Background MCHAS Digital Hearing Aid Cascade Joint Training Report on Planning and Implementation of the Programme May 2003 Cheshire is a large geographical area with three primary care health trusts within its borders. Mid Cheshire Hospital NHS Trust Countess of Chester Hospital NHS Trust East Cheshire NHS Trust The Education Support Service for young people with hearing impairment in Cheshire is comprised of: - A team of 9.4 (full time equivalent) centrally employed Teachers of the Deaf with a team leader, also a Teacher of the Deaf. The team comes under the umbrella of the Inclusion and School Improvement Service. This team of teachers supports young deaf children from pre- school up to FE level. Cheshire has also devolved funding for Hearing impaired units to schools ands there are 3 primary units and 3 secondary units across the county. There is also a Multiple Sensory Unit attached to a special school for children with complex needs Two Further Education Colleges within Cheshire employ part time teachers of deaf. The cascade training programme was developed to inform all of the teachers of the deaf working in these areas and the Audiology teams doing Paediatric work within the trusts MCHAS Initial Training Representatives from each Health Authority along with two centrally employed teachers attended the MCHAS 2 day Generic training and subsequent 3 day practical training sessions in Manchester. Groups went in December 2002, January and March. 2003 for the three days training. Following this a number of joint Health/Education meetings were organised to plan the delivery of cascade training to the target groups. These meetings took place between March and April 2003 1
Programme of Meetings DIGITAL CASCADE Meeting 1 23 rd January, 2003 Mid Cheshire Area/Health/Education Reps. Discussion on format of cascade cross county/area. Equipment for Education Auricles or Test Boxes. Aids to be purchased. Meeting 2 25 th February, 2003 Mid Cheshire Reps Education/Health Dates and venue agreed. Equipment ordered. Hearing aids for mid region. - First direct input shoes ordered by health. - Pre-school change over. - School age change over. Meeting 3 27 February, 2003 Cross area representatives Education/Health Trusts Cross County Generic Days. Equipment purchase/location Noah 3. MCHAS resources on Website. Aids to be purchased. Flow of information sheets first drafts to next meeting. Outline of programme for Theory Day. - Outside speaker from Phonak. - Teachers to look at Questionnaire. Meeting 4 17 th March, 2003 Education Amendments to Flow of information sheets. Criteria for fitting/change over timetable. Questionnaires to be used, PEACH and LIFE Meeting 5 27 th March, 2003 Cross area Representatives Education/Health Discussion on criteria for switchover. Programme for change aid fitted 4/6 weeks later Questionnaire collated 6/8 weeks, return visit to Audiology. Group looked at PEACH, LIFE. Flow of information from amendments. Theory day programme redrafted. 2
Meeting 6 29 th April, 2003 Cross Area Representatives, Education/Health Finalised programme for Theory Day. Programme for practical day agreed. Flow of information forms agreed. (Appendix 1) Decisions on contents of resource file to be collated for those attending course. ( Appendix 2) Those cross county professionals involved with these meetings included, Consultant Community Paediatrician (Audiology), Senior Clinical Medical Officer (Audiology), Audiological Scientist, Chief Audiological Technician, Teachers of the Deaf, Parental Representation Initial planning of the training was discussed at the March CHSWG ( Children and Hearing Services Working Group ). At this meeting it was decided that parent representatives should be invited in order that they could have an input on how information could be disseminated to parents. Cascade Training Days- The Programme The programme for the two days (See Appendix 3 ) was split into a theory day and a practical day. Representatives from Health and Education gave talks A representative from Phonak gave a talk on the theory day and two Starkey representatives provided a workshop on the practical day. The Venue Leighton Hospital in the Mid South region of the county was chosen for the venue because of it s location and because of it s new Audiology department Course Participants Teachers of the deaf, centrally employed, unit teachers, FE tutors, were invited. Audiological technicians from the Health Authority trusts. CHSWG parent representatives (to attend theory day). Over 40 people were invited, 39 were able to attend. 3
