Better Outcomes in Mental Health Care: Impact of Different Models of Psychological Service Provision on Patient Outcomes

2007 ◽  
Vol 41 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Belinda Morley ◽  
Jane Pirkis ◽  
Kristy Sanderson ◽  
Philip Burgess ◽  
Fay Kohn ◽  
...  

Objective: One hundred and eight Access to Allied Psychological Services projects have been funded under Australia's Better Outcomes in Mental Health Care programme since July 2001. All projects are run by Divisions of General Practice and enable general practitioners (GPs) to refer patients to allied health professionals for evidence-based care. They differ in the models they use to retain, locate and direct referrals to their allied health professionals. This paper examines the extent to which the projects are achieving positive patient outcomes, and explores the association between different models of service delivery and varying levels of patient outcomes. Method: The paper draws on two data sources (a purpose-designed minimum dataset and a survey of models of service delivery) to examine the level of patient outcomes within and across projects, and variations in the level of patient outcomes by models of service delivery. Results: The projects are achieving positive effects and these are mostly of large or medium magnitude. The projects do not differ markedly in terms of the patient outcomes they are achieving, despite differences in the models of service delivery they are using. However, those projects implementing a direct referral model, where the GP refers the patient directly to the allied health professional, have significantly greater effect sizes, indicating that they are achieving greater improvements in patient outcomes. In addition, there are non-significant trends toward direct employment of allied health professionals by Divisions being predictive of greater improvements in patient outcomes, and delivery of services from allied health professionals’ own rooms being predictive of weaker patient outcomes. Conclusions: Overwhelmingly, the Access to Allied Psychological Services projects are having a positive impact for patients in terms of their level of functioning, severity of symptoms and/or quality of life. Preliminary indications suggest that a service delivery model incorporating the use of a direct referral system may be associated with superior outcomes. The findings are discussed in the light of the imminent listing of psychologists’ services on the Medicare Benefits Schedule.

2006 ◽  
Vol 30 (3) ◽  
pp. 277 ◽  
Author(s):  
Jane Pirkis ◽  
Philip Burgess ◽  
Fay Kohn ◽  
Belinda Morley ◽  
Grant Blashki ◽  
...  

The Access to Allied Psychological Services component of Australia?s Better Outcomes in Mental Health Care program enables eligible general practitioners to refer consumers to allied health professionals for affordable, evidence-based mental health care, via 108 projects conducted by Divisions of General Practice. The current study profiled the models of service delivery across these projects, and examined whether particular models were associated with differential levels of access to services. We found: � 76% of projects were retaining their allied health professionals under contract, 28% via direct employment, and 7% some other way; � Allied health professionals were providing services from GPs? rooms in 63% of projects, from their own rooms in 63%, from a third location in 42%; and � The referral mechanism of choice was direct referral in 51% of projects, a voucher system in 27%, a brokerage system in 24%, and a register system in 25%. Many of these models were being used in combination. No model was predictive of differential levels of access, suggesting that the approach of adapting models to the local context is proving successful.


2004 ◽  
Vol 9 (4) ◽  
pp. 125-130 ◽  
Author(s):  
Jane Pirkis ◽  
Belinda Morley ◽  
Fay Kohn ◽  
Grant Blashkl ◽  
Philip Burgess ◽  
...  

2020 ◽  
Vol 33 (4) ◽  
pp. 339-349
Author(s):  
Lisa Beasley ◽  
Sandra Grace ◽  
Louise Horstmanshof

Purpose The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications Social implications This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value To the best of the authors’ knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change.


2006 ◽  
Vol 30 (2) ◽  
pp. 195 ◽  
Author(s):  
Sanjyot Vagholkar ◽  
Lesley Hare ◽  
Iqbal Hasan ◽  
Nicholas Zwar ◽  
David Perkins

Introduction: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001?2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice. This paper presents the findings of these evaluations. Method: Both evaluations analysed process and patient outcomes. This was obtained from a combination of program data and qualitative satisfaction data. Results: The two program models differed in the mechanism of retention of the psychologists and the method of referral of patients. Anxiety and depression were the main reasons for referral, and clinical data showed there was improvement in patient outcomes. Patients, GPs and psychologists expressed satisfaction with the programs. Discussion: The Access to Allied Psychological Services programs in both Divisions have proven popular. Flexibility in the program structure allows Divisions to develop a model which suits their local circumstances. There is support for ongoing Commonwealth funding and the challenge is to find the most effective and financially sustainable model of delivery for psychological services in primary care.


Author(s):  
Maria Gianino ◽  
Gianfranco Politano ◽  
Antonio Scarmozzino ◽  
Michela Stillo ◽  
Viola Amprino ◽  
...  

