Background
Speech pathology (SP) services provide swallowing and communication intervention to people with head and neck cancer (HNC) across the continuum of care. However, difficulties exist with access and delivery of services in rural areas. The study aim was to identify actionable goals for SP change, utilizing a concept mapping approach.
Methods
Eleven SP staff from two regional/remote services completed the concept mapping process. Multivariate analysis and multidimensional scaling were used to develop a final set of prioritized goals for change.
Results
Between the two participating health services, 30 actionable goals were identified within the “green‐zone” on the go‐zone graph of importance and changeability. Among the most highly rated areas for change was the need to deliver and receive more support for training, mentoring, and supervision to consolidate skills.
Conclusions
This methodology enabled identification of prioritized, actionable changes to improve SP services for people with HNC living in regional/remote areas.
Objective: Individuals with head and neck cancer residing in rural areas face numerous challenges accessing post-acute rehabilitation services, including speech pathology services. In order to inform future service enhancements, the key issues impacting access to, and the provision of, speech pathology head and neck cancer services in rural areas was explored through the perspectives of patients, carers, speech pathology clinicians and service managers. Setting: A rural health referral network in Queensland consisting of tertiary, regional and remote hospitals.Participants: Twenty-eight participants, including 12 speech pathology staff/ managers and 16 consumers (people with head and neck cancer/carers).Design: Qualitative methodology using semi-structured interviews was analysed using content analysis.
Results: Two themes were identified from the consumer group including (a) navigating health services for head and neck cancer management and (b) burden of accessing head and neck cancer care. Speech pathology staff/managers interviews raised 3 themes: (a) transfer of care and access to local services, (b) workforce and workload and (c) travelling impacts the service our patients can receive. An integrative theme across both groups highlighted the perceived disparity in health care access that existed for people with head and neck cancer in rural areas. How to cite this article: Foley J, Nund RL, Ward EC, et al. Clinician and consumer perceptions of head and neck cancer services in rural areas: Implications for speech pathology service delivery.
Background: People with head and neck cancer (HNC) have complex health care needs; however, limited evidence exists regarding the nature or patterns of service access and use. This study explored the post-discharge health care needs and experiences of individuals with HNC from metropolitan and rural areas. Methods: Health care appointments and services accessed by people with HNC were collated for 6-month post-treatment. Data analysis of the whole cohort examined patterns of access while journey mapping integrated participants' experiences of recovery.Results: The 6-month service access journey was mapped for 11 people. Rural participants attended a significantly greater number of appointments (p = 0.012), higher canceled/missed appointments (p = 0.013), and saw more professionals (p = 0.007). Rural participants reported higher stress and burden due to service access barriers and unmet needs.
Objective To utilise a concept mapping process to identify key opportunities for electronic medical record (EMR) optimisation for allied health professionals (AHPs). Methods A total of 26 participants (allied health managers, clinicians and healthcare consumers) completed the concept mapping process, which included generating statements, and then subsequently sorting all statements into groups, and also ranking each statement for importance and changeability (0 = not important/changeable, 4 extremely important/changeable). Multivariate analysis and multidimensional scaling were then used to identify core priorities for digital optimisation. Results Participants generated 98 discrete statements that were grouped into 13 conceptual clusters. Of these, 36 statements were subsequently determined to fall within the ‘green zone’ on the Go-Zone plot of importance and changeability (changeability ≥2.44, importance ≥2.79), and formed the set of key optimisation priorities. Clusters with the most items in the Go-Zone plot were ‘training and business rules’ and ‘service statistics.’ Conclusion Concept mapping facilitated identification of 36 key optimisation priorities considered both changeable and important to assist EMR optimisation for AHPs. Addressing these priorities requires action related to end-user skills and training, EMR system capacity, and streamlining of governance and collaboration for the optimisation process.
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