ORCID Profile
0000-0002-4003-7188
Current Organisation
University of South Australia
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Publisher: Springer Science and Business Media LLC
Date: 27-03-2015
Publisher: Wiley
Date: 21-04-2015
DOI: 10.1002/PRI.1627
Abstract: Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability contextual influences layered decision-making access issues value and beliefs and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with clinical decision-making and placing both within the broader healthcare context. The conceptual models provide a way of thinking about decisions informing rural physiotherapy service provision. Copyright © 2015 John Wiley & Sons, Ltd.
Publisher: Springer Science and Business Media LLC
Date: 05-01-2017
Publisher: Human Kinetics
Date: 07-2020
Abstract: The aim of this study was to describe and undertake an initial evaluation of a student-led assessment service for children with possible motor-skill difficulties. A secondary analysis of cross-sectional descriptive clinical data collected from 2015 to 2016 was undertaken. Children ( N = 102) were assessed in preschools by physiotherapy students (supervised by qualified physiotherapists). Key outcomes included the following: Children’s Activities Scale, Movement Assessment Battery for Children-2, and demographic/service-usage/onward referral statistics. The results highlighted that for every five children referred/assessed, two were at risk of motor-skill difficulties (∼43%). About 66% of children were subsequently referred on or monitored (40% requiring multidisciplinary follow-up). Conversely 34% of children did not require further services. In conclusion, a student-led assessment service may be a sustainable and feasible option to assist children at risk of motor-skill difficulties, enabling onward referral. Additional evaluation is required to garner stakeholder feedback.
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.PHYSIO.2013.08.004
Abstract: To investigate the perceptions of doctors, nurses and physiotherapists of emergency department physiotherapy for acute patients, and explore the scope of its contribution in an otherwise nontraditional allied health setting in Australia. Qualitative investigation using semi-structured interviews. A large, metropolitan tertiary hospital with a well-established emergency department physiotherapy/allied health network in place. Two emergency department doctors, two emergency department nurses and two senior physiotherapists working in an emergency department were recruited purposefully from the study hospital. Semi-structured interviews lasting from 20 minutes to 1 hour were conducted with each participant by the lead investigator. Data were analysed using NVivo software, coded manually and verified with member checking, facilitating constant case comparisons. Issues explored included defining the role of physiotherapists, uncovering organisational themes from the introduction of physiotherapy into the established emergency department setting, and conflicts around preserving and expanding an allied health identity in a highly-medicalised clinical environment. Participants described the benefits of having physiotherapists located in the emergency department, and the physiotherapists were eager to advance their roles and responsibilities, but were, at times, restricted by a complicated organisational landscape influencing professional autonomy and capacity for professional advocacy. Ongoing evidence supporting the breadth of physiotherapy practice in the emergency department is needed to further advocate the usefulness of the profession in this acute setting.
Publisher: Wiley
Date: 06-2014
DOI: 10.1111/AJR.12110
Abstract: To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive s ling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery.
Publisher: Springer Science and Business Media LLC
Date: 11-0007
Publisher: Athens Institute for Education and Research ATINER
Date: 22-09-2022
DOI: 10.30958/AJHMS.9-4-1
Abstract: Occupational health and safety (OHS) education is integral to healthcare practice. Nurses/nursing students are particularly vulnerable during their work in this high-risk industry. Current clinical teaching appears to focus on in idual risks rather than provide a broader overview of the complex issues involved. A novel educational resource, the Safety Assessment Framework for Evaluation and Assessment (SAFER), is presented, addressing a gap in current education resources for nursing students to broaden understanding about OHS. The study re-examined pilot focus group data from first- and third- year student OHS focus groups in an Australian university School of Nursing. The SAFER framework was informed by student nurses impressions/ experiences of OHS (published in 2015 and 2016), supported by a literature review. Central to the SAFER framework is OHS ‘risk management’. It incorporates stakeholders and Australian legislation, all in relation to ‘responsibility’ and ‘trust’. Ex les use focus group participant voice, linked with researcher interpretation and supporting documentation. Clinical educators now have a broad resource to facilitate student group discussions about OHS from multiple perspectives. SAFER’s value beyond face validity should be tested, to confirm its applicability as a teaching resource in various university and training environments. Keywords: occupational health, education, nursing, curriculum, student
No related grants have been discovered for Sophie Lefmann.