Evaluation of occupational therapy–led advanced practice hand therapy clinics for patients on surgical outpatient waiting lists at eight Australian public hospitals

Abstract

Resilient safety culture is characterized by continuous improvements to safety performance and the capacity to have foresight, recognizing and anticipating the changing shape of safety risks in complex sociotechnical systems. This study aims to conceptualize resilient safety culture in the construction environment by integrating resilience engineering principles into the concept of safety culture. To fulfill this research aim, a correlational research design was used. Data were collected using questionnaire surveys targeting construction project managers involved in the delivery of 78 recently completed building projects in Vietnam. The structural equation modeling (SEM) technique with partial least-squares estimation (PLS) was used to analyze the data. The results confirmed 3 dimensions (i.e., psychological resilience, behavioral resilience, and contextual resilience) with 24 measurable scale items to assess safety culture with respect to resilience. The study also revealed that psychological resilience has a weaker impact on accident prevention under higher contextual resilience and behavioral resilience levels. Theoretically, this study provides the theoretical development and empirical evidence to clarify the concept of resilient safety culture in terms of definition, purpose, and value in the context of construction projects. In practical terms, the study suggests that project hazards, unexpected events, and the risk tolerance of construction workers should be addressed to achieve consistently high safety performance. It also offers construction organizations a framework of safety practices to assess their capabilities in managing on-site safety risks.

Allied health led post‐operative hand clinic: Evaluation of an alternative model of care

“…Occupational therapy led hand clinics can reduce wait lists by providing conservative management of chronic hand conditions (Cox et al, 2020). A high patient satisfaction (90%) was associated with seeing an occupational therapist rather than a doctor (Cox et al, 2020).…”

“…Occupational therapy led hand clinics can reduce wait lists by providing conservative management of chronic hand conditions (Cox et al, 2020). A high patient satisfaction (90%) was associated with seeing an occupational therapist rather than a doctor (Cox et al, 2020). An Australian study into physiotherapy led clinics providing conservative management of orthopaedic conditions reported that they successfully operated independently in the assessment and management of 66% of patients, with few patients returned to orthopaedic clinics and 77% of the patients satisfied (Pearse et al, 2006).…”

Occupational Therapists, Physiotherapists and Orthopaedic Surgeons Agree on the Decision for Carpal Tunnel Surgery

“…To manage growing patient numbers, health services are increasingly adopting novel models of care as a strategy to improve treatment access. [11][12][13][14] For instance, triage clinics and therapist-led models of care, where therapists independently make treatment decisions within an agreed clinical decisionmaking framework, have been implemented for the management of musculoskeletal conditions. 11,[14][15][16][17][18][19] Results of retrospective and prospective studies suggest that these models of care have a positive impact on accelerating access to care, reducing the rate of surgery (if implemented prior to surgery) and improving patient outcomes and satisfaction.…”

“…[11][12][13][14] For instance, triage clinics and therapist-led models of care, where therapists independently make treatment decisions within an agreed clinical decisionmaking framework, have been implemented for the management of musculoskeletal conditions. 11,[14][15][16][17][18][19] Results of retrospective and prospective studies suggest that these models of care have a positive impact on accelerating access to care, reducing the rate of surgery (if implemented prior to surgery) and improving patient outcomes and satisfaction. 1,15,16,20 In these models of care, clinicians are required to independently assess, provide patient education and therapeutic interventions as well as make treatment decisions that are considered within, but more advanced than their typical scope of practice (for example, assessing the need for surgical intervention).…”

“… 18 , 19 There are no published data relating to the agreement between therapists and surgeons for the need for surgery for common hand conditions, such as CTS. Given therapist-led models of care are being proposed as a waitlist management strategy for hand conditions, 1 , 14 , 16 it is important to determine if therapists make decisions regarding a patient’s need for surgery that are consistent with surgeons to support these service developments.…”