Ma‑ramatanga whakaora ngangahau

Transcription

OT Insight
Ma‑ramatanga whakaora ngangahau
Magazine of the NZ Association of Occupational Therapists (Inc)
Vol. 31 No.8
September 2010
Contents
Features:
1
Clinical Leadership
6
Acquiring Assistive
Technology for Children
9
WF Disaster Preparedness
& Response CD
10 Facilitating Research and
Education
10 Mental Heath Awareness
Week
Regular Columns:
3
From the Editor
5
Letters to the Editor
11 Values Exchange Corner
12 Envisage
12 NZAOT at Work
13 Membership Matters
14 Te Umanga Whakaora
15 Info Exchange
17 Sector News
18 OTBNZ
19 CPE Calendar
Clinical Leadership
for a Better Health Outcome
Feedback from the Health Workforce
New Zealand (HWFNZ) national forum
Submitted by
Ellen Nicholson - professional leader, occupational therapy (mental health) – Auckland DHB
Wendy Hook – professional leader, occupational therapy – Waitemata DHB
A
t the end of June, we had the honour of representing NZAOT at HWFNZ’s national forum on health clinical
leadership. Part of the process of accepting a place on the forum was completing a poster representing how the
occupational therapy profession viewed “clinical leadership”. HWFNZ provided the template for the poster which
included four key headings: definition of clinical leadership; clinical leadership priorities; clinical leadership challenge,
and local initiatives. Contributions were received from members of the NZAOT OTLAM special interest group and key
occupational therapy leaders. Our final poster looked like this:
Occupational Therapy
Leadership
New Zealand
Association of Occupational Therapists
Clinical Leadership
Your definition of excellence
in Clinical Leadership:
• Competent, credible, visionary and inspiring
• Responsive and responsible engagement
and development of people, services, and
resources
• Genuine collaboration with consumers, other
professions, and agencies
• Raising the profile of the strength that
occupational therapy gains from diversity
• Culturally responsive leadership and practice
Clinical Leadership Priorities
• The right leaders in the right place at the right
time
• Ongoing development of inspirational
occupational therapy leaders who have
access to a sustainable occupational therapy
leadership framework
• Ensuring a united voice that encompasses all
contexts of occupational therapy practice
• Flexibility, communication, and development
of creative ways of knowing, being,
becoming, and doing
ISSN 1174-6556
Clinical Leadership Challenges
• Navigating the complex and demanding
practice environments
• Delivering with limited resources
• Remaining grounded in the reality and
challenges of everyday practice
• Raising the profile of the allied health
professions
• Creating the capacity and confidence of
future leaders within a small profession
Local Leadership Initiatives
• Te Umanga Whakaora: Accelerated
Ma‑ori Occupational Therapy Workforce
Development (Te Rau Matatini, 2009).
• Occupational Therapy Key Strategic
Stakeholders (OTKSS): Strategic Plan 20102015 (Theme Six: Leadership)
• Examples of innovative leadership projects
across health, social, community and
education sectors
Continued on page 4
➤
Vol. 31 No.8 September 2010 1
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O C C U P AT I O N A L
PRACTICE
R E h A b I L I TAT I O N
From the Editor…
Kia ora
W
elcome to the September edition of OT Insight
As I write, news of aftershock’s measuring up to
magnitude 5.1 shaking Christchurch and the Canterbury
region all week in the aftermath of the 7.1 magnitude
earthquake on 3 September is familiar to me.
Diary Dates of Note
19 September 1893: On this day, New Zealand
became the first self-governing country in the world
to grant all women the right to vote in parliamentary
elections. Women’s Suffrage Day allows us to reflect on
the tireless energy and will of suffragist, social reformer
and writer, Kate Sheppard.
The passing of the Electoral Act was the culmination of
years of agitation by the Women’s Christian Temperance
Union (WCTU) and other organisations. As part of this
campaign, hectic rounds of public speaking and debate,
and a series of massive petitions − including one earlier
in 1893 signed by almost one in four adult women in
New Zealand − were presented to Parliament.
In most other democracies – notably Britain and the
United States – women did not win the right to vote
until after the First World War. New Zealand’s world
leadership in women’s suffrage became a central part of
our image as a trail-blazing ‘social laboratory’.
On 2 March 1987, a magnitude 5.2 earthquake struck
the Bay of Plenty region, and minutes later a much
stronger quake rocked the region. This main shock had a
magnitude of 6.3 and was centred north of Edgecumbe.
Four aftershocks with magnitudes greater than 5
occurred in the next six hours, and smaller aftershocks
were felt for weeks.
At the time, I couriered the Rotorua Daily Post into the
region. As I was slowing down to park outside a dairy
in Kawerau early that afternoon, I thought I had a flat
tyre – until of course, I pulled to a stop and the car was
still rocking.
I was given a press pass to be allowed to return to the
region to continue to deliver the newspaper but honestly,
I just didn’t want to go there. The aftershocks were very,
very uncomfortable. Some Kawerau residents set up
camp in the outskirts of the town and didn’t move back
in to town for weeks.
I am writing on the eve of departing for the NZAOT
Shifting Sands Conference in Nelson. I will be able to
touch base with conference attendees from Christchurch,
and my feeling is that a good sleep or two without
Tina Larsen
the nervous anticipation of further
earthquakes will be a relief, but
tempering that will be concerns for
family and friends who are back
home. By the time you read this,
conference will be over, and for
those of you who attended from
the region, big ups – we here at the
NZAOT acknowledge it was perhaps
not an easy thing to do. From
the messages and letters that are
filtering through, the thoughts of
the entire membership and indeed
the world federation are with all
of the occupational therapists in
Christchurch and around the region.
Kia kaha
Tina
[email protected]
Letters to the Editor
To the editor, OT Insight
Dear Editor
Thanks to all of the people in the
wheelchair SIG that responded
to my request about the idea of
incorporating a remote cut out switch
on electric wheel chairs. There was
diverse opinion about the usefulness
of such a device - your replies led me
to realise just how diverse the field in
which you all work is, interesting.
As a past member of NZAOT,
I couldn’t agree more with
the quote in the inset on page 2 of
the Annual Report (OT Insight Vol.
31 August 2010) ‘Retirement is just
great....’
I eventually learned that such a
device is already available for $1500
locally, and have decided not to
proceed with the project.
I have done quite a bit of work on
assistive devices for paraplegics
and stroke victims (I have a vested
interest as well, my wife has made a
reasonable recovery from a serious
stroke).
If any of you have any ideas for a
gadget that might be useful in your
profession, that might incorporate
electrics, pneumatics, or electronics, I
would be interested in hearing from
you,
Regards
For it means (amongst many other
benefits) when I bring my copy of
‘Insight’ in from the letter box, I can
make a cup of tea and sit down and
read the magazine from cover to
cover. I always find it an interesting
read and this week it also gave me
a great laugh..... ‘the most regal
mothers of the profession’!!
What a grand title and thank you for
giving me such a laugh.
Kind regards,
Noeline Creighton
P.S. I hope one of the NZAOT team
has told past member’s of the great
subscription rate for retirees.
Have a great conference.
Richard Gabric
HCElectronics Ltd.
Rangiora ph +64 3 310 2258
Vol. 31 No.8 SEptember 2010 3
NZAOT
NEW ZEALAND ASSOCIATION
OF OCCUPATIONAL THERAPISTS
Founding Officer: Hazel Skilton
Executive Director: Siobhan Molloy
NZAOT COUNCIL
President: Tracey Partridge ph 0274 210318
Email: [email protected]
President Elect: Rita Robinson ph 07 889 6485
Secretary: Emily James ph 027 287 2352
Treasurer: Christine Pacey ph 03 445 0447
Ma-ori Perspective: Kevin Brown ph 021 0255 5106
Professional Standards: Christine Abernethy ph 03980 6466
Research & Development: to be advised.
Professional Representation: Angela Zame ph03 547 6556
Email:[email protected]
Marketing & Public Relations: Katrina Galbraith ph 03 382 3387
Email:[email protected]
WFOT Delegate: Alison Nelson ph 06 878 1304 ext, 2526
SPECIAL INTEREST GROUPS
Contact details at www.nzaot.com
Adults with Intellectual Disability: Helen Allen
Children and Young People’s
Occupational Therapy: Rita Robinson
Driving & Passenger Rehabilitation: Kevin O’Leary
Leaders and Managers: Christine King
Independent Practitioners: Seeking convenor now!
Mental Health: Pam Schofield
Neurology: Shona Paterson
Occupational Therapy Supervision: Marie Chester;
Ann Christie; Merrolee Penman; Carolyn Simmons Carlsson
Occupational Therapists working
with Older People: Petrouchka Schuurman
Oncology and Palliative Care: Tanya Loveard
Pain Management: Catherine Swift
Physical Community: Joanne Harper
Primary Health Care: Kirk Reed
Rheumatology: Karen Wilson
Spinal Cord Injury: Seeking convenor now!
Wheelchairs and Seating: Maria Whitcombe-Shingler
National Office
➤
Continued from page 1
Pre-readings for the day included a feasibility study
around the development and delivery of a clinical
leadership programme; leadership leverage points for
organisation-level improvement in health care; and a
report on strategies for transforming clinical governance
in New Zealand. Please refer to the bibliography (below)
for additional readings we have found useful on the
topic.
Over lunch, we enjoyed the
opportunity to meet and network,
as well as reviewing the posters
provided from a range of services
and disciplines. Our NZAOT poster
looked colourful and strong in
delivering local examples of clinical
leadership!
Around 200 predominantly mature (in experience and
years) delegates representing the medical and nursing
professions descended on the Michael Fowler Centre in
Wellington to discuss clinical leadership - and herein we
met our first challenge. What is “clinical leadership”
and who does “clinical leadership” belong too? In our
experience - and despite representation from a number of
allied health professionals - discourse was predominately
from a medical paradigm: that clinical leadership is
the concern of a medical professional. However, “the
elephant in the room” (a multidisciplinary understanding
and approach to clinical leadership) was only formally
acknowledged by the only woman speaker, Sue Wood,
director of nursing at the Midcentral DHB, at the panel
discussion at the close of the day.
The afternoon sessions were focussed
around brainstorming ideas and
actions for the future. We worked
in interactive groups in a style similar
to musical chairs. This provided us
with the opportunity to hear and
acknowledge a range of innovative
and creative solutions and challenges
for advancing clinical leadership
within the health sector. A summary
of each group was provided after
the forum. These included detailed
strategies for moving forward such
as:
The day was facilitated by Anne Patillo, who provided
an equal mix of humour and structured facilitation.
Des Gorman, chair of HWFNZ, opened the forum
and provided a context for clinical leadership within
a citizenship and social justice framework. Professor
Gorman acknowledged that health organisations are in
management crisis and “drowning in data”. The Tertiary
Education Commission has too long held the mandate
to train health professionals despite being removed
from practice and health workforce planning. His key
messages were around the need for a sustainable,
diversified health workforce needing to change in
structure and establish the correct relationship between
‘a dog and its tail’; the unification of health workforce
planning and funding through Health Workforce New
Zealand; and diversification of the New Zealand health
workforce through intelligence, innovation and clinical
leadership. Professor Gorman also provided a three-step
plan for developing clinical leaders:
1. recognise the shortfall and upskill
Level 9, 85 The Terrace, PO Box 10493,
Wellington 6143
Tel: 04 473 6510 Fax: (04) 473 6513
Editorial Office
Editor: Tina Larsen. Contact details as for National Office.
