Every person deserves a voice. Every voice deserves to be heard.

Transcription

1 NOVA SCOTIA HEARING AND SPEECH CENTRES 2016 Annual Report Every person deserves a voice. Every voice deserves to be heard.

2 Anne Mason-Browne CEO Bert Lewis Chair, Board of Directors Page 2

3 NSHSC set 38 targets in for advancing on all 10 of the Strategic Goals. By year end, 34/38 of the targets were completed, three were expanded and will be continued into , and one target will be redefined following consultation with external stakeholders. Please go to the NSHSC Strategic Plan 2020 Annual Report. The Strategic Planning Core Committee met on December 14, 2016 to complete an annual review of stakeholder and client input, environmental analysis, and review of recommendations from many working groups which are dedicated to a wide range of activities (e.g. quality improvement, ethics, health and safety, risk, patient/client and family centered care, standards and audit, communications, operations and management). The Strategic Plan was reviewed, updated and the annual targets for were identified for the NSHSC Business Plan. Page 3

4 NSHSC Serving the Province Nova Scotia Hearing and Speech Centres (NSHSC) is responsible for providing audiology services to Nova Scotians of all ages, and speech-language pathology services to preschool children and adults. NSHSC delivers integrated and standardized provincial services across 34 clinic sites, located in 24 communities. Nationally certified Audiologists and Speech-Language Pathologists with support from Communication Disorder Technicians and Administrative Support Professionals, provide core services (prevention, diagnosis, and treatment), develop and monitor provincial clinical standards, and collaborate with partners to deliver a number of special programs (e.g. Autism, Stroke, Cochlear Implant). Percentage of services delivered to inpatients Over 16 years old 22% Percentage of services by age category 16 years and under 38% 62% Location of clinical visits inside and outside of Halifax area 51% 49% 84,503 Client Visits* in % newborn babies received hearing screening *Visits are defined as episodes of care or services provided to clients and/or their caregivers Page 4

5 Quality Improvement: Evaluation of the NSHSC Early Childhood Development Project By Susan Doucette In June 2015, NSHSC received confirmation through its annual budget process that the Department of Education and Early Childhood Development (DEECD), in collaboration with the Department of Health and Wellness, allocated funding to the Nova Scotia Hearing and Speech Centres specifically to reduce wait times for preschoolers with speech and language assessment and intervention needs. Hiring was completed in the summer of 2015, program planning started in September and the first child was seen through the project on October 26, The focus of the project Year 1 was in the Halifax area (including Dartmouth, Halifax, and Lower Sackville); a related trial of a community-based service delivery model in a First Nations community near Sydney was also initiated in The overall goals of the project were to: 1. Reduce wait times for preschoolers requiring speech and language services; 2. Align designated project resources and services with the Early Years Framework aims; 3. Provide these designated services in an innovative way to support family-centred care. Service Delivery Model After each block of assessments, children and families were streamed into appropriate group service options. Key components of each service option included Recommendations: parent coaching and grouping of children and families. Continue the project for Year Two, with a focus on: Some innovative elements of the service delivery included: A group treatment program called Wee Chat that employed a continuous enrolment approach to treatment, which allowed for different children to join and leave the group according to their needs Programs were offered at non-traditional times to accommodate different family schedules (e.g., Wee Chat was offered on Saturdays). Programs were delivered in community-based settings such as churches, daycares, and libraries. The Results October 2016 In Year One a total of 257 children were assessed at their initial consultation (IC) appointment. Of those, 58% (148) went on to receive treatment, 32% (81) were scheduled for monitoring and re-assessment, 10% (28) required no further follow-up. Two cases were transferred to other services within NSHSC. There was also a significant reduction in average wait times for services for preschoolers in the Halifax area, from a high of 11 months reduced to 7 months between September 2015 and September Recommendations: Continue the project for Year Two, with a focus on: Patient and family centred care Adoption/adaptation of the model to reduce wait times in other targeted regions Sustaining reduced wait times Collaborative education with early child providers to build knowledge and skills in facilitation of speech and language development Page 5