This study aims to estimate the economic costs of sickness absenteeism of health care workers in a large Italian teaching hospital during the seasonal flu periods. A retrospective observational study was performed. The excess data of hospital’s sickness absenteeism during three seasonal influenza periods (2010/2011; 2011/2012; 2012/2013) came from a previous study. The cost of sickness absenteeism was calculated for six job categories: medical doctor, technical executive (i.e., pharmacists); nurses and allied health professionals (i.e., radiographer), other executives (i.e., engineer), non-medical support staff, and administrative staff, and for four age ranges: <39, 40–49, 50–59, and >59 years. An average of 5401 employees working each year were under study. There were over 11,100 working days/year lost associated with an influenza period in Italy, the costs associated were approximately 1.7 million euros, and the average work loss was valued at € 327/person. The major shares of cost appeared related to nurses and allied health professionals (45% of total costs). The highest costs for working days lost were reported in the 40–49 age range, accounting for 37% of total costs. Due to the substantial economic burden of sickness absenteeism, there are clear benefits to be gained from the effective prevention of the influenza.


1996 ◽  
Vol 2 (1) ◽  
pp. 92
Author(s):  
Jill Thoroughgood

In this paper, issues are discussed relating to the provision of quality allied health advice, and the focus of the allied health program in primary health care and community health settings in the Peninsula and Torres Strait Region of Queensland, since Regionalisation in 1991. It was apparent to allied health professionals working in community health, that the change process presented an opportunity to influence not only the Regional Health Authority, but also to act as a united voice for the professions and to be advocates for best practice models of care for the community. Why do allied health professionals need to be utilised in an advisory role in community based health settings? What are the impacts on policy, planning, and on the services provided by community health care workers? How can allied health advisers enhance the quality of outcomes of best practice for the consumers of community health programs? Allied health advisers are important for the whole health sector by ensuring that effective and appropriate allied health services are delivered, that there are increases in allied health resources, that there are improvements in health outcomes for clients, that primary health care models of care are implemented, and, finally, that best practice is implemented by the allied health professional.


2015 ◽  
Vol 39 (3) ◽  
pp. 255 ◽  
Author(s):  
Elizabeth H. Skinner ◽  
Kimberley J. Haines ◽  
Kate Hayes ◽  
Daniel Seller ◽  
Jessica C. Toohey ◽  
...  

Allied health professions have developed specialised advanced and extended scope roles over the past decade, for the benefit of patient outcomes, allied health professionals’ satisfaction and to meet labour and workforce demands. There is an essential need for formalised, widely recognised training to support these roles, and significant challenges to the delivery of such training exist. Many of these roles function in the absence of specifically defined standards of clinical practice and it is unclear where the responsibility for training provision lies. In a case example of physiotherapy practice in the intensive care unit, clinical placements and independence of practice are not core components of undergraduate physiotherapy degrees. Universities face barriers to the delivery of postgraduate specialised training and, although hospital physiotherapy departments are ideally placed, resources for training are lacking and education is not traditionally considered part of healthcare service providers’ core business. Substantial variability in training, and its evaluation, leads to variability in practice and may affect patient outcomes. Allied health professionals working in specialised roles should develop specific clinical standards of practice, restructure models of health care delivery to facilitate training, continue to develop the evidence base for their roles and target and evaluate training efficacy to achieve independent practice in a cost-effective manner. Healthcare providers must work with universities, the vocational training sector and government to optimise the ability of allied health to influence decision making and care outcomes for patients.


2014 ◽  
Vol 21 (4) ◽  
pp. 221-226 ◽  
Author(s):  
Sandra Peláez ◽  
Simon L Bacon ◽  
Mark W Aulls ◽  
Guillaume Lacoste ◽  
Kim L Lavoie

BACKGROUND: The recent literature has reported disparate views between patients and health care professionals regarding the roles of various factors affecting medication adherence.OBJECTIVE: To examine the perspectives of asthma patients, physicians and allied health professionals regarding adherence to asthma medication.METHODOLOGY: A qualitative, multiple, collective case study design with six focus-group interviews including 38 participants (13 asthma patients, 13 pulmonologist physicians and 12 allied health professionals involved in treating asthma patients) was conducted.RESULTS: Patients, physicians and allied health professionals understood adherence to be an active process. In addition, all participants believed they had a role in treatment adherence, and agreed that the cost of medication was high and that access to the health care system was restricted. Major disagreements regarding patient-related barriers to medication adherence were identified among the groups. For example, all groups referred to side effects; however, while patients expressed their legitimate concerns, health care professionals believed that patients’ opinions of medication side effects were based on inadequate perceptions.CONCLUSION: Differences regarding medication adherence and barriers to adherence among the groups examined in the present study will provide insight into how disagreements may be translated to overcome barriers to optimal asthma adherence. Furthermore, when designing an intervention to enhance medication adherence, it is important to acknowledge that perceptual gaps exist and must be addressed.


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