Articles: The editor welcomes the submission of articles.
Copy deadline is the 1st of each month.
Please refer to NZAOT website for author guidelines.
Publishing & Advertising Management:
Tasman Image, subsidiary of Adprint Ltd, Wellington.
NZ. Advertising Manager: Pam Chin. Tel: +64 4 384 2844,
Fax: +64 384 3265. Email [email protected]
Dates: Published every month on or about the 20th, except
January. Printed by Adprint, 60 Cambridge Terrace, Te Aro,
Wellington 6011, NZ.
This publication is printed on FSC Certified paper stock.
Disclaimer: OT Insight is published by Tasman Image Publishing
for the NZAOT (Inc). Views expressed in articles and letters do not
necessarily represent those of the Association, and neither NZAOT
or Tasman Image Publishing endorse any omissions or errors
on products or services advertised. NZAOT nor Tasman Image
Publishing accepts liability for its contents or for any consequences
which may result from the use of any information or advice given.
4 Vol. 31 No.8 September 2010
2. take a cradle to the grave approach to leadership
training, and
3. identify future leaders and establish career pathways,
guidance, and management.
He was followed by Chai Chuah, national director of
the National Health Board, who provided some of the
international context to clinical leadership, as well as
attributes and opportunities for clinical leaders.
One of the highlights of the day was Professor Harry Rea,
professor of Integrated Care and Medicine, CountiesManakau DHB presentation. Professor Rea provided
rich insights and narratives around ‘what it means to
practice and lead’, drawn from his extensive experience
of working in transdisciplinary care teams and a diverse
cultural environment. Professor Rea reminded us of the
importance of humility, engagement, and caring for one
another, and the importance of the “right person for the
job” in the service and care of clients who access health
services.
n
a national strategic and consistent
approach with a clear vision and
purpose – making better leaders to
improve our health system
n
a commitment to “not reinvent
the wheel”
n
a need to co-design programmes
and projects; drawing on the
work underway in DHBs, such
as Canterbury and Counties
Manukau DHB, and in individual
professions
n
exploration of partnerships with
established infrastructure, such
as at research developing within
universities
The forum summary acknowledges
the need to combine structured
learning of tangible leadership skills
with development of a wider culture
and environment that supports and
nurtures leaders. This empowers
health leaders to act, provide the
space to develop, and the tools to
be effective. Additionally, initiatives
developed from the forum need to
be underpinned by principles such
as teamwork, respect, biculturalism,
continuity of care, and creating more
time for sharing experiences and
learning through telling and listening
to stories.
Specific actions to be undertaken by
HWFNZ between July and December
2010 include:
n
coordination of discussions on the
establishment of a national ‘home’
(institute) of health leadership
development, with a view to
having the infrastructure in place
by the end of 2010
n
n
n
n
review of current (and may seek
further) expressions of interest
from health sector organisations
for development of health
leadership programmes, and
agreed funding support for
appropriate initiatives to maintain
momentum while the national
infrastructure is being established
funding of leadership roles as part
of new initiatives to recruit and
retain advanced trainees, and offer
a HWNZ fellowship for advanced
training
an expectation that all providers
in receipt of funding for clinical
training will ensure that individual
career plans are in place for
trainees from 2011
the scoping of the development
of a national health leadership
mentoring scheme, building on
the model of the existing career
guidance service, with matching of individuals to a
panel of experienced mentors
n
establishment of a multi-disciplinary forum to test
leadership concepts and provide advice on the
establishment of the national institute
Upon reflection, despite struggling to find a place for
allied health and occupational therapy on the day, the
summary provided from the forum gave an assurance
that the national approach must be inclusive of all health
professions, targeted at all levels and all organisations,
with coordination and shared learning across professional
bodies, education, and employers. The challenge
now is for occupational therapy to inform Health
Workforce New Zealand of occupational therapy
clinical leadership initiatives, and get behind
the work of the project to support and develop
occupational therapy leaders. One of the key
messages from our thinking and discussion around
clinical leadership since attending the forum is
that leadership happens in everyday practice at all
levels of healthcare organisations and services. As a
profession, we urgently need to move forward with
identifying and supporting our leaders - wherever
they may be.
We look forward to sharing our experience and readings
with others and can be contacted at [email protected].
nz or [email protected].
Bibliography:
Fry, K. (2010). Social work clinical leadership in allied health.
Aotearoa New Zealand Social Work, 21(4) & (22)1, 109- 117.
Lawson, I. & Cox, B. (2010). Exceeding expectation: the
principles of outstanding leadership. The International Journal of
Leadership in Public Services, 6(1), 4-14.
McNabb, D. (2010). Professional leadership for social work in
state mental health services in Aotearoa New Zealand. Aotearoa
New Zealand Social Work, 21(4) & (22)1, 103-108.
Sones, R., Hopkins, C., Manson, S., Watson, R., Durie, M., &
Naquin, V. (2010). The Wharerata Declaration: the development
of indigenous leaders in mental health. The International Journal
of Leadership in Public Services, 6(1), 53-63.
Wylie, D. & Gallagher, H. (2009). Transformational leadership
behaviours in allied health professions. Journal of Allied Health,
38(2), 65-73.
Pre-reading:
Reinersten, J.L, Pugh, M.D., & Bisognano, M. (2005). Seven
leadership leverage points for organisation-level improvement in
health care. (Institute for Healthcare Improvement Innovation
Series). Retrieved 01 September 2010 from http://www.wsha.org/
files/82/LeadershipWhitePaper2005.pdf
Ministry of Health, (2009). In good hands: Transforming clinical
governance in New Zealand. Retrieved 01 September 2010 from
http://beehive.govt.nz/sites/all/files/In%20Good%20Hands%20
Report.pdf
Acquiring Assistive Technology for Children
in the Lower North Island – a review
Sue Penman NZROT, visiting
neurodevelopmental
therapist, Child Development
Service, Hawke’s Bay Soldiers
Memorial Hospital, Hastings.
[email protected]
Sue has worked as a visiting neurodevelopmental
therapist (VNT) both in the Auckland and Hawke’s Bay
region. Recently she has been working in the Napier area
with children under two years, and in the Wairoa area
with children under five years in her role as VNT, and as
an occupational therapist for those aged between five
and sixteen years who are not Ongoing and Reviewable
Resourcing Schemes (ORRS) funded or requiring “whole
of life” equipment. She acts as the clinical leader
(equipment) to sign off urgent equipment applications for
the Child Development Service
Introduction:
This study ascertains the equity in the provision of
assistive technology and assistive technology services (AT
and AT services) for children with disabilities. Variations
in the way district health boards (DHB’s) source different
pieces of equipment, and the training therapists have in
the provision of AT & AT services may result in a range
of solutions for children; thus as a consequence may not
meet the best practice requirement for family centred
care.
A review of the acquisition of paediatric equipment was
undertaken to identify the consistency between DHB’s,
the ease of acquisition, and to survey therapists to obtain
self assessment of their expertise in acquiring AT & AT
services for the children and the families who they work
with. Additionally for them to have an opportunity to
comment on their perceived level of training in this field.
Two recent publications are significant in the ongoing
provision of AT and AT services for children. These are
a Ministry of Health (MoH) discussion document titled
‘Proposed accreditation framework for equipment and
modifications’, May 2009(5) and ‘Therapy and Assistive
Technology / Equipment Operational Guidelines’, Ministry
of Education (MoE), also 2009.(4)
Paediatrics is a specialist field, and equipment needs
are different to those of adults. Children are growing
and developing and live within a family/whanau group,
making this an area requiring particular attention so that
the child’s potential is realised, to minimise their disability,
and to maximise their opportunities to live a full life
without causing undue stress or injury to their caregivers.
With the Ministry of Health’s consideration to amend the
accreditation, it is important that the area of paediatrics
is well represented. Education of staff in all aspects of
AT (aids to daily living, play, electronic solution provision)
within the field of paediatrics is essential. Therefore
a limited research study was completed to gauge the
funding avenues used by therapists and their perceptions
of their training in this field.
Definitions
For the purposes of this paper the following definitions
from within the USA legislation(3) are used.
Assistive technology (AT): any
item, piece of equipment or product
whether acquired, commercially
or off the shelf, modified, or
customised, that is used to increase,
maintain or improve the functional
capabilities of individuals with
disabilities.
Assistive technology services
(AT services): The evaluation of
the needs of the child; purchasing,
leasing, or otherwise acquiring a
specific device; selecting, designing,
fitting, customising, adapting,
applying, maintaining, repairing,
or replacing of specific devices;
co-ordinating and using other
services such as therapy, education,
rehabilitation and vocational
training or technical assistance to
the child, family, or caregivers in
the use of specific devices; and
technical assistance or training for
professionals or others who provide
services to the child.
It should also be noted from the
United Nations Convention on the
Rights of the Child charter(2) that
“If you have a disability, you should
receive special care and support so
you can live a full and independent
life.”
Research Questions:
1. What is the competency of the
accredited assessor to accomplish
the processes around AT for
children?
2. What are the avenues for acquiring
AT for children with disability, and
is the process easily completed,
equitable and timely?
research(1) looked at the confidence therapists had in the
prescription of AT and AT services. They looked at the
training these therapists had had in the past, and what
their perceived preference was in acquiring additional
training. They identified most therapists had received 20
hours or less instruction on the provision of AT and AT
services during their training.
The research asked paediatric physical therapists how
highly they rated their training and preparation in AT, in
the following five areas of knowledge:
1.
2.
3.
4.
5.
Stalmeijer et al(6) describe the difficulty in clinical teaching
within a hospital setting (as the core responsibility of a
hospital is treating patients), while Gitlow and Sandford(7)
discuss the lack of trained AT professionals, able to
match people with disabilities with AT, impedes access to
technologies.
In New Zealand, post-graduate work in this area is funded
by MoH through contracts run by Seating to Go. These
courses and hands-on practicum’s can be run at a central
point or regionally by arrangement, and occasionally postgraduate distance learning opportunities are available.
The courses have concentrated on seating and mobility
solutions and 24 hour positioning.
New Zealand Environment
The governmental agencies that fund equipment for
children in New Zealand are:
n
MoH via Enable New Zealand fund “essential
equipment” for the habilitation of acquired disability
including equipment that allows the child to remain in
the home, and to prevent the escalation of disability
for the child and his/her caregiver. The funding
excludes funding for therapy equipment
n MoE fund AT & AT services to “access the curriculum”
Other avenues for funding AT include:
Previous Research
n
Research into the needs of paediatric
clients for AT and AT services is
limited, especially considering the
vast amount of research into family
centred care.
n
“When used properly, AT can help
toddlers engage in active discovery
and participate in normal social
routines, activities and outings. It
is important that early intervention
practitioners know the benefits of AT
for young children with disabilities
and have the skills to help families
use this valuable resource in their
daily lives.” (Moore and Wilcox).(8)
A database search identified only one
paper directly related to the training
and prescription of AT and AT
services for children. Long and Perry’s
Working with clients with disabilities
Service delivery systems
Working with families
Collaborating with other service providers
Legislation, regulation and policy related to AT and AT
services.
