Advanced Physiotherapy Practice: A qualitative study on the potential challenges and barriers to implementation in Ghana

Tawiah, Andrews K.; Borthwick, Alan; Woodhouse, Linda J.

doi:10.1080/09593985.2018.1484535

Cited by 8 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in contrast to the study by Morris, Grimmer, et al (2014), where stakeholders have identified the need for formal training of APPs from the outset (Morris, Grimmer, et al, 2014). Formal training programmes facilitate external recognition of physiotherapists' capacity to perform competently in an advanced scope role (Morris, Grimmer, et al, 2014), and the development of the same is supported by several authors (Fennelly et al, 2018a; Tawiah, Borthwick, & Woodhouse, 2018). It is most likely that preferences for in‐house training and mentoring are due to the initial novel nature of any new service, and one‐to‐one training at the early stage allows for the development of constructive interprofessional working relationships.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic consultant surgeons perceptions of an advanced practice physiotherapy service in paediatrics: A qualitative study

Mir

Blake

Cunningham

et al. 2020

Musculoskeletal Care

View full text Add to dashboard Cite

Objectives The objective of this study is to determine orthopaedic consultants' perceptions of an advanced practice physiotherapy (APP) service in paediatrics. Design This is a qualitative study that use semi‐structured interviews to explore consultant doctors' experiences of an APP paediatric orthopaedic service and its development. Data were transcribed verbatim and subsequently underwent thematic analysis. Participants Five orthopaedic consultants in two hospital settings participated, and all of whom had experience of working with paediatric orthopaedic APPs. Results Seven themes were derived from the analysis, with all participants in the study identifying factors affecting the development of the service and demonstrating broad support for the APP role, with benefits noted as including improved efficiency of service, expansion of skill mix within the team, positive impressions of the standard of care and improved education and liaison with the families and community practitioners at large. Conclusions This paper highlights many of the factors that should be considered when introducing an APP service in an outpatient setting. This study demonstrates consistent cross‐site positive regard in the skill and competency of the APP in paediatric orthopaedics, to enhance orthopaedic services for children.

show abstract

Section: Discussionmentioning

confidence: 99%

Orthopaedic consultant surgeons perceptions of an advanced practice physiotherapy service in paediatrics: A qualitative study

Mir

Blake

Cunningham

et al. 2020

Musculoskeletal Care

View full text Add to dashboard Cite

show abstract

“…The topic list was based on the available knowledge from the literature [14][15][16][17][18], enriched with elements of the constellation approach (i.e., culture, structure and practice characteristics) [19], and the personal input of the researchers (SP, ER, AP). The topic list included the following topics; reasons for starting a collaboration, extent of implementation and activities of APPs, training of APPs, awareness and need for an APP, support from the professional association, barriers and facilitators in the collaboration, alignment with the core values of Dutch general practice, and opportunities and future prospects for APPs.…”

Section: Data Collection and Data Analysismentioning

confidence: 99%

“…The current study shows that many of these factors, such as physician trust and demonstrating clear added value to stakeholders and the nancing structure, have not yet been su ciently realised to facilitate the implementation of APP. Organisational introduction and support have been described as helpful in studies of APP embedded in secondary or tertiary care [14,15,17,18]. Such support is lacking in the implementation of APP in the Netherlands, and an individual APP working independently in primary care will need to build a partnership without support.…”

Section: Comparison With Literaturementioning

confidence: 99%

“…Several qualitative studies [14][15][16][17][18] have explored the barriers and facilitators in the implementation of APP in secondary health care settings, and have shown that knowledge, skills, availability of APP, motivation and experience have a large impact on successful implementation. Although these studies are of great value in improving the implementation of APP, their outcomes may not be applicable for the Dutch primary care setting.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Introduction of Advanced Practice Physiotherapy in Dutch Primary Care is a Search for Possibilities, Added Value, and Mutual Trust; A Qualitative Study Among Advanced Practice Physiotherapist and General Practitioners.

