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Accessible healthcare
116
ACQ
Volume 12, Number 3 2010
ACQ
uiring knowledge in speech, language and hearing
Keywords
COMMUNICATIVE
ACCESSIBILITY
HEALTH CARE
ORGANISATIONS
Aphasia Institute (Kagan, 1998), however, was beginning to
reveal the crucial role environmental barriers and facilitators
play in determining an individual’s ability to participate in
communicative life. We had started to embrace a more
integrated, functional approach, which gave us options
beyond the limits of addressing impairment alone. But it
was this particular discussion, in October, that opened my
eyes to the plight of the many people spread across our
healthcare network right at that moment struggling to make
sense of the systems, information and attitudes through
which we delivered our care.
For me there was a sudden clarity of purpose. The
next day I sent an email to a handful of colleagues across
Barwon Health inviting them to a meeting to discuss the
issue of communicative access (CA). The result was the
Communicative Access Care Improvement Group (CACIG).
What follows is not a discussion of CA per se but rather
an attempt to highlight and share key learnings that have
emerged through our struggle to make organisation-wide
improvement to CA in our corner of the public health system.
The Barwon Health Communicative
Access Care Improvement Group
(CACIG)
The CACIG is a multidisciplinary group of clinicians,
managers, and consumers. We dwell in the possibility that
one day: All consumers (will) readily access the information
they need to communicate effectively with others, make
decisions and participate more fully in their own healthcare.
The group’s mission is to: Strive to be instrumental in
creating healthcare that is accessible to, and inclusive of,
those who struggle to talk, read, hear or understand. We
work to achieve this by:
This paper describes the development of the
Communicative Access Care Improvement
Group – a multidisciplinary practice
improvement group comprised of clinicians,
managers, and consumers. The primary
objectives of the group are to identify potential
barriers to effective communication within
Barwon Health; to motivate for change toward
a communicatively accessible and inclusive
healthcare system; and to participate in
achieving this by providing ongoing education
and consultation. This discussion focuses
specifically on the key strategies used and
lessons learned in our attempts to put
communicative access on the agenda of our
large healthcare network.
M
ost people would agree that effective communi
cation is fundamental to the quality of life of every
individual. This applies across all cultures and all
facets of life, including those times in our lives when we require
access to healthcare. The collaborative and respectful
partnership that is an integral concept to person-centred
care cannot be achieved without effective communication
between the health provider and the user (Bensing, Verhaak,
van Dulmen, & Visser, 2000). People with communication
disabilities, however, are at risk of not being able to
communicate effectively with healthcare providers and as a
consequence have their right to participate in their own care
compromised (O’Halloran, Hickson, & Worrall, 2008).
It was at a routine staff meeting in October 2003 that this
issue came sharply into focus for the speech pathology
group at Barwon Health (BH). Discussing the Inpatient
Functional Communication Interview (IFCI; O’Halloran,
Worrall, Toffolo, Code, & Hickson, 2004) through the
conceptual framework of the
International Classification
of Functioning, Disability and Health
(ICF; World Health
Organization, 2001), Robyn O’Halloran spoke of a
fundamental shift in the way we might view our roles as
therapists and the responsibility we have to our patients.
Many of us employed the traditional, individualised
therapeutic approach aimed at addressing communication
problems with an individual, at an impairment level. Exposure
to the work of Connect (Communications Forum, 1997; Parr,
Wimborne, Hewitt, & Pound, 2008), and the work of the
Creating communicative
access in Barwon Health:
Dwelling in possibility
Natalie Anderson