Australian Experience with Implementing the Family Partnership Approach

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Australian Experience with Implementing the
Family Partnership Approach

• What can we learn?
• Graham Vimpani
• Hunter New England Health,
• University of Newcastle, NSW

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ORIGINS
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From Parent Advisor to Family Partnership Program
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Range of training
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Contagion effect

• Experiences of WA NSW shared through the
  National Council of Community Child Health and
  the nursing grapevine

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Survey of key informants in each state and
territory, Feb

• When was it introduced?
• How many have been trained at each level?
• What categories of professionals have been
  trained?
• Do you think the program is sustainable? In what
  agencies? Under what conditions?
• What do you see as the greatest benefits?
• What are the biggest hurdles to be overcome?
• The best things about FPT are.
• What would you like me to tell conference
  delegates?

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Roll-out of FPT in Australasia
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Progress to date.

• 60 Facilitators active -37 metro 23 rural
• 5 trainers of Facilitators
• gt82 completed courses
• 1128 professionals trained
• 4 Government departments/several not for profit
• 13 disciplines
• Metropolitan and rural/remote
• Training in SA and NSW - now in all States
• Managers courses , supervisor training, support
  staff

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Core course
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Facilitator training courses
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Disciplines of Trainees

• Community child and family and school health
  nurses
• Clinical psychologists
• Social workers, Family strength workers
• Family care workers, Child carers
• Parent educators
• Disability workers
• Indigenous health workers
• DA workers
• Youth workers
• Primary school teachers
• Midwives

• Social trainers
• Early childhood educators
• Speech pathologists, Occupational therapist,
• Physiotherapists
• Aboriginal health/liason workers
• Adoption workers
• Medical officers/Paediatricians
• Mental health workers
• Family Court counsellor
• Police
• Policy makers and managers
• Telephone helpline staff
• Remote Area Nurses
• Administrative staff
• Youth justice workers

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Departments/agencies

• Health
• Education
• Community Development/Services
• Disability Services
• NGOs
• Universities

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Additional courses

• Managers course
• Supervisors course
• Support staff course

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What have we learnt?
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History in NSW

• Word of mouth from Trevor Parry re Montreal WAIMH
  in September 2000
• Attendance at Child Youth Health Adelaide,
  March 2002
• Facilitators Course in Newcastle in October 2002
• Train the facilitators course in Wollongong in
  2003

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History in NSW

• Coincided with government commitment to universal
  home visiting for all newborns
• Two level 3 trained staff funded by Families NSW
  (Families First) to roll-out facilitator and core
  training across NSW in 2004 -2005
• Major Area Health Services Reorganisation July
  2004 - January 2005 impeded roll-out
• Perceived lack of central support due to other
  priorities
• Change in departmental responsibility for whole
  of government early intervention strategy

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History in NSW Key Issues

• Inability of project staff to meet the contract
  education target numbers
• Difficulty of engaging and including mental
  health staff and staff from Aboriginal and Torres
  Islander and Culturally and Linguistically
  Diverse backgrounds.
• Uptake of the programs by midwives has been
  limited.
• Maintaining the fidelity of the Family
  Partnership course once the project ceases will
  be problematic.
• Ongoing project sustainability once the education
  component of this project ceases at the end of
  April 2006.
• An increase in the number of state-wide
  facilitators who are able to provide the
  Facilitator workshops are required these
  facilitators need to come from a variety of
  professional backgrounds.
• There is potential to expand the project into a
  user pay model for other government agencies if
  seed funding is provided.

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History in NSW

• Coincided with government commitment to universal
  home visiting for all newborns
• Two level 3 trained staff funded by Families NSW
  (Families First) to roll-out facilitator and core
  training across NSW in 2004 -2005
• Major Area Health Services Reorganisation July
  2004 - January 2005 impeded roll-out
• Perceived lack of central support due to other
  priorities
• Change in departmental responsibility for whole
  of government early intervention strategy

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Issues of sustainability

• 5 jurisdictions indicated no guarantee of
  sustainability
• Lack of secure funding
• Insufficient numbers of trained facilitators
• Staff move on and no longer able to facilitate
• No backfill for facilitators or participants
  major problem for acute service staff especially
  nurses
• Lack of administrative support to organise
  training
• Lack of central agency commitment reflected by
  non-inclusion in KPIs
• Regarded as desirable core training for some
  professional groups
• Not included in professional curricula (or a
  half-day nod _at_ FPT)
• Integral part of some training calendars

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A Response from a child family nursing training
organisation

• XXX covers the basics of family partnership
  training in the first on-Campus week.
• Currently (a facilitator trainer) does a 3 hour
  session outlining the main points and is doing
  some role play with the students.
• XXX is currently rewriting 2 of the distance
  education packages and have included discussion
  on the principles of family partnership in them.
  The principles are also integrated in the
  discussion throughout the Package.

