scholarly journals Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies’ guidance

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055823
Author(s):  
Enza Leone ◽  
Nicola Eddison ◽  
Aoife Healy ◽  
Carolyn Royse ◽  
Nachiappan Chockalingam

ObjectivesThe COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies’ guidelines.DesignScoping review following Aksey and O’ Malley methodological framework.Data sourcesCINHAL and MEDLINE were searched from inception to March 2021 using terms related to ‘telehealth’, ‘guidelines’ and ‘AHPs’. Additionally, the UK AHP professional bodies were contacted requesting their guidelines.Study selectionArticles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review.Data extractionOne reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations.Results2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family’s and caregiver’s roles and the costs. There was lack of clarity on the AHPs’ registration requirements, costs and coverage, and legal aspects.ConclusionThis study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world’s leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.

2019 ◽  
Vol 14 (2) ◽  
pp. 19-30 ◽  
Author(s):  
Janice McKeever ◽  
Ted Brown

Background: Leadership is viewed as the panacea the complex problems in modern health care where chronic disease, contracting budgets and rising consumer expectation are challenging care provision. As the second largest workforce in Australia, Allied Health Professionals (AHP) are core contributors to health teams however they are largely absent from leadership positions and there is little evidence of their impact on client outcomes. Aim: A scoping review was carried out to synthesise evidence on the client, organisational and employee-related outcomes of high quality leadership in Allied Health. Method: A search of grey literature, peer and non-peer reviewed literature was undertaken using Embase, Emcare, SCOPUS and Psychinfo from 2010-2017. Data were sourced from journals, government reports, conference presentations and other grey literature. The reference list of key articles were hand searched for relevant research. Results: A total of 5880 articles were identified and after screening 35 articles were included for in depth review. Leadership contributed towards positive outcomes in all three domains and had influence across professional groups and services. Leaders are highly valued and respected by their teams. Allied Health leaders did not feature in any of the articles and AHP were the focus of only seven studies. The majority of articles were conference papers or case reviews that provided little robust data making it difficult to draw substantive conclusions on the outcome of AHP leadership. Conclusion: There was a lack of robust data specific to AHP leaders. Future research should attempt to gather evidence of the outcomes of AHP leadership through qualitative and quantitative means to substantiate the anecdotal evidence for high quality AHP leaders. 


2021 ◽  
Author(s):  
Landoni Marta ◽  
Petrovic Milica ◽  
Ionio Chiara ◽  
Gaggioli Andrea

AbstractObjectiveThis review paper examines the concept of vulnerability in the overall literature and its relation to informal caregivers.Vulnerability is frequently associated with the sense of being at risk of harm instead of being acknowledged as a human trait to embrace.Taking a cue from two well-known videos of Brené Brown on how to enact “vulnerability,” we aimed to see if emotional vulnerability - posed/explored as strength or weakness - exists in the informal care context, potentially acting as a powerful resource that teaches individuals to look inward and inspires them to work on themselves.DesignScoping reviewData sourcesFollowing PRISMA-ScR checklist for scoping review, the literature was searched in various databases, including PubMed, Scopus and ScienceDirect.Study selection and data extractionWe systematically searched for: 1) observational studies, experimental studies, and systematic reviews 2) that examined the topic of emotional vulnerability in a caregiving context 3) that were relevant to informal caregivers of older adults 4) that were published from 1976 to 2021 5) in English 6) that included populations ≥18 years old 7) and excluded conceptualization of vulnerability outside of the emotional perspective (i.e., environmental, financial, social, biological, genetic, medical). Two reviewers independently reviewed titles and abstracts, reviewed the full text of relevant articles, and extracted the dataResultsFrom 2502 articles, 21 were determined as eligible.ConclusionThe reviewed articles showed the complexity of the vulnerability construct and several different approaches taken to explore this topic. This research concludes the value of vulnerability for human beings. The paucity of literature on the concept of vulnerability for informal caregivers offers a promising avenue for future research in this field.Article summary: Strengths and limitations of this studyThis study reviews the conceptualization of vulnerability across literature from 1976 to date, which was never done beforeThis study draws a unique parallel between vulnerability in formal care settings and informal careThis study re-defines the concept of emotional vulnerability in informal careThe study lacks more concrete first-person perspectives on vulnerability shared by informal caregivers, hence more concrete involvement of informal caregivers would be desirable for representative understanding of the concept of emotional vulnerability in informal care.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051957
Author(s):  
Line Klingen Gjærde ◽  
Jane Hybschmann ◽  
Daniel Dybdal ◽  
Martha Krogh Topperzer ◽  
Morten Arnborg Schrøder ◽  
...  

