ORCID Profile
0000-0003-2041-3120
Current Organisations
Eastern Health
,
Monash University
,
Peninsula Health
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Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.MSKSP.2022.102632
Abstract: Despite explanatory studies have identified a wide range of modifiable and non-modifiable characteristics, uncertainty persists as to what characteristics are predictive of patient reported outcome following ankle fracture in adults, therefore hindering the selection of candidate variables in prognostic models without compromising the accuracy. To establish consensus-based characteristics which clinicians believe are predictive of patient reported outcomes following ankle fracture. Three-round online modified Delphi survey. In Round 1, participants provided responses to open-ended questions, as to what characteristics within the first eight weeks following ankle fracture are predictive of short- ( 2 years) patient reported outcome. Rounds 2 and 3 presented consensus and gathered agreement on statements. Twenty participants answered the open-ended questions, including 13 physiotherapists and seven orthopaedic/trauma surgeons. Participants reached consensus for fracture characteristics and agreement for age, recovery of signs and symptoms, fracture management complexity, medical comorbidities, mental health status and patient journey at the short-term timepoint agreement for age, engagement in recovery process, recovery of signs and symptoms, fracture characteristics, medical comorbidities and socioeconomic status at the medium-term timepoint agreement for engagement in recovery process, fracture characteristics and medical comorbidities at the long-term timepoint. Clinicians believed in certain modifiable and non-modifiable characteristics predictive of patient reported outcome following ankle fracture. Our findings may provide insights about characteristics which can be selected in prognostic model development and future explanatory studies, allowing targeting adults at risk of developing long-standing symptoms and disability.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2022
DOI: 10.1007/S11136-021-03071-1
Abstract: To appraise the measurement properties of generic patient-reported outcome measures (PROMs) measuring postoperative quality of life in adults undergoing elective abdominal surgery. We conducted a systematic review of PROMs administered after elective abdominal surgery. We systematically searched Ovid MEDLINE, Embase, the Cumulative Index to Nursing & Allied Health Literature database, and the Cochrane Library from earliest available dates to July 24, 2021, using relevant search terms. Articles were included if they reported assessment of measurement properties of a generic PROM/s measuring postoperative quality of life in adults who had undergone elective abdominal surgery. We used the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) Risk of Bias checklist to assess methodological quality. We synthesized the data and used the COSMIN criteria for good measurement properties and the Grading of Recommendations, Assessment, Development and Evaluations criteria to rate the certainty of evidence. Of 12,121 identified articles, nine articles assessing five PROMs (SF-6D, EQ-5D, SF-36, SF-12, PROMIS-10) met inclusion criteria. Measurement properties assessed included internal consistency (n = 2), construct validity (n = 5), and responsiveness (n = 8). Two PROMs had high quality evidence for a single measurement property each. The SF-6D demonstrated high quality evidence for responsiveness and the EQ-5D had high quality evidence for construct validity. There is insufficient evidence to support the choice of a specific generic PROM to evaluate quality of life following elective abdominal surgery. Clinicians and researchers should be aware of the current limitations in knowledge of the measurement properties of available PROMs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-08-2019
Publisher: Informa UK Limited
Date: 06-04-2020
DOI: 10.1080/09638288.2020.1745906
Abstract: We assessed the ability of patients discharging home from inpatient rehabilitation to meet criteria for community ambulation. Cross-sectional observational study design. Participants were assessed, within 48-hours of discharge on their ability to: ascend/descend three steps, walk at a speed of 0.44 m/s, ascend/descend a slope, ascend/descend a kerb, and walk 315 m continuously. Demographic data were collected from medical records. Multiple logistic regression determined factors predictive of meeting criteria. Of 200 participants (mean 73 years, 66% women, mixed diagnosis), 64 (32%) met all criteria. The least commonly met criteria were walking 315 m continuously (37%) and ascending/descending steps (70%). Participants who were female (OR: 0.27, 95%CI: 0.12-0.61), with a high comorbidity index (OR: 0.71, 95%CI: 0.56-0.91) or a traumatic orthopaedic diagnosis (OR: 0.22, 95%CI: 0.05-0.96) were less likely to meet all criteria. Participants with a higher admission functional independence walk item score (OR: 1.37, 95%CI: 1.05-1.78) or higher ambulatory self-confidence (OR: 1.02, 95%CI: 1.01-1.04) were more likely to meet all criteria. Approximately, one-third of inpatients discharged home from a publicly funded rehabilitation centre met the community ambulation criteria, suggesting many may not be physically prepared to participate in their community.Implications for RehabilitationOnly about one in three inpatients discharging home from a publicly funded rehabilitation centre met physical criteria for community ambulation.Patients discharging home from inpatient rehabilitation have most difficulty walking long distances (≥315 m) compared to other criteria required for community ambulation (i.e., walking at a speed of 0.44 m/s, stepping up/down a kerb, ascending/descending a slope and ascending/descending three steps) and rehabilitation during this phase may require an increased focus on improving walking endurance hysical activity.Women with a high co-morbidity index, traumatic orthopaedic diagnosis, low self-confidence with ambulation on discharge and who require more assistance with walking on admission are least likely to meet the physical criteria for community ambulation at discharge, and therefore may require additional rehabilitation or supports.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2019
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.PHYSIO.2018.11.007
Abstract: Task-specific training is an effective form of rehabilitation for improving mobility in neurological conditions. However, it remains unclear if task-specific training is effective in people with progressive disease. To establish the efficacy of task-specific training on the mobility of in iduals with progressive neurological conditions. Electronic databases MEDLINE, EMBASE, CINAHL and Cochrane Database of Systematic Reviews. Randomised controlled trials investigating the effect of task-specific training on mobility and falls rate in in iduals with progressive neurological conditions. Risk of bias of in idual studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Mean differences (MD) and 95% confidence intervals were calculated and combined in meta-analysis. Analysis of 16 trials found treadmill training improved comfortable walking velocity (m/second) in people with Parkinson's disease (MD 0.21m/second, 95%CI 0.15 to 0.27) and multiple sclerosis (MD 0.36m/second, 95%CI 0.20 to 0.52). Treadmill training improved stride length (m) (MD 0.12m, 95%CI 0.02 to 0.23) and step length (m) (MD 0.12m, 95%CI 0.01 to 0.23) in people with Parkinson's disease and walking endurance in people with multiple sclerosis (MD 26.53m, 95%CI 12.23 to 40.84). Treadmill training had no effect on cadence and did not improve walking endurance in Parkinson's disease. Over-ground walking did not improve mobility in Parkinson's disease or multiple sclerosis. Study s le sizes were small and findings must be interpreted with caution. Treadmill training may be effective for improving mobility in people with Parkinson's disease and multiple sclerosis. The effectiveness of over-ground walking is uncertain. CRD42016047334.
