Allied health structures and leadership positions vary throughout Australia and New Zealand in their design and implementation. It is not clear which organisational factors support allied health leaders and professionals to enhance clinical outcomes. The aim of this project was to identify key organisational contexts and corresponding mechanisms that influenced effective outcomes for allied health professionals. A qualitative realist evaluation was chosen to describe key aspects of allied health organisational structures, identify positive outcomes and describe how context and processes are operationalised to influence outcomes for the allied health workforce and the populations they serve. A purposive sample of nine allied health leaders, five executives and 49 allied health professionals were interviewed individually and in focus groups, representing nine Queensland Health services. Marked differences exist in the title and focus of senior allied health leaders' roles. The use of a qualitative realist evaluation methodology enabled identification of the mechanisms that work to achieve effective and efficient outcomes, within specific contexts. The initial middle range theory of allied health organisational structures in Queensland was supported and extended to better understand which contexts were important and which key mechanisms were activated to achieve effective outcomes. Executive allied health leadership roles enable allied health leaders to use their influence in organisational planning and decision-making to ensure allied health professionals deliver successful patient care services. Professional governance systems embed the management and support of the clinical workforce most efficiently within professional disciplines. With consistent data management systems, allied health professional staff can be integrated within clinical teams that provide high-quality care. Interprofessional learning opportunities can enhance collaborative teamwork and, when allied health professionals are supported to understand and use research, they can deliver positive patient and business outcomes for the health service. A collective allied health organisational structure encourages engagement of allied health professionals within healthcare organisations. Organisational structures commonly include management and leadership strategies and service delivery models. Allied health leaders in Queensland work across a range of senior management levels to ensure adequate resources for sufficient suitably skilled professional staff to meet patient needs. Literature to date has described how allied health professionals operate within organisational structures. This paper examines key aspects of allied health management, governance and leadership, together with mechanisms that support allied health professionals to deliver effective clinical and business outcomes for their local community. Health service executives and allied health leaders should consider supporting executive allied health leadership roles to influence strategic pl...

Background The purpose of this scoping review was to ascertain how ‘telehealth’ is utilised within health care, from pre hospital to admission, discharge and post discharge, with patients who have suffered major trauma. Methods A scoping review of the literature published in English since 1980 was conducted using MEDLINE, Ovid EMBASE, PsychINFO, CINAHL, Austhealth, Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane library) and Web of Science MEDLINE and MEBASE to identify relevant studies. Results We included 77 eligible studies with both randomised controlled trial and cohort design methodology. A variety of trauma was included such as traumatic brain injuries ( n = 52; 67.5%), spinal cord injury ( n = 14; 18.2%) and multi-trauma ( n = 9; 11.7%) to both adult ( n = 38) and paediatric ( n = 32) participants. Telehealth is used in pre-hospital and acute-care settings ( n = 11; 14.3%) to facilitate assessment, and in rehabilitation and follow-up ( n = 61; 79.2%) to deliver therapy. Effects on health were reported the most ( n = 46), with no negative outcomes. The feasibility of telehealth as a delivery mode was established, but coordination and technical issues are barriers to use. Overall, both patients and clinicians were satisfied using this mode of delivery. Conclusion This review demonstrates how telehealth is utilised across a spectrum of patients with traumatic injuries and to facilitate delivery of therapy, specialist consultations and assessments, with many studies reporting improvements to health. There is a paucity of high-quality rigorous research, which makes replication of findings and uptake of the intervention problematic. Future telehealth and trauma research should focus on the quality and reproducibility of telehealth interventions and the economic feasibility of using this platform to deliver trauma care.

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