THE ACCEPTANCE AND IMPLEMENTATION OF INTERNATIONAL FRAMEWORKS THAT DO NOT REFLECT UPON THE AUSTRALIAN CONTEXT.
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1 Is It Blind Faith? THE ACCEPTANCE AND IMPLEMENTATION OF INTERNATIONAL FRAMEWORKS THAT DO NOT REFLECT UPON THE AUSTRALIAN CONTEXT. Prepared By: Mark Brown (Social Worker - RNSH) Betsy Sajish (Senior Social Worker - NCCC) Kim Hobbs (Senior Social Worker CPMCCW) Dr Laura Kirsten (Principal Clinical Psychologist - NBMLHD)
2
3 Introduction
4 Australia has a great health care system
5 Blind adoption examples?
6
7 So why look at this issue? How did this idea come to fruition? 40% of cancer patients were estimated to suffer from significant emotional distress (Carlson et al. 2012). 30% have a comorbid mental disorder (Mehnert et al. 2014). Only 30%-50% of those with high level distress seek help, and fewer accept support (Baker-Glen et al. 2011). So we aimed to implement a NCCC QI project titled RPAC: Rapid Psychosocial Access Clinic to interrogate the validity of these claims. Please attend the session by Betsy Sajish this afternoon if you wish to know more about the actual study.
8 NCCN Distress Thermometer and associated Problem Check List
9 Areas of Social Work service delivery in Oncology Practical Emotional Support Family Cancer Socio-Legal Physical Spiritual
10 Identify the deficiencies in the screening tool. Circle the number (0-10) that best describes how much distress the patient has been experiencing in the past week, including today. Indicate any of the following that has been a problem for the patient in the past week, including today. Be sure to check YES or NO for each. YES NO Practical Problems YES NO Legal Concerns YES NO Physical Problems Child care Will Appearance Housing Power of attorney Bathing/dressing Insurance/superannuation Enduring guardian Breathing Financial Advance care planning Changes in urination Transportation Parental planning Constipation Work/school Diarrhoea Support Concerns Eating Family Problems Family/friends Fatigue Dealing/communicating Professional/service Feeling swollen with children about Fevers diagnosis Spiritual/religious Getting around Dealing with Indigestion partner/carer stress Memory/concentration Dealing with close Mouth sores friends/relatives Nausea Nose dry/congestion Emotional Problems Pain Depression Sexual Fears Skin dry/itchy Nervousness Sleep Sadness Tingling hands/feet Worry Loss of interest in activities NCCN Problem Check List Australian Social Work Problem Check List (ASW-PCL)
11 Endorsed
12 External Referrals
13 Identified deficiency in PCL To suit the Australian context we need to consider: 1. Questions that need to be added. 2. Cultural acceptability. In 2018 the Cancer Institute has initiated the Patient Reported Measures Solution (includes the PCL) which is going to be rolled out throughout NSW. However, if after interrogation we have had to adjust this framework to suit the Australian context, then do the rest need to be interrogated?
14 What can we do as Social Workers? Social work has developed a perspective on the relationship between policy and health that is driven by a primary mission of promoting human well-being. This perspective is informed by social work training, which emphasises systemic influences on behaviour, health and well-being. It is further reinforced by social work practice; social workers are often responsible for frontline implementation of health policy, and our work frequently places us in close interaction with the most vulnerable segments of the population, both of which provide natural insights into the design and effectiveness of health policies.
15 I don t have the answers Do you?
16 Implementation science* The scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices (interventions, programs, innovations) into routine practice and improve the quality and effectiveness of health services and care. - Eccles & Mittman, Implementation science, 2006 Implementation scientists at IPOS 2018 commented about how people are innovating at their workplaces but not disseminating. * Acknowledge differences in terminology: knowledge translation, dissemination & implementation research, improvement sciences.
17 Data and facts are not like pebbles on a beach, waiting to be picked up and collected. They can only be perceived and measured through an underlying theoretical and conceptual framework, which defines relevant facts, and distinguishes them from background noise - Wolfson
18 Thank You
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