Publisher: American Chemical Society (ACS)
Date: 07-02-2022
Publisher: Wiley
Date: 28-03-2021
DOI: 10.1111/AJAG.12941
Abstract: To describe the patterns of personal emergency response systems (PERS) use in a statewide cohort of older Australians. PERS data from clients enrolled in the Personal Alarm Victoria program between January 2014 and June 2017 were analysed. Alarm activation reasons were extracted, and a medical record audit was performed for a sub‐cohort of patients admitted to a local hospital following an alarm event. Descriptive statistics were used. There were 42,180 clients enrolled during the study (mean age 80 years, 80% female, 93% living alone). An ambulance attended 44% of the fall‐related events and 81% of events coded as unwell. Activation reasons were distributed equally between a fall and feeling unwell, and a repeating pattern of activation reasons was observed. In our sub‐cohort (n = 92), the majority of admissions (86%) followed an alarm activation coded as unwell. We demonstrated recurring patterns associated with the reasons for alarm use.
Publisher: Wiley
Date: 08-10-2019
DOI: 10.1002/PRI.1813
Abstract: The objective of this review was to determine whether the combination of aquatic physiotherapy with usual care and results in greater improvements in activity limitations and neurological-related impairments in in iduals with neurological conditions than usual care physiotherapy alone. A systematic review of controlled trials was utilized to compare usual care physiotherapy with usual care physiotherapy combined with aquatic physiotherapy for adults with any neurological condition. Standardized mean differences and 95% confidence intervals were calculated from postintervention means and standard deviations. Ten trials with a total of 490 participants met the inclusion criteria. Of the included trials, combined aquatic and usual care physiotherapy was evaluated in people with stroke in eight trials and in people with Parkinson's disease in two trials. Trial and outcome heterogeneity prevented the completion of meta-analyses. Data from five trials (n = 259) in people with stroke suggest that aquatic physiotherapy improves measures of balance, walking, mobility, and activities of daily living. No significant differences were detected in measures of activity limitation for people with Parkinson's disease nor measures of impairment for people with stroke or Parkinson's disease. This review provides preliminary evidence that the combination of aquatic physiotherapy with usual care physiotherapy may improve activity limitations in people with stroke. This review found no evidence to support the combination of aquatic physiotherapy with usual care physiotherapy to improve activity limitations in Parkinson's disease or other neurological populations. These results should be interpreted with caution due to the mixed quality of the included trials.
Publisher: Springer Science and Business Media LLC
Date: 28-11-2017
Publisher: Springer Science and Business Media LLC
Date: 19-10-2018
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2020-045096
Abstract: Timely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model. Using a prospective pre–post design, an economic analysis was completed comparing the health system costs for participants who were referred for community outpatient services post-implementation of STAT with a traditional waitlist comparison group. Eight community outpatient services of a health network in Melbourne, Australia. Adults and children referred to community outpatient services. STAT combined targeted activities to reduce the existing waiting list and direct booking of patients into protected assessment appointments. STAT was compared with usual care, in which new patients were placed on a waiting list and offered appointments as space became available. Health system costs included STAT implementation costs, outpatient health service use, emergency department presentations and hospital admissions 3 months before and after initial outpatient appointment. Waiting time was the primary outcome. Incremental cost-effectiveness ratios (ICERs) were estimated from the health system perspective. Data from 557 participants showed a 16.9 days or 29% (p .001) reduction in waiting time for first appointment with STAT compared with traditional waitlist. The ICER showed a cost of $A10 (95% CI −19 to 39) per day reduction in waiting time with STAT compared with traditional waitlist. Modelling showed the cost reduced to $A4 (95% CI −25 to 32) per day of reduction in waiting, if reduction in waiting times is sustained for 12 months. There was a significant reduction in waiting time with the introduction of STAT at minimal cost to the health system. Australian New Zealand Clinical Trials Registry (ACTRN12615001016527).
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-047970
Abstract: Community-dwelling people recovering from hip fracture have the physical capacity to walk in their community but lack the confidence to do so. The primary aim of this trial is to determine whether motivational interviewing increases time spent walking at 12 months in community-dwelling people after hip fracture compared with an attention placebo control group. Secondary aims are to evaluate cost effectiveness, patient and health service outcomes and to complete a process evaluation. An assessor-blinded parallel group randomised controlled design with embedded health economic evaluation and process evaluation will compare the effects of n=270 participants randomly allocated to an experimental group (motivational interviewing) or a control group (dietary advice). For inclusion, participants are aged ≥65 years, living at home independently within 6 months of discharge from hospital after hip fracture and able to walk independently and communicate with conversational English. Key exclusion criteria are severe depression or anxiety, impaired intellectual functioning and being medically unstable to walk. Participants allocated to the experimental group will receive 10 (8 weekly and 2 booster) telephone-based sessions of motivational interviewing to increase walking over 16 weeks. Participants allocated to the control group will receive an equivalent dose of telephone-based dietary advice. The primary outcome is daily time spent walking over 7 days assessed at weeks 0, 9, 26 and 52. Secondary outcomes include measures of psychological-related function, mobility-related function, community participation, health-related quality of life and falls. Health service utilisation and associated costs will be assessed. Process evaluation will assess the fidelity of the motivational interviewing intervention and explore contextual factors through semistructured interviews. Ethical approval obtained from Eastern Health (E19-002), Peninsula Health (50261/EH-2019), Alfred Health (617/20) and La Trobe University (E19/002/50261). The findings will be disseminated in peer-reviewed journals, conference presentations and public seminars. ACTRN12619000936123.
