Development of the Translating Allied Health Knowledge (TAHK) Framework

Hitch, Danielle; Pépin, Geneviève; Lhuede, Kate; Rowan, Sue; Giles, Susan

doi:10.15171/ijhpm.2019.23

Cited by 12 publications

(13 citation statements)

References 71 publications

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“…Medical staff (and nursing staff) were gatekeepers for this service, as they triaged and determined whether appropriate patients were referred for assessment and treatment. This is a common feature of the allied health practice context, and demands multidisciplinary collaboration which adds to the complexity of implementation of every innovation (30). The ndings of this study indicated these relationships were successfully negotiated during this implementation process.…”

Section: Discussionmentioning

confidence: 70%

Implementing specialized vestibular physiotherapy in an emergency department: A process evaluation

Lloyd

Luscombe

et al. 2021

Preprint

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Background:Dizziness and vertigo-like symptoms, often caused by common peripheral vestibular disorders such as Benign Paroxysmal Positional Vertigo (BPPV), may have a significant detrimental impact on function and quality of life. The impact of these symptoms often result in Emergency Department (ED) presentations. Evidence based clinical practice guidelines strongly recommend the use of physical assessment and treatment maneuvers for the assessment, diagnosis and treatment of these symptoms. The aim of this study was to evaluate the process of implementing specialized vestibular physiotherapy in an emergency department, from the clinician perspective. Methods:This implementation study utilized a retrospective mixed methods process evaluation to understand how specialized vestibular physiotherapy operated in an Australian emergency department. The PARiHS Framework was embedded within the methodology and analytical approach of the study, to ensure a comprehensive approach which was closely aligned to implementation science. Nine clinicians retrospectively completed the Organizational Readiness for Change Assessment (ORCA), Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM). Seven clinicians also participate in a focus group or interview. Results: A range of barriers and facilitators to the implementation process were identified by participants, some of which spanned multiple domains of the PARiHS framework. Relationships with service leaders, champions and medical staff were found to be a key facilitator to implementation, along with a generally held perception that specialized vestibular physiotherapy was acceptable and feasible. The main barrier identified was a lack of capacity to deliver and support this innovation, both within the physiotherapy workforce and the broader multidisciplinary team. Conclusions: This study demonstrates the process of implementation of a specialized vestibular physiotherapy team in an ED setting was generally well received by clinicians, but also involved some challenges and barriers. Services looking to implement specialized vestibular physiotherapy in the ED may refer to the recommendations arising from the findings of this study to guide their approach to innovation.

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Section: Discussionmentioning

confidence: 70%

Implementing specialized vestibular physiotherapy in an emergency department: A process evaluation

Lloyd

Luscombe

et al. 2021

Preprint

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“…The shift in qualitative data to 'external' sources of support in the second survey may indicate that the strategy was meeting needs more effectively at the organizational level, but could not meet all of The multidimensional workplace strategy implemented in this study directly addressed several of the determinants known to increase the effectiveness of allied health knowledge translation (49). The strategy was aligned with organizational systems (such as supervision) which helped to embed it into practice, and leadership structures at multiple levels of the organization were utilized to drive and maintain momentum, particularly in regards to cultural changes.…”

Section: Discussionmentioning

confidence: 92%

Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.

Apostol

Cranwell

Hitch

2020

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Background: The term ‘’life limiting conditions’ refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for two years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: 103 occupational therapists responded (n=55 pre, n=48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.

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“…The focus on skin and wound care, and nutrition found in the literature review as not as prominent in the participants perceptions, but were mentioned in passing. Given the influence of contextual factors on implementation in healthcare (44), some variation in focus and priority is expected between healthcare organisations and systems, but does pose a challenge to the development of generalised models of care. Many examples of multidisciplinary approaches to the care of people with obesity are available in the literature (9,26-28), although few have been evaluated for their ability to enable patients to receive a personalized package of care that meets their specific constellation of needs.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of clinical leaders and managers of inpatients with obesity in an Australian public health service

Qvist¹,

Pazsa²,

Hitch³

2021

J Hosp Manag Health Policy

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Background: In 2014-15, 63.4% of Australian adults were overweight or obese, with 25% categorized as obese. Internationally, people with obesity are reported to experience inadequate quality of care, increased length of stay, more adverse events and higher costs of care. There are unique challenges associated with ensuring this cohort is provided with safe care which promotes their personal dignity. The aim of this study was to describe the experience of clinical leaders and managers of care provision to people with obesity, during inpatient admissions to an Australian public health service.Methods: A purposive, convenience sampling method was utilised, resulting in the recruitment of 17 participants. Data was collected via semi-structured interviews in the workplace, which were all digitally recorded for verbatim transcription. All data was subjected to thematic analysis, with identified codes reorganised into overall themes.Results: Five overarching themes were identified, four of which are discussed in this publication. The main themes and subthemes were (I) resource allocation (incorporating inequality, economic resources, human resources and physical resources); (II) service context (incorporating understanding 'bariatric', physical/ built environment, staff knowledge and skills, and organisational culture; (III) care transitions (incorporating transitions in care, communication and organisational processes; and recommendations for best care for people with obesity. Conclusions:The experience and perceptions of participants reflect the issues they prioritised in their respective roles, and confirm that providing care for people with obesity has significant policy and practice implications. These issues cannot be considered in isolation, with significant overlap and interdependence was evident. Participants also described the positive outcomes and progress which could be achieved when organisations take direct action to improve the care they provide to people with obesity.

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Development of the Translating Allied Health Knowledge (TAHK) Framework

Cited by 12 publications

References 71 publications

Implementing specialized vestibular physiotherapy in an emergency department: A process evaluation

Implementing specialized vestibular physiotherapy in an emergency department: A process evaluation

Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.

Perceptions of clinical leaders and managers of inpatients with obesity in an Australian public health service

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