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  • 1
    Online Resource
    Online Resource
    Beyond forced telehealth adoption: A framework to sustain telehealth among allied health services
    SAGE Publications ; 2022
    In:  Journal of Telemedicine and Telecare
    Details
    In: Journal of Telemedicine and Telecare, SAGE Publications
    Abstract: As COVID-19 restrictions reduce globally, services will determine what components of care will continue via telehealth. We aimed to determine the clinician, service, and system level factors that influence sustained use of telehealth and develop a framework to enhance sustained use where appropriate. Methods This study was conducted across 16 allied health departments over four health service facilities (Brisbane, Australia). It used a multi-method observational study design, involving telehealth service activity data from hospital administrative databases and qualitative interviews with allied health staff (n  =  80). Data were integrated and analysed using Greenhalgh's Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework. Results Increased telehealth use during the peak COVID period reverted to in-person activity as restrictions eased. Telehealth is unlikely to be sustained without a clear strategy including determination of roles and responsibilities across the organisation. Clinician resistance due to forced adoption remains a key issue. The main motivator for clinicians to use telehealth was improved consumer-centred care. Benefits beyond this are needed to sustain telehealth and improvements are required to make the telehealth experience seamless for providers and recipients. Data were synthesised into a comprehensive framework that can be used as a blueprint for system-wide improvements and service enhancement or redesign. Discussion Sustainability of telehealth activity beyond the peak COVID period is unlikely without implementation strategies to address consumer, clinician, service, and system factors. The framework can inform how these strategies can be enacted. Whilst developed for allied health disciplines, it is likely applicable to other disciplines.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    URL: Article
    DOI: 10.1177/1357633X221074499
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2007700-2
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  • 2
    Online Resource
    Online Resource
    Digital divide or digital exclusion? Do allied health professionals’ assumptions drive use of telehealth?
    SAGE Publications ; 2023
    In:  Journal of Telemedicine and Telecare
    Details
    In: Journal of Telemedicine and Telecare, SAGE Publications
    Abstract: Telehealth use within allied health services currently lacks structure and consistency, ultimately affecting who can, and cannot, access services. This study aimed to investigate the factors influencing allied health professionals’ (AHP) selection of consumers and appointments for telehealth. Methods This study was conducted across 16 allied health departments from four Australian hospitals. Semi-structured focus groups were conducted with 58 AHPs. Analysis was underpinned by Qualitative Description methodology with inductive coding guided by Braun and Clarke's thematic analysis approach. Results Six themes were identified that influenced AHPs’ evaluation of telehealth suitability and selection of consumers. These included the following: (1) ease, efficiency and comfort of telehealth for clinicians; (2) clear benefits of telehealth for the consumer, yet the consumers were not always given the choice; (3) consumers’ technology access and ability; (4) establishing and maintaining effective therapeutic relationships via telehealth; (5) delivering clinically appropriate and effective care via telehealth; and (6) external influences on telehealth service provision. A further theme of ‘assumption versus reality’ was noted to pervade all six themes. Discussion Clinicians remain the key decision makers for whether telehealth is offered within allied health services. Ease and efficiency of use is a major driver in AHP's willingness to use telehealth. Assumptions and pre-conceived frames-of-reference often underpin decisions to not offer telehealth and present major barriers to telehealth adoption. The development of evidence-based, decision-support frameworks that engage the consumer and clinician in determining when telehealth is used is required. Services need to actively pursue joint decision-making between the clinician and consumer about service delivery preferences.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    URL: Article
    DOI: 10.1177/1357633X231189846
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 3
    Online Resource
    Online Resource
    Changing from telephone to videoconference for pre-treatment pharmacist consults in cancer services: Impacts to funding and time efficiency
    SAGE Publications ; 2021
    In:  Journal of Telemedicine and Telecare Vol. 27, No. 10 ( 2021-12), p. 680-684
    Details
    In: Journal of Telemedicine and Telecare, SAGE Publications, Vol. 27, No. 10 ( 2021-12), p. 680-684
    Abstract: Introduction: This study examined the reimbursement opportunity and the time efficiency of a standard care model of unscheduled telephone consults compared to scheduled videoconference consults for obtaining pre-treatment medication histories for patients with cancer. Methods: Data related to (a) the available and the claimed activity-based funding for both models and (b) the number of contacts and the duration of each contact to complete the patient’s medication history via either unscheduled telephone or scheduled videoconference consults were collected and compared. Results: Data was collected for 86 telephone and 56 videoconference consults. The actual activity-based funding claimed for telephone consults was $0, even though $86 of activity-based funding was available for each consult. This represented a $0 reimbursement for the staff time spent conducting the telephone consults, and a missed opportunity to claim $86 per consult. Activity-based funding was claimed for all but one videoconference consult with an average of $205 received per consult, when $221 per consult was available. Videoconference consults were an average of 2.3 min shorter than telephone consults. Discussion: When compared to unscheduled telephone consults, the scheduled videoconference consults represented increased reimbursement and equivalent time efficiency for the cancer pharmacist completing pre-treatment medication histories.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    URL: Article
    DOI: 10.1177/1357633X211048393
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Post‐acute health care needs of people with head and neck cancer: Mapping health care services, experiences, and the impact of rurality
    Wiley ; 2022
    In:  Head & Neck Vol. 44, No. 6 ( 2022-06), p. 1377-1392
    Details
    In: Head & Neck, Wiley, Vol. 44, No. 6 ( 2022-06), p. 1377-1392
    Abstract: People with head and neck cancer (HNC) have complex health care needs; however, limited evidence exists regarding the nature or patterns of service access and use. This study explored the post‐discharge health care needs and experiences of individuals with HNC from metropolitan and rural areas. Methods Health care appointments and services accessed by people with HNC were collated for 6‐month post‐treatment. Data analysis of the whole cohort examined patterns of access while journey mapping integrated participants' experiences of recovery. Results The 6‐month service access journey was mapped for 11 people. Rural participants attended a significantly greater number of appointments ( p  = 0.012), higher canceled/missed appointments ( p  = 0.013), and saw more professionals (p = 0.007). Rural participants reported higher stress and burden due to service access barriers and unmet needs. Conclusions Multiple challenges and inequities exist for rural people with HNC. Findings inform opportunities to enhance the post‐treatment recovery of people with HNC in rural areas.