ObjectivePlay is a non-invasive, safe and inexpensive intervention that can help paediatric patients and their families manage difficult aspects of being ill or hospitalised. Although play has existed in hospitals for decades, research on hospital play interventions is scarce. This review aimed to categorise and synthesise the last 20 years of research on hospital play interventions.DesignScoping review.Data sourcesPubMed, CINAHL, CENTRAL, ERIC and PsycINFO (1 January 2000– 9 September 2020).Study selection and data extractionWe systematically searched for original peer-reviewed articles, written in English, on hospital play interventions in paediatric patients (0–18 years) in non-psychiatric settings. Two reviewers independently screened titles and abstracts, reviewed full text of relevant articles and extracted data. We thematically synthesised the data from the included studies, and a descriptive analysis, based on a developed framework, is presented.ResultsOf the 297 included articles, 78% came from high-income countries and 56% were published within the last 5 years. Play interventions were carried out across all ages by various healthcare professionals. Play interventions served different roles within four clinical contexts: A) procedures and diagnostic tests, B) patient education, C) treatment and recovery and D) adaptation. Across these contexts, play interventions were generally facilitated and purpose-oriented and had positive reported effects on pain, stress, and anxiety.ConclusionsPlay in hospitals is an emerging interdisciplinary research area with a significant potential benefit for child and family health. Future research should further describe principles for play in hospitals. High-quality studies investigating short-term and long-term effects are needed to guide when and how to best integrate play in hospitals.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bruno Miranda dos Santos ◽  
Flavio Sanson Fogliatto ◽  
Carolina Melecardi Zani ◽  
Fernanda Araujo Pimentel Peres

Abstract Background Surgical Tray Rationalization (STR) consists of a systematic reduction in the number of surgical instruments to perform specific procedures without compromising patient safety while reducing losses in the sterilization and assembly of trays. STR is one example of initiatives to improve process performance that have been widely reported in industrial settings but only recently have gained popularity in healthcare organizations. Methods We conduct a scoping review of the literature to identify and map available evidence on surgical tray management. Five methodological stages are implemented and reported; they are: identifying research questions, identifying relevant studies, study selection, charting the data, and collating, summarizing and reporting the results. Results We reviewed forty-eight articles on STR, which were grouped according to their main proposed approaches: expert analysis, lean practices, and mathematical programming. We identify the most frequently used techniques within each approach and point to their potential contributions to operational and economic dimensions of STR. We also consolidate our findings, proposing a roadmap to STR with four generic steps (prepare, rationalize, implement, and consolidate) and recommended associated techniques. Conclusions To the best of our knowledge, ours is the first study that reviews and systematizes the existing literature on the subject of STR. Our study closes with the proposition of future research directions, which are presented as nine research questions associated with the four generic steps proposed in the STR roadmap.


2021 ◽  
Author(s):  
Haowen Jiang ◽  
Sunitha Vimalesvaran ◽  
Jeremy King Wang ◽  
Kee Boon Lim ◽  
Sreenivasulu Reddy Mogali ◽  
...  

BACKGROUND Virtual reality (VR) is a digital education modality that produces a virtual manifestation of the real world and it has been increasingly used in medical education. As VR encompasses different modalities, tools and applications, there is a need to explore how VR has been employed in medical education. OBJECTIVE The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research METHODS We performed a search of 4 bibliographic databases in December 2020, with data extracted using a standardized data extraction form. The data was narratively synthesized and reported in line with the PRISMA-ScR guidelines. RESULTS Of 114 included studies, 69 studies (61%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15 [14%]) and virtual worlds (20 [18%]), mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68 [60%]) and of high interactivity (79 [70%]). There is limited evidence on the use of more novel VR modalities such as mobile VR and virtual dissection tables (8 [7%]), as well as the use of VR for training of non-surgical and non-psychomotor skills (20 [18%]) or in group setting (16 [14%]). Only 3 studies reported the use conceptual frameworks or theories in the design of VR. CONCLUSIONS Despite extensive research available on VR in medical education, there continues to be important gaps in the evidence. Future studies should explore the use of VR for the development of non-psychomotor skills and in areas other than surgery and anatomy.


Author(s):  
Bryan Yijia Tan ◽  
Tivona Thach ◽  
Yasmin Lynda Munro ◽  
Soren Thorgaard Skou ◽  
Julian Thumboo ◽  
...  

Knee osteoarthritis (OA) causes pain, disability and poor quality of life in the elderly. The primary aim was to identify and map out the current evidence for randomised controlled trials (RCTs) on complex lifestyle and psychosocial interventions for knee OA. The secondary aim was to outline different components of complex lifestyle and psychosocial interventions. Our scoping review searched five databases from 2000 to 2021 where complex lifestyle or psychosocial interventions for patients with knee OA were compared to other interventions. Screening and data extraction were performed by two review authors independently and discrepancies resolved through consensus and in parallel with a third reviewer. A total of 38 articles were selected: 9 studied the effectiveness of psychological interventions; 11 were on self-management and lifestyle interventions; 18 looked at multifaceted interventions. This review highlights the substantial variation in knee OA interventions and the overall lack of quality in the current literature. Potential areas of future research, including identifying prognostic social factors, stratified care models, transdisciplinary care delivery and technology augmented interventions, have been identified. Further high-quality RCTs utilizing process evaluations and economic evaluation in accordance with the MRC guidelines are critical for the development of evidence-based knee OA programs globally.


2020 ◽  
pp. 1-9
Author(s):  
Anthony T. Fuller ◽  
Ariana Barkley ◽  
Robin Du ◽  
Cyrus Elahi ◽  
Ali R. Tafreshi ◽  
...  