Publisher: Informa UK Limited
Date: 22-01-2019
Publisher: Oxford University Press (OUP)
Date: 04-2022
Abstract: The importance of clinical supervision, a professional support and clinical governance mechanism, to patients, healthcare workers and organizations has been well documented. Clinical supervision has been shown to support healthcare workers during challenging times, by reducing burnout, enhancing mental health and wellbeing at work, and improving job satisfaction. However, clinical supervision participation and effectiveness are pre-requisites for realising these benefits. During times of stress and increased workloads (e.g. during the Coronavirus pandemic), healthcare workers tend to prioritise clinical duties and responsibilities over clinical supervision. Effective supervision practices can be restored, and healthcare workers can be better supported in their roles during and in the post-pandemic period only if healthcare workers, policy makers, healthcare organizations, clinical supervision trainers and researchers join forces. This paper sheds light on this important topic and offers a number of practical recommendations to reboot effective clinical supervision practices at the point of care.
Publisher: Informa UK Limited
Date: 18-02-2022
Publisher: Informa UK Limited
Date: 16-09-2021
DOI: 10.1080/09638288.2021.1976290
Abstract: To assess whether meeting criteria for community ambulation and ambulatory self-confidence on discharge from inpatient rehabilitation are associated with participation in community activities. Prospective longitudinal observational study design. Participants were assessed within 48-hours of discharge on ability to complete tasks reflective of community ambulation (walking 315 m, ascending/descending three stairs, a r , and a street curb and walking at 0.44 m/s) and ambulatory self-confidence. At 8 weeks post-discharge frequency of participation in domestic, leisure/work and outdoor activities was measured using the Frenchay Activities Index (FAI). Multivariable regression analysis determined factors associated with total and outdoor FAI score. Seventy-four of 79 participants were followed up at 8 weeks post-discharge. Meeting all ambulation criteria was positively associated with FAI outdoor score ( Capacity to meet ambulation criteria and ambulatory self-confidence are modifiable factors that could be targeted during rehabilitation to improve participation in community activities.Implications for rehabilitationMeeting community ambulation criteria and confidence with walking on discharge from inpatient rehabilitation are positively associated with performance of outdoor community activities 8 weeks after discharge.Capacity to meet community ambulation criteria and ambulatory confidence may be useful measures for rehabilitation teams to consider when discharging patients home.Meeting ambulation criteria and ambulatory confidence are modifiable factors that could be addressed through targeted therapy to improve community integration following hospitalisation.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.JPHYS.2014.04.002
Abstract: Does preoperative intervention in people undergoing cardiac surgery reduce pulmonary complications, shorten length of stay in the intensive care unit (ICU) or hospital, or improve physical function? Systematic review with meta-analysis of (quasi) randomised trials. People undergoing coronary artery bypass grafts and/or valvular surgery. Any intervention, such as education, inspiratory muscle training, exercise training or relaxation, delivered prior to surgery to prevent/reduce postoperative pulmonary complications or to hasten recovery of function. Time to extubation, length of stay in ICU and hospital (reported in days). Postoperative pulmonary complications and physical function were measured as reported in the included trials. The 17 eligible trials reported data on 2689 participants. Preoperative intervention significantly reduced the time to extubation (MD -0.14 days, 95% CI -0.26 to -0.01) and the relative risk of developing postoperative pulmonary complications (RR 0.39, 95% CI 0.23 to 0.66). However, it did not significantly affect the length of stay in ICU (MD -0.15 days, 95% CI -0.37 to 0.08) or hospital (MD -0.55 days, 95% CI -1.32 to 0.23), except among older participants (MD -1.32 days, 95% CI -2.36 to -0.28). When the preoperative interventions were separately analysed, inspiratory muscle training significantly reduced postoperative pulmonary complications and the length of stay in hospital. Trial quality ranged from good to poor and considerable heterogeneity was present in the study features. Other outcomes did not significantly differ. For people undergoing cardiac surgery, preoperative intervention reduces the incidence of postoperative pulmonary complications and, in older patients, the length of stay in hospital.
Publisher: Frontiers Media SA
Date: 23-03-2021
DOI: 10.3389/FRESC.2021.638602
Abstract: Background: Waiting lists are often thought to be inevitable in healthcare, but strategies that address patient flow by reducing complexity, combining triage with initial management, and/or actively managing the relationship between supply and demand can work. One such model, Specific Timely Appointments for Triage (STAT), brings these elements together and has been found in multiple trials to reduce waiting times by 30–40%. The next challenge is to translate this knowledge into practice. Method: A multi-faceted knowledge translation strategy, including workshops, resources, dissemination of research findings and a community of practice (CoP) was implemented. A mixed methods evaluation of the strategy was conducted based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, drawing on an internal database and a survey of workshop and CoP participants. Results: Demonstrating reach, at July 2020 an internal database held details of 342 clinicians and managers from 64 health services who had participated in the workshop program ( n = 308) and/or elected to join an online CoP ( n = 227). 40 of 69 (58%) respondents to a survey of this population reported they had adopted the model, with some providing data demonstrating that the STAT model had been efficacious in reducing waiting time. Perceived barriers to implementation included an overwhelming existing waiting list, an imbalance between supply and demand and lack of resources. Conclusion: There is high quality evidence from trials that STAT reduces waiting time. Using the RE-AIM framework, this evaluation of a translation strategy demonstrates uptake of evidence to reduce waiting time in health services.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.PHYSIO.2017.01.002
Abstract: Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient. Determine the most beneficial active physiotherapy interventions in acute hospital and inpatient rehabilitation for improving pain, activity, range of motion and reducing length of stay for adults who have undergone TKA. Electronic databases MEDLINE, CINAHL, PUBMED and EMBASE. Randomised controlled trials investigating the effect of active physiotherapy interventions in the acute hospital or inpatient rehabilitation setting for adults who have undergone TKA. Risk of bias for in idual studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Standardised Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals were calculated and combined in meta-analyses. Quality of meta-analyses was assessed using the Grades of Research, Assessment, Development and Evaluation approach. Accelerated physiotherapy regimens were effective for reducing acute hospital length of stay (MD -3.50 days, 95% CI -5.70 to -1.30). Technology-assisted physiotherapy did not show any difference for activity (SMD -0.34, 95% CI -0.82 to 0.13). From high quality in idual studies pain, activity and range of motion improved with accelerated physiotherapy regimens and activity improved with hydrotherapy. Lack of blinding and small s le sizes across the included trials. After TKA, there is low level evidence that accelerated physiotherapy regimens can reduce acute hospital length of stay. Systematic review registration number PROSPERO (Registration number CRD42014013414) www.crd.york.ac.uk/PROSPERO.
