Bureaucratic Barriers to Service Delivery, Administrative Advocacy, and Mother Goose

2000 ◽  
Vol 81 (3) ◽  
pp. 304-314 ◽  
Author(s):  
Andrew Malekoff
2014 ◽  
Vol 23 (1) ◽  
pp. 42-54 ◽  
Author(s):  
Tanya Rose Curtis

As the field of telepractice grows, perceived barriers to service delivery must be anticipated and addressed in order to provide appropriate service delivery to individuals who will benefit from this model. When applying telepractice to the field of AAC, additional barriers are encountered when clients with complex communication needs are unable to speak, often present with severe quadriplegia and are unable to position themselves or access the computer independently, and/or may have cognitive impairments and limited computer experience. Some access methods, such as eye gaze, can also present technological challenges in the telepractice environment. These barriers can be overcome, and telepractice is not only practical and effective, but often a preferred means of service delivery for persons with complex communication needs.


2016 ◽  
Vol 30 (3) ◽  
pp. 243-258
Author(s):  
Stephanie L. Lusk ◽  
Lynn C. Koch ◽  
Teresia M. Paul

Purpose:In this article, we examined how individuals with co-occurring psychiatric disabilities and substance use disorders encounter numerous challenges when it comes to the vocational rehabilitation (VR) process.Method:A comprehensive review of the literature demonstrated barriers to service delivery (e.g., access to services, exclusionary eligibility requirements) and hindrances to VR planning (e.g., lack of training of VR counselors, lack of work-related skills) which all serve to create obstacles through which they must navigate. This article provides a brief overview of (a) the challenges that these individuals face in treatment and VR and (b) general considerations for providing more recovery-oriented VR services to increase their participation in the VR process, facilitate recovery, and improve VR outcomes.Results:Our review highlighted that VR participation and successful outcome rates among this group as a whole are much lower than the rates of those with other types of disabilities. Researchers have suggested a myriad of strategies that have proven advantageous when working with these individuals all of which serve to increase rates of sustained recovery and employment success.Conclusion:Additional research is still needed to substantiate the barriers to service delivery for this underserved VR population, evaluate how to implement more recovery-oriented practices within the VR system, and determine if such changes do indeed lead to improved outcomes for consumers with co-occurring disabilities.


2017 ◽  
Vol 5 (1) ◽  
pp. 120 ◽  
Author(s):  
Jacqueline Lim ◽  
Patricia McCabe ◽  
Alison Purcell

Background, aims and objectives: This study aimed to compare the perception of barriers to service delivery among speech-language pathologists (SLPs) in Canada and Australia and the extent to which they used parent or carer training to overcome these barriers.  Methods: Participants were 81 Australian and 63 Canadian SLPs who completed an online survey. Questions comprised open ended and forced choice questions with some ranking of questions also required. Chi-square analyses were conducted comparing Canadian and Australian SLPs.  Results: Few differences existed among the respondents. Respondents overwhelmingly selected “not enough speech-language pathology positions to meet demand” as their main barrier. This barrier along with “parents/carer’s lack of knowledge about the need for speech-language pathology”, “lack of parent/carer engagement” and “lack of awareness of role of speech-language pathologist” were the principal barriers. Training parents and carers to conduct therapy at home was the most used strategy among both Canadian and Australian SLPs.  Discussion: The finding that the SLPs perceive low engagement from parents both in the training sessions and when working with their child may suggest that there is a need for speech-language pathologists to determine more effective ways to train and engage parents and carers.  Conclusion: More research into the efficacy of parent or carer training across a wider range of speech-language pathology practice areas and across a more diverse range of parents or carers needs to be undertaken.


2022 ◽  
Vol 7 ◽  
pp. 239694152110701
Author(s):  
Robyn Garnett ◽  
Bronwyn Davidson ◽  
Patricia Eadie

