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The Gloucestershire experience


  • pg 1
									The Gloucestershire
 Anne-Marie B-Mitchell
• Introduction to the Project,
• The reasons behind the Project,
• Problems and Solutions,
• How we did it:
      -     patient selection,
      -     environment,
      -     props and “things”,
      -     staff used, etc…
• Where are we now?
• The future?
    Introduction to the Project
• The facts:
  – September 2002 – 9/10 months wait for
    Analogue New Fits.
  – January 2003: PCs in place ready for MHAS.
  – Official start of MHAS: April 2003
    Introduction to the Project
• The pressures:
  – Everyone wants a Digital Aid!
  – Nobody wants to wait!
  – The Staff didn’t want to start fitting Digis
     before waiting list was cleared.
    Introduction to the Project
• Who did we call?
  – The Trust,
  – The local Health Authorities,
  – MHAS,
  – Ghostbusters????? Well… AoE
The reasons behind the Project
• None of the other possible sources of help
  were responding to our pleas,
• Money was offered by AoE,
• But, there was a catch!!!!
• Group Instruction Project was born in

• Where do we do       • 3 County locations
  these Groups?          (Stroud,Glos,Chelt)
• How many Patients    • 6 + significant other
  per Group?             (up to 12 in 1 room)
• How long should it   • 1 hr 30 min (10 min fit
  last?                  and 1 hr instruction)
• When?                • 7 weeks of Saturday
          Patient selection
• Difficult as Patient was last seen 9 or 10
  months previously,
• Similar hearing aid (BE101, 103 and 38; or
  GB10 and GB30),
• Aged below 90,
• Not F & E, blind or with disability,
• Similar location.
• Gloucester:
  Hearing Therapy room – a bit squashed
• Cheltenham:
  Paediatric Booth - OK
• Stroud:
  Out-patient waiting area - brilliant
           Props and things…
• Props:
  – Flip-chart made by Action on Team
  – Each Patient with a “dummy” aid to hold
• Leaflets:
  – Explanation leaflet with consent and
    appointment letter
• Hand-outs:
  – Usual + Questionnaires
           MHAS “things”
• Modified Glasgow Part I handout given as
  Patient arrives for the Group.
• Modified Glasgow Part II handout given as
  Patient arrives for the Group Review.
             AoE “things”
• Service Satisfaction Questionnaire for 200
  Group Patients and 200 individual
• Group satisfaction Questionnaire for 200
  Group Patients,
• DNA Questionnaire sent to some 60
  Patients who didn’t attend their Review.
      Who was going to do it?
• All volunteers gratefully accepted in the
• All admin Staff,
• Even an Assistant!
• Each Group was instructed by a fully
  qualified MTO (mostly a 3), “helped” by
             How did it run?
• First 2 Patients arrived at 09:00
  – Mould(s) and aid(s) fitted
  – Ushered into the room with Glasgow to fill in
• Next 2 Patients arrived at 09:10
  – ditto
• Last 2 Patients arrived at 09:20
  – ditto
• Start of session at 09:30, with:
  – Aims and objectives,
  – Basic Deaf Awareness,
  – Hearing aid use,
  – Hearing aid insertion,
  – Environmental aids,
  – Further help,
• End of session at 10:30. Next start at
    What about the difficult one?
•   The one that doesn’t like the aid…
•   The one that cannot hear well…
•   The one with 1 arm only…
•   The one who knows it all…
•   The loud one…
•   The shy one…
       What about the Staff?
• Some had previous experience (done it in
  the past, used to doing Tinnitus groups,
  used to teach in classroom…),
• Some learned by observing,
• Some didn’t want to do it.
            The outcomes
• Patient satisfaction (Questionnaires),
• Staff satisfaction (money and job),
• Trust satisfaction (we took 200 Patients off
  the W/L),
• MHAS satisfaction (Questionnaires),
• AoE Team satisfaction (I hope!).
               The present
• Started Digital Group Instructions slowly
  – 4 MTOs fitting aid(s) + REMs to 4 Patients for
    20 minutes,
  – 1 MTO instructing the Group,
  – Glasgow done at assessment,
  – Satisfaction Questionnaire at Group session,
  – Review individually.
                The future
• Looking into Groups of 6 Patients
  – 3 MTOs fitting (with REMs) 2 Patients each,
  – 1 MTO taking the Group,
  – Reviews in Groups.
  Consent letter
Dear Sir/ Madam,                                        Date as Postmark

Re:   Your Hearing Aid Fitting Appointment

As part of a National initiative, the Gloucestershire Hospitals NHS Trust has
been granted a sum of money to study if Group Instructions for hearing aid
issues would be helpful .

The enclosed letter is inviting you to such a Group Instruction. There will be
no more than 6 people and the session will last approximately 1 hour.

If you feel that you would prefer an individual appointment, could you please
let us know as soon as possible, so that we can offer the appointment to
someone else who has also been waiting a long time for their hearing aid.

We must emphasise that, if you do not wish to attend the Group Instruction,
you will still keep your place on the current waiting list

If you wish to attend a Group Instruction, but this date is inconvenient, please
let us know as soon as possible.

Should you have any questions about the study, do not hesitate to contact us
on the above number.

We look forward to seeing you on the day.

Yours sincerely,

Mrs H Cant
Head of Audiology Services

         Modified Glasgow Pt I
SITUATION 1. Listening to the TV with other family or friends, when
the volume is adjusted to suit them.
                                                              yes     no
Does this situation happen in your life? (please tick)
If your answer is “yes” please answer the 2 questions below:
In this situation, how much difficulty do you How much does this amount of difficulty
have? (Please tick one of the five options    worry, annoy or upset you? (Please tick one of
below) Is it …..                              the five options below) Is it …..

1. No difficulty                              1. Not at all

2. Only slight difficulty                     2. Only a little

3. Moderate difficulty                        3. Moderately

4. Great difficulty                           4. A great deal

5. Cannot manage at all                       5. Very much indeed
        Modified Glasgow Pt II
SITUATION 1. Listening to the TV with other family or friends, when
the volume is adjusted to suit them.
                                                         yes         no
Does this situation happen in your life? (please tick)
If your answer is “yes” please answer the 2 questions below:
In this situation, what proportion of the time In this situation, how much does your
do you wear your Hearing Aid? (Please tick Hearing aid help now? (Please tick one of the
one of the five options below). Is it…         five options below). Is it……….

1. Never/Not at all                         1. Hearing Aid no use

2. About ¼ of the time                      2. Hearing Aid is some help

3. About ½ of the time                      3. Hearing Aid is quite helpful

4. About ¾ of the time                      4. Hearing Aid is a great help

5. All of the time                          5. Very much indeed
Service Satisfaction
Group Satisfaction
DNA letter
Any questions?
        Thanks for listening

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