Understanding Groups in Audiology

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Action On Groups
Heather Pitchford Relationship Manager David
Ormerod Hearing Centres
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In the next 30 minutes

• Whose idea was it anyway?

• Why groups?

• Early findings

• and to go where no man has gone before

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Back to the NHS Plan
Provides a strategy for Health Reforms over the
next 10 years
Sets out measures to put people directly at the
heart of the NHS
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Hidden behind this..
Government driven initiatives for high volume
specialties with access issues

• Brief to reduce waiting times and improve access
  to patients

To ensure that services are focused around the
needs of the individual patient
To identify, share and sustain good clinical and
organisational practice throughout each specialty
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The Service we would want for ourselves, and our
family and friends
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Whose idea was it anyway?

• Group clinics have been running in audiology
  services for many years

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Staff survey all Heads of Audiology in England
Confidentiality will be compromised
There is not enough space to see people in
groups
Patients wont be able to ask questions in a
group
Patients cant hear in a group situation
Patients dont like being seen in groups
152 questionnaires returned out of 257 59
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3 Reasons to try group clinics

• Literature tells us that group clinics should
  work
• A facilitative approach in a group setting is
  more likely to achieve a situation where the
  group members have greater motivation and
  commitment Bee et al 1999

Facilitation Skills F and R Bee 1999 Cromwell
Press
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Potential advantages include

• Promotes discussion and questioning
• Encourages people to control their own learning
• Promotes change in individual attitudes and
  motivation
• Improves confidence and self esteem
• Elwyn et al 2001

A guide to small group work in healthcare
management G Elwyn et al 2001 Radcliffe Medical
Press
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• There is no published literature to suggest that
  patients do not like to be seen in groups

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• There was a chance that waiting times could be
  reduced without compromise to the quality of
  service provided

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Willing volunteersCrewe
Gloucester Kath Lewis
Anne-Marie Boisriveau-Mitchell
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Early findings

• Professionals thought it was a dreadful idea
• What did the patients think?

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Staff survey comment
Patient results
There is not enough space to see people in
groups Confidentiality will be compromised
Patients wont be able to ask questions in a
group Patients cant hear in a group
situation Patients dont like being seen in
groups
Very true - need to think of alternative venues
Patients were given the choice to be seen in a
group

98 of patients said they were able to ask
questions
100 of patients said they could hear in the
group

NO patients said they were uncomfortable in a
group

203 returns from 271 questionnaires 75
return rate
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Why did people like the group clinics?

• I felt I was not alone with my hearing problem
• Being in a group saves on embarrassment - I
  enjoyed it very much
• It was helpful to hear other peoples questions

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But do they wear their hearing aids?
Group Individual
Totally or very satisfied 60
43 Totally or very dissatisfied 6
18 Totally or very satisfied 88
79 Totally or very dissatisfied 1
6

• How satisfied are you with your hearing aid?
• How satisfied were you with the service you
  received?

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• Nowadays do you usually use your hearing aid?
• All or some of the time Right ear...
• Groups Individual
• 54 55
• Not at all Right ear
• 2 6

Groups 179 returned out of 257 questionnaires
69 Individual 146 returned out of 200
questionnaires 73
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Glasgow Hearing Aid Benefit Profile

• Watch this space
• Initial evaluation suggests that results are
  favourable when compared to Stuart Gatehouse
  results for people fitted with analogue hearing
  aids in one to one consultations

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Staff Focus Groups

• I am a total convert

The atmosphere is good
I feel that patients really benefit
They (the patients) did the troubleshooting
themselves
I felt our job was made easier
Eighteen staff attended focus groups
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Does it cost more to run group clinics?

• Extra costs may be associated with a need for
  extra training
• Value for money

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In Conclusion

• Next phase
• - a digital revolution underway in Crewe
• Impact on waiting times
• quality vs quantity