Publisher: Springer Science and Business Media LLC
Date: 21-10-2020
DOI: 10.1186/S12913-020-05824-Z
Abstract: Timely access is a challenge for providers of outpatient and community-based health services, as seen by the often lengthy waiting lists to manage demand. The Specific Timely Appointments for Triage (STAT) model, an alternative approach for managing access and triage, reduced waiting time by 34% in a stepped wedge cluster randomised controlled trial involving 8 services and more than 3000 participants. Follow up periods ranged from 3 to 10 months across the participating services in accordance with the stepped wedge design. This study aimed to determine whether outcomes were sustained for a full 12 months after implementation of the STAT model at each site. Routinely collected service data were obtained for a total of 12 months following implementation of the STAT model at each of the 8 services that participated in a stepped wedge cluster randomised controlled trial. The primary outcome was time to first appointment. Secondary outcomes included non-attendance rates, time to second appointment and service use over 12 weeks. Outcomes were compared to pre-intervention data from the original trial, modelled using generalised linear mixed effects models accounting for clustering of sites. A 29% reduction in waiting time could be attributed to STAT over 12 months, compared to 34% in the original trial. A reduction in variability in waiting time was sustained. There were no significant changes in time to second appointment or in the number of missed appointments in the extended follow up period. STAT is an effective strategy for reducing waiting time in community-based outpatient services. At 12 months, small reductions in the overall effect are apparent, but reductions in variability are sustained, suggesting that people who previously waited the longest benefit most from the STAT model. This is a 12-month follow up of a stepped wedge cluster randomised controlled trial that was registered with the Australia and New Zealand Clinical Trials Registry ( ACTRN12615001016527 ).
Publisher: Hindawi Limited
Date: 10-06-2022
DOI: 10.1111/HSC.13874
Abstract: Allied health assistants (AHAs) are important members of the health workforce and key to meeting population health needs. Previous studies exploring the role and utility of AHAs from multiple stakeholder perspectives suggest AHAs remain poorly utilised in many healthcare settings. This qualitative study explores the experiences and perspectives of AHAs working in healthcare settings to determine the contextual factors influencing their role, and mechanisms to maximise their utility. We conducted semi-structured interviews using purposive s ling with 21 AHAs, from one regional and three metropolitan health services in Australia, between February and July 2021. We used a team-based framework approach to analyse the data. Four major themes were identified: 1) AHAs' interpersonal relationships, 2), clarity and recognition of AHA roles and role boundaries, 3) AHAs accessing education and professional development, and 4) the professional identity of the AHA workforce. Underpinning each of these themes were relationships between AHAs and other healthcare professionals, their patients, health services, and the wider AHA workforce. This study may inform initiatives to optimise the utility of AHAs and increase their role in, and impact on, patient care. Such initiatives include the development and implementation of guidelines and competencies to enhance the clarity of AHAs' scope of practice, the establishment of standardised educational pathways for AHAs, and increased engagement with the AHA workforce to make decisions about their scope of practice. These initiatives may precede strategies to advance the AHA career structure.
Publisher: Informa UK Limited
Date: 21-11-2014
DOI: 10.3109/09593985.2014.982775
Abstract: To establish the level of research activity in physiotherapy departments of Australian tertiary hospitals. Prospective cross-sectional survey. Physiotherapy managers from 37 principal referral hospitals and specialist women's and children's hospitals as identified from the Australian Institute of Health and Welfare (2011). A purpose-designed predominantly open-response questionnaire investigating site demographics, research activity and research support was developed, piloted and administered. Thirty-seven surveys were completed (54% response rate). Median [IQR] respondent equivalent full-time staffing was 23.8 (19-39). Respondents represented a median [IQR] 6.5 (3-20) publication output in the past 2 years. Twelve respondents (32%) reported that staff had completed a doctorate in the past 5 years and 49% of respondents reported no staff had completed higher degrees. A total of 71 grants had been received and 73% of respondents indicated they had no allocated staffing for research activity. The most common indicators of research culture were organization-led research dissemination events and research training (i.e. manager attending research events and celebrating research achievements). This is the first study to report on research activity in hospital-based Australian physiotherapy departments. Few sites allocate staff to conduct or support research. Despite this, physiotherapy departments regularly publish and present research results. Future studies could investigate how hospital-based physiotherapy departments can optimize research culture and output.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S41687-023-00617-4
Abstract: Patient-reported outcome measures (PROMs) provide a measure of self-perceived health status or health-related quality of life. They have been used to support provider-patient decisions, healthcare delivery, and value-based healthcare models. A barrier to routine collection of PROMs is the perception that PROMs lack clinical utility. As such, it is important to establish clinicians’ acceptability of the PROM prior to large-scale implementation. This study explored the acceptability of the routine use and collection of a generic PROM in healthcare services from the perspective of healthcare staff. In idual semi-structured interviews were completed from September 2020 to March 2021 with 26 staff from two multi-disciplinary community healthcare services in Melbourne, Australia. Interviews explored their experiences of using the EQ-5D-5L in their routine care. Interviews were recorded and transcribed verbatim. Data were analysed according to a framework approach, using inductive and deductive techniques. Participants discussed the acceptability of the EQ-5D-5L with reference to four themes: practicalities of use holistic nature influence on client care and influence on health service. Participants found the EQ-5D-5L quick and easy to administer, and appreciated that it measured multiple domains of health that were relevant to their clients’ care. They believed the EQ-5D-5L helped to identify client problems, and inform service delivery. They also reported features that were less acceptable, including a lack of item specificity to some healthcare disciplines. Participants reported the challenge of managing conflict between their assessment of the client’s health and the client’s perspective of their own health, leading some to question whether the client could provide an accurate reflection of their own health. The EQ-5D-5L has several features that healthcare staff viewed as acceptable for routine collection and use in healthcare. Training on the validity of the patient reported perspective and broadening the scope of PROMs collection beyond the EQ-5D-5L should be considered to facilitate large-scale implementation.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.INJURY.2022.02.016