Pellekooren

Donker

Reijnders

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Despite the increasing deployment and added value of Advanced Practitioner in Physiotherapy (APP) in musculoskeletal care internationally, APP is not widely accepted in Dutch primary care yet. This may be due to constraints in the implementation of APP within the Dutch health care system. The aim of this study was to explore experiences and perceptions of APP and General Practitioners (GP) in implementing APP in Dutch primary care. Methods: This was an explorative and interpretive qualitative study among 13 APPs and 3 GPs that were in various stages of implementing an APP care model. Semi-structured interviews were conducted from January to March 2021. The topic list was based on existing literature, personal input of researchers, and the Constellation Approach framework. Data were analysed using a thematic inductive approach.Results: Four main themes emerged from the data; 1) The start-up of an APP practice requires trust and clear added value for the GP, 2) Starting APP must be strongly supported by GP, 3) Positioning of APP is still unclear, and 4) Ownership of patients with musculoskeletal complaints. These four themes put forward perceived difficulties in gaining trust, lack of clarity regarding the added value of APP, ambiguity of the APP’s professional profile and positioning, lack of reimbursement structure, and APP’s struggle in seeking balance with current care. Conclusion: This study shows that the implementation of an APP model of care is challenging. The deployment of APP does not sufficiently align with the core values of GPs, and GPs seem reluctant to hand-over some control over patient care to APPs. APP does not appear to have ownership of the implementation, given its strong dependence on the practice, values and needs of the GP.Trial registration: Ethical approval is obtained from the Medical Ethics Committee of the VU University Medical Centre in Amsterdam; reference number 2020.17. All participants were asked written informed consent before participating in this study.

show abstract

“…Healthcare transformation, designed to improve access and quality of care while containing cost, is a worldwide priority [ [93] , [94] , [95] ], aligned with value-based care and enabled through MoCs. Many countries have responded by enabling existing healthcare professionals to work to their maximum scope (advanced scope of practice [ [96] , [97] , [98] , [99] , [100] , [101] ], which has also been articulated as an enabler to implementing MoCs [ 102 ]. Historically, this approach has worked to address shortages in available healthcare practitioners in remote and rural areas and on the front line to triage injured soldiers during wartime.…”

Section: Implementing Models Of Care To Support Value-based Carementioning

confidence: 99%

Implementing models of care for musculoskeletal conditions in health systems to support value-based care

Speerin

Needs

Chua

et al. 2020

Best Practice & Research Clinical Rheumatology

View full text Add to dashboard Cite

Models of Care (MoCs), and their local Models of Service Delivery, for people with musculoskeletal conditions are becoming an acceptable way of supporting effective implementation of value-based care. MoCs can support the quadruple aim of value-based care through providing people with musculoskeletal disease improved access to health services, better health outcomes and satisfactory experience of their healthcare; ensure the health professionals involved are experiencing satisfaction in delivering such care and health system resources are better utilised. Implementation of MoCs is relevant at the levels of clinical practice (micro), service delivery organisations (meso) and health system (macro) levels. The development, implementation and evaluation of MoCs has evolved over the last decade to more purposively engage people with lived experience of their condition, to operationalise the Chronic Care Model and to employ innovative solutions. This paper explores how MoCs have evolved and are supporting the delivery of value-based care in health systems.

show abstract

Advanced Physiotherapy Practice: A qualitative study on the potential challenges and barriers to implementation in Ghana

Cited by 8 publications

References 16 publications

Orthopaedic consultant surgeons perceptions of an advanced practice physiotherapy service in paediatrics: A qualitative study

Orthopaedic consultant surgeons perceptions of an advanced practice physiotherapy service in paediatrics: A qualitative study

Introduction of Advanced Practice Physiotherapy in Dutch Primary Care is a Search for Possibilities, Added Value, and Mutual Trust; A Qualitative Study Among Advanced Practice Physiotherapist and General Practitioners.

Implementing models of care for musculoskeletal conditions in health systems to support value-based care

Contact Info

Product

Resources

About