ACQ Vol 12 No 3 2010

• 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.

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.

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

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

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ACQ Volume 12, Number 3 2010

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