Utilising an Allied Health Practitioner Capability Audit and Confidence Survey to Identify Implications for Telehealth Safety and Risk-A Chronicle of a Health Service Improvement Activity.

Whilst the benefits of telehealth were identified during the COVID-19 pandemic, we noted barriers to its use at a vital time. Through a health service improvement approach, we sought to increase allied health professional capability in telehealth, but we also sought to understand if there were risks associated with its use. We designed and implemented tools to evaluate allied health professional competence and confidence in using telehealth with private and public patients in a metropolitan teaching hospital setting. With an emphasis on technology capability, we undertook audits over three consecutive years (2020 to 2022) of allied health professional telehealth occasions of service reporting on compliance with the audit criteria and investigating staff confidence in undertaking telehealth sessions using a co-designed survey. The audit tool and confidence survey results were used to identify risk factors to telehealth service delivery using a Modified Health Failure Modes, Effects Analysis. Although confidence levels were relatively high among staff, confidence in managing safety factors and technology risks associated with telehealth were not initially verified by the audit findings. Remedial efforts resulted in service improvements in many identified risk factors, yet technology performance and its troubleshooting remained a primary variable in the ability of staff to comply with the requirements of the real-time audits. Health workers using telehealth should have training to engage safely and effectively in telehealth care and the technology.

Working Towards an Optimal Allied Health Telehealth Service: A Model for Improvement.

Beginning in 2018, Mater Health was enacting its next stage of strategic planning focusing on services designed around consumers and strengthening technology to improve access to care and information for delivering better outcomes. Telehealth was part of the strategy. Allied health services sought to meet future community needs by increasing the number of its offsite or virtual services without the need for expensive infrastructure. Our aim was to reinforce allied health professional capability in telehealth, as part of sustainable allied health telehealth delivery. We used a Model for Improvement that included use of the Plan, Do, Study, Act cycles, incorporating a community of practice and evaluation framework with strategies such as appreciative inquiry designed to enhance communication and understanding among team members. Telehealth has proven of great value to health services and consumers during the COVID-19 pandemic. Scaling up of telehealth during the pandemic resulted in recognition of multiple factors needing to be addressed for telehealth to be sustainable. Our work provides insights into staff and consumer perspectives of TH, forming a basis for future telehealth research.