Outcomes The evaluations from the training suggested it was very successful. (Appendix 4) The practical day seemed to consolidate the information from the theory day and the balance between theory and practical seemed to be right although all were aware that we were consolidating large amounts of information into a short time Some comments on evaluation forms included: - A thoroughly enjoyable and challenging two days This has proved useful not only for imparting information but developing relationships across audiology and teachers A well run course, very informative, good venue, nice lunch! Practical experience very useful Very useful- it s given me the background knowledge that I felt I lacked Excellent- it was invaluable to be able to use the test boxes especially with other members of the team to share and discuss ideas. I have found the course to be excellent- a brilliant idea to bring health and education together as we rarely meet. Very good for teachers and audiologists to appreciate each other s difficulties and bond! Abbreviation Sheet was helpful Recommendations from evaluations It would be helpful to have a very basic handout that would be comprehensible to the majority of parents Would be nice to have a booklet highlighting the advantages of digital aids. What they can and can t do (myths etc) to give to parents Many participants requested ongoing and joint training events 4
Further Training The local East Cheshire NDCS group has arranged for outside speakers from Phonak and Starkey to talk about Digital aids at the AGM at Tatton Park on June 7 th 70 people have asked to attend. Other target groups- Speech and Language Therapists, Health Visitors Maureen Cunningham Teacher of the Deaf June 2003 5
Appendix 1 Flow of Information Sheets 6
D1 Hospital: NHS number: Forename: Paediatric Audiology Initial Diagnosis Referral Form Health to Education Surname: Referring Clinician: Date of Referral: D.O.B: Age: Parent/guardian: Address: Postcode: Contact Numbers: Home Work Mobile Fax Text E-mail Family School: Ethnic group: Home Language: Additional Difficulties: Date of Confirmation of Hearing Loss: Type/ Degree of Loss: Hearing Test results attached: Y N Paediatrician: ENT Consultant Aetiology Parental Verbal Consent for Referral : Y N Referral to SLT Y N Date of Next appointment : Comments Area Education Offices Telephone Fax Mid North/ Jane Walton 01606 815706 01606 815052 Mid South 01270 505212 01270 505234 East 01625 534870 01625 534852 West 0151 357 6863 0151 357 6875 7
D2 Paediatric Audiology Hearing Aid Information Health to Education Hospital Clinician Unity/Auriclel NHS number Forename: Date Surname: D.O.B: Age: Parent/guardian : Address: Tel. No: Postcode: Previous Aids R L Digital Aid Issued: R L Serial Numbers Right Left Hearing Aid Features Details Hearing Aid Features Details R L R L WDRC/Linear Programs 1. 2. Noise Reduction 3. DAI 4. Channels 5. Directional Mic Default setting Volume Control Feedback Control (If notch filter state frequency) Range DAI shoe: Remote control : supplied Y N Supplied: Y N Earmoulds R L SPLogram: Attached Y N Frequency Response Curve: Attached Y N Comments:- Date of Next appointment :- 8
D3 Paediatric Audiology Flow of Information Education to Health NHS Number: BATOD Number: Name: ADDRESS: TELEPHONE NUMBER: AGE: SCHOOL: D.O.B. YEAR: Statemented for Hearing Loss: Digital aids R L FM System: Questionnaire Results Attached Y N Type DAI Shoe Y N Peach Life Date Date Speech Tests Type Attached Y N Date Child/Adult Transition Pack Issued Y N Date Comments: Date of Next Monitoring Visit: 9
PAEDIATRIC TO ADULT SERVICES TRANSFER INFORMATION Form D4 Your Personal Details Your currently held details are in the left column. If there are any changes please amend the details in the right column. Name Date of birth Address Telephone number Minicom number Mobile number E-mail address Other contact numbers Your Preferred Method of Communication Please tick the appropriate box(es) I prefer to use spoken English. I prefer to use BSL. I prefer to use SSE. Other (please specify) I require a communicator/interpreter when I attend appointments. 10
Your Future Intentions Please tick the appropriate box and then give details. I intend to stay at this school. I intend to transfer to another school. I intend to go to College (6 th Form). I intend to go to College (FE). I intend to go to University. I intend to take up a training option. I intend to go into employment. I am unsure about what I will do. I intend to continue my education at college and agree that details in my file may be passed on to the relevant person at college. Signed. Date. Information of Interest to You Please tick the appropriate box(es) I have received information about Benefits. I have received information about Disability Support Grants (FE). I have received information about Access to Work. I have received information about environmental aids. I would like to be referred to the Deafness Support Network. I have received the information pack about transfer to adult audiological services from the hospital. Contacting You Any future contact will be made with you at the address you have given on this form. PLEASE INFORM THE HOSPITAL/EDUCATIONAL SERVICE OF ANY CHANGES. If you expect any changes to be made in the near future please give details in the box below. Signature Date.. For Office Use Only 11
Appendix 2 Resource File Contents 12
