Objectives: To establish an organisational wide consumer informed approach to implementing the NDIS High Intensity Support Skills Descriptors (HISS) which supports the delivery of the Severe Dysphagia Management Practice Standards for individuals with complex support needs. Methods: Our methods involved a multidisciplinary and interprofessional cross functional collaboration to co-develop and implement an organisational wide innovative care pathway to address the new HISS practice standards. Professional collaboration was sought from subject matter experts sourced internally within Therapy Services, Clinical Health Leads, Community Services, Quality Governance, Learning & Development and Information Communication Technology. We developed a severe dysphagia assessment criteria, process and tools based on latest evidence based practice and clinical practice points combined with a novel approach to delivering individualised mealtime management training for customers deemed at highest risk. Consumer consultation into the development phase of this approach was sought, to ensure it was person centred and practical in its application for the customers directly engaging and participating in the service delivery of our care pathway. Our customer representative had complex communication needs and met the eligibility criteria for HISS. Results: A recent NDIS audit of our severe dysphagia management approach demonstrated compliance with all aspects of implementing the standards, with no minor or major recommendations made for organisational wide improvement. Pre and post training measures completed with support staff (and customers where possible), indicated an improvement in satisfaction and performance scores with the translation of the HISS training component into practice. Conclusion: Our approach is leading the sector in the innovative application of HISS. This is helping to shape and improve outcomes for our customers who have the highest support needs and are most at risk of adverse health outcomes occurring. Our approach could be replicated by other organisations with the assurance of high quality outcomes for NDIS participants.

Key take away messages from this presentation include:
1. Understanding how the NDIS Practice Standards apply to a clinical population with severe dysphagia;
2. Sharing knowledge of an organisational wide innovative approach to improving safety outcomes for customers with severe dysphagia;
3. How individualised mealtime management training may be delivered differently.