Ms Emma Barbagallo1
1BERT – Metro North Health, Brisbane, Australia
Biography:
Emma is a Certified Practicing Speech Pathologist with extensive experience across diverse clinical settings, including tertiary hospitals, community services, and NDIS environments. She has worked in metropolitan, regional, and rural areas, as well as internationally in the United Kingdom. Specialising in supporting individuals with complex communication needs, Emma has a keen interest in the intersection of behaviour and communication. As an advanced speech pathologist with the pioneering Behavioural Escalation Response Team (BERT), she is dedicated to advancing the understanding of supported decision-making and improving outcomes for those with complex communication support needs.
Abstract:
Supported decision-making (SDM) has been well recognised across several settings as a gold-standard tool which can promote choice and control for people with a cognitive or neurodevelopmental disability. Unfortunately, this is often not viewed as a key role for patient facing staff within hospital health services, due to attitudinal and communication barriers for people with disability in decision-making about the provision of health services. Some individuals with a disability may have Guardianship or Administration orders which authorise another person to make decisions on their behalf, this is called substituted decision-making.
The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability 2023 report outlines the impact that substituted decision-making can have on a person’s life, including on their freedoms, privacy, right to speak out about their experiences, and connection with family, friends and community.
The study utilises a mixed-methods approach, combining a quantitative survey and qualitative interviews with Metro North Health clinical staff who interact with adult patients with disabilities. By analysing the knowledge and attitudes of health staff on the use of supported decision-making for people with disabilities, we have improved understanding of the current barriers healthcare professionals face in implementing SDM, including attitudinal and communication challenges. By increasing health worker capacity to enable participation of patients with disability to be involved in decisions related to their health, there can be a positive impact on a patient’s quality of life, freedoms and right to make choices.