DIGITAL TRAINING DAY MONDAY 19/5/03 SEMINAR ROOM LEIGHTON HOSPITAL CONTENTS Programme and Workbook Sections 1. Introduction to MCHAS Illustration of Desired Sensation Level 2. MCHAS Guidelines 1,2,3 (x 2), 5,6 (Guideline 4 FM Advantage in Section 9) 3. Digital Aids some things to watch for NDCS Factsheet Digital Hearing Aid Abbreviations 4. Selection Verification Flow Chart 5. Flow of Information Form 6. Outcome Measure PEACH LIFE 7. Child to Adult Transition 8. Evaluation Form 9. (Wednesday Case Study) Workshop Instructions FM Advantage, 21 st May, 2003) 13
Appendix 3 Course Programmes 14
MCHAS Digital Hearing Aid Cascade Joint Training Mid Cheshire Hospital NHS Trust Countess of Chester Hospital NHS Trust East Cheshire NHS Trust Cheshire Service for Sensory Impaired Monday 19 th May 2003 Leighton Hospital Seminar Room Audiology Department 8.30 Arrival Tea and Coffee 9.00-9.45 Why Modernisation? Dr. Batchelor 9.45-10.45 Principles of Compression Features of Digital Aids Helen Tsang and Jagjit Sethi 10.45-11.00 Break 11.00-11.50 Selection and Verification of Aids Dr Wendy Floate and Kath Lewis 11.50-12.00 Flow of Information Forms Maureen Cunningham, Mary Kean, Fran Sherratt, Liz Gresty 12.00-1.00 Lunch 1.00-2.30 Demonstration of Testing Digital Aids using FP35 Roger Lewin Phonak 2.30-3.00 Outcome Measures Maureen Cunningham, Mary Kean, Fran Sherratt, 3.00-3.15 Tea Break 3.15-3.30 Transition from Child to Adult Services Dr. Batchelor 3.30-4.00 Working Groups 4.00-4.30 Plenary 15
MCHAS Digital Hearing Aid Cascade Joint Training Mid Cheshire Hospital NHS Trust Countess of Chester Hospital NHS Trust East Cheshire NHS Trust Cheshire Service for Sensory Impaired Wednesday 21 st May 2003 Leighton Hospital Seminar Room Audiology Department Arrival Tea and Coffee 8.30-8.45 Start Recap of Theory Day / Feedback on Forms 8.45 9.30 Case Study Taking a Child from Start Of Process Onwards Dr.Leslie Batchelor Dr.Wendy Floate 9.30 9.45 Introduction to Workshops Chris Haigh 9.45 12.15 Workshop Coffee/Tea will be available during the morning. 12.15-1.00 Lunch 1.00-3.30 Workshop 3.30-4.00 Final Plenary and Evaluation Forms 16
Appendix 4 Course Evaluations 17
MCHAS Digital Hearing Aid Cascade Joint Training Mid Cheshire Hospital NHS Trust Countess of Chester Hospital NHS Trust East Cheshire NHS Trust Cheshire Service for Sensory Impaired DIGITAL AIDS CASCADE TRAINING - 19 TH May Name (not essential) We would really value your comments. Please circle as appropriate. 1 Usefulness of the programme: how useful do you believe this programme will be in your work life? 1 (0) 2 (3) 3 (8) 4 (14) Not very useful Quite useful Useful Very useful Comments: 2 Topic coverage of Theory Day (19th May) 1 (16) 2 (9) 3 (0) Thorough Adequate Insufficient Comments: 3 Level 1 (2) 2 (22) 3 (1) Too demanding Just right Too simple Comments: 4 Do you feel you now have a greater understand of the following: (please circle) a) Features of Digital hearing aids Yes (24) No (1) b) How to use the Health/Education Flow of Information Forms Yes (24) No (1) correctly? c) Administering feedback questionnaires? Yes (23) No (2) d) Have you been given enough information about digital aids? Yes (16) No (9) Comments: 18
5 How would you rate: a) The administrative arrangements for the day. 1 (14) 2 (9) 3 (2) 4 (0) Excellent Good Satisfactory Poor b) Course materials handouts 1 (17) 2 (7) 3 (1) 4 (0) Excellent Good Satisfactory Poor Any further comments- 19
MCHAS Digital Hearing Aid Cascade Joint Training Mid Cheshire Hospital NHS Trust Countess of Chester Hospital NHS Trust East Cheshire NHS Trust Cheshire Service for Sensory Impaired DIGITAL AIDS CASCADE TRAINING - 21 ST MAY 2003 Name (not essential) We would really value your comments. Please circle as appropriate. 1 Usefulness of the programme: how useful do you believe this programme will be in your work life? 1 (0) 2 (2) 3 (1) 4 (22) Not very useful Quite useful Useful Very useful Comments: 2 Topic coverage of Practical Workshop Day (21st May) 1 (22) 2 (3) 3 (0) Thorough Adequate Insufficient Comments: 3 Level 1 (1) 2 (24) 3 (0) Too demanding Just right Too simple Comments: 4 Do you feel you have a greater understanding of the following: (please circle) a) The process of transferring a child onto digital hearing Yes (25) No (0) aids b) Principles behind Real Ear Measurements Yes (23) No (2) c) Programming process Yes (24) No (0) d) Testing a digital hearing aid through a testbox? Yes (25) No (0) e) Balancing a radio aid system through a testbox? Yes (25) No (0) f) Have you been given enough information about digital aids? Yes (21) No (4) 20
Comments: 5 How would you rate: a) The administrative arrangements for the day. 1 (13) 2 (11) 3 (1) 4 (0) Excellent Good Satisfactory Poor b) Course materials handouts 1 (21) 2 (4) 3 (0) 4 (0) Excellent Good Satisfactory Poor Any further comments Do you have any further training issues? 21
Appendix 5 Photographs 22
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