ACC who fund rehabilitation as a result of accidents
Lotteries Grants Board who fund sundry large items of
equipment
n a range of charitable trusts and funds who have their
own criteria and geographical niche
n private funding by raising money locally
Method
Using the methodology described by Long and Perry,
questionnaires were developed and trialled by the child
development teams of Tairawhiti and Waitakere. Minor
alterations were made to promote better interpretation.
Participants
Team leaders of the Hawke’s Bay, Midcentral, Whanganui,
Capital and Coast, and Hutt Valley DHB’s, and the
Ministry of Education (MoE) were contacted to provide
contacts for paediatric occupational therapists and
physiotherapists working in this area. The MoE team
leader responsible for the lower North Island did not
respond.
Procedure
Team leaders and therapists were
asked to respond to the five
questions (as in Long & Perry’s
research) from their perspective.
They were also asked questions
specific to training, funding, and
supervision around AT provision.
Likert scoring was used for these
questions. Additionally there were
some open-ended questions to allow
more detail.
Therapists were also asked to
respond to seven Likert-scored
questions about the processing of
applications for each agency they
used to fund AT and AT services for
their patients.
Analysis
The questions were analysed by using
the statistics software SPSS version
17.0.
This research contained no personal
information about clients or their
families / whanau so no ethical
approval was deemed to be required.
The Hawke’s Bay DHB was notified of
the research project.
Results
Team Leaders (TL’s)
TLs were surveyed on their
perceptions of the knowledge and
skills their therapists had, as well as
about resources available to train and
supervise them in the five areas of
knowledge (above). All felt positive
about these topics.
The TLs were asked if there was an
in-house format for the training of
therapists. Three responded that
they did not, while the last indicated
there was a “pathway”. None had a
written system.
They were asked if there was
adequate funding to train and
maintain competence for their
staff in AT and AT services. On this
topic they were neutral while one
disagreed.
TL’s noted a lack of consistency across
the country. They were concerned
at the amount of time taken away
from therapeutic activities, the
services provided by less experienced
therapists, and the inconsistencies of
funding between ACC and MoH.
Paediatric Therapists
Paediatric therapists, 25 (62%) of
whom replied, who provide AT and
AT services to children and their
families, are (in the main) senior
therapists having worked an average
of between 13 to 15 years each.
When these therapists were asked how well they were
prepared, resourced, and funded, the responses showed
that although many felt competent and well resourced
in these areas, there is a significant proportion who were
neutral, disagreed, or strongly disagreed with these
statements.
Supervision - who provides supervision
to therapists around access to AT & AT
Services
It was noted that most of the supervision falls within
the “other” category of peers, supervisors, the Enable
outreach professional advisor or no one.
Therapists were asked how they had been trained in the
area of AT and AT service delivery. 20% indicated that
they had gained their knowledge only on the job while
80% indicated there was a combination of on the job
training and courses.
It must be noted that some therapists had done many
courses while others just one or two. This represents
a huge range in the quality of training received and of
the courses mentioned, is hugely weighted towards
seating and wheeled mobility. A significant number
noted the need for basic as well as advanced courses or
workshops with the ability to objectively compare and
contrast products and services across the board including
ADL, communication, and AT to access play. Despite the
number of equipment supplier workshops or ‘Show your
Ability’ roadshow days people attended, they felt that
they still did not know the range of products available,
nor did they feel it was easy to keep up with new product
- some feeling quite overwhelmed. Equipment suppliers
and their reps provide substantial (and for some therapists
all) information to therapists, but the
value of such information without the
ability to objectively evaluate similar
product at the same time must be
questioned.
Agencies - which agencies
are used to access AT &
AT service funding
The therapists were also asked
which agencies provided the AT for
their clients and how easily they felt
they were able to gain the required
equipment.
to be attended to in a timely manner. Therapists also
appreciated and that accredited assessors could get
things from the stores if they visited. 56% of the group
were extremely concerned about the waiting time for
ADL and mobility equipment (Priority 1). For example
a 4½ year old boy showing an interest in toileting
independently and six months later still not having the
equipment to do this.
However, where the DHB had decided that the
professional advisor would be the sign-off person,
and that person had no paediatric experience, sign-off
could be very difficult. There was concern that this
type of process was seriously compromising children’s
developmental potential.
Other suggestions included paediatric application forms
to better reflect the requirements of children within family
units, tick boxes, a photographic catalogue of equipment
in stores on the web site, providing store staff with more
information as to what “similar” equipment was. Other
ideas included less repetition in the complex application
forms.
Therapists filled in additional agency forms depending on
their case load, geographical area of work or experience
and knowledge.
Therapists were neutral to happy with their experiences
of ACC, Halberg Trust, Lotteries Grants board and other
trusts and clubs.
Only two of the therapists who responded had used the
MoE process and both had found it difficult to present
their application in the required style, even though other
therapists had supported the education therapists to
make applications.
CATCH YOUR
PATIENT’S BEFORE
THEY FALL
The Invisa-Beam System
Enable is by far the biggest funder
(96%) of AT and it was apparent
from the results that when this
was unsuccessful sometimes no
alternatives were sought. Some felt
confident in accessing only a limited
range of equipment.
When asked if there was any
equipment they would like to be
able to apply for, most therapists
requested an expanded list of
common list and preferred product.
It was noted that in comparison with
adult services there was little common
list equipment available.
When asked if there was anything
in the process that would make it
easier or more streamlined, there
was general appreciation that
“urgent applications” were able
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Discussion
The purpose of developing an accreditation framework(5)
is stated as being to improve the quality and consistency
of assessments and to improve / maintain competence
and accountability of assessors.
The needs of children and their families require a
paediatric “mindset” which recognises the timely use
of AT and AT services so as not to aggravate the child’s
disability (requiring additional resources over the long
term). This paediatric “mindset” is not recognised well
in the current Enable application process. For example,
when applying for funding (the Enable Equipment
Manual)(9), the areas of essential funding on the
application form that apply to children include: Mobility
in the Home, Remaining in the Home, Fulltime Education,
Main Carer and Communication. These terms are
defined in the manual from the point of view of adult
rehabilitation without a clear definition of how these
terms may be interpreted when accessing AT for child’s
“whole of life” habilitation. It was felt by the researcher
that this lack of definition with respect to children may
result (through varying interpretations by different
therapists), in not all children having access to all types of
AT possible from this provider.
While MoE’s procedures and documentation are
child-focused there is a prescriptive and exhaustive
process to be able to obtain equipment. Especially so
for an adapted physical education programme, and
therapists may try to classify school equipment to access
the curriculum as “whole of life” equipment so they can
use the simpler MoH process even when it is not used at
home.
There was a very low uptake of funding from alternative
sources of funding and the researcher theorised that
alternatives may not have been fully researched by
the DHB child development services. Further to this,
looking at the figures supplied by Enable - on the money
spent by each DHB, and the population figures for the
corresponding DHB’s - it suggests an uneven uptake of
public funding.
J ournal of Allied Health; Spring 2003;
Career and Technical Education 46-51.
8. Moore, H.W., Wilcox, M.J. (2006)
Characteristics of Early Intervention
Practitioners and their confidence in the
use of assistive technology. Topics in Early
Childhood Education 2006, 26, 15-23
Other Relevant Literature and Policy
Procedure that may be useful
This has been a small study which would be worth
replicating across the country preferably before the
accreditation framework is finalised so that an equitable
service of provision of AT and AT services are available to
children and their families across the country.
9. MoH Equipment Manual - Enable &
Accessable
References
Dale Sheehan, Clinical Teaching
Co-ordinator and Senior Lecturer,
Canterbury University, for assistance
with research design, writing and
editing.
1. Long, T.M., Perry, D.F., (2008). Paediatric Physical Therapists’
Perceptions of their training in Assistive Technology. Physical
Therapy, 88(5), 629-639.
2. United Nations Convention on the Rights of the Child 1989
3. Technology-Related assistance for Individuals with Disabilities
Act, 29 USC §2202 (1999).
4. Operational Guidelines. Therapy and Assistive Technology /
Equipment. Between the Ministry of Education and The Ministry
of Health. (2009).
5. Proposed Accreditation Framework for Equipment and
Modifications. Discussion Document. Ministry of Health (May
2009).
6. Stalmeijer, R.E., Dolmans, D.H.J.M., Wolfhagen, I.H.A.P.,
Muijtjens, A.M.M., Scherpbier, J.J.A. (2008) The development
of an instrument for evaluating clinical teachers: involving
stakeholders to determine content validity. Medical Teacher: 30:
e272-e277.
7. Gitlow, L., Sandford, T., (2003) Assistive Technology
Education Needs of Allied Health Professional in a Rural State.
10. MoE Equipment Policy and
Application Form for funding
Acknowledgments.
Lyn Davis, Team Leader, Tairawhiti
Child Development Team. For
supervision throughout this project
and trialling the questionnaires.
Susan Peters, Team leader, Waitakere
Child Development Team, for trialling
the questionnaires
Susan Sinclair, Quality & Risk
Service, Hawke’s Bay District Health
Board. For help with the Likert
questioning and analysis of the data.
World Federation Disaster
Preparedness & Response CD
T
here was international
apprehension as the year 2000
was ushered in and relief when
the seconds ticked on and nothing
happened. The decade since has
been characterized by a succession
of major natural and man-made
disasters involving huge losses of
life, environmental and community
disruption. The September 11
terrorist attacks in America in 2001
and Hurricane Katrina in 2005
gave impetus to the involvement of
occupational therapists in response
and recovery activity. Professional
literature in the US started to reflect
this, as well as the need to focus
forward and to be prepared in the
future.
Major work has been done by the
World Federation of Occupational
Therapists (WFOT) arising out of the
2004 Indian Ocean tsunami, which
as we know, devastated a huge area
and caused the death of thousands
and thousands of people.
Just after the tsunami, the World
Federation was asked to help and
so began what has become known
as the “Disaster Preparedness &
Response Project” (DR&R). WFOT
sent a very small number of people
to the area to join with occupational
therapists already there, to do
a situational analysis – an initial
assessment. They saw a need to
build occupational therapy capacity
in the areas affected, and decided
to start the process with workshops
- to brainstorm preparedness and
response strategies. The two reports
that have come out of this work, plus
other material, have been captured
on a CD which can be bought online
from the WFOT shop at www.wfot.
org.au .
People stand outside a building damaged by a 7.1-magnitude
earthquake in Christchurch in New Zealand 3 September. Picture: AP
enterprise and a resulting workshop took place in the
NZAOT Clinical Workshops in Tauranga.