6 Quality Improvement by Removing Barriers to Service: The Case History Form Elimination Project By Teresa Alexander-Arab For many years (decades even) NSHSC Speech service has been sending out detailed Case History Forms (CHF) to clients and caregivers at time of referral. The original intent of sending out the form was to streamline the referral intake process by identifying priorities, allow for caseload triaging, and assist clinicians in preparing for initial consultations. Over time clients and families who did not return the form were removed from the waitlist based on the assumption that these individuals were not interested in our services. The process was costly in terms of human and material resources. Additionally there was potential for confusion as Audiology had a different intake process. Over the years NSHSC had received feedback from clients, families and stakeholders that the process served as a barrier to service, especially to those families for whom written communication and health literacy are challenges. The most common word we heard in describing this process was unfair. In December 2014 a working group was formed with the task of reviewing the referral intake process for adults and pediatric clients to develop a more client/family friendly process. The discussions during the meetings were heated with individuals arguing passionately for or against requiring the CHF before seeing the client. In the end the working group made the recommendation that as of September 1, 2015 CHFs were no longer going to be sent to pediatric clients. With any change there is uncertainty as to whether we will achieve the desired outcome: fewer families lost to follow-up. To look at the outcome of this project we pulled data from the waitlists of HRM and two satellite locations. We looked at the number of families lost to follow-up before they came through our doors before and after elimination of the CHF requirement Before As you can see, the number of families who did not come through our door decreased by almost 50% following the elimination of the CHF. The administrative time spent on the mailing, tracking, following up and scanning these forms is now used on other tasks. Furthermore, examination of the Quarterly Reports indicates that this change did not affect wait times for services. This Quality Improvement project demonstrates how a powerful change can be achieved by our staff being willing to look at a process and recommend changes. We would like to thank the following individuals who contributed to this project: Christine Comeau, Kirsten Hovey, Janice Whebby, Beth Roberts, Lynnanne Snair, Erin Burke, Heather MacLean, Susan Murphy, Susan Atkinson, Teresa Alexander-Arab, Susan Doucette. 54 After Page 6

7 Audiology Advanced Audiological Training Re-defining hearing tests By Greg Noel It can be said that we hear with our brains, not our ears, so it is important for audiologists to gather as much information about clients hearing and listening needs in order to provide the best service possible. One strategic goal for NSHSC this year was to promote training advanced audiological techniques to NSHSC audiologists. These procedures gather information from the auditory system past the inner ear or cochlea and work in tandem with other systems such as speech and language, cognition and memory. Of course, not everyone needs such testing. Kelly Breau, Audiologist, getting ready for her next advanced diagnostic session. An extensive chart review, undertaken in , revealed that 84% of NSHSC audiologists provide advanced testing. In addition, the majority of NSHSC audiologists are providing some amount of hearing therapies for their clients and reporting positive changes in hearing and listening abilities after therapy. It should be pointed out that other audiologists are providing services in other areas that require specialized skills and expertise such as balance, tinnitus, amplification and cochlear implant. The advanced testing has driven even more change from the NSHSC Standards and Audit Committee by developing new standards for provincial audiology services. For example, standards for speech in noise testing as well as auditory evoked potentials will help audiologists provide better counselling and support for the client s needs and help to monitor change within the auditory system. We have seen an increase in the number of clients being referred for hearing related concerns after suffering a concussion. NSHSC Audiology testing has revealed that for the most part, the hearing problems occur as a result of trauma past the inner ear and advanced testing has helped confirm the client s hearing issues. Hearing training and working with other health care providers has helped these clients improve; so much so, that some have been able to return to work. Our audiology team is certainly re-defining the value of in depth hearing assessments for clients and families. Did you know...? Nova Scotia Hearing and Speech Centres offers free services with a valid NS Health Card Nova Scotia Hearing and Speech Centres have an open referral policy we do not require a doctor s referral to set up your appointment! If you think you need hearing or speech-language services, go to our website at Page 7