Abstract: The incidence of ankle fractures is increasing and the clinical outcome is highly variable. What person and fracture characteristics are associated with patient reported outcomes after surgically or conservatively managed ankle fractures in adults? Medline, EMBASE, and Allied and Complimentary Health Medical Database (AMED) databases were searched from the earliest available date until 16th July 2020. Prognostic factors studies recruiting adults of age 18 years or older with a radiologically confirmed ankle fracture, and evaluating function, symptoms and quality of life by patient reported outcome measures, were included. Risk of bias of in idual studies was assessed by the Quality in Prognostic Factors Studies tool. Correlation coefficients were calculated and data were analysed using narrative synthesis. Fifty-one phase 1 explanatory studies with 6177 participants met the inclusion criteria. Thirty-one studies were rated as high risk of bias using the Quality in Prognostic Factors Studies tool. There was low quality evidence that age, body mass index, American Society of Anesthesiologists classification and pre-injury mobility were associated with function, and low to moderate quality evidence that age, smoking and American Society of Anesthesiologists classification were associated with quality of life. No person characteristics were associated with symptoms and no fracture characteristics were associated with any outcomes. There was low to moderate quality evidence that person characteristics may be associated with patient reported function and quality of life following ankle fracture. PROSPERO registration number CRD42020184830.
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-054298
Abstract: Guidelines for hip fracture care state that patients with hip fracture should be mobilised on the day after surgery and at least once a day thereafter. However, compliance with these guidelines is poor. One approach that would assist physiotherapists to meet mobility guidelines after hip fracture is to delegate the provision of daily mobilisation to allied health assistants under their supervision. Therefore, we plan to conduct a randomised controlled trial to determine the feasibility of an allied health assistant providing daily inpatient rehabilitation to patients with hip fracture. Using a parallel group randomised controlled design with one-to-one allocation, participants will be randomly allocated to an experimental group (allied health assistant management) or a comparison group (physiotherapist management). Inclusion criteria are: adult with diagnosis of hip fracture inpatient in acute hospital walked independently pre-hip fracture and able to communicate in conversational English. The experimental group will receive routine physiotherapy rehabilitation, including daily mobilisation, from an allied health assistant following initial physiotherapist assessment. The comparison group will receive routine rehabilitation from a physiotherapist. The primary outcome will be the feasibility of allied health assistant management of patients with hip fracture. Feasibility will be determined using the following areas of focus in Bowen’s feasibility framework: acceptability (patient satisfaction), demand (proportion of patients who participate), implementation (time allied health assistant hysiotherapist spends with participant, occasions of service) and practicality (cost, adverse events). Staff involved in the implementation of allied health assistant care will be interviewed to explore their perspectives on feasibility. Secondary outcomes include compliance with daily mobilisation guidelines, discharge destination, hospital readmission, falls, functional activity and length of stay. We aim to recruit 50 participants. Descriptive statistics will be used to describe feasibility and mobilisation rates will be calculated using Cox proportional hazards regression to compare compliance with mobilisation guidelines. Ethics approval was obtained from the Peninsula Health human research ethics committee (HREC/63 005/PH-2020). The findings will be disseminated in peer-reviewed journals and conference presentations. Australian and New Zealand Clinical Trial Registry ACTRN12620000877987 Pre-results.
Publisher: Wiley
Date: 25-08-2022
DOI: 10.1111/IMJ.15634
Abstract: Care navigation is commonly used to reduce preventable hospitalisation. The use of Electronic Health Record‐derived algorithms may enable better targeting of this intervention for greater impact. To evaluate if community‐based Targeted Care Navigation, supported by an Electronic Health Record‐derived readmission risk algorithm, is associated with reduced rehospitalisation. A propensity score matching cohort (5 comparison to 1 intervention cohort ratio) study was conducted in an 850‐bed Victorian public metropolitan health service, Australia, from May to November 2017. Admitted acute care patients with a non‐surgical condition, identified as at‐risk of hospital readmission using an Electronic Health Record‐derived readmission risk algorithm provide by the state health department, were eligible. Targeted Care Navigation involved telephone follow‐up support provided for 30 days post‐discharge by a registered nurse. The hazard ratio for hospital readmission was calculated at 30, 60 and 90 days post‐discharge using multivariable Cox Proportional Hazards regression. Sixty‐five recipients received care navigation and were matched to 262 people who did not receive care navigation. Excellent matching was achieved with standardised differences between groups being .1 for all 11 variables included in the propensity score, including the readmission risk score. The Targeted Care Navigation group had a significantly reduced hazard of readmission at 30 days (hazard ratio 0.34 95% confidence interval: 0.12, 0.94) compared with the comparison group. The effect size was reduced at 60 and 90 days post‐discharge. We provide preliminary evidence that Targeted Care Navigation supported by an Electronic Health Record‐derived readmission risk algorithm may reduce 30‐day hospital readmissions.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2018
Publisher: CSIRO Publishing
Date: 2021
DOI: 10.1071/AH19254