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    URL: Article
    DOI: 10.1002/hed.v44.6
    DOI: 10.1002/hed.27037
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2001440-5
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  • 5
    Online Resource
    Online Resource
    Enhancing speech-language pathology head and neck cancer service provision in rural Australia: Using a plan, do, study, act approach
    Informa UK Limited ; 2023
    In:  International Journal of Speech-Language Pathology Vol. 25, No. 2 ( 2023-03-04), p. 292-305
    Details
    In: International Journal of Speech-Language Pathology, Informa UK Limited, Vol. 25, No. 2 ( 2023-03-04), p. 292-305
    Type of Medium: Online Resource
    ISSN: 1754-9507 , 1754-9515
    URL: Article
    DOI: 10.1080/17549507.2022.2050300
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
    detail.hit.zdb_id: 2406625-4
    SSG: 7,11
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  • 6
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    Online Resource
    Speech pathology service enhancement for people with head and neck cancer living in rural areas: Using a concept mapping approach to inform service change
    Wiley ; 2021
    In:  Head & Neck Vol. 43, No. 11 ( 2021-11), p. 3504-3521
    Details
    In: Head & Neck, Wiley, Vol. 43, No. 11 ( 2021-11), p. 3504-3521
    Abstract: Speech pathology (SP) services provide swallowing and communication intervention to people with head and neck cancer (HNC) across the continuum of care. However, difficulties exist with access and delivery of services in rural areas. The study aim was to identify actionable goals for SP change, utilizing a concept mapping approach. Methods Eleven SP staff from two regional/remote services completed the concept mapping process. Multivariate analysis and multidimensional scaling were used to develop a final set of prioritized goals for change. Results Between the two participating health services, 30 actionable goals were identified within the “green‐zone” on the go‐zone graph of importance and changeability. Among the most highly rated areas for change was the need to deliver and receive more support for training, mentoring, and supervision to consolidate skills. Conclusions This methodology enabled identification of prioritized, actionable changes to improve SP services for people with HNC living in regional/remote areas.
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    URL: Article
    DOI: 10.1002/hed.v43.11
    DOI: 10.1002/hed.26850
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2001440-5
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  • 7
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    Clinician and consumer perceptions of head and neck cancer services in rural areas: Implications for speech pathology service delivery
    Wiley ; 2022
    In:  Australian Journal of Rural Health Vol. 30, No. 2 ( 2022-04), p. 175-187
    Details
    In: Australian Journal of Rural Health, Wiley, Vol. 30, No. 2 ( 2022-04), p. 175-187
    Abstract: Individuals with head and neck cancer residing in rural areas face numerous challenges accessing post‐acute rehabilitation services, including speech pathology services. In order to inform future service enhancements, the key issues impacting access to, and the provision of, speech pathology head and neck cancer services in rural areas was explored through the perspectives of patients, carers, speech pathology clinicians and service managers. Setting A rural health referral network in Queensland consisting of tertiary, regional and remote hospitals. Participants Twenty‐eight participants, including 12 speech pathology staff/managers and 16 consumers (people with head and neck cancer/carers). Design Qualitative methodology using semi‐structured interviews was analysed using content analysis. Results Two themes were identified from the consumer group including (a) navigating health services for head and neck cancer management and (b) burden of accessing head and neck cancer care. Speech pathology staff/managers interviews raised 3 themes: (a) transfer of care and access to local services, (b) workforce and workload and (c) travelling impacts the service our patients can receive. An integrative theme across both groups highlighted the perceived disparity in health care access that existed for people with head and neck cancer in rural areas. Conclusions In rural areas, consumers face multiple barriers navigating the head and neck cancer treatment pathway, while health services encounter specific challenges ensuring access and equity in care. Despite the complexities, possible avenues for service change and service enhancement are proposed. Speech pathology services in rural areas need to proactively evaluate services and address existing disparities in order to enact positive change for people with head and neck cancer living outside metropolitan locations.
