ACQ Vol 12 No 3 2010

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ACQ Volume 12, Number 3 2010 117
wayfinding efforts, then all users (including staff) would find
access intuitive and easy.
The review of Wayfinding included:
• internal signage audit
• Community Rehabilitation Centre client survey
• Inpatient Rehabilitation Centre Visitor survey
• staff time and occasions for providing directions and
wayfinding assistance at main reception, Café 45.
This project resulted in a comprehensive wayfinding
strategy for rehabilitation services including the development
of accessible:
• previsit information
• spoken directions training for staff
• road signs and entrances clearly marked
• traffic management and parking strategies
• logical and intuitive internal signage
• art and design in Wayfinding in order to ensure a
welcoming environment.
• identifying the barriers to communicative access in
partnership with consumers and the community;
• developing sustainable strategies, guidelines and systems
that facilitate communicative access for everyone;
• promoting awareness and achieving better practice within
Barwon Health and beyond.
Key CACIG projects
Since its inception the group has driven and participated in
many projects throughout the organisation. Some of the key
projects include the Cognitive Identifier Project, the McKellar
Wayfinder Project. These are discussed in more detail below.
The Cognitive Identifier Project
This project aimed to increase staff’s skills in communicating
with people with a cognitive impairment (CI). A total of 1471
staff attended training over the 12 month period that training
was offered face to face, across acute, inpatient
rehabilitation and outpatient rehabilitation services. Training
was provided to increase staff awareness and understanding
of CI, improve communication skills with patients with CI and
to introduce the Cognitive Identifier symbol. This was funded
through the DHS Dementia Care in hospitals project
following the pilot project conducted at Ballarat Health
service. Sustainability was addressed through the
development of a CD-ROM self-directed learning package,
an intranet web page, and training for all new clinical staff
embedded in the Barwon Health orientation program. To
date 3704 staff have been trained using the self directed
learning package or as a new starter to BH as part of
orientation (including the 1471 staff who attended initial
education sessions). In addition the Cognitive Impairment
Identifier symbol (see figure 1) is now a clinical alert
communicated using patient information systems. This will
also be incorporated into the organisation’s ehealth patient
care planning system which is under development.
Figure 1. Cognitive Impairment Identifier
The McKellar Wayfinding Project
Clients, carers and visitors’ often experience BH when they
are at their most vulnerable. In addition, many of our clients
have physical, sensory, communication and/or cognitive
impairments that make it difficult to access some services
and buildings. Complex buildings require a comprehensive
range of devices and strategies to help people get to their
desired destination with confidence, ease and in time. Poor
design in finding their way results in lost and flustered people
whose overall experience of the organisation, from the
outset, is negative. Anxious people are less likely to be able
to take in information and gain the most from the therapeutic
environment.
The aim of the McKellar Wayfinding Project was to design
the built environment and its systems to support and
facilitate people’s intuitive abilities to find their way. It was
assumed that if users with physical, sensory, communication
and/or cognitive impairments experienced success from their
Figure 2. Red corridor and corresponding colour-coded signage in
the McKellar Community Rehabilitation Centre
Accessible written information
A BH-wide protocol, systems of review and a toolkit/
resource were established to ensure that all written
information produced for consumers is communicatively
accessible. This project is currently being reviewed within the
context of broad organisational changes with regard to visual
standards and the development of a ‘plain English’ policy.
From dwelling in possibility to
seeing organisational change
We understand that there is a vast difference between
knowing there is a problem and attempting to do something
about it. In implementing the projects described briefly above
the CACIG has gathered experience and learned many
lessons about working towards creating more
communicatively accessible healthcare environments. These
are shared and discussed below in order to provide a
starting point for clinicians wanting to improve
communicative access – to turn knowing into doing in their
own organisations, big or small.
1. Involve consumers at every step and tell
their stories
In thinking about creating more communicatively accessible
environments we started to observe many of our patients in