Abstract: ObjectivesMePACS is a triage and support-based personal alarm emergency response system designed to assist older and/or disabled people to live safely in their homes. The aim of this study was to estimate avoidable ambulance attendances and transports to emergency departments and quantify the cost savings attributed to MePACS compared with a comparison cohort without a personal alarm system. MethodsAlarm activation and demographic data for clients registered in the program from June 2016 to May 2017 and funded through the Personal Alert Victoria program were extracted from routinely collected MePACS electronic data. Information on alarm use, event outcomes and ambulance attendances was extracted. Using published Ambulance Victoria data, a comparison cohort was simulated to model the experience of a similar cohort without access to a personal alarm system who experienced a health emergency and called Australia’s emergency call service number. The incremental management cost, incorporating the operation cost of MePACS and ambulance fees, was calculated to compare the potential cost savings of MePACS with the comparison cohort. ResultsAmong 18421 eligible clients, there were 7856 emergency alarm activations due to falls or medical events from 4275 clients (79.5% female 81.1% aged & years 91.8% living alone). MePACS resulted in approximately one-third of ambulance attendances being avoided. Potential annual cost savings of A$1414732.8 (A$76.8 per person per year 95% confidence interval A$60.0–93.6 per person per year P& .001) were attributed to avoidable ambulance utilisations for 18421 MePACS clients. ConclusionTriage-based personal alarm systems, such as MePACS, provide a cost-saving strategy because of fewer ambulance attendances and transports to emergency departments for older and/or disabled people living in the community. What is known about the topic?Personal alarm systems, either a safety alarm, a panic alarm or a medical alarm, have been widely used to support older people and at-risk groups to live independently. The health effects of personal alarm systems are well documented. There is limited information published on the potential economic benefits of these interventions. What does this paper add?We identified the potential economic benefits associated with the MePACS triage-based personal alarm system operating within Victoria, Australia. Personal alarm systems that are triage based and use the support of family members and carers may provide financial benefits not provided by alarm systems that do not provide this type of service. What are the implications for practitioners?The management of older people and at-risk groups living alone is a health care priority. Alternative models to calling emergency services, such as triage-based personal emergency response systems, may provide a low-cost, effective approach.
Publisher: Informa UK Limited
Date: 21-09-2023
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH16145
Abstract: Objectives Wait lists are common in ambulatory and community-based services. The aim of the present study was to explore managers’ perceptions of factors that contribute to wait times. Methods A qualitative study was conducted using semi-structured interviews with managers and team leaders of ambulatory and community health services within a large health network. Interviews were transcribed and coded, and the codes were then grouped into themes and subthemes. Results Representatives from 26 services participated in the project. Four major themes were identified. Three themes related to reasons and factors contributing to increased wait time for services (inefficient intake and scheduling processes service disruptions due to human resource issues and high service demand). A fourth theme related to staff attitudes towards wait times and acceptance and acknowledgement of wait lists. Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow. What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to grow as health service delivery shifts from hospital to community settings. What does this paper add? Although demand is an important driver of wait times, there are other modifiable factors that also contribute, including process inefficiencies and service disruption related to human resource issues. An underlying staff attitude of acceptance of wait times appears to be an additional barrier to improving access. What are the implications for practitioners? The findings of the present study suggest that there are opportunities for improving access to ambulatory and community health services through more efficient use of existing resources. However, a more consumer-focused approach regarding acceptability of wait times is needed to help drive change.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2020
DOI: 10.1186/S12913-020-05312-4
Abstract: Allied health assistants (AHAs) are support staff who complete clinical and non-clinical tasks under the supervision and delegation of an allied health professional. The effect of allied health professional delegation of clinical tasks to AHAs on patient and healthcare organisational outcomes is unknown. The purpose of this systematic review was to investigate the effect of allied health professional delegation of therapy to AHAs on patient and organisational outcomes. A systematic review and meta-analysis was conducted. Databases MEDLINE (Ovid), Embase (Ovid), Informit (all databases), Emcare (Ovid), PsycINFO (Ovid), Cumulative Index to Nursing and Allied Health Literature [CINAHL] (EbscoHost) and the Cochrane Database of Systematic Reviews were searched from earliest date available. Additional studies were identified by searching reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of the study was rated using internal validity items from the Downs and Black checklist. Risk ratios (RR) and mean differences (MD) were calculated for patient and organisational outcomes. Meta-analyses were conducted using the inverse variance method and random-effects model. Twenty-two studies met the inclusion criteria. Results of meta-analysis provided low quality evidence that AHA supervised exercise in addition to usual care improved the likelihood of patients discharging home (RR 1.28, 95%CI 1.03 to 1.59, I 2 = 60%) and reduced length of stay (MD 0.28 days, 95%CI 0.03 to 0.54, I 2 = 0%) in an acute hospital setting. There was preliminary evidence from one high quality randomised controlled trial that AHA provision of nutritional supplements and assistance with feeding reduced the risk of patient mortality after hip fracture (RR 0.41, 95%CI 0.16 to 1.00). In a small number of studies ( n = 6) there was no significant difference in patient and organisational outcomes when AHA therapy was substituted for therapy delivered by an allied health professional. We found preliminary evidence to suggest that the use of AHAs to provide additional therapy may be effective for improving some patient and organisational outcomes. CRD42019127449 .
