Designing a
This presentation is the property of its rightful owner.
Sponsored Links
1 / 18

Designing a complex needs service PowerPoint PPT Presentation


  • 98 Views
  • Uploaded on
  • Presentation posted in: General

Designing a complex needs service. Shahad Howe Manchester Royal Infirmary [email protected] Cambridge severe-profound study day Dec 2013. Current Strengths One management structure Flow of staff between different services Need to Develop

Download Presentation

Designing a complex needs service

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Designing a complex needs service

Designing a

complex needs service

Shahad Howe

Manchester Royal Infirmary

[email protected]

Cambridge severe-profound study day Dec 2013


Designing a complex needs service

Current Strengths

One management structure

Flow of staff between different services

Need to Develop

A complex hearing needs service linking together the specialist services

Local professional network

MRI Services for Adults with Complex Needs

BAHA

Brainstem

Implant

APD

Cochlear

Implant

Complex

Hearing

Needs

Clinic

Middle

Ear

Implant

Hearing

Therapy

Unilat

HL

X Hg aids

BAHA

Learning

Disability

Adult

Hg Aids


Development and implementation of clinic

Development and implementation of clinic

Define the ‘Complex Hearing Needs’ group

Current referral rates

Current treatment pathways and times to treatment

Current specialist services

Create Specialist Hearing Assessment and Rehabilitation Clinic from the subset of existing specialist services (SHARC)

Develop process map for the clinic

Develop referral guidelines for accessing the clinic

Develop clear triage guidelines for new referrals

Identify additional resources required

Identify any training needs of staff

Evaluate outcomes

Appropriateness of referral and triage

RTT time

Patient benefit and satisfaction

Complex

Hearing

Needs


Designing a complex needs service

How do we define a

‘Complex Hearing Need’?

Severe / Profound HL

APD

Learning Disability

Anyone who is

not routine!?

Mixed / Conductive HL

Needs Interpreter

Unilateral HL

NOHL

Additional Sensory Impairment

Requires frequent follow-up

Ski-slope HL

Fluctuating HL

Auditory Neuropathy /De-synchrony


Designing a complex needs service

Referral criteria


Designing a complex needs service

Referral criteria


Designing a complex needs service

Assessments

PTA

Speech testing

TEN test

Objective assessment

OAEs

Tympanometry

Acoustic reflexes

Visible speech mapping

  • Management

  • Hearing aid fitting / fine tune (with non-routine hearing aids and visible speech mapping)

  • Onward referral to specialist services

  • Referral to other agencies

Initial appointment 1.5 hours

Follow up appointment 1 hour


Designing a complex needs service

  • Severe-profound patients

    • Hearing reassessment

      • Unaided and aided

      • Speech testing

      • Consider dead regions

    • Hearing aid optimisation

      • Consider non-conventional hearing aids and signal processing

      • Consider non-routine earmould types

    • Screening for cochlear implant suitability

    • Annual review


Designing a complex needs service

Referral rate

N = 276


Designing a complex needs service

Referral source

N = 276


Designing a complex needs service

Referral reason

N = 276


Designing a complex needs service

RTT


Nwchnn

NWCHNN

Northwest Complex Hearing Needs Network

8 meetings to date

Covering e.g. NOHL, severe-profound fittings, complex REMs, speech testing, counselling, CROS systems, ALDs etc

Share good practice

Forum for case presentations and discussion

Develop treatment pathways

Develop good practice guidelines

Currently 28 key-workers representing 18 departments

Attend and host network meetings

Communication link between departments in

the region

Work with and support Manchester CI, MEI, BAHA

and SHARC teams


Benefits qipp

Innovation

Productivity

Quality

More clearly defined pathway and continuity of care for patients

66% of patients reported increased level of satisfaction (compared with previous experience)

Introduction of designated clinic for patient group

Collaboration of secondary and tertiary providers through network

Increased referrals for appropriate treatment at appropriate time with potential positive impact on cost efficiency and waiting times

Benefits - QIPP


Designing a complex needs service

What do we do with ‘complex’ patients on AQP pathway?

  • May require more time and resources

  • RAQP (rejected AQP) pathway developed and agreed with commissioners to use SHARC referral criteria to define ‘complex’

  • Currently seen within routine clinics but standard outpatient tariff per appointment is used rather than whole treatment tariff (as used in AQP)

  • Manchester AQP Tariff


Designing a complex needs service

‘Complex’ Tariff

  • Further discussions around more appropriate treatment tariff is currently taking place:

    • May require more time and resources

    • More specialised assessments required

    • More frequent visits

    • More expensive hearing aids fitted


Designing a complex needs service

References

Pushing the boundaries - Evidence to support the development and implementation of good practice in Audiology 2010

Shaping the Future: Strengthening the Evidence to Transform Audiology Services

Copies available from http://www.improvement.nhs.uk/audiology/resources.html


  • Login