Preparedness, response and recovery
We found the material in the CD extremely useful. WFOT
was specifically focused on the main countries affected
by the Indian Ocean tsunami, and was encouraging
them to think about their own national strategy i.e.
the Sri Lankan, the Indonesian, the Thai and the Indian
strategies. Common to each was the threefold structure
of preparedness, response and recovery, the distinct
phases of a disaster, and possible occupational therapy
involvement in each. At the same time, in promoting the
work done through the CD, WFOT is encouraging the rest
of the world’s occupational therapists to think ‘disaster’,
to think ‘be prepared’, to think ‘what is our role?’. What
we wanted to do in the Tauranga workshop was to
raise the awareness of Kiwi Occupational therapists and
to start to think about what an Aotearoa/New Zealand
strategy might look like.
The CD contains material from the WFOT workshops,
some of which we used (with WFOT’s permission) such
as the baseline question: how prepared are we in each
of the three areas, key points for preparing a national
plan of action, challenges, issues around the framework
of DR&R, occupational therapy as a dynamic system
contributing to DP&R (a fascinating little diagram),
tools & resources, outcomes, capacity building, possible
occupational therapy roles in each phase, the approaches
taken in each of the four countries, recommendations…
and much more.
As a result of using the CD as a resource, Ann, Jo and
myself would certainly endorse it as an essential aid to
similar discussion and exploration. We would suggest
that DHB occupational therapy services, private therapists
and also perhaps importantly, the training schools, should
give consideration to its purchase. We look forward to
further discussion and perhaps the development of a
national strategy for DP&R, which will contribute with
others internationally, to the ongoing work of this WFOT
initiative.
Alison Nelson
NZROT
NZAOT has purchased the
CD: “Disaster Preparedness &
Response WFOT Information &
Resource Package for Occupational
Therapists”. We wanted to be
able to let colleagues know about
its usefulness as a resource for the
occupational therapists of New
Zealand. Being the WFOT delegate,
the task became mine.
Ann Webster and Joanna
Cunningham, both community
occupational therapists in Hawkes
Bay, agreed to take part in the
Facilitating Research and Education within the Profession
Reports from the NZAOT Research and Education Trust award recipients
for 2009 Ema Tokalahi and Ellen M Nicholson.
Ema Tokolahi
I
am an occupational
therapist working
at a Community Child
and Adolescent Mental
Health Service (CAMHS)
and working towards
my masters. In 2009 I
was awarded one of the
inaugural grants from
the NZAOT Research
and Education Trust to
support the Leaping Hurdles evaluation project. This
research evaluated the acceptability and effectiveness
of Leaping Hurdles: an occupation-based anxiety and
mood management group intervention for children
aged 10-14 years, alongside a parallel parenting
group. The research was clinic-based and used a
quasi-experimental, repeated measures design with
no randomisation. Self-, parent - and clinicianrated measures were administered at waitlist, pre-,
post-group, and three months follow-up to explore
comparison to a control group (waitlist) and retention
of change (follow-up).
Leaping Hurdles was found to be an acceptable and
useful intervention for reducing child-, parent- and
clinician-rated symptoms of anxiety and mood
disorders while increasing functioning. The findings
from this study support the use of Leaping Hurdles
with a clinical population of 10-14 year olds and their
parents. Furthermore, results indicate the intervention
promotes positive change in being maintained or
continued at follow-up. This research represented
a significant opportunity to evaluate an occupationbased group treatment intervention for 10-14 year olds
in New Zealand with moderate mental health concerns
related to anxiety, depression and occupational
disruption. Indications are that further research into
this area is warranted.
generic child and adolescent mental health journal in the hope
of promoting this occupation-focused treatment intervention
beyond the occupational therapy profession. It will also be
presented at this year’s NZAOT conference in Nelson. The best
part of the project for me was facilitating the intervention and
getting empirical data that supported the positive anecdotal
feedback we were receiving from clients. Working with a great
team, Cheryl, Laura and Sarah, made the process more enjoyable
and manageable too. For anyone considering research in the
future I recommend having a solid team you can rely on and not
being afraid to delegate. Furthermore, do not be deterred by the
paperwork required when submitting for funding – it’s worth it.
Thank-you.
Ellen M. Nicholson
Professional Leader
Occupational Therapy (Mental
Health) – Auckland DHB
Doctoral Candidate (AUT)
W
inning one of the inaugural
NZAOT Research and
Education Grants was just the kickstart I needed to get my doctoral
research project started. I had been
very anxious and ambivalent about
starting the project - questioning my validity as a researcher and
wading my way through a seemingly treacherous (but actually
very reasonable) ethics process - and the grant provided me the
opportunity to purchase the Enabling Occupation II textbooks
pivotal to the success of the study.
For those that aren’t aware, the “Occupation in Action”
project utilises participatory action research to investigate how
occupational therapists working with children, young people,
and families integrate theory into practice in “real world”
settings and enable participation in occupation for children.
The project aims to investigate and affect the application of
theory in the development of best practice in the New Zealand
context. It involved recruiting paediatric occupational therapists
as co-researchers to read the revised Enabling Occupation II text
(Townsend & Polatajko, 2007), participate in collegial discussion,
I am employed as a generic clinical team member
and contribute practice stories to an interactive discussion forum
– not a researcher – and although this research was
over a 9-12 month period. This project is part of an international
supported by my service, support did not extend to the
initiative describing the clinical utility and outcomes of
financial costs of time for the other clinicians involved
implementation of the revised CMOP-E framework in a range of
and myself to write-up our findings. This is where
practice settings, using a participatory action research approach,
the NZAOT grant enabled our research team to take
and involving occupational therapy researchers in New Zealand,
time away from work (without the need to use annual
Australia, Canada, and Finland.
leave) and write-up our findings, extending the value
and utility of our efforts beyond our own service. A
A call for participants early in the year resulted in six therapists
write-up of our findings has been submitted to a
joining the project as co-researchers and we have completed
The Mental Health Foundation have
announced the 2010 theme for Mental Health
Awareness Week (4 to 10 October) as Flourishing for
everyBODY: Feel good and function well. Over the last
century or more, the focus on mental health in society
has been on mental disorders, and either treating or
preventing them. So much so that most people think
about mental health only as a problem or something
negative. There are also many more stressors on mental
health today generally relating to increased pace and
determine the level of positive mental health in
complexity of life.
populations. When someone is flourishing they
Flourishing is a measure of mental health that has been experience, most of the time, positive emotions,
developed within the last decade and can be used to
positive interest and engagement with the world
four project meetings to date. Each
meeting is centred around a specific
chapter, or chapters, in the Enabling
Occupation II text and provides an
opportunity for the therapists to review the
specific content of the individual chapters
and reflect on the “realities” of translating
and applying ideas from the book into
practice. We are currently in a dual reflect/
action phase of the action research process
and some of the preliminary themes
drawn from the discussion to date focus
on the challenges to implementation of
authentic occupation-based paediatric
practice within the current configuration
of health, disability and education services;
the realities of “client-centred practice”
when working with multiple stakeholders;
and managing expectations of “traditional”
paediatric occupational therapy practice
and roles. We are utilising GoogleWave
(www.googlewave.com) as our online
discussion software and there are some
interesting discussion threads and resources
available to the group online that supports
the progress of the face-to-face meetings.
As principal researcher, I have been
so impressed at how supportive and
encouraging the therapists are of one
another and their absolute commitment
to providing the best for the children and
families that they serve. And we are all
extremely appreciative of the opportunity to
read and review a significant occupational
therapy textbook, one chapter at a time…
a professional development luxury in these
financially pressured times. The project
group are committed to meeting until the
end of the year and we will review in the
coming months the possibility of extending
the project to ensure that we cover all the
chapters and “enable” all the possibilities.
Once again, I would very much like to
formally thank NZAOT and the Research
and Education Trust, the project team,
and my supervisors, Associate Professor
Marion Jones and Associate Professor Clare
Hocking, for their support and commitment
to this project.
around them, and meaning and purpose in
their lives. Evidence suggests that people
who are flourishing are less at risk of physical
and mental health problems and have better
social relationships.
Flourishing is about focusing on the good
things in life. It’s about the things we aspire
to, both as individuals and as members of
a wider community. Think about how you,
your family, friends and community might
flourish. Key areas to focus on are positive
emotions, engagement and interest, and
meaning and purpose.
NZAOT Values Exchange Corner
The NZAOT Values Exchange Corner is a new initiative that aims to disseminate news and information
about the NZAOT Values Exchange, and to feature at least one Values Exchange case or survey each month.
Alternative suggestions
Featured case
Prepared by Simon Leadley, NZAOT VX
Administrator,
August 2010.
Everyone who answered “I agree”
Alternatives:
n One option would be for John to end his
therapy with Liz, and for them both to have
supervision/psychology support/advice that would help.
To have time apart before making the decision to enter
into the friendship or not. It would be helpful to clarify
the law in this matter.
Status: Open, closes 30 September 2010
Can we befriend our clients?
J
ohn is an occupational therapist who has been
working with Liz for several months and he now
realises he is quite attracted to her. In one of their last
sessions together at Liz’s home, Liz asks John if he would
like to come to a party with her at her friend’s house.
Liz explains to John that she is very attracted to him
and would like to develop their friendship. John also
continues to have strong feelings for Liz. John reminds
himself that Liz will soon no longer be his patient/client.
What should John do in such a situation?
It is proposed that: John ends his therapy with Liz
and for them both to have the supervision/psychology
support/advice, and have time apart before making the
decision to enter into the friendship or not.
Everyone who answered, “I disagree”
Alternatives:
n
John reminds himself of professional boundaries and
legislation that surrounds them and puts the patient’s
needs before his own personal needs. John discusses
with Liz the nature of their therapeutic relationship.
John discusses this with his manager and is transparent
with information with management.
n
The therapist should not cultivate a personal
relationship with an active client. If the therapist and
client were to accidentally meet a reasonable amount
of time after the therapeutic relationship had finished,
the client would have had a chance to shake the client
role and could be allowed to make a decision about
the relationship as a peer.
It is proposed that John accepts the offer to go out
with Liz and start a friendship with her.
Useful links for the case include: a case featured on the
New Zealand Health Practitioners Disciplinary Tribunal,
detailing a case where professional boundaries between
an occupational therapist and a client became ‘blurred’.
What were some of the results from our deliberation in
the case of John and Liz?
Poll Results
n
John should definitely terminate his therapy
relationship with Liz prior to attending any sort of
party with her. He should also discuss the matter
with a supervisor or manager, and hand over
her case for any ongoing needs or follow up. A
cooling off period may be appropriate, before any
relationship could commence.
It is proposed that: John declines the offer to go
out with Liz and start a friendship with her.
Who matters most question – from the Ring
and wedges section
n
It is proposed that: the therapist wait until
the case is closed before beginning a personal
relationship with the woman.
