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InPsych 2016 | Vol 38

October | Issue 5

Cover feature : Private practices into the future

Achieving sustainability, safety and good clinical governance in a multi-site model of practice

Business models at work…

Developing Minds has a team of 13 part-time psychologists employed across two locations and delivers therapy services to children, teens and their families, plus provides training programs in schools and online support via a dedicated web portal. Two part-time practice managers, an office manager and two part time receptionists make up the administrative team.

Central to the practice’s revenue are therapy sessions with funding via the Better Access initiative and the National Disability Insurance Scheme (NDIS), plus the local Primary Health Network (PHN) and private health insurance. Other sources of revenue come from the provision of training and seminars in schools, product sales (two books for children/teens/parents), supervision of psychologists outside the practice and the online portal which offers psycho-education and video resources for children, their parents and also for professionals. Having multiple sources of income supports sustainability of the practice.

Kirrilie Smout, the practice director, describes three additional elements that she considers vital to the practice’s sustainability:

  • Developing a speciality: Developing Minds provides therapy only (i.e. not learning assessment/legal reports) to a particular demographic – children and adolescents (and their families). As a result, the supports, systems, clinical rooms and materials, professional development, supervision etc. of the practice is designed to provide effective therapy to kids/teens. This narrow focus helps ensure quality services and ongoing referrals.
  • Being helpful: Developing Minds sends a free fortnightly newsletter to more than 4500 subscribers with ideas for supporting kids and teens, offers of affordable workshops to schools and the community each month, free articles on social media daily, free consultation to schools on crisis matters, responses to the media when needed and assistance for families and professionals (teachers, psychologists, doctors etc.) who work with families where possible. Kirrilie notes that following this approach for the past 15 years has been key to Developing Minds being regarded positively in the local community.
  • Prioritising the wellbeing of staff: Kirrilie reports that much of her time is spent supporting/supervising (or developing systems to support/supervise) staff and clinicians. The practice is dedicated to maintaining and improving clinicians’ wellbeing, knowledge, and skills. Kirrilie considers this approach responsible for a strong, loyal, sustainable and talented team of psychologists at the practice (only one clinician has left the practice in 15 years).

Achieving safety and good clinical governance has been one of the practice’s upmost priorities and this has been accomplished through developing a set of standardised policies and procedures, extensive communication, training and supervision systems, and valued feedback mechanisms from both staff of the practice as well as client feedback.

Kirrilie acknowledges that it has taken a substantial commitment and sustained effort to develop these standardised procedures and practices and inaugurate them across the two practice sites. Thus far, the practice has more than 50 standardised policies and procedures (from topics as diverse as Transfer Clients, Risk Assessment, Clinical Room Set-up, Initial Session Informed Consent Procedures, Sick-day Procedures, GP Letter Procedures etc.) with input sought from every member of the administrative and clinical team every month. Staff input into how the practice is run is considered vital.

The practice’s systems of communication, training and supervision are also very well developed with an extensive set of supportive structures and templates designed to help clinicians feel confident in working with families, reduce stress and any feelings of isolation, while also prioritising client outcomes and safety. Some of these structures and templates include annual clinician self-assessments, casenote self-audits, monthly supervision for all clinicians, quarterly PD meetings, monitoring of adherence to procedures, monthly staff memos, admin team meetings and a daily online web-chat available for staff to communicate with one another.

Complementing these structures and procedures is the practice’s commitment to collecting client outcome measures and feedback which provides valuable quantitative information about the efficacy of interventions, as well as overall client satisfaction with the service.

In addition to the clinical governance, sustainability and systems approaches outlined above, Kirrilie, as practice director, is also responsible for marketing, HR processes, maintaining funding models, communication and IT systems, client complaints/satisfaction, property management, and overseeing the financial and accounting aspects of the business. While challenging, Kirrilie describes it as an ongoing process of quality improvement with each day an opportunity to offer better support to families and the staff of the practice – which makes it wholly rewarding.

References

Disclaimer: Published in InPsych on October 2016. The APS aims to ensure that information published in InPsych is current and accurate at the time of publication. Changes after publication may affect the accuracy of this information. Readers are responsible for ascertaining the currency and completeness of information they rely on, which is particularly important for government initiatives, legislation or best-practice principles which are open to amendment. The information provided in InPsych does not replace obtaining appropriate professional and/or legal advice.