Dysphagia screening using an allied health assistant delegation model: service considerations for implementation

Schwarz, Maria; Ward, Elizabeth C.; Cornwell, Petrea; Coccetti, Anne

doi:10.1080/09638288.2020.1800109

Cited by 5 publications

(2 citation statements)

References 56 publications

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“…Finally, as noted at the beginning of the methods section, a "framework synthesis" approach will be applied to address the fourth study question, on the factors influencing the use or implementation of telehealth approaches. This meta-theoretical framework, which provides a repository of standardized implementation-related constructs and is focused on its determinants, has been applied extensively in the health care field, inclusively for synthesising data on rehabilitation topics [31,[60][61][62]. The CFIR comprises 39 constructs organized across five major domains, all of which interact to influence implementation and implementation effectiveness [63].…”

Section: Data Synthesismentioning

confidence: 99%

Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis

Jesus

Kamalakannan

Bhattacharjya

et al. 2023

WOR

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BACKGROUND: Telehealth approaches are promising for the delivery of rehabilitation services but may be under-used or under-implemented. OBJECTIVE: To report a review protocol to identify how much telerehabilitation (telehealth approaches to the delivery of rehabilitation services) have been used and implemented, and which factors have affected such implementation. METHODS: A mixed-methods systematic review with a framework synthesis. Six databases for the scientific literature will be searched, complemented by snowballing searches and additional references coming from key informants (i.e., rehabilitation researchers from a networking group in health services research). We will include English-language empirical research examining the routine use or implementation of telehealth technologies in physical rehabilitation services or by physical rehabilitation professionals from a range of study designs, excepting case studies, case reports, and qualitative studies with n < 5. Two independent reviewers will perform the screenings, quality appraisals (using the Joanna Briggs Institutes’ appraisal checklists), and the data extractions. The Consolidated Framework for Implementation Research will be used to synthesize the data on the enablers and barriers of the implementation of telerehabilitation approaches. All the authors will be involved at this synthesis, and key informants will provide feedback. CONCLUSION: The results can inform further implementation endeavours.

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Section: Data Synthesismentioning

confidence: 99%

Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis

Jesus

Kamalakannan

Bhattacharjya

et al. 2023

WOR

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“…The CFIR provides a uniform language and structure, in a flexible format, to implement and evaluate healthcare interventions across multiple contexts (Damschroder, 2020). Speech and language therapy services have used CFIR to evaluate the various implementation projects including a complex multidisciplinary head and neck cancer model of care (Messing et al., 2019), a delegation model for allied health assistant dysphagia screening (Schwarz et al., 2020) and a large multisite telepractice dysphagia service (Ward et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the implementation of a speech and language therapist‐led referring model for VFSS using the Consolidated Framework for Implementation Research (CFIR)

Taubert

Burns

Ward

et al. 2022

Intl J Lang & Comm Disor

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Background Speech and language therapists (SLTs) use videofluoroscopic swallow study (VFSS) results to manage dysphagia. Yet, in some services only doctors can directly request a VFSS, potentially creating workflow inefficiencies and delaying patient access to VFSS. An alternative model, where SLTs directly refer patients for VFSS, is used in many services in the UK and Australia. However, processes for implementing and sustaining this model have not been reported. Aims To evaluate the implementation of an SLT‐led inpatient VFSS referring model using the Consolidated Framework for Implementation Research (CFIR) to ascertain implementation barriers, facilitators and critical sustainability factors. Methods & Procedures This implementation evaluation examined stakeholder perceptions of implementing the SLT‐led VFSS referring model via interviews of (1) SLTs who treat and refer inpatients for VFSS; (2) doctors who manage and refer inpatients for VFSS; (3) radiologists; and (4) trained VFSS referring SLTs. The CFIR was used to prospectively guide implementation planning, evaluation and outcome reporting, regarding barriers, facilitators and sustainability factors. Outcomes & Results Implementation facilitators were (1) the advantage of SLT‐led VFSS referring over the standard model (doctors referring), in promoting high‐quality VFSS referrals; (2) compatibility of the model with the SLT skill set; (3) supportive communication networks between staff groups; and (4) engaging stakeholders throughout implementation. Adequate availability of trained VFSS referring SLTs was both a barrier and a facilitator of implementation. It was also a critical sustainability factor, along with ongoing staff education and outcome monitoring. Conclusions & Implications The CFIR supported systematic evaluation of implementation facilitators and barriers, and adjustment of factors critical for implementing and sustaining the new model. Findings may assist other organizations to establish the SLT‐led VFSS referring model. What this paper adds What is already known on the subject Models where SLTs directly refer patients for VFSS have been described in the literature, with evidence of appropriate referrals and adherence to radiation safety standards. However, the process for establishing and sustaining this referring model has not been published. What this paper adds to existing knowledge This study describes the process and outcomes of implementing an SLT‐led VFSS referring model, using the CFIR. A key advantage of the new model that facilitated implementation was the improved quality of VFSS referrals compared with the standard referring model. Important facilitating factors in the environment were the compatibility of the model with SLTs’ skillset and supportive communication network between doctors and SLTs. Initially, an implementation barrier was the inadequate availability of trained SLT referrers. Using proactive implementation strategies, more referrers were trained (which was a facilitating factor for implementing and sust...

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Implementation Science Research in Communication Sciences and Disorders: A Scoping Review

Douglas²,

Danowski

2022

Am J Speech Lang Pathol

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Purpose: The purpose of this study was to complete a scoping review of implementation science (IS) research in communication sciences and disorders (CSD) over time and to determine characteristics of IS research in CSD. Method: A scoping review was conducted of PubMed and Education Resources Information Center for sources published in English that (a) included CSD practitioners, (b) addressed IS research, and (c) identified a specific evidence-based practice. Resulting sources were systematically examined for study aim, patient populations, implementation framework utilized, setting of the study, implementation strategy examined, and implementation outcome measured. Results: The majority of the 82 studies that underwent a full-text review (80.5%) were published in 2014 or later. One fourth of the studies were concept papers, and another one fourth focused on context assessment (25.6% of studies, each), 11% focused on designing implementation strategies, and 36.6% focused on testing implementation strategies. The patient population most frequently represented aphasia (21.3%), and most studies (34.4%) were conducted in inpatient medical settings. Nearly half (42.6%) of the nonconcept studies lacked an IS framework. Among implementation strategies identified, approximately one third of studies focused on education and/or training plus another strategy and one fourth focused on education and/or training alone. Implementation outcomes measured typically represented early stages of implementation. Conclusions: This scoping review of IS research in CSD described the landscape of IS studies in CSD. IS is intersecting with CSD at a rapid rate, especially since 2014. Future IS research in CSD should adopt an implementation framework a priori and consider the broad range of implementation strategies and outcomes to support the uptake of research into typical practice settings.

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Dysphagia screening using an allied health assistant delegation model: service considerations for implementation

Cited by 5 publications

References 56 publications

Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis

Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis

Evaluation of the implementation of a speech and language therapist‐led referring model for VFSS using the Consolidated Framework for Implementation Research (CFIR)

Implementation Science Research in Communication Sciences and Disorders: A Scoping Review

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