What conclusions can we draw from a
brief analysis of this case?
n
19 out of 21 respondents disagreed and only
2 agreed with the proposal ‘that John accepts the
offer to go out with Liz and start a friendship with
her’.
n
There were more divergent views about ‘who
matters most’ in the case when responded to
by the group that ‘disagrees’ with the proposal,
versus those that ‘agreed’ or those that ‘disagreed
strongly’.
n
The areas of concern in this case that were
most frequently highlighted in the ethical grid
section included: support, worries, principles, and
health.
There were a range of alternative
suggestions and proposals but
mostly these views could be
summarised by two broad themes
that include:
1. That John follows professional
boundaries by not forming a
relationship with Liz outside of his
occupational therapist role. That
he seeks help from his manager
or supervisor, and declines any
contact with Liz out of his role as
a therapist.
2. Or, that John, and possibly
Liz, consult with a supervisor,
manager, or a psychologist, after
terminating their therapeutic and
professional relationship. Take
time out to consider their feelings
for each other and their friendship,
and consider the views of these
support persons before developing
their friendship further.
Conclusions
We can say that this sort of issue that is to say maintaining appropriate
and clear boundaries between a
health professional and their client is treated seriously by our governing
authorities. This can be seen in the
New Zealand Health Practitioners
Disciplinary Tribunal case about an
occupational therapist and their client
that was referenced in this case. But
who ‘draws the line’ about what is
appropriate between the client and
the therapist. Who decides what
constitutes professional behaviour?
Who has the power to decide what is
right and wrong in our society? How
do we deliberate on matters such as
in this case, that are bound to occur
when we work together as human
beings?
The NZAOT Values Exchange enables
us to consider such matters. Enquire
critically and explore both our
thoughts and feelings, able to share
these together with each other in an
open and safe manner. It is through
this process that we can learn
from each other and enhance our
decision-making process in a mature
and ethical manner.
NZAOT at Work
Envisage
A
whirl of activity occurred in the NZAOT
office this last month centring around
preparations for the conference, annual general
meeting, and NZAOT Issues Forum – not least a
brief sashay into the World of Wearable Arts to
decide what Dael, Tina and I might wear for the
Life is a Beach – conference dinner in Nelson!
The Bridge Builder
Siobhan Molloy
Executive Director
As you read this, NZAOT will have a new
president as Tracey Partridge steps in to complete
the term of office vacated by Elizabeth Rowland.
I expect a president-elect and a new secretary –
more next month.
Professional Representation at Work
n
An old man, going a lone highway,
Came at the evening, cold and gray,
To a chasm, vast and deep and wide,
Through which was flowing a sullen tide.
The old man crossed in the twilight dim -That sullen stream had no fears for him;
But he turned, when he reached the other side,
And built a bridge to span the tide.
“Old man,” said a fellow pilgrim near,
“You are wasting strength in building here.
Your journey will end with the ending day;
You never again must pass this way.
You have crossed the chasm, deep and wide,
Why build you the bridge at the eventide?”
The builder lifted his old gray head.
“Good friend, in the path I have come,” he said,
“There followeth after me today
A youth whose feet must pass this way.
This chasm that has been naught to me
To that fair-haired youth may a pitfall be.
He, too, must cross in the twilight dim;
Good friend, I am building the bridge for him.”
Will Allen Dromgoole
Spotted in the NZDoctor (25
August, 2010) the headline: “Is
this patient fit to drive?”. The
header was suggestive of the
assessment tool SIMARD MD
being able to tell a GP if a patient
is fit to drive or not. However,
upon a review of the web site it
is clear the tool is a screening tool
only, which may assist GP’s in their
clinical decision-making about
whether a patient is medically at
risk to drive, and if an onward
referral for an occupational
therapist assessment is advised. It
will not tell a GP if a patient is fit
to drive.
NZAOT wrote to NZDoctor about
this possible misconception and
they have acknowledged we have
a point – I await to hear if we can
get some clarification and some
in-depth information out to GPs
about occupational therapy driving
assessment. For more detail on the
SIMARD MD go to www.driveable.
co.nz .
n
Better sooner more convenient
primary health care – I recently
attended a ministry primary
health care meeting regarding the
progress of the nine successful
expressions of interest for primary
health care business. From 01 July
at least six out of nine successful
business cases began their phased
roll out. Full details of the nine
proposals can be found at: http://
bit.ly/9UtBAn
oDHB
plans will reflect and
support the business cases.
oThere
was an emphasis on
service delivery and relationships
based on principles including
openness, transparency,
collaboration and information
sharing, integration, high levels
of trust, flexibility in funding,
and joint decision making and
accountability.
oFunding
will come from a
pool of already existing but
reallocated monies.
oA
monitoring framework is
being developed.
To further promote the role of
occupational therapists in primary
health care, NZAOT on behalf
of OTKSS wrote to each of the
successful proposers and shared
the NZAOT position statement:
Occupational Therapists in Primary
Health Care and also the publication:
Broadening Horizons: A professional
resource for occupational justice and
participation, written and edited by
staff and students of AUT University’s
undergraduate occupational
therapy programme. Students
worked together with a community
organisation to develop programmes
that will enhance health and
citizenship of an identified group that
experiences occupational disruption,
disadvantage, or injustice.
Both publications can be found
online: NZAOT position statements
www.nzaot.com and the AUT
publication: via www.aut.ac.nz
n
Consensus statement: Health
Benefits of Work: NZAOT has
commented on and agreed to sign
a consensus statement developed
by the Australasian Faculty of
Occupation and Environmental
Medicine. In essence, the
statement acknowledged three
fundamental principles about the
relationship between health and
work. This subsequently followed
with a commitment to work
together alongside government
and other stakeholders to
encourage and enable New
Zealanders to achieve the health
and wellbeing benefits of work.
A series of ways that signees to
the statement would advocate for
and work towards improvements
in the health of the working age
population and their families was
outlined.
I believe NZAOT has made several
insightful and useful suggested
additions and changes to the
original document which reflects the
occupational therapy world view, and
is consistent with the basic principles
of occupational justice.
n
Allied Health Professional
Associations’ Forum (AHPAF) –
AHPAF meets every two months
to discuss issues of importance to
the allied health sector. Recently,
the forum has reviewed its
strategic plan and developed a
new business plan to implement its
strategic goals. Planned activities
include:
oActively
seeking opportunities
for consultation and involvement
in the formation of relevant
policy, legislation and other
issues at the earliest stages,
including greater participation in
the select committee process.
pursuing relationships
with key groups and
stakeholders.
Professional Development at Work
Conference 2010 may be over but planning is already
underway for next year’s clinical workshops – and what
an exciting venue to choose – Waitangi, in the beautiful
Bay of Islands.
NZAOT Clinical Workshops 2011
Baskets of Knowledge –
Nga Kete o te Matauranga
Fill your baskets with knowledge over three days at the
2011 NZAOT Clinical Workshops and return to your
workplaces excited, refreshed and reassured about what
you know!
The overall theme for the workshops is ‘competency’. In
order to achieve competence in our practice we need to
build on our knowledge - fill our ‘Baskets of Knowledge’.
We have chosen four underlying themes to put the
knowledge into, and each theme focuses one or two
competencies from the competencies framework of the
New Zealand Occupational Therapy Board. All of the
topics in the themes could be interchangeable.
oActively
oMaking
media statements where
appropriate.
To this end current activity includes
the development of key messages
across a range of priority areas such
as the promotion of allied heath,
workforce development, primary
health care, regulation, public health
and ACC.
Theme 1 –
Firm foundations.
This theme will focus on the competencies of
ethical practice and cultural competence. Given
that we are holding the workshops at Waitangi there
will a presentation on the founding documents of the
declaration of independence and Te Tiriti o Waitangi.
We will also be looking for workshops on the values
exchange, ethical grid, who is the client, privacy issues,
cultural competence and tangata whenua, working with
interpreters, and working with people from other cultural
backgrounds e.g. Muslim, Chinese, Pacific.
Membership Matters
I
n addition to our printed publications (OT Insight and The
NZ Journal of Occupational Therapy), the number of online
communication options have grown in recent times. Now we have
a vast array of choices with which we can hear from you, and with
which you can hear from us!
For issues concerning occupational therapists there are always many
discussions taking place in our online special interest groups, debates
happening on our values exchange website, as well views being
aired on our facebook page. Regarding facebook, if you did not
Dael Williams attend the NZAOT conference earlier this month, you can contribute
Membership and
your views to the discussions that took place on our graffiti
Marketing Co-ordinator
boards, by going to the discussion tab of our facebook page – this
covers topics such as everyday challenges, what is unique about
occupational therapy in this country, professional identity, professional responsibility, and the
NZAOT issues forum.
It was also very exciting to have some of our members tweeting from conference – they
were able to share the key messages as they were being given, and bring
outside comments back to the conference (#nzaot10 for those who
would like to follow this conversation).
Theme 2 Standing tall.
This theme will focus on competency in occupational
therapy practice. We want to celebrate who we are
as therapists! We are looking for presentations that
celebrate occupational therapy through telling stories what your do, how you do it, the outcomes, promotion
of occupational therapy and therapists, innovation,
working in primary care settings, adventure programmes
(we have water, kayaks, walking tracks, beaches - use
them for the workshops), and anything else that is out
there eager to be talked about.
Theme 3 Grass roots.
This theme will focus on the competencies of
communication, managing self and others. Here
we are seeking workshops looking at how technology
helps practice or is used in practice, working in teams
from a distance, working with clients in rural settings,
presentation skills, suicide management for the workplace
assessor.
Theme 4 Nurturing growth
This theme has a focus on the competency of
professional development. In this stream we want
to focus on taking care of ourselves - a pamper session
for therapists (relaxation, hand massage, yoga, walking,
adventure), managing supervision, reflective practice, self
directed learning after graduation, self defence, and an
introduction to personal safety.
Important dates
regarding abstracts
A call for abstracts will be opened by the end of
October 2010 and will close on 31 March 2011.
Abstracts that are accepted will be notified by 01
May 2011.
We look forward to your creativity and enthusiasm to
participate and share your unique perspectives.
Kind regards, Diane Henare, convenor.
n
August special interest group highlights
a discussion on the disability support
strategy included reflections on the five themes
- inclusion, right and empowerment, participation,
opportunity, and diversity. Food for thought came
when there was a suggestion some behaviours get
socially conditioned – and “as we accept our clients
as they are… we might not recognise that these
behaviours have been socially conditioned…”
oCHYPOT:
oNeurology:
there was some useful commentary on
how many occupational therapists (FTEs) should
staff an inpatient stroke unit?
What cognitive assessments are
used? - Addenbrookes ACE-R, Cognistat, Modified
Mini-Mental State, AMPs… and more.
oOTWWOP:
Siobhan Molloy
Executive Director
Te Umanga Whakaora
Te Ara Tika guidelines launched
By Dr Paul Reynolds, Pütaiora Writing
Group member
Hui Whakapiripiri 2010, hosted by the Health
Research Council (HRC) and held recently in Rotorua,
was an excellent opportunity to launch the new
guidelines, Te Ara Tika Guidelines for Mäori
Research Ethics: A framework for researchers and
ethics committee members. HRC Chief Executive, Dr
Robin Olds, presented the guidelines at the Rotorua
conference, along with three of the Pütaiora
Writing1 Group members present, Dr Barry Smith,
Maui Hudson and Dr Paul Reynolds.
