Speak Out August 2018

Ethics of care approach worksheet

Are there any factors, including policies, structure of health services, attitudes, and values of health professionals, which may disempower this client? By taking into consideration the parent’s and speech pathology student’s knowledge, attitudes and preferences, Phill can support beneficial outcomes for the client. Phill needs to be aware what is an appropriate role for an AHA as a delegated worker in this situation and consider evidence based interventions that are appropriate and how best to work with the student. He also needs to be prepared to take time to educate the family and the student about delegated work in a way that is sensitive to their values and attitudes and discuss how it can be beneficial as well as cost-effective. The team also need to be aware of the evidence Phill will use to support choice of an AAC method/device. If Phill does not address those factors, the risk is that the student may not continue her involvement with this client or the parents may ask him to stop working with her. Phill must plan how to discuss these topics to avoid damaging the relationship he has with the parents, as well as demonstrating that it is a cost-effective way to utilise the funding the client has available. Phill can support the parents to take this information back to the NDIS planner, to assist their understanding of delegated AHA work and the need to have appropriate supervision by a qualified professional in order to ensure benefit to the client. Phill can refer to the NDIS Provider Toolkit which confirms that an AHA may work with a NDIS participant under supervision of a qualified AHP. What resources are required to provide competent health care? Do I/we require more knowledge or training to manage this client? Are the available resources appropriate? Phill has experience working with non-verbal clients requiring support to develop functional AAC use. He needs to be mindful of where his experience may limit his decisions about which AAC methods/devices to trial, and make sure he has current knowledge about the options available. This will avoid making a decision based purely on the AAC he has used before, i.e. he should explore a range of AAC methods/devices to ascertain which is the most appropriate for this client. That may involve attending PD or training sessions, or seeking professional supervision to increase his knowledge and skill in this area of practice. It is important that he does not dismiss the use of an iPad immediately either, just because he didn’t introduce it and it has not been successful yet. It might be useful for this client if trialled and supported in an appropriate way. How are clients responding to care? What feedback mechanisms are in place? How does the team/service respond to client feedback?? Phill organises training for the parents, AHA and SDS teachers in the chosen AAC method/device. He sets up a consistent method for recording the client’s use of AAC, to gain information across the environments where she uses it. This information is provided to everyone on the team and reviewed regularly to inform changes necessary to support progress towards goals. He negotiates with the parents to allocate funds to have regular meetings between all key stakeholders, to make sure everyone has the opportunity to ask questions about the AAC and gain confidence in supporting the client.

How can I improve the care offered to clients? How can I effectively advocate for an individual client and family?

What steps can I take to facilitate knowledge, skills, and resources for clients in my community? How can I advocate for changes in policies/service delivery that will enhance client care? Advocacy for this client includes education of key stakeholders regarding appropriate roles within the team. This includes the parents, the speech pathology student and the NDIS planner and will provide clarity regarding the appropriate use of funds available, to maximise the outcomes achieved. Phill provides written information regarding how he, as a qualified speech pathologist, will work with the AHA to ensure use of funds in the most cost-effective way while still confirming that the speech pathology program is designed, monitored and managed by him.

Trish Johnson Senior Advisor, Ethics and Professional Issues

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August 2018 www.speechpathologyaustralia.org.au

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