Measurement and quality improvement

An effective quality improvement system is operating across the organisation.

Incorporate consideration of intellectual disability into the health service organisation’s safety and quality systems

Involving people with intellectual disability, their families and supporters in the development, implementation, monitoring and evaluation of healthcare delivery can increase the visibility of people with intellectual disability at all levels of the health service organisation.^2,3 

Strategies to increase the visibility of people with intellectual disability include: 

• Adjusting consumer feedback systems and patient satisfaction surveys to accommodate people with intellectual disability
• Exploring models of care that support flexible approaches, for example a clinical pathway for access to examination or investigation under anaesthesia, or the Victorian Department of Health Disability Liaison Officer program. Disability Liaison Officers create a link between the person and the health system to facilitate reasonable adjustments 
• Developing and making public the clinical care pathways available for people with intellectual disability in core elements of the health services system
• Identifying the risks of psychological and emotional trauma in the healthcare setting and how reasonable adjustments may address these risks 
• Increasing workforce awareness of how to provide health care to people who use non-verbal communication
• Including consumer representatives and/or specialist clinicians as part of the organisation’s safety and quality systems – for example, in the review of a critical incident in a health service involving a person with intellectual disability.

Audit systems and processes to identify where there may be risks for people with intellectual disability

Conduct a review of existing systems, staff knowledge and skills to identify risks and gaps in safety and quality systems for people with intellectual disability. This can lead into developing and implementing an action plan to improve healthcare outcomes for people with intellectual disability. 

This review could include an audit of staff knowledge, confidence and attitudes in the provision of health care to people with intellectual disability. For example, the review could ask how safe and high-quality health care is provided to a person who cannot communicate verbally or who needs support to understand information? 

• National Roadmap for Improving the Health of People with Intellectual Disability – A Primary Care Enhancement Program is being piloted in four Primary Health Networks (PHNs) over four years, with a view to national rollout across all PHNs. 
• Queensland’s Metro South Health Equity and Access Team is working to improve health services for people with disability, and has developed initiatives and tools for use in an acute care setting.