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14020
Abstract: Objectives Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. Methods CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total score was calculated, which was compared with the reported threshold score of 73 for effective supervision. Sixty registered physiotherapists (response rate 92%), working for a large metropolitan public health service, with six different site locations, completed the survey. Results The mean (± s.d.) total MCSS-26 score was 71.0 ± 14.3 (95% confidence interval (CI) 67.4–74.6). Hospital site was the only variable that had a significant effect on total MCSS-26 score (P = 0.005) there was no effect for supervisor or supervisee experience, or hospital setting (acute vs subacute). Physiotherapists scored a significantly lower mean percentage MCSS-26 score on the normative domain compared with the restorative domain (mean difference 7.8% 95% CI 2.9–12.7 P = 0.002) and the formative domain (mean difference 9.6% 95% CI 6.3–13.0 P 0.001). Of the two subscales that form the normative domain, ‘finding time’ had a significantly lower mean percentage MCSS-26 score than ‘importance/value of CS’ (mean difference 35.4% 95% CI 31.3–39.4 P 0.001). Conclusions Within this publicly funded physiotherapy department there was uncertainty about the effectiveness of CS, with more than half the physiotherapists rating their supervision as less than effective, suggesting there is opportunity for improvement in the practice of physiotherapy CS. Physiotherapists scored lowest in the normative domain, indicating that they found it difficult to find time for CS. What is known about the topic? Previous research into CS for allied health professionals has shown that, on average, it is effective. However, these results cannot be generalised to specific allied health disciplines. Currently, the effectiveness of CS for physiotherapists is unknown. What does this paper add? This study is the first to investigate the effectiveness of CS in a large physiotherapy department of a publicly funded Australian healthcare service. What are the implications for practitioners? Requiring all physiotherapists to receive CS may not be useful if supervision is not effective. Finding time for CS appears to be the main barrier to effective CS. Focus should be directed towards developing a framework within which to practice CS that includes protected time for participation in CS.
Publisher: Public Library of Science (PLoS)
Date: 19-11-2021
DOI: 10.1371/JOURNAL.PONE.0260156
Abstract: To review the impact of clinical supervision of post-registration/qualification healthcare professionals on healthcare organisational outcomes. Clinical supervision is a professional support mechanism that benefits patients, healthcare professionals and healthcare organisations. Whilst evidence is growing on the impact of clinical supervision on patient and healthcare professional outcomes, the evidence base for the impact of clinical supervision on organisational outcomes remains weak. This review used a convergent segregated approach to synthesise and integrate quantitative and qualitative research findings, as per the Joanna Briggs Institute’s recommendations for mixed methods systematic reviews. Databases searched included CINAHL, Embase, PubMed, PschINFO, and Scopus. Whilst a narrative synthesis was performed to present the findings of the quantitative and qualitative studies, the evidence from both quantitative and qualitative studies was subsequently integrated for a combined presentation. The review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Thirty-two studies including 27 quantitative, two qualitative and three mixed methods studies, were included in the review. The results of the quantitative analysis showed that effective clinical supervision was associated with lower burnout and greater staff retention, and effective supervisor was associated with lower burnout and greater job satisfaction. Qualitative findings showed that healthcare professionals believed that adequate clinical supervision could mitigate the risk of burnout, facilitate staff retention, and improve the work environment, while inadequate clinical supervision can lead to stress and burnout. The evidence from quantitative and qualitative studies were complementary of each other. Clinical supervision can have a variable effect on healthcare organisational outcomes. The direction of this effect appears to be influenced by the effectiveness of both the clinical supervision provided and that of the clinical supervisor. This highlights the need for organisations to invest in high quality supervision practices if maximal gains from clinical supervision are to be attained.
Publisher: Wiley
Date: 18-08-2020
DOI: 10.1111/JAN.14483
Publisher: Wiley
Date: 19-10-2023
DOI: 10.1002/JMRS.623
Abstract: Allied health assistants are support staff who assist medical imaging professionals in their clinical and non‐clinical role. Assistants can improve efficiency of medical imaging services however, little is known about the specific tasks they perform. A two‐phase explanatory, sequential mixed‐methods study design comprising a time motion survey and qualitative interviews was conducted across three health services in Victoria, Australia. Participants were medical imaging assistants supporting medical imaging professionals. Participants recorded tasks completed on a time motion proforma across two working days. Time spent on tasks was categorised into patient related and non‐patient related tasks. Semi‐structured interviews were conducted to explore assistants' perspectives about tasks, their roles and any responsibilities. Time motion data was descriptively analysed. Qualitative data were audiotaped, transcribed verbatim and analysed using the framework analysis method. Quantitative and qualitative findings were integrated using data triangulation. Four medical imaging assistants participated, providing 4170 min of time motion data and 138 min of interview data. Integration of time motion and interview data revealed the medical imaging assistant role is predominantly non‐patient facing autonomous and critical to workflow erse and requires flexibility has the potential to expand into a more patient‐facing role. Medical imaging assistants make significant contributions to workflow management. Their role is predominantly non‐patient facing but there appear opportunities for the clinical role to expand. Realizing these opportunities will require careful consideration of the challenges and benefits of extending their scope of practice.
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.APMR.2021.12.007
Abstract: To investigate the effect of rehabilitation on the physical, social, and psychological dimensions of community reintegration after hip fracture. Electronic databases Embase, EMCare, MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health, and SPORTDiscus were searched from the earliest date available to second June 2021. Searching identified 1844 potentially relevant articles. Twenty randomized controlled trials evaluating physical retraining, cognitive retraining, and model of care interventions on physical, social and psychological aspects of community reintegration for 3075 adults after hip fracture were included. Data were extracted using predetermined templates for participant characteristics, intervention type and setting, and outcomes related to community reintegration. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and the Grading of Recommendations, Assessment, Development, and Evaluations approach was applied to each meta-analysis. Post intervention data were pooled to calculate risk ratios (RRs), mean differences, standardized mean differences, and 95% confidence intervals (CIs) using inverse variance methods and a random-effects model. Compared with usual care or no rehabilitation, there was moderate-quality evidence to suggest that physical retraining interventions improved outdoor mobility (RR, 1.45 95% CI, 1.09-1.91 I Preliminary evidence suggests that physical rehabilitation after hip fracture improves physical and social aspects of community reintegration. The effect of psychological and home-based interventions on community reintegration is currently unclear. Further research is needed to determine the effect of rehabilitation on community reintegration, using interventions and measures that encompass all dimensions of community reintegration.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 11-2021
Abstract: Purpose: The purpose of this study was to evaluate change in the effectiveness of clinical supervision of physiotherapists who took part in a clinical supervision training programme. Method: Our pre–post study design used both quantitative and qualitative methods. The programme consisted of three interactive sessions held with physiotherapists from a metropolitan public health network in Melbourne, Victoria, Australia. The effectiveness of clinical supervision of supervisees was measured using the Manchester Clinical Supervision Scale (MCSS–26). The effectiveness of clinical supervision from the supervisors’ perspective was measured using a clinical supervisor questionnaire. The physiotherapists’ experience of participating in the training programme was then explored in focus groups. Results: A total of 36 physiotherapists participated in the training programme. Twelve weeks later, the physiotherapists (35) reported a moderate improvement in the effectiveness of clinical supervision, with a mean improvement of 5.4 units (95% CI: 2.0, 8.9 p = 0.003) on the MCSS–26 (score range 0–104). After training, a higher proportion of physiotherapists reported receiving effective clinical supervision (97% after vs. 53% before p = 0.001). In the focus groups, the physiotherapists reported greater flexibility in their approach to clinical supervision and a more effective supervisory relationship. However, difficulty finding time for supervision remained a barrier. Conclusions: Physiotherapists reported an improvement in the effectiveness of clinical supervision after a clinical supervision training programme.
