ENT Specialist Clinics Philippa Pearce Acknowledgments: - - PowerPoint PPT Presentation

Implementation of an Advanced Practice Physiotherapy Vestibular Assessment Clinic (PVAC) within ENT Specialist Clinics​

Acknowledgments:

• Victorian Government Department of Health and

Human Services – Advanced Practice in Allied Health Grant Program 2015-16.

• QLD Health (RBWH and PCH)
• Ballarat Health Services – ENT Department

Philippa Pearce Senior Clinician Physiotherapist Ballarat Health Services

Background

Objectives/Aims To evaluate the acceptability and feasibility of an Advanced Practice Physiotherapy Vestibular Assessment Clinic (PVAC).

203% Increase in referrals 383 Day wait time to see ENT Delayed diagnosis & Treatment. Duplication

• f referrals

32% Prevalence

• f dizziness in

50+yrs

Advanced Practice successful elsewhere No Dedicated Clinic

Images: 1. “Questions” Created by Marek Polakovic from the Noun Project

• 2. “Speech bubble” Created by Aldric Rodríguez from the Noun Project

Intervention

Development and Implementation of PVAC

2015-16

Pre-intervention Data Collection

Feb 2016

Funding Application (DHHS)

May/June 2016

Engage stakeholders/ Steering Committee

Oct 2016

Clinic Commenced (Fortnightly)

Oct 2016-March 2017

Physiotherapists Complete Competency training package

Dec 2017

Project Complete Business Case Submitted Physiotherapy assessment

• Gait and mobility
• Balance
• Oculomotor/vestibular

function

• Review of a pure tone

audiometry Competency Framework

• Clinical skills

modules (x4)

• Observation (by ENT

Specialist)

• Discussion with ENT

staff

• Documentation Audit
• Clinical

Governance Documents

• Clinic processes
• competencies

for advanced practice role. Increased referrals to Falls Clinic and Sub-Acute Outpatient PT.

Outcomes

• 54 Patients
• Further investigation (e.g.,

CT/MRI)

• ENT Intervention (Prescription of

Meds)

• Average Wait time reduced

383 to 82 days

“Women” Created by Milinda Courey from the Noun Project

Outcomes

• 9.89/10 rating for positive experience
• 98% “Very Satisfied”

“I feel much better about my condition.” “I felt very safe, comfortable and understood during my appointment.”

“The trial has been very successful and has made a material difference to the management of vestibular patients in the region”.

Images:

• 1. “Speech bubble” Created by Gregory Radek

from the Noun Project

• 2. “Dizziness” Created by Priyanka from the Noun Project
• 3. “Doctor” Created by Delwar Hossain from the Noun Project

Ensuring Long Term Success

Identify need Build relationships Determine available resources Establish framework for development and implementation Develop succession plan

• Excessive wait times
• Duplication of referrals
• Pre-existing relationship with

Senior ENT Specialist

• Staff with appropriate skills
• Equipment
• Room availability
• Hand picked Steering

Committee

• Over-reliance on 1-2 senior staff
• Lack of space to expand
• Difficult to demonstrate cost

effectiveness

• Growing demand for service