8 Page 8 NSHSC ANNUAL REPORT 2016

9 NSHSC STATEMENT OF FINANCIAL POSITION March 31, 2017 NSHSC ANNUAL REPORT 2016 Page 9

10 OUR MISSION: To provide the best Audiology and Speech-Language Pathology services to Nova Scotians High quality identification, diagnostic, prevention-promotion, and treatment Education of clients, students, care providers, stakeholders, and communities Provincial standard setting, evaluation, and improvement in concert with our professions and our partners Thank you to our 2016 Board of Directors Dr. Joy Armson, Halifax Mr. Perry Jackson, Canning (Past Chair) Ms. Anne Mason-Browne, Halifax (CEO) Mr. J. Scott Barnett, Halifax Mr. Peter Konings, Falmouth Ms. Robyn McIsaac, Wolfville (Treasurer) Mr. Frank Barteaux, Bedford (Vice Mr. Bert Lewis, Port Hawkesbury (Chair) Mr. Gordon Moore, Halifax Chair) Mrs. Odille Campbell, D Escousse Mrs. Margaret Ann MacCuspic, Grand Mrs. Helen Morley, Mount Uniacke River Mr. Ed Colquhoun, Amherst Ms. Tammy Manning, Halifax Mr. John R. Sylliboy, Millbrook First Nation Back row L to R: Ed Colquhoun, Robyn McIsaac, Perry Jackson, Scott Barnett, Margaret Ann MacCuspic Seated L to R: Frank Barteaux, Bert Lewis, Odille Campbell, Anne Mason-Browne Missing from photo: Joy Armson, Peter Konings, Tammy Manning, Gordon Moore, Helen Morley, John Sylliboy We are a volunteer Board of Directors and are always looking for new members. If you are interested, please contact Bert Lewis at info@nshsc.nshealth.ca. Page 10

11 Nova Scotia Hearing and Speech Centres Sites NSHSC ANNUAL REPORT 2016 (A) = Audiology Services (S) = Speech-Language Pathology Services Amherst (A & S) 18 South Albion Street (902) Antigonish (A & S) St. Martha s Regional Hospital (902) ext 4197 Bridgewater Site 1 (A & S) South Shore Regional Hospital (902) ext 2248 Site 2 (S): 42 Glen Allan Drive, Suite 208 (902) Dartmouth Site 1 (A & S) 45 Alderney Drive, Suite 606 (902) Site 2 (S) Dartmouth General Hospital (902) Digby (S) Digby General Hospital (902) ext 3360 Evanston (S) Strait Richmond Hospital (902) Halifax Halifax Community Clinic (A & S) (902) Halifax-EIBI (S) 7071 Bayers Rd, Suite 160 (902) IWK Health Ctr (A & S) (902) IWK Health Ctr (A) Newborn Hearing Screening (902) QEII Health Sciences Ctr (A & S) Dickson Building (902) QEII Health Sciences Ctr (S) Halifax Infirmary (902) QEII Health Sciences Ctr (S) NS Rehabilitation Centre (902) Kentville (A & S) Site 1: 10 Webster Street (902) Site 2: Valley Regional Hospital (Inpatients only) Liverpool (S) Queens General Hospital (902) ext 1246 Lower Sackville (A & S) Cobequid Community Health Centre (902) Lunenburg (S) Fishermen s Memorial Hospital (902) ext 3242 Middleton (S) Soldiers Memorial Hospital (902) ext Musquodoboit Harbour (S) Twin Oaks/Birches Continuing Care Centre (902) New Glasgow (A & S) Site 1: 112 Provost Street (902) Site 2: Aberdeen Professional Centre (Inpatients only) Pictou (S) Sutherland Harris Memorial Ctr (Inpatients only) Sheet Harbour (S) Eastern Shore Memorial Hospital (902) Shelburne (S) Roseway Hospital (902) ext 2269 Springhill (S) All Saints Hospital (Inpatients only) Sydney (A & S) Site 1: Health Park 45 Weatherbee Road, Ste 106 (902) Site 2: Cape Breton Regional Hospital (Inpatients only) Sydney Mines (A & S) Harbour View Hospital (902) Truro (A & S) Colchester East Hants Health Centre (902) Waterville (S) Kings Regional Rehabilitation Centre (902) ext 162 Windsor (S) Hants Community Hospital (902) Yarmouth (A & S) Yarmouth Regional Hospital (902) ext 1364 Provincial Administrative Office 5657 Spring Garden Road Suite 401, Box 120 Halifax NS B3J 3R4 (902) Visit us online at or call toll-free Every person deserves a voice. Every voice deserves to be heard. Page 11