ACQ Vol 12 No 3 2010

Accessible healthcare

Clinical insights Reflections on improving hospital access for people who are Deaf or have a hearing impairment Evelyn Towers

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.

Keywords ACCESS CAPTIONING COMMUNICATION DEAF HEARING IMPAIRED HOSPITAL

Evelyn Towers

120

ACQ Volume 12, Number 3 2010

ACQ uiring knowledge in speech, language and hearing