Publisher: Oxford University Press (OUP)
Date: 09-06-0006
Abstract: To determine whether clinical supervision (CS) of health professionals improves patient safety. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital. Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I(2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I(2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I(2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I(2) = 0%). CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals.
Publisher: Informa UK Limited
Date: 13-05-2019
Publisher: University of Toronto Press Inc. (UTPress)
Date: 08-2020
Abstract: Purpose: We explored physiotherapists’ perceptions of clinical supervision. Method: In idual semi-structured interviews were conducted with a purposive s le of 21 physiotherapists from a public hospital. Qualitative analysis was undertaken using an interpretive description approach. The Manchester Clinical Supervision Scale (MCSS–26) was administered to evaluate the participants’ perceptions of the effectiveness of the clinical supervision they had received and to establish trustworthiness in the qualitative data by means of triangulation. Results: The major theme was that the content of clinical supervision should focus on professional skill development, both clinical and non-clinical. Four subthemes emerged as having an influence on the effectiveness of supervision: the model of clinical supervision, clinical supervision processes, supervisor factors, and supervisee factors. All sub-themes had the potential to act as either a barrier to or a facilitator of the perception that clinical supervision was effective. Conclusions: Physiotherapists reported that clinical supervision was most effective when it focused on their professional skill development. They preferred a direct model of supervision, whereby their supervisor directly observed and guided their professional skill development. They also described the importance of informal supervision in which guidance is provided as issues arise by supervisors who value the process of supervision. Physiotherapists emphasized that supervision should be driven by their learning needs rather than health organization processes.
Publisher: Wiley
Date: 10-03-2022
DOI: 10.1111/AJAG.13062
Abstract: To explore older persons’ perceptions of the impact of COVID‐19 restrictions on participating in community activities after discharge from inpatient rehabilitation. Mixed‐methods study design. Participants were older adults who were discharged home following inpatient rehabilitation. Interviews were conducted with 70 participants, with a variety of diagnoses, 8 weeks after discharge from inpatient rehabilitation. Frequency of participation in domestic, leisure/work and outdoor activities was measured using the Frenchay Activities Index (FAI). Qualitative analysis was completed using qualitative content analysis and triangulated with FAI scores. In all, 70 older adults (mean age: 73.0 years, SD: 9.9 59% female) participated in the study. The overarching theme was that participants felt socially isolated following discharge from rehabilitation, with COVID‐19 restrictions increasing perceptions of social isolation and complicating their return to participating in community activities. The four categories informing the overarching theme were as follows: physical health was the primary limitation to participation in community activities COVID‐19 restrictions limited participation in social activities and centre‐based physical rehabilitation low uptake of videoconferencing to facilitate socialisation and rehabilitation and reduced incidental physical activity. Mean FAI score was 21.2 (SD 7.8), indicating that participants were moderately active. Participants most commonly performed domestic activities (mean: 10.0, SD: 4.1), followed by outdoor activities (mean: 6.6, SD: 3.5) and leisure/work activities (mean: 4.5, SD: 2.5). COVID‐19 restrictions exacerbated perceptions of social isolation and the limitations already imposed by poor physical health after discharge from rehabilitation. The findings highlight the need for rehabilitation that addresses the psychological and social dimensions of community reintegration.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-02-2021
Publisher: Springer Science and Business Media LLC
Date: 31-12-2019
DOI: 10.1186/S12913-019-4873-8
Abstract: Clinical supervision is recommended for allied health professionals for the purpose of supporting them in their professional role, continued professional development and ensuring patient safety and high quality care. The aim of this mixed methods study was to explore allied health professionals’ perceptions about the aspects of clinical supervision that can facilitate effective clinical supervision. In idual semi-structured interviews were conducted on a purposive s le of 38 allied health professionals working in a metropolitan public hospital. Qualitative analysis was completed using an interpretive description approach. To enable triangulation of qualitative data, a quantitative descriptive survey of clinical supervision effectiveness was also conducted using the Manchester Clinical Supervision Scale (MCSS-26). Three main themes emerged from qualitative analysis: Allied health professionals reported that clinical supervision was most effective when their professional development was the focus of clinical supervision the supervisor possessed the skills and attributes required to facilitate a constructive supervisory relationship and the organisation provided an environment that facilitated this relationship together with their own professional development. Three subthemes also emerged within each of the main themes: the importance of the supervisory relationship prioritisation of clinical supervision relative to other professional duties and flexibility of supervision models, processes and approaches to clinical supervision. The mean MCSS-26 score was 79.2 (95%CI 73.7 to 84.3) with scores ranging from 44 to 100. MCSS-26 results converged with the qualitative findings with participants reporting an overall positive experience with clinical supervision. The factors identified by allied health professionals that influenced the effectiveness of their clinical supervision were mostly consistent among the professions. However, allied health professionals reported using models of clinical supervision that best suited their profession’s role and learning style. This highlighted the need for flexible approaches to allied health clinical supervision that should be reflected in clinical supervision policies and guidelines. Many of the identified factors that influence the effectiveness of clinical supervision of allied health professionals can be influenced by health organisations.
Publisher: Elsevier BV
Date: 10-2022
No related grants have been discovered for David Snowdon.