With the driving goal to present proactive optometric and therapy solutions to improve patient life experiences, the Bullseye Optometry and Sensory Clinic in Perth, Western Australia, has become a successful model for holistic patient care.
The concept came about when, in the midst of COVID-19 lockdowns, then Optometry Australia National President, Darrell Baker, and his wife, Christine, decided to transform their existing optometry business.
Inspired by Optometry Australia’s 2040 project, which foresees a future where optometrists work together with other health care providers for an integrated approach to patient care, the Bullseye Optometry and Sensory Clinic has taken a number of allied health practitioners under its expanding wing.
The positive benefits of the integrated clinic are only just starting to show, after a year or more of refining and creating the team and processes
Christine Baker (left) with Sensory Clinic receptionist, Nicola Sieg.
The practices, situated in the Perth suburbs of Leederville and Leeming, are a one-stop- shop for paediatric, developmental, neurological, speech, vision, and occupational therapy services.
Both practices have a sensory clinic, separate from the optometry clinic, with rooms dedicated to fine and gross motor skills, and vision therapy, as well as an instrument room which houses the RightEye instrument – for binocular vision testing – and a virtual reality space.
When mivision first spoke to Christine Baker in 2021, she and her husband’s original BullCreek Optometry and Eyes on Oxford practices had been forced to operate on a reduced scale due to the pandemic.
“We looked at the situation and decided that, although there was nothing we could do to change COVID, somewhere in there we could find an opportunity for our business,” said Ms Baker.
“The disruption triggered a review of our strategic planning, and we looked for opportunities to broaden and protect our revenue stream by offering an array of services, some of which can be offered via telehealth and/or funded by the National Disability Insurance Scheme (NDIS), which would enable us to operate a more sustainable business.”
The goal back then, as Ms Baker explained, was to have a clinic in north and south Perth. Fast-forward to late 2022 and both clinics, situated either side of the Swan River, are now up and running.
But this wasn’t achieved without a considerable shake-up of the existing routine.
THE STAFF
“The first thing we did was work on strengthening staff communication and training, both clinical and operational,” said Ms Baker. “We knew we had to bring everyone together, keep them connected and feeling as positive as possible.”
To achieve this, staff training sessions were initiated where, every Tuesday, the day started out with a whole-team meeting, followed by a break-down of clinical, dispensing, therapy and admin groups. The team quickly identified the importance of developing a streamlined approach to patient care, and the business model, to ensure a successful transition.
“On the whole, the staff have adapted well to the new model, but it was not without its challenges, and one of the critical parts of the adoption of the model was the development of a formal internal inter-practitioner referral process,” said Ms Baker.
Virtual reality for visual therapy.
This included the redevelopment of questions asked of new patients and the patient/ parent rating system, which now provides optometrists with a user-friendly process for facilitating referrals to occupational, vision or speech therapists. To ensure the optometrists could see the value of these therapies, they were also provided with active and positive case histories of patients who had moved from the optometry clinic into therapy.
“Also important were professional staff sessions where the therapists and optometrists could educate each other, so the allied professions could understand each field more comprehensively. Our vision therapist is a former optical dispenser, as is one of our occupational therapists. We have another former optical dispenser who is now studying occupational therapy on a part-time basis,” said Ms Baker.
Although there remains a heavy focus on optometry – 55% of the 26 staff members are optometrists – there is growing strength in the other fields – 10% of staff are in vision therapy, 10% in occupational therapy, 5% in speech therapy, and the remaining 15% in administration.
All staff are either employed on a full or part-time basis to provide job security, as well as employment benefits.
AN INTEGRATED APPROACH
Ms Baker says with the optometrists excited to work alongside allied health professionals for the benefit of the patients, and their own learning, the new model is now coming to fruition.
“The positive benefits of the integrated clinic are only just starting to show, after a year or more of refining and creating the team and processes.
“We have all recognised that the study of optometry, just like the study of any other allied health area, is confined to that profession, for good reason, but as optometrists, we now have a far greater understanding of the growth, emotional, sensory processing, neurological and developmental factors that shape how well children and adults see, learn, and function.
“It is especially rewarding to be able to enhance the benefits of vision correction and/ or the treatment of binocular vision disorders with the complementary therapies that our team can offer in one location.”
By combining these disciplines under one roof, the Bullseye team has developed a greater understanding of how children’s and adults’ vision and oculomotor issues do not exist in isolation, but rather are combined with, or caused by, other related sensory or motor challenges.
“This knowledge has allowed us to think more broadly about how we will comprehensively service patients by actively pursuing the aspirational model for optometry, as defined in the Optometry Australia 2040 project,” Ms Baker commented.
After over a year in the making, the Bullseye Optometry and Sensory Clinic has just received NDIS registration, which will provide a significant opportunity for patients with NDIS support to benefit from the clinic’s vision-led sensory and therapy offerings.
Beyond this, the Bullseye Optometry and Sensory Clinic also conducts professional development sessions for school teachers, and allied health professionals in the occupational therapy, physiotherapy and neurological services.
THE PATIENT EXPERIENCE
Patients who visit the new practices are welcomed into a spacious, well-lit clinic. The individual rooms are a good balance of stimulation, without being too overwhelming for children with sensory issues. In the Leeming practice, there is a large room set up for patients with disabilities, where the optometry consulting chair moves out of the way to accommodate wheelchairs, and the refraction unit and slit lamp are positioned on tables, designed for easy use with all patients.
The child-friendly nature of the clinic is evident from the street front.
Best highlighting the benefits of the integrated care model is the support provided for the paediatric patient base. Children with learning difficulties, often manifesting as emotional, processing, or spectrum disorder challenges, are traditionally taken by their parents to separate practitioners at various locations without any integration of complementary therapies and services.
These patients are often identified when referred to the Bullseye Optometry and Sensory Clinic for a binocular vision assessment by their teacher.
“We can now approach the support of these kids as a team, formulating a flexible and collaborative plan put together in conference. This is invaluable as these kids require flexible, complementary therapies to assist the related processing and sensory issues,” says Ms Baker.
“The parents immediately see how much easier it might be for them, in turn, to support their kids, as they don’t have to try and formulate a strategy on their own. It’s important to take into account what the goals of the parent, and the child might be, as families have varying capacity to engage in, and sustain therapies.”
Ms Baker estimates that 10–15% of children access more than one service. In one month, between the two locations, the seven optometrists see approximately 400 children, of which 40 are seen by the therapists.
“We also have a very small number of adult neurological patients who might access some form of therapy too, and we are building on this,” she said.
A POSITIVE RESPONSE
For herself and her husband, Ms Baker said the integrated model has “deepened our knowledge and understanding of how we learn, thrive and participate in life”. A sentiment that rings true for many involved – from staff to patients, parents, and referrers.
In fact, to the team’s credit, the general response has been overwhelmingly positive. The community immediately engaged with the concept that patients can access multidisciplinary services from an integrated team in one location.
“It’s possible that externally, some allied health practitioners in our collective fields might see this model as too progressive or broad in scope, but we haven’t encountered any external concerns, only support,” said Ms Baker.
FUTURE AMBITIONS
With the vision of further expansion, Mr and Ms Baker have plans to incorporate educational psychology into their offering, and to potentially induct a tutor into their team. As well as this, they are looking at ways to enhance therapy for vision defects caused by brain injury, stroke, and neurological disease.
“Our mindset was changed by COVID-19 and I think we’re not alone in that – health professionals are starting to think differently about how they do business and consumers are also thinking differently about how they seek out health services. I’m looking forward to seeing how the clinic develops and to helping other practitioners adapt the same model,” Ms Baker concluded.
