Research Aims: 1.According to senior management, how is ‘success’ defined and evaluated in hearing care organisations in Australia? a)What are the organisational values used to drive clinical practice and clinical change? b)What are the measures used to drive clinical practice and clinical change? c)To what extent it PCC reflected in these values and measures? 2.What short and long term effects does a PCC approach have on the measures?

1. Organisation Outcomes of Person-Centred Hearing Care
Gerard Williamab, Caitlin Barr, Ph.Dab, Carly Meyer Ph.Dbc, & Robert Cowan, Ph.Dab
a Department of Audiology & Speech Pathology, The University of Melbourne b The HEARing Cooperative Research Centre, c School of Health and Rehabilitation Sciences, The University of Queensland
Background
Person-centred care (PCC) is most simply described as a
context-specific healthcare approach that meets the individual
needs, values and beliefs of patients6,7,9.
PCC is purported to provide many benefits to a patient’s
recovery and satisfaction1,6-10.
A person-centred approach is likely to benefit hearing
rehabilitation1,6. Australian audiologists7 and patients5
prefer a person-centred approach; however, this is not
widely evident in clinical practice1,2,6.
Outside hearing care, evidence reports that successful
implementation of PCC requires cohesion between
organisational senior management, staff, and patient-family
factors3,8,10. Within hearing care, research is currently
exploring the facilitators of and barriers to implementing PCC
at the clinician level5; however, there is a gap in knowledge
regarding the current values and understanding of PCC
according to senior management in hearing care
organisations. Moreover, little is known about how PCC
impacts outcomes valued by senior management. This
research will address the aforementioned gap, to facilitate
implementation of PCC throughout hearing care clinical
practice.
Aims:
1. According to senior management, how is ‘success’ defined
and evaluated in hearing care organisations in Australia?
a) What are the organisational values used to drive clinical
practice and clinical change?
b) What are the measures used to drive clinical practice
and clinical change?
c) To what extent it PCC reflected in these values and
measures?
2. What short and long term effects does a PCC approach
have on the measures described in Aim 1 compared to
standard care?
Phase 2: Person-centred care outcomes
A mixed-methods approach will evaluate the effects of
implementing PCC on the outcomes identified in Phase 1. A
person-centred care intervention introduced by means of a
stepped-wedge RCT design will assess outcomes of new
patients across two time periods:
Short-term (3 months) & Long-term (12 months).
10 clinicians from various clinics will be recruited to provide the
care, and will receive the intervention. Approximately 150 first-
time adult hearing rehabilitation patients of these clinicians will
be invited to participate. Subsequent to each time period, 10
patients will be invited to participate in an interview to
understand their experience of hearing care. Recruited clinicians
will also be invited to be interviewed at the conclusion of the
study.
Implications:
Detailed findings of the impact of person-centred care on short
and long term outcomes that are valued by audiology
organisations should influence the provision of hearing care
services in Australia, and help reduce the clinical service gap.
Progress:
• Ethics application submitted through the University of
Melbourne Human Ethics Advisory Group.
• Recruitment and interviews of participants will follow.
creating sound value www.hearingcrc.org
References:1. Ekberg, K., Grenness, C., & Hickson, L. (2014). Addressing Patients’ Psychosocial Concerns Regarding Hearing Aids Within Audiology
Appointments for Older Adults. American Journal of Audiology, 23(September), 337–351. http://doi.org/10.1044/2014
2. Ekberg, K., Meyer, C., Scarinci, N., Grenness, C., & Hickson, L. (2015). Family member involvement in audiology appointments with older people
with hearing impairment. International Journal of Audiology, 54(2), 70–76. http://doi.org/10.3109/14992027.2014.948218
3. Helfrich, C. D., Sylling, P. W., Gale, R. C., Mohr, D. C., Stockdale, S. E., Joos, S., … Meredith, L. S. (2015). The facilitators and barriers
associated with implementation of a patient-centered medical home in VHA. Implementation Science, 11(1), 24. http://doi.org/10.1186/s13012-016-
0386-6
4. Hosford-Dunn, H., Roeser, R.J., & Valente, M. (2008). What is Practice Management? In Audiology Practice Management (pp.1-12).New York,
NY: Thieme Medical Publishers, Inc.
5. Grenness, C., Hickson, L., Laplante-Lévesque, A., & Davidson, B. (2014). Patient-centred audiological rehabilitation: Perspectives of older adults
who own hearing aids. International Journal of Audiology, 53(S1), S68–S75. http://doi.org/10.3109/14992027.2013.866280
6. Grenness, C., Hickson, L., Laplante-lévesque, A., Meyer, C., & Davidson, B. (2015). Communication Patterns in Audiologic Rehabilitation History-
Taking: Audiologists, Patients, and Their Companions. Ear & Hearing, 36, pp.191-204. http://doi.org/0196/0202/2015/362-0191/0
7. Laplante-Lévesque, A., Hickson, L., & Grenness, C. (2014). An Australian survey of audiologists’ preferences for patient-centredness.
International Journal of Audiology, 53(S1), S76–S82. http://doi.org/10.3109/14992027.2013.832418
8. Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting patient-centered care: A qualitative study of facilitators and barriers in healthcare
organizations with a reputation for improving the patient experience. International Journal for Quality in Health Care, 23(5), pp.510–515.
9. McMillan, S. S., Kendall, E., Sav, A., King, M. A., Whitty, J. A., Kelly, F., & Wheeler, A. J. (2013). Patient-Centered Approaches to Health Care: A
Systematic Review of Randomized Controlled Trials. Medical Care Research and Review, 70(6), 567–596.
http://doi.org/http://dx.doi.org/10.1177/1077558713496318
10. Rosengren, K. (2016). Person-centred care : A qualitative study on first line managers experiences on its implementation. Health Services
Management Research, pp.1-8. http://doi.org/10.1177/0951484816637748
Please contact Gerard William for further information:
gerard.william@unimelb.edu.au
Methods:
Phase 1: Organisational leaders’ views
The first aim will be addressed by qualitatively through
exploratory in-depth interviews. Approximately fifteen leaders
of hearing rehabilitation organisations will be invited to
participate through professional bodies. Findings will also
inform the metrics used to evaluate PCC outcomes in a form
relevant to hearing rehabilitation organisations.
Phase 1 Phase 2
Aim 1 2
Participants: 15 hearing rehabilitation
organisation senior
managers in Australia (do
not have to be clinicians)
Representation from:
• Various sized clinics
• Ownership model
• Funding models
200 first-time adult patients (>18 years
old) to an audiology clinic
Via
50 audiologists working in adult
rehabilitation in Australian clinics
Method Exploratory in-depth
interviews
Stepped-wedge RCT design evaluating
the outcomes of a PCC intervention.
Analysis /
Measures
Qualitative thematic
analysis
Mixed methods:
Quantitative: Questionnaires &
organisational metrics (all participants).
Qualitative: Interviews (10 patients per
time period; clinicians at the conclusion
of the study)
Timeline Collection:
Nov ‘16 –
Jan ’17
Analysis:
Jan ‘17 –
May ‘17
Collection:
Short-term
Quant: Jul - Oct ’17
Qual: Oct - Nov ‘17
Long-term
Quant: Jul ‘17-Jun ’18
Qual: Jul – Aug ‘18
Analysis:
Nov ‘17
Dec ’17- Apr’18
Jul ’18
Sep – Dec ‘18
Table 1: Summary of methods for both phases