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Major benefits identified

• Crucial underpinning for new child and family
  nursing service model with extended role of home
  visiting
• Partnership with strong client focus recognises
  client strengths
• Promotes client empowerment and capacity building
• Not expert driven
• Self-reflective practice the models concept,
  helping process, ways of engaging with others
• Promotes better (more honest and trusting)
  relationships
• Between staff and clients
• Between staff of different disciplines
• Between agencies
• Diminishes dominance of medical model
• Emergence of common language across nursing and
  allied health disciplines
• Networking and interagency collaboration

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Major hurdles

• Funding
• Release time and backfill
• Lack of facilitators
• Lack of time in busy clinical situation to
  implement learnings
• Overcoming resistance of some professionals who
  dont want to change
• Cross-agency engagement
• Developing supervision framework
• Avoid it being seen as the next big thing
• Applicability to culturally diverse communities
  Maori, Pacifica, Aboriginal

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Best thing

• Networking interagency collaboration
• Facilitating change in paradigm of service
  delivery
• Away from expert model
• Emphasising importance of relationships with
  other staff, managers, clients

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Best thingQuote from Tasmania

• Working with people from different areas and
  learning from each other of their experiences in
  truly working in partnership with families. This
  has been very powerful and there have been a
  number of examples of how this has really changed
  the approach of how services work with the family
  and of how the family have moved towards working
  with services rather than avoiding them.

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Best thingQuote from Victoria

• It is interesting to observe the parallel
  process that happens when staff reflect on their
  work with families and how that often mirrors the
  issue seen between child and parent. When staff
  are stuck in their work with families they are
  often working alongside a parent who is stuck in
  the way they are relating to the child.

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What would you like to tell Conference delegates

• Hi Hilton
• A big personal hello to Hilton

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What would you like to tell Conference delegates

• Emphasises the importance of the how in helping
• Invaluable extension of my skills
• A very concerted effort is needed to bring about
  change in an entrenched bureaucracy
• Addressing the issue of ongoing supervision
  provision which often proves difficult
• Review final sessions of core training could
  these become the basis for a more extended course

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What would you like to tell Conference delegates

• Whenever I get to this stage in training I feel
  as though too much is assumed to be clear and
  self-evident. Instead I feel that this section
  is comparatively underdescribed and lacking in
  robustness

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FUTURE DIRECTIONS
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Other opportunities

• Opportunities for research evaluation
• Most participants very positive and talk amongst
  colleagues with enthusiasm
• Changes in outcomes?
• Curriculum development in RACP
• Acute sector
• Backfill
• Time to apply the model in practice
• Nurse-Family Partnership in Australian Indigenous
  communities

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Extract from RACP curriculum

• Demonstrates the ability to build rapport with
  the patient.
• Demonstrates the ability to communicate
  effectively with adolescents.
• Demonstrates active listening by
• making appropriate eye-contact
• asking open-ended questions
• attending to verbal and non-verbal cues
• clarifying information provided by patient
• clarifying patients understanding of
  information delivered.
• Gives feedback to patient in an open and honest
  way.
• Uses body language appropriately.
• Uses various questioning techniques to elicit
  information from the patient.

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Extract from RACP curriculum
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Issues for doctors

• Time required for training
• Time to apply the model in a busy practice
• Humility

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Other opportunities

• Opportunities for research evaluation
• Most participants very positive and talk amongst
  colleagues with enthusiasm
• Changes in outcomes?
• Curriculum development in RACP
• Acute sector
• Backfill
• Time to apply the model in practice
• Nurse-Family Partnership in Australian Indigenous
  communities

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AUSTRALIAN BOARD

• April 2006
• Integrity
• Standards
• Sustainability
• Support
• Research

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WEBSITE

• www.fpta.org.au

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LETS JUST DO IT!!