Allied health weekend service provision in Australian rehabilitation units

Caruana, Erin L.; Kuys, Suzanne; Brauer, Sandra G.

doi:10.1111/ajag.12500

Cited by 13 publications

(15 citation statements)

References 21 publications

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“…Central to the context of this study is evidence that, within Australia, allied health therapeutic services are provided during business hours in (20,21). Typically, reduced allied health services are available during weekends, with the goal of facilitating patient discharge, and preventing adverse events and escalation of care.…”

Section: Introductionmentioning

confidence: 99%

“…Typically, reduced allied health services are available during weekends, with the goal of facilitating patient discharge, and preventing adverse events and escalation of care. Further, there is a variety in weekend allied health provision both within (22) and between health services (20,21). Within services, allied health departments have different levels of availability during weekends based on perceived benefits (23,24).…”

Section: Introductionmentioning

confidence: 99%

“…Within services, allied health departments have different levels of availability during weekends based on perceived benefits (23,24). Between services, there is a large unwarranted variation in care, with approximately 43-61% of acute hospitals and 30-53% of sub-acute hospitals providing weekend services (20,21). Variations in care can often be ascribed to uncertainty around the effectiveness of specific healthcare approaches (25), emphasising the importance of evidence dissemination and implementation into policy and practice.…”

Section: Introductionmentioning

confidence: 99%

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Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.

White

Grant

Sarkies

et al. 2020

Preprint

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BackgroundHealth policy and management decisions rarely reflect research evidence. In response, it is important to determine how to improve evidence-informed decision-making. As part of a broader study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. MethodsAllied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and sub-acute rehabilitation wards were eligible for inclusion. Consenting participants were randomised to: (1) control group or; (2) Implementation Group 1: received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) Implementation Group 2: received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. Serial focus groups were conducted with a sample of over 80 allied health managers recruited to Implementation Group 2 only. Out of 6 waves of recruitment, up to four focus groups were conducted with each wave during the 12 months study period. In total 17 health services participated in serial focus groups according to their allocated wave, over a 12-month study period. Data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved.ResultsResults provide insights into resource allocation and decision-making, including the interplay between barriers and facilitators concerning implementation of recommendations outlined in evidence-based policy recommendation document. Five key themes emerged: (1) Local data trumps, or is more influential; (2) How good is the evidence and does it apply to us; (3) It is difficult to change things; (4) Historically that’s how we have done things; and (5) What if we get complaints?ConclusionsThis study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence base practice from fully, and successfully occurring such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.

White

Grant

Sarkies

et al. 2020

Preprint

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“…In many settings, the multidisciplinary team typically only provide services to GEM patients on weekdays. About half of Australian hospitals provide weekend allied health services to rehabilitation wards including GEM, most commonly limited to half‐day physiotherapy services . One reason why Saturday allied health services may not be provided more commonly in GEM is the cost of staffing these services.…”

Section: Introductionmentioning

confidence: 99%

“…About half of Australian hospitals provide weekend allied health services to rehabilitation wards including GEM, most commonly limited to half-day physiotherapy services. 5 One reason why Saturday allied health services may not be provided more commonly in GEM is the cost of staffing these services. In the context of the need for value-based | 65 TAYLOR eT AL.…”

Section: Introductionmentioning

confidence: 99%

Saturday allied health services for geriatric evaluation and management: A controlled before‐and‐after trial

et al. 2019

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Objective To assess the effect of Saturday allied health services on a geriatric evaluation and management ward. Methods A controlled before‐and‐after trial at two wards. Allied health services were added to usual weekday staffing on Saturdays for 6 months on the experimental ward. Length of stay, functional independence, readmissions, discharge destination and costs were evaluated at pre‐intervention (N = 331) and intervention (N = 462). Results Relative to the comparison ward, the experimental ward had longer length of stay (mean 7.8 days, 95% CI 4.7‐10.8), fewer readmissions (mean 3.1 days, 95% CI 0.6‐5.7) and no difference in the proportion discharged home. Cost‐effectiveness demonstrated no significant difference in cost ($2639, 95% CI $‐386 to $5647) and functional independence gain (3.6 units, 95% CI 0.8‐6.5) favouring the experimental ward. Conclusion These findings do not support the provision of additional Saturday allied health services in geriatric evaluation and management to reduce length of stay.

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Weekend / holiday effect on stroke mortality in regional Australia: A ten-year retrospective study

He,

Mnatzaganian,

Rutherford

et al. 2024

Journal of Stroke and Cerebrovascular Diseases

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Allied health weekend service provision in Australian rehabilitation units

Abstract: Despite increasing evidence of effectiveness, only half of Australian rehabilitation facilities provide weekend services. Further efforts are required to translate evidence from clinical trials into feasible service delivery models.

Cited by 13 publications

References 21 publications

Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.

Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.

Saturday allied health services for geriatric evaluation and management: A controlled before‐and‐after trial

Weekend / holiday effect on stroke mortality in regional Australia: A ten-year retrospective study

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