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Accessible healthcare
120
ACQ
Volume 12, Number 3 2010
ACQ
uiring knowledge in speech, language and hearing
Evelyn Towers
Keywords
ACCESS
CAPTIONING
COMMUNICATION
DEAF
HEARING IMPAIRED
HOSPITAL
Working towards an accessible
environment
The task of organisation-wide access improvement
commenced in 1999 with planning for a large-scale
redevelopment of the hospital. Prior to this, initiatives to
facilitate service delivery to people who are Deaf or hearing
impaired were limited to providing a few patients with
listening devices, giving ad hoc in-service education on
hearing tactics and management of hearing aids, and
providing sign language interpreters. The redevelopment of
the Princess Alexandra Hospital provided the impetus for our
organisation to examine and address access issues in a
systematic way. The major aim of improving access was to
enable all patients, including those with special needs, to
optimally utilise health services in the most efficient and
informed way.
The organisation identified the redevelopment as a real
opportunity for improvement and innovation and engaged
staff in the process. In particular the hospital wished to
improve user satisfaction and health outcomes as well as to
demonstrate compliance with government requirements and
relevant legislation such as the
Disability Discrimination Act
(1992).
As director of the Audiology Department I was asked to
contribute in two ways. First, by looking at the barriers to
access experienced by those who are Deaf and by those
with a hearing impairment, and second, by implementing
strategies to address these barriers. This work initiated a
new role for the Audiology Department in driving access
initiatives within the organisation on an ongoing basis.
The scale of the redevelopment was large and
included the construction of a new building to replace
the existing main building along with the redevelopment
and reorganisation of a number of its outlying services. All
services in the hospital were engaged in the project and
this environment enhanced opportunities for change in both
physical and communication access.
The extent of change also created competition for the
attention of staff at all levels in the organisation, which was
a potential barrier as was the reassignment of resources
to areas perceived to be non-clinical. The sheer physical
size of the hospital was challenging and a new model for
service delivery with outpatient clinics situated adjacent to
their specialty wards increased the locations where access
requirements needed to be investigated.
A number of strategies were employed to address these
potential barriers. Key personnel with credibility and well-
This article describes the journey undertaken
by Princess Alexandra Hospital to create a
more accessible environment for patients who
are Deaf
1
or have a hearing impairment. It
outlines the identification of communication
barriers as part of planning for a large-scale
redevelopment and discusses what has been
achieved in the ten years since. Areas
addressed include assistive technology,
resource development, and service
improvement. Suggestions are given for
others who wish to improve access in their
organisation together with suggested
directions for the future.
P
rincess Alexandra Hospital is a major tertiary teaching
hospital located on the south side of Brisbane. The
hospital provides all of the major adult acute medical
and surgical specialties and mental health services, and
has specialised rehabilitation services including spinal injury,
geriatric, and brain injury services. It is a large organisation
employing over 5000 staff, which in 2008–09 provided
more than 459,000 outpatient appointments and had
over 74,000 admissions to the hospital. In 2007 Princess
Alexandra Hospital received the inaugural access award
from the peak body Deafness Forum of Australia and the
Queensland Disability Action Week Award for Local and
State Government in recognition of its work in creating
accessible healthcare services for people who are Deaf or
hearing impaired.
This article describes how we began working towards the
development of a more accessible healthcare environment
and outlines what has been achieved, provides tips for
others setting out on a similar journey, and offers some
thoughts for the future. While a number of the initiatives
documented here have also provided benefits for visitors
and staff who are Deaf or have a hearing impairment, their
specific issues have not been outlined below. Reflection on
the last ten years has provided insights into what worked
well and what didn’t. In sharing these experiences, I hope to
remove one of the early barriers to progress – the lack of a
healthcare model.
Clinical insights
Reflections on improving hospital access for people who
are Deaf or have a hearing impairment
Evelyn Towers