Centre Sydney	Rehabilitation Disability Forums Rehab library Rehab RN Course Spinal Chord Injury Outreach Service	Utilise telehealth to link rural sites - required coordination Expanding to rural Annual in rural setting Include education component for clinicians	Telehealth pilot - series of 3 funded by IRCST 2 rural multidisciplinary workshops per year proposed 2008-2010 Rural membership Rural course Dubbo May Calendar distriuted via REHAB
NSW College of Nursing	Nil. Need identified by AHS survey Jan 07	Courses will be available or all rehabilitation disciplines	Rehabilitation recognised as a specialty area. Distance Education course under development.

Three Disability Forums were conducted face to face at Royal Rehabilitation Centre Sydney and were broadcast via telehealth to 14 rural sites with average 60 rural clinicians in attendance, in a trial funded by the IRCST. Royal Rehabilitation Centre Sydney is to commence two rural workshops per year in 2008.

Rehab_Teleconf_Cropped

Aim 2: NETWORKS

To provide support and foster links between rural clinicians working in rehabilitation services in metropolitan and rural areas.

Rehabconnect

The rural Rehabilitation Clinician Network Project facilitated the establishment of the Rehabconnect list serv, a rural rehabilitation network with 200 clinicians subscribed. This network enables rural clinicians to have access to clinical information relating to rehabilitation such as conferences, scholarships, courses, links to articles and also to post clinical case management queries for collaboration and discussion.

CLICK HERE TO JOIN REHABCONNECT

Sole Practitioner Peer Support

“Virtual Teams” are being established in rural AHS, linking sole practitioners with a senior colleague in a larger regional centre. Strategies implemented include linking sole practitioners to their referral centre for inclusion in team meetings, inservice calendar, case discussion and creation of peer support network by email, teleconference or videoconference.

Rehabilitation Clinical Nurse Consultant positions

The absence of Rehabilitation CNC positions in rural NSW, identified over the project period, has led to discussion with Chief Nursing Officer (CNO) NSW Health who has recommended that consideration be given to inclusion of the establishment of a rural rehabilitation CNC network as a priority when the 2002 Rural Health Plan is revised in 2008.

Rehabilitation Nurse Practitioner Positions

Two Rehabilitation Nurse Practitioner positions are to be established in rural NSW in 2008. Written endorsement has been received from AFRM supporting establishment of the first positions in NSW which will facilitate day to day assessments / slow stream case management / discharge planning and follow up maintenance.

Aim 3: RAISE THE PROFILE OF REHABILITATION

To change the culture of rehabilitation from the media driven exposure of celebrity figures undergoing ‘rehab’ for substance abuse often associated with public shame; and create a positive image based on a wellness model, focusing on ability and not disability to achieve dreams and goals.

Rehabilitation Week is now designated on the DoH health promotion activities calendar as an annual event to be held in conjunction with National Stroke Week and NSW Brain Injury Awareness Week.

13 regional centres participated in a coordinated campaign across NSW: Rehabilitation Expos, static display of equipment and disability aids in shopping centres, staff BBQ’s, community seminars, one facility even organised a hospital fete! Most sites identified a past patient to share their motivational stories of recovery with media, with widespread media cover capturing newspaper, ABC radio and television across NSW.

AIM 4: COLLABORATIVE PARTNERSHIPS / RESEARCH

MANAGED CLINICAL NETWORK MODELS

To develop a sustainable approach for rehabilitation beyond the life of the rural rehabilitation Clinician Network Project.

Community Based Rehabilitation.

Charles Sturt University (CSU) and Royal Rehabilitation Centre Sydney (ROYAL REHAB) have submitted a proposal to NSW IRCST for funding to review CBR literature and health care models.

Eighteen sites participated and forty clinicians were consulted. The project will be undertaken over a six month period (January – July 2008) and will develop draft recommendations for a CBR approach and implementation framework for rural NSW with potential for a funded trial in a rural community 2008.

NSW College of Nursing

Rehabilitation has been identified by the NSW College of Nursing as a subject area with potential for course development, and a continuing education course is under development.

Australasian Rehabilitation Nurses Association (ARNA)

ARNA have agreed to take over governance and monitoring of REHABconnect list serv at the conclusion of the project period, which will ensure that REHABconnect remains an efficient and effective clinical communication network. ARNA plan to enhance rural memberships and extend the annual study day to rural locations on rotation.

Australasian Faculty of Rehabilitation Medicine

AFRM conduct a comprehensive global telehealth education training calendar primarily for rehabilitation physician trainees and are trialling the expansion of broadcast network to include multidisciplinary rehabilitation clinicians.

REHABILITATION FRAMEWORK MODELS

A major component of the Rural Rehabilitation Clinician Network Project was to identify other framework models which could be adapted to rehabilitation services to offer professional development and support to rural clinicians.

Managed Clinical Networks

To achieve a sustainable structure for rehabilitation services across rural and remote NSW, the establishment of area wide clinical networks for Aged Care and Rehabilitation Services is recommended by the rural rehabilitation project officer as a priority.

1) Child Health Networks

There are three pediatric networks in NSW which give strategic direction and statewide co-ordination to pediatric services across NSW. Each network is linked to a tertiary pediatric hospital.

2) Mental Health Framework

NSW Mental Health services have adopted a new direction, promoting recovery and rehabilitation support from first assessment as an inpatient to community reintegration. The rehabilitation framework aims to build co-ordinated partnerships with Home and Community Care Services, Division of GP’s, local Councils, housing, education and employment support agencies

3) Chronic Care Rehabilitation Model

Based on the self management theory in an integrated area wide model people are supported to self manage involving individual assessment, tailor made programs and self management support from service providers.

4) Clinical Services Redesign Program (CSRP)

The main aim of redesigning health care is to improve total coordination of care. The patient is on a single journey and all the different services are ‘one team’.

EVALUATION

A post project survey was distributed to 170 clinicians via REHABconnect list serv in October 2007. 80 surveys were returned, a response rate of 47%.

MISSION STATEMENT

To increase access of rural and remote rehabilitation clinicians across NSW to education and training, clinical networks and peer support by 80% within 12 months.

When final survey results collated in October 2007, were measured against the initial needs analysis collated in January 2007, the Rural Rehabilitation Clinician Network Project has almost met the 80% goal set by the mission statement. Evaluation of project strategies confirmed that access by rural and remote rehabilitation clinicians across NSW to education and training, clinical networks and peer support has increased by 75% over the twelve month project period.

RECOMMENDATION

At the conclusion of the project, the project officer recommends that:

Intersectoral collaboration research be undertaken to establish a Managed Clinical Network for Rehabilitation services across rural NSW. Inclusion of Chronic Care into the network would facilitate sharing of disability resources and programs, expand communication with private rehabilitation providers and referral agencies already established, and strengthen community participation.

See Rural Rehabilitation Clinician Network Project Final Report for detailed report.

PRESENTATIONS

Presentation prepared for IRCST February 2007

NEWSLETTERS

Monthly newsletters were generated to maintain communication on project developments. 180 clinicians are on the distribution list.

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