Earlier this year, Te Ara Tika was endorsed to be
appended to the HRC Guidelines for Researchers
on Health Research Involving Mäori. As a result, it
is expected that all those who undertake research
involving Mäori will read both guidelines prior to making
a submission to an ethics committee. The national
application form (NAF) for ethical approval of a research
project requires that researchers read the HRC booklet
Guidelines for Researchers on Health Research Involving
Mäori before approving their application2.
The content of the Te Ara Tika document is aligned with
the operational standard and acts as a supplement for
particular problem areas identified through accredited
ethics committee’s annual reporting, such as identifying
what constitutes adequate
consultation and engagement with
Mäori3.
The guidelines can be used by a
variety of audiences, including:
Mäori members of ethics committees
to support them in assessing research
applications coming before them;
ethics committees themselves
in the course of their ethical
deliberations; and researchers more
generally as a guide to Mäori ethical
understandings and perspectives.
Mäori communities, whänau,
hapu and iwi may also use Te
Ara Tika as a tool to be able to
monitor any research carried out
in their communities to ensure
it is conducted in an ethical
and respectful way. Professor
Karina Walters4 encapsulates this
respectfulness in the following quote:
“Everything we do is about a
relationship and goes beyond the
individual to include the collective.
For example, it is important for
genetic researchers to think about
Occupational Therapist
We are looking for an experienced Occupational
Therapist to join our multidisciplinary team.
This is a contract position - preferably full-time,
although part-time will be considered depending
on skill level.
Rehabworks has an experienced team who
provide a range of community and workplace
based rehabilitation and assessment services
throughout Northland - predominantly via the
TI, TIAS, Social Rehab, Vocational Rehab, FRP
and PFWI contracts. We also provide nationwide
coverage for Serious Injury Assessments.
For further information please contact:
Frances Coutts
Ph: 021 374 450 or e-mail:
[email protected]
www.rehabworksnorth.co.nz
the implications of their research,
not just for the individual but for the
tribe, the iwi, the hapu, all those
levels.”
And back home, Dr Melanie
Cheung puts it very simply for us:
“The most important thing is that I
do research that benefits whänau, hapu and iwi.”
Te Ara Tika is a tool that can be used to assist in
identifying whether or not any research application being
assessed will benefit whänau, hapu and iwi health and
wellbeing.
Hard copies of Te Ara Tika will be widely circulated
to ethics committees and interested parties for their
reference, and limited copies will be made available
through the HRC. If you would like to receive a copy
please contact Sandra Reid, the HRC’s Senior Advisor,
Legal and Ethics, email: [email protected]. Alternatively,
Te Ara Tika is available on the HRC website:
http://www.hrc.govt.nz/root/Publications/Ethics_Reports_
and_Guidelines.html.
Notes:
1. The other two member of the writing group are Moe Milne and
Dr Khyla Russell.
2. Question F1, Section F: Cultural and social responsibility.
3. An article was written by the Pütaiora Writing Group giving
an overview of the framework, which was published in the
November 2009 Edition of Ethics Notes, available here: http://
www.hrc.govt.nz/root/Publications/Periodicals.html
4. From the Choctaw Nation in the USA and presenter at the
HRC hosted Ninth Global Forum on Bioethics in Research, 3-5
December 2008.
Info Exchange
Groundbreaking researcher and
worldwide authority in the field of
occupational therapy
Gary Kielhofner, DrPH,
OTR/L, FAOTA
It is with great sadness that I
acknowledge, on behalf of the
NZ Association of Occupational
Therapists, the passing of Gary
Kielhofner on 2nd September
2010.
Gary was a man of great influence in the world of
occupational therapy and health especially noted for
his development of the Model of Human Occupation
(MOHO). He contributed over the years to many areas
of practice promoting the participation of people of all
ages, in meaningful occupations within society, including
the active application of the International Classification of
Function, Disability and Health (ICF).
We would like to join with family and friends at mourning
the loss of this esteemed man.
Elizabeth Rowland, President NZAOT
Are New Zealand graduate
occupational therapists prepared for
practice?
Recently, a report examining new graduate and recent
migrant occupational therapists perspectives on work
preparedness, professional development and work
environment issues (COTRB, 2008) revealed that only
9.3% of New Zealand graduates reported feeling very
well prepared for practice. This low statistic raises
questions such as how are undergraduate curriculums
preparing graduates and what are employers expecting of
new graduates in practice?
AUT, funded by the Occupational Therapy Board of
New Zealand (OTBNZ), are currently undertaking some
research to investigate the preparedness for practise of
New Zealand graduate occupational therapists. We are
interested in finding out your perspectives regarding how
prepared New Zealand graduates are for practise and
whether changes need to be made to the current level of
training and invite you to take part in a short (10-15min)
electronic survey which is located on the OTBNZ website:
www.otboard.org.nz.
For further information contact Shoba Nayar at: shoba.
[email protected] or 09 921 9999 ext. 7304
Judgements - take note!
Rest home referred to the director of proceedings: In
two separate decisions involving the same rest home,
rest home manager, and registered nurse, the deputy
commissioner has found the staff and rest home in
breach of the code. While recognising that the nurse
was “…very junior, with no experience in geriatric care…
a heavy workload and little clinical support… and that
“the rest home’s policies and procedures were often
deficient and lacking in detail, providing her with little
guidance or support” the deputy commissioner found
that she must take some responsibility for her actions
and omissions, including the inadequate assessment,
care planning and pain and medication management;
inadequate communication with the patients’ family
MNZAOT Hidden Talents
and doctors; inadequate response to falls and patient
deterioration; and inadequate documentation. Staff
need to have clear guidance for assessing residents,
planning their care and preventing and managing
falls, and the deputy commissioner found that the rest
home’s policies and procedures were insufficient and
superficial. The Deputy Commissioner also found that
rest home failed to ensure that its employees had the
experience and skills to perform safely. www.hdc.org.nz/
media/138116/09hdc01050resthome.pdf
A futuristic world where people
choose their appearance, a
disillusioned Ponsonby housewife,
and an ode to a grandmother were
what caught the judges’ attention
in the first AUT Creative Writing
Competition. The competition which
looked at short stories as well as
song lyrics was open to unpublished
writers.
Booklet on access to long-term
residential care
MNZAOT Rosemary Cullen won
the 25+ age category of the short
story section with her portrayal of
a futuristic dystopia in WYSIWYG.
The story explores the idea that
personal image in an e-world has
been branded into a product and
can be bought and changed at will
according to fashion or mood.
The Ministry of Health has published a new booklet
that summarises how older people can access long-term
residential care under the Social Security Act 1964. The
booklet discusses all aspects of long term residential care
but particularly provides information on the financial
means assessment and the residential care subsidies. For
more information see www.moh.govt.nz/moh.nsf/
pagesmh/10203/$File/long-term-residential-care-olderpeople-2010.pdf
Collaborate for Rehabilitation
The New Zealand Rehabilitation Association is pleased to
collaborate with the National Institute of Rehabilitation
Research (NIRR-NZ) and the University of Otago
Rehabilitation and
Disability Research
Theme to offer this
conference which will
focus on innovation
in rehabilitation,
and in particular
applications of
novel technologies
including virtual reality, and other ways to promote
engagement in rehabilitation. Call for abstracts 26
October 2010. Please see CPE for further information.
Allied Health Summit – Leadership and
Practice Innovation in Action
The Allied Health Summit this November in Wellington,
is a showcase of examples of leadership and/or practice
innovation in action that makes a difference. Speakers
will be from New Zealand across all health care settings
and will share their successes. New Zealand has a
wealth of leadership and innovation and have chosen
to showcase and celebrate home grown talent at this
summit.
Cullen, an occupational therapist,
mother of three, and soon to be
grandmother, has been writing sci-fi
fan fiction and her own original sci-fi
for around 15 years, but it has only
been in the last few years since her
children have left home that she has
really had a chance to hone her craft.
Congratulations Rosemary, and we
look forward to sampling your work
in the OT Insight December Envisage
column.
Vitamin D Deficiency
Increases the Risk of
Cognitive Decline in the
Elderly
Low vitamin D levels may be an
early warning signal for the risk
of dementia
A research team from the Peninsula
Medical School, University of Exeter,
has established the first clear link
between vitamin D deficiency and the
development of cognitive problems
that are a key feature of dementia.
Presenters from each region around New Zealand will
discuss their motivation and cover key issues, strategy
for resolution, collaborative leadership, outcomes
(effectiveness, efficiency, best practice). Please see CPE
for further information.
Applied Ethics and Related Law for
Health Professionals Study Day
Many health professionals are eager to increase their
understanding of health care ethics in practice. A oneday event held in Auckland in mid November provides
workshops to assist participants in their ethical decisionmaking. The study day is relevant to health and disability
providers, registered health practitioners, managers and
educators. Please see the CPE for further information.
Findings from the study led by Dr.
David J. Llewellyn are being published
in the prestigious journal Archives of
Internal Medicine, and are the result
of an international collaboration
involving researchers from the
University of Michigan, the UK
Medical Research Council Biostatistics
Unit, the Perugia University Hospital
➤
➤
and Medical School in Italy, and the US National Institute
on Aging.
Vitamin D is a fat-soluble vitamin that is present in a
few foods such as oily fish and is available as a dietary
supplement. Vitamin D is mainly produced when skin is
exposed to ultraviolet rays from sunlight. However, as
people age their skin becomes less efficient at producing
vitamin D, and the majority of older adults in Europe and
the US have insufficient levels. Interest in vitamin D has
intensified recently as researchers have identified that it
may play an important role in protecting against a wide
range of age-associated diseases such as cancer, heart
disease and stroke.
Dr. Llewellyn said “Cognitive decline and dementia are
very common in older adults, though the underlying
causes are still largely unknown and current options
for prevention and treatment are limited. Vitamin D
deficiency is therefore a highly promising therapeutic
target for the prevention of dementia, particularly as
supplements are inexpensive and safe and have already
been shown to reduce the risk of falls, fractures and
death. Given the coming dementia epidemic funding
should now be made available to extend our research and
conduct intervention trials as a matter of urgency.”
Connecting occupational therapists
online
OT 4 OT http://ot4ot.weebly.com
OT 4 OT was
developed by a
core group of
early adopters of
technology, to
share knowledge
about online
technologies.
It is for
occupational therapists to participate in vibrant and
effective online communities that support occupational
therapy practice, education and research, locally and
globally.
The power of occupation
One of the first big projects for OT 4 OT is a 24 hour
virtual exchange on World OT day, 27 October. The
virtual exchange will have a range of speakers from
around the globe, each presenting on topics related to
occupational therapy practice, research or education. Speakers will include occupational therapy academics,
occupational therapy consumers, occupational therapy
practitioners, each with inspiring stories and experiences
to share. The theme is “The Power of Occupation”. The idea was developed by Merrolee Penman at Otago
Polytechnic in NZ - her colleague Sarah Stewart has run
this type of event twice to celebrate the International Day
of the Midwife. Otago Polytechnic will host the virtual
exchange using elluminate.