Background & Aims Estimates suggest that one in 59 children receive a diagnosis of autism and that early intervention can be effective if applied consistently and intensively. Parent implemented intervention can increase intervention consistency and intensity however, availability of providers, geographical factors, time constraints, and parental stress levels can all act as barriers to service access. Limitations in understanding elements that support family engagement can also impact participation in intervention. Telepractice can increase availability of intervention services and decrease the time and costs associated with face-to-face delivery. Research focused on children with autism has shown that telepractice is acceptable to parents. Despite positive findings for telepractice services with individual clients, limited research has been conducted on telepractice services for parent groups; parent perceptions and preferences regarding intervention; and service delivery methods. This research aimed to investigate parent perceptions of a group intervention programme for autism; the telepractice approach; parent and child outcomes; and parental stress. The purpose of the investigation was to build an understanding of parent's intervention preferences to inform future service offerings, increase choice, and support participation. Methods Eleven parents of preschool children with autism participated in a telepractice delivered group training programme called Hanen More Than Words (HMTW). The intervention is traditionally delivered face to face and teaches strategies to facilitate social-communication development in young children. Quantitative and qualitative measures were used to evaluate parent perceptions of the telepractice HMTW intervention. Data were collected via the Parenting Stress Index, HMTW programme evaluation forms, and online parent survey. Quantitative data was analysed using descriptive statistics. Pre- and post-intervention comparisons of parenting stress were conducted using paired T-Tests. Open comment field responses were analysed qualitatively using a directed content analysis. Results Parents reported high levels of satisfaction with telepractice delivered HMTW across intervention and post programme evaluations. Interactive learning opportunities, group participation, video coaching, individualisation of service, and programme facilitation were identified as key supports to learning. Parents perceived increased insight into the interaction, learning, and behaviour of themselves and their children. They reported positive changes in strategy implementation and confidence. Parents also perceived improvements in their children's communication, responsiveness, interaction, and play following intervention. Parental stress measurements from pre- to post intervention, were not significantly different. Conclusions Telepractice may reduce service barriers and improve access, particularly with the efficiency of a group delivery approach. Utilising technology to deliver group intervention was acceptable to parents and perceived to have positive outcomes for both parent and child. Further investigation into parent perceptions of intervention types and delivery approaches, could facilitate a broader understanding of family needs with respect to service access and engagement. Implications Expansion of telepractice offerings can increase efficiencies and service choice for families and providers. Limitations in service availability and barriers to service access and engagement, confirm the importance of pursuing ongoing service improvements and evaluating the preferences of service users. Development of standardised tools to measure and compare parent perceptions across intervention types and service delivery approaches would be beneficial.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015049 ◽  
Author(s):  
Fiona Riordan ◽  
Sheena M McHugh ◽  
Katie Murphy ◽  
Julie Barrett ◽  
Patricia M Kearney

ObjectivesInternational evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement.DesignA cross-sectional survey of hospital and community-based DNS in Ireland.MethodsBetween September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave.ResultsThe response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration.ConclusionsDelivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed.


2019 ◽  
Vol 95 (7) ◽  
pp. 488-495 ◽  
Author(s):  
Julia Gauly ◽  
Jonathan Ross ◽  
Isobel Hall ◽  
Irekanmi Soda ◽  
Helen Atherton

BackgroundPharmacies are increasingly providing services related to contraception and STIs. Identifying pharmacy staff’ and users’ experiences and attitudes relating to sexual health services is critical to understand users’ needs and examining how pharmacy staff can most effectively contribute to patient-centred care. This systematic review aimed to examine pharmacy staff and pharmacy users’ experiences and attitudes towards the delivery of a large range of sexual health services.MethodsSeven electronic databases and the reference lists of all included studies were searched in September 2018. Studies giving insight into pharmacy users’ and pharmacy staff’s experiences and attitudes towards the delivery of services related to contraception and STIs were included. The Mixed Methods Appraisal Tool was used to assess the quality of included studies and a narrative synthesis applied to analyse evidence.ResultsNineteen studies were included. Eleven studies looked at pharmacy staff, four at users and four at both groups. Users found services accessible and convenient and staff found service provision feasible. However, several barriers to service delivery were identified including lack of privacy for delivering services, lack of trained staff available to provide services and subjective judgements being made on who should be provided or offered a service.DiscussionBarriers to service delivery need to be addressed to allow pharmacies to deliver their full potential. Future research on pharmacy-based gonorrhoea and syphilis screening, and hepatitis B vaccination is needed.PROSPERO registration numberCRD42018106807.


1989 ◽  
Vol 29 (1) ◽  
pp. 86-92 ◽  
Author(s):  
D. E. Biegel ◽  
M. K. Petchers ◽  
A. Snyder ◽  
B. Beisgen

2011 ◽  
Vol 26 (S2) ◽  
pp. 1965-1965 ◽  
Author(s):  
C. Forchuk ◽  
S. Giustizia ◽  
N. Annett ◽  
M. Connoy ◽  
R. Csiernik ◽  
...  

This project will work closely with existing service partners involved in street level services and focus on testing and evaluating three approaches for street level interventions for youth who are homeless and who have severe or moderate mentally illness. Youth will be asked to choose their preferred service approach:Housing First related initiatives focused on interventions designed to move youth to appropriate and available housing and ongoing housing supports.Treatment First initiatives to provide Mental Health/Addiction supports and treatment solutions, and; Simultaneous attention to both Housing and Treatment TogetherOur primary objective is to understand the service delivery preferences of homeless youth and understand the outcomes of these choices. Our research questions include:1.Which approaches to service are chosen by youth?2.What are the differences and similarities between groups choosing each approach?3.What are the critical ingredients needed to effectively implement services for homeless youth from the perspectives of youth, families and service providers?Focus groups with staff and family members will occur to assist in understanding the nature of each of service approach, changes that evolve within services, & facilitators and barriers to service delivery. This work will be important in determining which approach is chosen by youth and why. Evaluating the outcomes with each choice will provide valuable information about outcomes for the service options chosen by youth. This assist in better identifying weaknesses in the services offered and inform further development of treatment options that youth will accept.


1981 ◽  
Vol 12 (4) ◽  
pp. 233-239
Author(s):  
Linda Goodman ◽  
Robin Kroc

This article describes a strategy used to teach sign communication to severely handicapped students in the classroom. It recommends that the speech-language pathologist adopt a consultant role in service delivery.


Sign in / Sign up

Export Citation Format

Share Document