OBJECTIVEGlobal neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no centralized report detailing these efforts. This scoping review aims to characterize the field of global neurosurgery by identifying partnerships between high-income countries (HICs) and low- and/or middle-income countries (LMICs) that seek to increase neurosurgical capacity.METHODSA scoping review was conducted using the Arksey and O’Malley framework. A search was conducted in five electronic databases and the gray literature, defined as literature not published through traditional commercial or academic means, to identify studies describing global neurosurgery partnerships. Study selection and data extraction were performed by four independent reviewers, and any disagreements were settled by the team and ultimately the team lead.RESULTSThe original database search produced 2221 articles, which was reduced to 183 final articles after applying inclusion and exclusion criteria. These final articles, along with 9 additional gray literature references, captured 169 unique global neurosurgery collaborations between HICs and LMICs. Of this total, 103 (61%) collaborations involved surgical intervention, while local training of medical personnel, research, and education were done in 48%, 38%, and 30% of efforts, respectively. Many of the collaborations (100 [59%]) are ongoing, and 93 (55%) of them resulted in an increase in capacity within the LMIC involved. The largest proportion of efforts began between 2005–2009 (28%) and 2010–2014 (17%). The most frequently involved HICs were the United States, Canada, and France, whereas the most frequently involved LMICs were Uganda, Tanzania, and Kenya.CONCLUSIONSThis review provides a detailed overview of current global neurosurgery efforts, elucidates gaps in the existing literature, and identifies the LMICs that may benefit from further efforts to improve accessibility to essential neurosurgical care worldwide.


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.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026204
Author(s):  
Lysanne Lessard ◽  
Agnes Grudniewicz ◽  
Antoine Sauré ◽  
Agnieszka Szczotka ◽  
James King ◽  
...  

IntroductionHealth systems in North America and Europe have been criticised for their lack of safety, efficiency and effectiveness despite rising healthcare costs. In response, healthcare leaders and researchers have articulated the need to transform current health systems into continuously and rapidly learning health systems (LHSs). While digital technology has been envisioned as providing the transformational power for LHSs by generating timely evidence and supporting best care practices, it remains to be ascertained if it is indeed playing this role in current LHS initiatives. This paper presents a protocol for a scoping review that aims at providing a comprehensive understanding of how and to what extent digital technology is used within LHSs. Results will help to identify gaps in the literature as a means to guide future research on this topic.Methods and analysisMultiple databases and grey literature will be searched with terms related to learning health systems. Records selection will be done in duplicate by two reviewers applying pre-defined inclusion and exclusion criteria. Data extraction from selected records will be done by two reviewers using a piloted data charting form. Results will be synthesised through a descriptive numerical summary and a mapping of digital technology use onto types of LHSs and phases of learning within LHSs.Ethics and disseminationEthical approval is not required for this scoping review. Preliminary results will be shared with stakeholders to account for their perspectives when drawing conclusions. Final results will be disseminated through presentations at relevant conferences and publications in peer-reviewed journals.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Sukardi Suba ◽  
Michele M. Pelter

Abstract Background Premature ventricular contractions (PVCs) are one of the most common arrhythmias detected from electrocardiographic (ECG) monitoring. PVCs were thought to cause lethal arrhythmias and thus were closely monitored and treated. However, in current practice, PVCs generally do not required treatment. There is also concern that PVCs contribute to excessive alarms and lead to alarm fatigue. Practice guidelines for in-hospital monitoring state that monitoring for PVCs may be indicated on some patients but do not recommend continuous ECG monitoring. Despite these recommendations, PVC monitoring practices remain part of routine care, especially in the intensive care unit, for worry of missing potentially significant arrhythmia events. A thorough scoping review of the literature regarding the clinical significance of PVC is imperative, precisely to map out the evidence on the diagnostic and prognostic values of PVCs and to identify research gaps on this issue. Methods The primary question of this review is “what is the clinical significance of PVCs in adults?” Preparation of this scoping review will use the PRISMA-P statement. A scoping review framework by Arksey and O’Malley will be adopted. In identifying relevant studies, the Population-Concept-Context (PCC) framework by the Joanna Briggs Institute will be used. A search strategy will be developed, and four major electronic databases will be searched: CINAHL, Embase, PubMed, and Web of Science Core Collection. Manual searches will also be conducted. The study selection process will adopt the 2009 PRISMA flow diagram. EndNote X8 will be used to manage citations, as well as for duplicates screening in addition to Microsoft Excel 2016. Two independent reviewers will assess potential studies in detail against inclusion criteria. A standardized data extraction form will be developed. Finally, critical appraisal will be conducted using a tool adapted from the Quality Appraisal Checklist by the National Institute for Health Care Excellence (NICE). Discussion We believe this scoping review will provide a general foundation of evidence on the potential significance of PVCs concerning its diagnostic and prognostic value among the adult patient population. The findings will allow us to map out research gaps on this topic that could shape future research and ultimately clinical practice. Scoping review registration This scoping review has been registered in the Open Science Framework (OSF), DOI: https://doi.org/10.17605/OSF.IO/GAVT2.


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