The second aspect of this project is to integrate the
wikiflash activity already undertaken by a group of British
occupational therapists, and is the annual “tidy up” of
the occupational therapy page on wikipedia. This is the
third year this is taking place.
For more information http://ot4ot.weebly.com/
Visit the wiki for online technology information http://
wfotcongress2010.pbworks.com/
Lifemark makes its mark
ACC and the Ministry of Health could
save millions of dollars if the new
design and build approach Lifemark
is adopted in New Zealand, according
to a report by the Ministry of Social
Development (MsD).
The analysis reveals private
homeowners, taxpayers, housing
developers and government could
benefit from significant savings
if Lifemark, the building sector’s
equivalent to Tourism New Zealand’s
Qualmark, was incorporated into
new home design.
Homes awarded the Lifemark
have 33 design features including
a level entry, widened doors and
passageways, all aimed at making
the house accessible for everyone
and easy to adapt as residents’ needs
change over time.
Constructing new homes to the
Lifemark would mean an end to the
expensive task of retrofitting housing
in New Zealand. UK studies show
that retrofitting an existing house is
considerably more expensive than
designing with the future in mind at
the point of construction.
Lifemark has secured the support of
Ministry of Social Development chief
executive Peter Hughes, who said
“…the demand for disability-friendly
housing is set to rise significantly over
the next 30 years as the population
ages. The reality is that the design
of New Zealand’s housing stock
does not yet take into account this
dramatic shift in demographics.
For more information please contact
Sam Halstead, [email protected]
Make your mark for
occupational therapy
research
Research Partnerships for New
Zealand Health Delivery - New
funding round 2010.
Five research projects have been
allocated just under $200,000
of funding each for research
partnerships which will utilise the
experience and expertise of frontline
clinicians to provide innovative and
workable solutions to improve health
delivery services.
The HRC has established Research
Partnerships for New Zealand Health
Delivery to support collaborations
that position research within
service delivery. A key feature is
the requirement for involvement of
health delivery decision makers (in
all aspects of the research process) to ensure research
evidence directly meets the needs of health delivery
organisations and to increase the likelihood for effective
knowledge transfer.
The new funding round for 2010 is open for applications.
Stage one, an expression if interest, is due 8 October
2010. Log on to the HRC website, hrc.govt.nz or follow
this link: http://www.hrc.govt.nz/root/pages_policy/
Research_Partnerships_for_New_Zealand_Health_Delivery.
html
Senior Road User Toolkit Available
Nationally in March 2011
NZTA is aiming to reach a greater proportion of the older
target age group than was reached by Safe with Age with
a new initiative - the Senior Road User Toolkit. The new
delivery model addresses the emerging and continued
priority area of older drivers in the Road Safety to 2020
strategy.
Local groups will be able to use the toolkit free of charge
to engage people through their own local networks. The
NZTA has a register of local authorities that are classified
as ‘Communities at Risk’ because they have a relatively
higher levels of crashes relating to particular issues,
e.g. speed, drink driving, older drivers etc. Where the
register identifies a community at risk due to high level
of crashes involving older drivers, the local authority may
apply for NZTA funding for activities addressing the issue.
The current communities that have been identified as
“communities at risk” for drivers aged 70 years and over
are: Kapiti, Horowhenua, Whanganui, Selwyn, Waitaki,
Central Hawkes Bay, Central Otago, Napier, Ashburton,
Dunedin, Christchurch and Nelson.
For more information please contact Adrian Stephenson,
Senior Education Advisor, at adrian.stephenson@nzta.
govt.nz
Work - talk it up!
The Human Rights Commission recently released the
report, “What next? The National Conversation about
Work”.
It is the result of 3,000 conversations with employers
and employees nationwide, undertaken to identify what
constitutes good work and what makes for decent
workplaces in New Zealand. http://www.hrc.co.nz/hrc_new/hrc/cms/files/
documents/19-Jul-2010_09-16-34_HRC_What_Next_
Report.pdf
Technology innovation
Dynamic Controls today
announced recently its
innovative iPortal is now
available worldwide. The iPortal
solution connects powered
wheelchairs to the internet
using an iPhone or iPod in a
special mount and also includes
a ‘chair doctor’ diagnostics
feature that interprets any
problems with the wheelchair
and an on-chair charger so
devices never run flat.
To view the iPortal please visit http://www.
dynamiccontrols.com/iportal/
Sector News
Meaningful occupations undermined?
A New Zealand Listener article: Wanted: work not walls,
(17 July) decried the closure of sheltered workshops
by IHC. The families featured expressed concern that
mainstream employment is not viable for disabled people
who are less able. They argued that the repeal of the
Disabled Persons Employment Promotion Act in 2007 has
led to their family member being more isolated with less
to do.
www.listener.co.nz/issue/3662/features/15789/wanted_
work_not_walls.html.
The article suggests that people with disabilities
are content to work for a third world wage and no
employment rights – no holidays, no sick pay, no
minimum wage.
IHC responded with the lead letter published the
following week: www.ihc.org.nz/NewsEvents/tabid/1651/
articleType/ArticleView/articleId/121/Response-to-articlein-The-Listener-about-IHCs-vocational-services.aspx.
This emotive and political issue was first aired with
contrary viewpoints in the OT Insight - OTI March and
April 2005 (letters to the editor). The first was an open
letter to members of parliament raising concerns about
the repeal of the Act – the argument being that a ‘job’
in a sheltered workshop means more than wages to
a person with a disability, ‘it means the opportunity
to be gainfully employed like every other member of
society.’ The response from an occupational therapist
and the chief executive of a disability vocational service
unreservedly favoured the repeal of the Act, arguing that
the repeal of the Act will require sheltered workshops
who engage people in work to treat them as an
employee in every aspect, including employment law and
payment of a fair wage.
What do you think it will take to ensure an inclusive
society – one that supports meaningful participation in
work and the community?
Ministry of Health Update; Equipment
and Modification Services
Over the past two years, the Ministry of Health has been
undertaking a number of projects to support ongoing
improvements to the provision of equipment and
modifications for disabled people of all ages. This work
will also assist with management of increased demand
for these services. A summary of key projects which have
involved representation from occupational therapists and/
or will impact on the practice of those who are currently
working as specialised assessors for the provision of
equipment and modification services is provided below.
1. DHB Assessor engagement
Over the last 5 years, despite significant increases in
funding, waiting lists have grown and many people have
to wait longer for services. Thirty-five people, mainly
occupational therapists and physiotherapists working
in DHBs, attended meetings in Wellington, with robust
debate about many suggested options that have potential
to assist with managing demand. Several ideas were
discussed including:
n
improving information about consumers purchasing
their own equipment and/or modifications
n working with other agencies and groups to encourage
people to better plan for their changing needs as they
age
n reviewing eligibility criteria to better target services
n improving training for therapists who undertake the
assessment role
support specific skill development.
Further information is available
from your EMS provider or the
Health Improvement and Innovation
Resource Centre (HIIRC) website
http://disabilityservices.hiirc.org.nz
and will be available from 30 August
2010. This provides comprehensive
information and resources to assist
assessors transitioning or applying
for accreditation. If you have any
immediate queries, please contact
Christine Howard-Brown, who is
leading this work on the Ministry’s
behalf. Email: chris.hb@paradise.
net.nz or phone 021 439 775.
Suggestions made from the two meetings will guide
future planning that will assist with managing demand
for equipment and modifications. The contributions
made to these discussions have been highly valued, and
we look forward to progressing some of the suggestions
in the coming year.
2. Prioritisation
The prioritisation tool is currently being finalised and
will be trialled in three DHB areas - Counties Manukau,
Hutt and Southern. In addition, some specialised
assessment services (such as wheelchairs and seating
and communication assistive technology) will also be
participating in the trial. A key part of this tool is the
inclusion of a client self-assessed questionnaire about
the impact of their disability on their life, which will
be completed by them (or their key support people).
Consumer representatives have been involved in
the development of this brief questionnaire and an
application is being made for ethics approval for this
section of the new prioritisation tool.
The new framework has three levels
of accreditation for access to ministry
funded equipment and modification
services:
i. Approved assessors – allied
health professionals (for example
occupational therapists and
physiotherapists) whose existing
graduate level training is
considered sufficient to assess for
and recommend equipment (for
example commode chairs, walking
frames, household management
items) and basic housing
modification services. Approved
assessors will also include other
support personnel such as
service coordinators working for
organisations supporting people
who have sensory loss.
3. NASC and EMS Guideline for High Cost and/
or Complex Applications
This guideline has been developed because it is
recognised that consideration of many high cost and/
or complex equipment and modifications should be
undertaken in collaboration with needs assessment and
service coordination (NASC) organisations. The guideline
outlines the circumstances where increased collaboration
between the EMS assessors and NASC is required. It
will assist with ensuring that services, particularly costly
housing modifications, provide the best value for money
solution/s to meet the person’s needs.
4. Assessor accreditation
An expert advisory group, comprising representation from
relevant clinicians working in DHBs and other assessment
services, has been working with the Ministry to prepare
for the implementation of the framework, which
commences on 30 August 2010.
If you are an existing specialised assessor it is important
to note that you will automatically be transitioned to
the relevant equivalent category on the accreditation
framework. This means that you will be able to continue
to undertake assessments and submit applications
recommending equipment or modifications for your
clients. You will however, need to complete requirements
within the relevant categories within six months to retain
your accreditation status without having to reapply until
the re-credentialling requirements fall due.
Enable New Zealand will continue to manage the
administration of the accreditation framework. This will
include receiving and processing accreditation status
applications from assessors and sending reminders
to assessors one month prior to the expiry of their
accreditation, which is valid for a three year period.
Where credentialling is a new requirement, the Ministry
has put in place a number of training opportunities to
ii Credentialed assessors – specific
service areas where additional
training requirements will be
necessary before clinicians can
recommend ministry funded
equipment and modification
services. These service areas
will include wheeled mobility
and postural management,
communication assistive
technology, housing modifications,
and vehicle purchase and
modifications.
iii Service accreditation - specific
service areas (primarily community
health services), can be accredited
to allow relevant DHB staff to
undertake assessments for certain
equipment items (for example
low cost, low risk, high volume
equipment such as shower
stools and over toilet frames)
thereby reducing duplication of
assessments and streamlining
equipment provision.
Sue Primrose
Development Manager
Disability Support Services
➤
➤
Implementing the Revised Therapy
and Assistive Technology/Equipment
Operational Protocols
The MoH and MoE confirm that the joint therapy and
assistive technology/equipment operational protocols has
been signed and is ready for implementation in your area.
Purpose of the Operational Protocols
The revised Therapy and Assistive Technology/Equipment
Operational Protocols(2010) for school aged students
with disabilities (available from the MoH website) will
assist the achievement of the best possible service
delivery outcomes for children and young people with
disabilities through identifying the differing roles and
responsibilities as they relate to the funding and provision
of occupational therapy, physiotherapy services and
assistive technology/equipment.
