SILVER LININGS AND NEW DISCOVERIES Through the process of tele-AAC program planning and im- plementation, we discovered many unanticipated opportunities and quality improvement measures for our AAC program. The necessity to relook at all of our existing program processes, ma- terials, and services to meet the needs of our clients and families over the telehealth platform, resulted in overall quality improve- ment.v
TELECONSULTATIONS AND SYNCHRONOUS FOLLOW-UP
We initiated the use of a teleconsultation with the family and caregivers of participating AACcelerate clients two weeks prior to the beginning of the program in order to check in about the families’ current status. This includes the location of the thera- peutic services, and the current level of comfort with videocon- ferencing and AAC technology. We also used this consultation to check in about goal areas of interest in conjunction with the AACcelerate intake paperwork. During this, we discussed expec- tations for family involvement, as a high level of involvement of family support is indicative of success outcomes. Additionally, the opportunity to see the client communicating by video prior to their initial evaluation allows for more guided clinical deci- sion making related to equipment and treatment planning. We will be continuing to utilize teleconsultation after the return to in-person services. We also plan to utilize the telehealth plat- form to ensure increased continuity of care post-program, es- pecially for those clients and families who live in more remote geographic areas. CONTINUITY OF CARE Initiation of the use of the telehealth platform in the AACcel- erate program has already had a positive impact on continuity of care before, during, and after program participation. Virtual consultations have improved not only the processes of screen- ing for program fit and equipment planning as described above, but have also allowed for ease and efficiency of access to con- sultations for both new and existing CI clients. Prior to the use of this platform, new families completed a quick phone consul- tation and then scheduled a free consultation in the clinic. This sometimes took weeks to schedule, and the consultation was frequently with an intake coordinator only, as the AACcelerate program directors’ schedules did not always allow for them to be present in the clinics where the consultations took place. The use of telehealth has allowed the program directors to almost always be at least virtually present in a consultation. The capa- bilities of telehealth have also helped to increase the number of appropriate program referrals from CI therapists who are seeing clients for 1:1 SLP or OT services. The program directors are now able to easily complete virtual consultations with both thera- pists and caregivers during a scheduled telehealth treatment session. Previously, this was challenging due to scheduling and
program will be saved on a flash drive as a .pdf file along with embedded videos, and mailed to families upon program com- pletion. We emphasize celebration of both small victories and long term achievements in the AACcelerate program, so both clients and therapists look forward to the program completion party on the last day of AACcelerate. To maintain this important part of our program on the telehealth platform we made plans to celebrate virtually, sending favorite treats and decorations to our clients and giving them the option to invite other family and friends to celebrate their achievements virtually. TRAINING: THERAPIST AND CAREGIVER COMPETENCY In order to ensure the clinical success of the virtual AACcel- erate program we needed to ensure that both caregivers and treating clinicians knew how to utilize the telehealth platform. All therapists at our company were provided with training on the utilization of the platform when we began our broader tran- sition to telehealth services. Throughout the months leading up to summer, those treating in the program were also provided with additional specialized training in tele-AAC. Caregivers were also provided with video tutorials about the use of the Zoom telehealth platform, and the first telehealth session was spent learning how to utilize features such as screen share, annotate, and microphone and video functions as appropriate. Addition- ally, in order to ensure baseline caregiver competencies regard- ing AAC equipment to be utilized in the program, we included written instructions and access to how-to equipment videos pri- or to the start of the program. Assistive technology equipment boxes being packed for delivery prior to the beginning of AACcelerate to allow for virtual at home trials during the program.
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