    Type of Medium: Online Resource
    ISSN: 1038-5282 , 1440-1584
    URL: Issue
    URL: Article
    DOI: 10.1111/ajr.v30.2
    DOI: 10.1111/ajr.12829
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2069573-1
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  • 8
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    Online Resource
    Comprehensive quality assessment for aphasia rehabilitation after stroke: protocol for a multicentre, mixed-methods study
    BMJ ; 2024
    In:  BMJ Open Vol. 14, No. 3 ( 2024-03), p. e080532-
    Details
    In: BMJ Open, BMJ, Vol. 14, No. 3 ( 2024-03), p. e080532-
    Abstract: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. Methods and analysis This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4). Ethics and dissemination Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women’s Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry custodians, consumer support organisations, and individuals with aphasia and their families.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2023-080532
    Language: English
    Publisher: BMJ
    Publication Date: 2024
    detail.hit.zdb_id: 2599832-8
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  • 9
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    Online Resource
    Exploring the impact of remoteness on people with head and neck cancer: Utilisation of a state‐wide dataset
    Wiley ; 2023
    In:  Australian Journal of Rural Health Vol. 31, No. 4 ( 2023-08), p. 726-743
    Details
    In: Australian Journal of Rural Health, Wiley, Vol. 31, No. 4 ( 2023-08), p. 726-743
    Abstract: Living in regional/rural areas can impact outcomes for people with head and neck cancer (HNC). Using a comprehensive state‐wide dataset, the impact of remoteness on key service parameters and outcomes for people with HNC was examined. Methods Retrospective quantitative analysis of routinely collected data held within the Queensland Oncology Repository. Design Quantitative methods (descriptive statistics, multivariable logistic regression and geospatial analysis). Setting All people diagnosed with HNC in Queensland, Australia. Participants The impact of remoteness was examined in 1991 people (1171 metropolitan, 485 inner‐regional, 335 rural) with HNC cancer diagnosed between 2013 and 2015. Main Outcome Measures This paper reports key demographics and tumour characteristics (age, gender, socioeconomic status, First Nations status, co‐morbidities, primary tumour site and staging), service use/uptake (treatment rates, attendance at multidisciplinary team review and timing to treatment) and post‐acute outcomes (readmission rates, causes of readmission and 2‐year survival). In addition to this, the distribution of people with HNC across QLD, distances travelled and patterns of readmission were also analysed. Results Regression analysis revealed remoteness significantly ( p   〈  0.001) impacted access to MDT review, receiving treatment, and time to treatment commencement, but not readmission or 2‐year survival. Reasons for readmission did not differ by remoteness, with dysphagia, nutritional inadequacies, gastrointestinal disorders and fluid imbalance indicated in the majority of readmissions. Rural people were significantly ( p   〈  0.0001) more likely to travel to care and to readmit to a different facility than provided primary treatment. Conclusions This study provides new insights into the health care disparities for people with HNC residing in regional/rural areas.
    Type of Medium: Online Resource
    ISSN: 1038-5282 , 1440-1584
    URL: Issue
    URL: Article
    DOI: 10.1111/ajr.v31.4
    DOI: 10.1111/ajr.13005
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2069573-1
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  • 10
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    Online Resource
    An evaluation of telephone versus videoconference consults for pre-treatment medication history taking by cancer pharmacists
    SAGE Publications ; 2022
    In:  Journal of Telemedicine and Telecare Vol. 28, No. 10 ( 2022-12), p. 750-756
    Details
    In: Journal of Telemedicine and Telecare, SAGE Publications, Vol. 28, No. 10 ( 2022-12), p. 750-756
    Abstract: The primary aim was to compare the successful completion rates of pre-treatment medication history consults conducted by pharmacists with patients either via an unscheduled telephone consult (current standard care) or a scheduled videoconference consult model. Secondary aims were to examine pharmacist perceptions of the telephone and videoconference consults and explore patient (+/− support person) perceptions of videoconference consults. Method Completion data were collected and compared for the two modalities. In addition, pharmacists commented on any positive/negative factors impacting all consults. For the final 35 participants completing a videoconference consult, patients, support people, and pharmacists involved, completed a survey exploring perceptions and satisfaction. Results A significantly higher completion rate ( p  〈  0.0001) was found for the videoconferencing model, with 94% (76 of 81) completed successfully compared to 72% (76 of 105) of the unscheduled telephone consults. Pharmacists reported multiple factors impacting the success of the telephone consults including scheduling issues and patient factors. Survey responses revealed that 100% of patients/support people and 82% of pharmacists reported satisfaction with videoconference consults. Surveyed participants noted some technical issues, however, the ‘ability to show/view medication containers and/or labels’ and ‘convenience of scheduled time’ were benefits of the videoconference model. Discussion Results indicate that pre-treatment medication history consults should be offered via videoconference to maximise success.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    URL: Article
    DOI: 10.1177/1357633X221122140
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2007700-2
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