Speak Out June 2020

also meant they were typically more comfortable in their familiar environment, which created a more collaborative approach towards therapy. “In the early days, for a short period my work continued as usual. However, as the pandemic started to increase my concern for my family’s health and wellbeing became my priority. I live with someone who is in the higher risk population so it was my preference to limit as much face-to-face contact. Thankfully my manager was very supportive of this decision and my adventure into telehealth began.” Carly Veness in her practice located in Melbourne’s outer northern suburbs, is primarily focused on supporting infants and children with feeding and swallowing difficulties. “Before the COVID-19 pandemic we provided about 99% of our services in a face-to-face context. “Like all our colleagues, we had to adapt and adapt quickly! We made the decision relatively quickly to shift entirely to Telehealth services and for all our team to work from home. This was a completely new experience and a challenge for our team as we had not provided this model of service before. ‘Jumping in the deep end’ and ‘rapid learning curve’ are phrases that come to mind!! I was also worried about how the transition into Telehealth would go and how we could adapt our current assessments and therapies to the Telehealth setting. Would families be keen to engage in Telehealth? Could we still keep our practice open and running? How would it all work?” Making the transformation The move to telepractice and other ways of working was a steep learning curve for many practitioners. For some the pandemic fast-tracked digital transformation of their business practices and for others the need to change advanced their personal skill sets. Genuine concerns about being able to adapt to meet the needs of clients was matched by concerns for health and safety of teams and staff. Karina Quince Mobile private practice McDevitt Speech Pathology Adelaide Before the pandemic Karina serviced clients via school and home visits. A previous role as the lead speech pathologist involved in the development of tele-rehabilitation in the Southern Adelaide Local Health Network at SA health gave her extensive experience in telehealth and she was able to draw on this to support her team to adapt to the changing landscape. “My early concerns were for my team and their clients, rather than being concerned about being able to deliver telepractice services myself. I was concerned about my colleagues losing income and their clients not being able to access services and the repercussions for their clinical outcomes. “I was confident in the quality of telepractice as a service delivery option for many clients, I had transferrable knowledge and skills, and I was able to quickly prioritise the most important actions necessary to shift to telepractice clinical services. I was also fortunate that I was on maternity leave, I had time on my hands, which enabled me to be proactive and help to prepare my team early. “I firstly sought to reassure my team about the efficacy of telepractice and shared my positive experiences from my prior work with them. I investigated recommendations made by both SPA and ASHA. I investigated and trialled various video conferencing platforms. I invested in a headset with a microphone, document camera and second computer monitor. I

developed a telepractice consent form and user guides for both our team and clients. I accessed online webinars relevant to telepractice. I learned how to digitalise my existing resources via PDF documents, PowerPoint and Boom Cards and also began creating new documents. I completed training sessions with my colleagues via video conference calls using screen sharing functions. “I was worried about my colleagues and others in the profession. Personally, I was excited to be engaging in the telepractice service delivery model again and I found that the situation hastened my return from maternity leave. I was also very inspired by the camaraderie of the profession, the generosity of those who shared information and resources, and I was able to see how our profession and my own clinical practice were advancing as a result of this terrible situation.” “I believe that my clinical practice has changed forever. I will continue to use personalised, interactive digital resources wherever possible, so as to engage my clients and also so as to minimise the environmental impacts of printing and laminating. I will continue to use digital practice management software, including digital forms, for the convenience of the families that I work with. I will continue to offer telepractice as a mode of service delivery where clinically appropriate. I will also offer it as a means of communicating with families and as a method to increase communication with my mobile practice team mates. Kate Lalor Community Health Paediatrics Northern Territory Kate Lalor and her team in the NT began by exploring and upskilling in various telepractice options early on to prepare if community spread was reported in the NT. “We began gathering data from new clients at assessment to determine their capacity for using telepractice should we suddenly need to cease face-to-face sessions. As the pandemic escalated we took more steps to reduce face-to-face sessions and began trialling telehealth sessions with families. We completed screening questions at the time of booking clients and the day before or day of appointments to ensure clients were safe to attend. Our main concerns related to our rural clients and those unlikely to have access to internet or data should telehealth become the only option and the potential impacts on some of our more vulnerable clients who can be difficult to engage with even without the new barriers. We also worried about our waitlist growing as our ability to see clients slowed. We have been lucky enough not to reach the point of community spread in the NT, therefore in-person visits never actually ceased. In saying that, certainly high-risk client and/or staff did cease face-to-face visits and in these instances telepractice was a successful alternative. “Since we have no community spread in the NT, we have been able to return to a relatively ‘normal’ way of operating, with additional measures including: social distancing within sessions, restricted number of people in rooms, not running groups, completing strict health screening calls prior to sessions. Our main changes include now having access to (and confidence to use) the technology required for providing services via telepractice. “I think one of the biggest challenges has been keeping abreast of the frequent changes and messaging from our managers and changing our practice accordingly. Keeping our clients and families informed and ensuring we are communicating our service changes and reasons for changes clearly has also been very important. “Most of our clients have been very understanding of changes to our service. We have found we have been seeing fewer

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June 2020 www.speechpathologyaustralia.org.au

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