Principles
The following principles guide the memorandum of
understanding and operational guideline:
1. The best interests of the child and young person are
the primary concern and purpose of the services.
2. Services will develop and foster collaborative working
relationships at all levels.
3. Best practice and professional
standards will be adhered to.
7. Services will work flexibly and be provided across a
range of environmental settings.
4. Employees and contracted agents
of the Ministries of Education and
Health will work together and
co-operate with each other in
undertaking their respective duties
and responsibilities in relation to
therapy, and the assessment and
provision of assistive technology/
equipment for eligible children and
young people with disabilities.
8. This Memorandum of Understanding and the
Operational Guideline will inform local level
agreements. The local level agreement will outline
how health and education services work together to
deliver quality services.
5. Employees and agents of the
Ministries of Education and Health
will work together and co-operate
with each other to find solutions
for those children and young
people both services are involved
with, and in a timely manner.
What happens now?
6. When assistive technology/
equipment is required for both
education and health reasons,
the organisations will take
responsibility for identifying a lead
agency and therapist.
9. Both Ministries will collaborate to make the best use of
available resources.
10. Service continuity for the child or young person is a
priority in decision making processes.
Each DHB and Ministry of Education District will appoint
implementation leaders at both management and
operational levels who will work together to raise the
awareness and support the implementation of the
operational guideline and develop local level agreements.
If you have any queries about the implementation process
or the operational protocol you can contact:
Pam Henry, Ministry of Health (Therapy) Pam_Henry@
moh.govt.nz or
Karen Hunter, Ministry of Health (Equipment) Karen_
[email protected]
OTBNZ
Preparedness to practice
T
here is increasing debate within the profession about
the preparedness to practice of new graduates. In an
effort to answer some of the questions generated by the
debate, the OTBNZ has commissioned AUT to undertake
a piece of work with the following aims and objectives:
1. To undertake a systematic literature review including:
a. contextual issues of where occupational therapists
may work upon graduation
b. OTBNZ evidence regarding new graduates and their
practice
c. international work from occupational therapy and
other health professional groups
2. To elicit the opinions of the profession and key
stakeholders with regards to:
a. developing contextual information of whether there
is a need to change the documents; and if so
b. what changes are needed
3. To establish a steering group comprising: OTBNZ, New
Zealand Association of Occupational Therapists (NZAOT),
education, and employer representatives.
4. Produce a report for consideration by the OTBNZ
with recommendations for ensuring the preparedness of
practice for new graduate occupational therapists in New
Zealand.
A survey will be coming out to practitioners, so make sure
you complete it and have your say.
Following the report the OTBNZ will
be reviewing the competencies for
registration and the code of ethics.
These two documents have been in
use for sometime and are therefore
due for review.
New board members
There have been some new
appointments to the board.
Rangimahora Reddy is a lay
representative and will join the board
in September when our present lay
person Candis Craven’s term ends.
Colleen Naughton a practitioner
based in Hawkes Bay will be joining
the board in November when Kim
Henneker’s term ends.
Visits
Thank you to all those people who
have kindly arranged and hosted my
visits. It is great to go out and put
names to faces and to listen to the
issues practitioners are raising. One
of the obvious things I am seeing is
the broad range of areas practitioners
are working in. As the health and
social care provision changes it is
important that practitioners feel able
to move with the times. The
board is very cognisant of the
changing roles of practitioners
Andrew Charnock
and is supporting this through a
document which will be coming
out for consultation soon. The document is called
‘Practice boundaries for occupational therapists: a guide
for practitioners’. Can I encourage you to read it and
provide the board with feedback?
CCFR handbook
We are in the process of reviewing and then re-issuing
the CCFR handbook. This will coincide with the release
of the new improved CCFR and practitioner interface. It
is our intention to place the handbook on the website
so that practitioners can download and print it if they
wish. We will present hardcopies to new graduates and
practitioners qualified outside New Zealand as a welcome
to the profession.
APC cards
The Board has recently decided to change the look of
the APC card. The change should simplify the process
of producing the cards and reduce costs. One of the
main changes will be that the card will no longer carry a
photograph.
CPE
Continuing Professional Education Calendar
2010
September
23 - 25 Cutting Edge’ 15th National
Alcohol and Addiction Treatment conference
hosted by DAPAANZ (Drug and Alcohol
Practitioners’ Association) with principal
support from the Ministry of Health. Preconference meetings 22nd and workshops
25th. For further information visit website
www.cuttingedge2010.org.nz
25 – 26 ‘Mental Health: Are
we on the right track?’ General
Practice Symposium Controversies
in Healthcare 2010. Dunedin, NZ. For
further information email Sally Boult sally@
events4you.co.nz or view website www.
events4you.co.nz/GP2010.html
Health & Wellbeing in Children,
Youth and Adults with
Developmental Disabilities: Autism,
Intellectual Disabilities and Other
Neurodevelopmental Disorders.
Vancouver, Canada. For further information,
visit website http://interprofessional.ubc.ca/
or email [email protected]
October
1
The Treatment Tree –
Personality Disorder Conference 2010.
Dunedin. A bi-annual meeting of health
professionals from all over NZ. For further
information email: conference@ashburn.
co.nz
2 – 4 Inaugural JobFit System
Conference ‘Health, Productivity
& Sustainability’ Hamilton Island,
Queensland, Australia. Information: www.
jobfitsystem.com or email conference@
jobfitsystem.com
5 - 12 Cognitive Behaviour Therapy
training events. Wellington: Primary
Certificate in REBT (4 days), Treating Anxiety
Disorders (1 Day), Mindfulness (2 Days),
CBT with Children & Their Families (1 day). For further information see website: www.
rational.org.nz or email: training@rational.
org.nz
11 - 12 ‘Generating the Tides of
Change: Innovations in ageing
wellness and rehabilitation practice”.
OT Australia Qld 2010 Symposia. Sunshine
Coast, Qld, Australia. Email [email protected].
au or view website www.otqld.org.au for
further information.
12 – 13 ‘Transitions &
Transformations: Developing Through
Change’ OT Australia Victoria 2010
State Conference. MCG, Melbourne,
Australia. Early Bird Registration: 7
September. NZAOT members can attend
this conference for OT Australia member
rates. For further details email: otvic2010@
thinkbusinessevents.com.au or view website
www.otvicconf.com.au
12 – 14 Malaysian Singapore
Occupational Therapy Symposium
‘Occupational Therapy: Promoting
Participation in Work and Enhancing
quality Community’. Kuala Lumpur,
Malaysia. For more information go to www.
occupational-therapy.org.my
17
Computer Guidelines
Seminar. Nelson. NZES2010 in
conjunction with ACC is running a free
seminar on the soon-to-be-released
‘Computer Guidelines’ at the same venue as
conference below. Bookings for seminar are
separate from conference registration. No
8 - 9
‘Self-Esteem: The Key to
Learning’ Dyspraxia 2010 Conference. other free training is being offered for this
seminar. Morning session. Contact maddy.
Christchurch. For further information,
contact by email: joanne@conferenceteam. [email protected] co.nz or view website www.dyspraxia.org.nz Optional ACC DPI Programme training
in the afternoon. When booking for the
26 – 28 Occupational Health & Safety Computer Guidelines seminar let Maddy
Industry Group Conference. Wellington. know if you wish to complete the DPI
programme as well.
For further information view website www.
ohsig.co.nz or email [email protected]
18 - 19 ‘Preventing Worked-related
27 & 28 Skills Training in Dialectical
Musculoskeletal Disorders – Present
Behaviour Therapy: The Essentials.
and Future Challenges’ New Zealand
Auckland. All enquiries: [email protected]
Ergonomics Society’s 16th Conference
or call Lynda or Cathy at SBA Thames (07)
2010. Nelson, New Zealand. Call
867 9122
for Papers – submit an abstract by 10
May; feedback by 10 June. For further
November
information, go to website http://www.
ergonomics.org.nz/ConferenceNZES2010.
4 – 5 Safe Client Handling – a
aspx
two-day practical Train the Trainer
workshop. Christchurch. Presented by
Ann Newson, NZRP, MNZSP. Enquiries to
Therapy Professionals: Ph: (03) 377 5280;
email: [email protected] or
website: www.therapyprofessionals.co.nz
5 – 7 ‘Implementing the Disability
Convention Making the Difference’.
Disabled Persons Assembly (NZ) 28th
National Assembly and Conference.
Invercargill. For further information contact
DPA Conference 2010, PO Box 27-524,
Wellington or Ph: (04) 4801 9100.
18 - 19 The 3rd Australasian
Mental Health Outcomes Conference.
Auckland. For further information visit
http://www.tepou.co.nz/page/402australasian-mental-health-outcomesconference
18 – 19 Supporting the Healthcare
Workforce – Innovations in OH&S.
Melbourne, Australia. Visit website www.
changechampions.com.au for further
information.
19
Applied Ethics and Related
Law for Health Professionals Study
Day. AUT North Shore Campus, Auckland. Certificates of attendance will be issued
by AUT University. $165 for the day
including morning and afternoon teas and
lunch. Registration closes 5 November
2010. For further enquiries please contact
Moira Wright – [email protected]
20 & 30 Individual Psychotherapy
in Dialectical Behaviour Therapy.
Wellington. All enquiries: [email protected]
or call Lynda or Cathy at SBA Thames (07)
867 9122
24 & 25 Allied Health Summit –
Leadership and Practice Innovation in
Action. Wellington Hospital, Wellington. For more information or to register email
[email protected]
2011
March
03 – 06 2011 New Zealand
Rehabilitation Association
Biennial Conference ‘Innovation in
Rehabilitation: Connecting People
and Technologies’. Auckland, New
Zealand. Registration available September
2010. Closing date for receipt of abstracts
– 26 October 2010. Early bird closing
date – 16 December 2010. Contact www.
nzrehabconf2011.co.nz
Paediatric Foundation Course 2011:
Assessment & Intervention with
Children/Young People with Cerebral
Palsy & Developmental Disabilities
based on the Bobath/NDT Approach
(NZBA certificate course). Venue:
Auckland. Part One: Mon 7th March to
Friday 1st April 2011 (4 weeks: includes
2 Saturdays – 12th/26th March); Part
Two: Monday 29th August to Friday
16th September 2011 (3 weeks; includes
1 Saturday – 3rd September). Course
Organiser: Sue Buswell sue@neurorehab.
co.nz
14 – 22 IPH is holding Cognitive
Rehabilitation workshops with Kit
Malia and Anne Brannagan OBE of
Brain Tree Training. Auckland. 2 day
Cognitive Rehabilitation workshop 14
& 15 March; 1 day How to do Cognitive
Rehabilitation Therapy (CRT) 16 March;
2 day Insight workshop 21 & 22 March. Further information contact IPH by phone: 09 638 7501 or email: workshops@iphltd.
co.nz
17 - 20 The New Zealand Pain Society
36th Annual Scientific Meeting
‘Planning for Pain Management’.
Christchurch, New Zealand. For further
information contact Donna Clapham; email: [email protected]
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Ma‑ramatanga whakaora ngangahau

Transcription

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