Longitudinal evaluation of a knowledge translation role in occupational therapy.

BACKGROUND: In 2014, a large metropolitan mental health service in Australia developed a senior role (Lead Research Occupational Therapist) to address an identified need for greater research and knowledge translation, and associated capacity building. The aim of this study was to evaluate the impact, in the first 2.5 years, of this role across a range of variables. METHODS: Multiple methods were used to gather a comprehensive range of data. Workforce surveys were completed both online and in hard copy in early 2014 (n = 42) and late 2016 (n = 44). Research key performance indicators (academic, research production and cultural) were also identified for measurement over time. The data from these surveys were analysed using descriptive and inductive analysis, and also with social network analysis. RESULTS: This role has demonstrated positive outcomes across a range of variables. There was a medium effect on the quantity of participation in quality assurance and knowledge translation activities by the workforce. Most knowledge translation behaviours were occurring regularly, although several were absent. An improving trend in attitudes towards evidence-based practice was recorded, and perceptions of the knowledge translation role were generally positive. The Lead Research Occupational Therapist moved from the periphery to the centre of the evidence based practice social network. Improved awareness of other clinicians deploying evidence based practice was observed, and the frequency of interaction between clinicians increased. The role has met all key performance indicators, across the academic, research production and cultural domains. CONCLUSIONS: The shift in focus of this role from research to knowledge translation has produced tangible outcomes for the occupational therapy workforce. These achievements have had a positive impact on the sustainability of the role, which will be continued for at least another two years. An ongoing challenge is to directly measure the impact of this role on outcomes for people with mental illness and their carers.

Research priorities in mental health occupational therapy: A study of clinician perspectives.

BACKGROUND/AIM: The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. METHODS: A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. RESULTS: Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. CONCLUSIONS: Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. SIGNIFICANCE OF THE STUDY: This study provides an updated indication of research priorities for mental health occupational therapy in Australia.

Developing performance indicators for homeless outreach psychiatric services.

OBJECTIVE: Performance indicators (PIs) aim to improve services by measuring key activities in a way that allows comparison over time, between services and against benchmarks. This paper describes the development and implementation of Homeless Psychiatric Service PIs and explores their potential benefits and limitations. METHOD: We collected descripton of quality service from key stakeholders. We identified eight key parameters, from which PIs were developed and tested over a 12-month period. RESULTS: The use of the PIs led to increased awareness of the practice being measured. PIs were used to stimulate practice changes. They played a positive role in team dynamics and were useful in clarifying team aims and identity. The main challenge to their use was the burden of data collection and analysis. CONCLUSION: Homeless service PIs can assist in determining how well the programs are performing in activities that are relevant to clients and non clinical services for the homeless. With the movement of homeless clients away from inner urban areas, homeless performance measures may aid teams to develop the capacity to work effectively with homeless clients.

The Pathways to Participation (P2P) Program: A Pilot Outcomes Study.

Research has consistently found that people with mental illness (known as consumers) experience lower levels of participation in meaningful activities, which can limit their opportunities for recovery support. The aim of this study was to describe the outcomes of participation in a group program designed to address all stages of activity participation, known as Pathways to Participation (P2P). A descriptive longitudinal design was utilized, collecting data at three time points. Outcomes were measured by the Camberwell Assessment of Need Short Appraisal (CANSAS), Recovery Assessment Scale-Domains and Stages (RAS-DS), Behavior and Symptom Identification Scale (BASIS-24), Living in the Community Questionnaire (LCQ), and time-use diaries. All data were analyzed using descriptive statistics and Chi-square analyses. A total of 17 consumers completed baseline data, 11 contributed post-program data, and 8 provided follow-up data. Most were female (63.64%) and had been living with mental illness for 11.50 (±7.74) years on average. Reductions in unmet needs and improvements in self-rated recovery scores were reported, but no changes were identified in either time use or psychosocial health. The findings indicate that the P2P program may enable consumers to achieve positive activity and participation outcomes as part of their personal recovery.

Development of the Translating Allied Health Knowledge (TAHK) Framework.

BACKGROUND: While evidence-based practice is a familiar concept to allied health clinicians, knowledge translation (KT) is less well known and understood. The need for a framework that enables allied health clinicians to access and engage with KT was identified. The aim of this paper is to describe the development of the Translating Allied Health Knowledge (TAHK) Framework. METHODS: An iterative and collaborative process involving clinician and academic knowledge partners was utilised to develop the TAHK Framework. Multiple methods were utilised during this process, including a systematic literature review, steering committee consultation, mixed methods survey, benchmarking and measurement property analysis. RESULTS: The TAHK Framework has now been finalised, and is described in detail. The framework is structured around four domains - Doing Knowledge Translation, Social Capital for Knowledge Translation, Sustaining Knowledge Translation and Inclusive Knowledge Translation - under which 14 factors known to influence allied health KT are classified. The formulation of the framework to date has laid a rigorous foundation for further developments, including clinician support and outcome measurement. CONCLUSION: The method of development adopted for the TAHK Framework has ensured it is both evidence and practice based, and further amendments and modifications are anticipated as new knowledge becomes available. The Framework will enable allied health clinicians to build on their existing capacities for KT, and approach this complex process in a rigorous and systematic manner. The TAHK Framework offers a unique focus on how knowledge is translated by allied health clinicians in multidisciplinary settings.

Supporting safe driving practices among consumers of mental health services: guidelines for assessment.

Driving is often omitted or ignored during assessment and ongoing work with consumers of mental health services. This Open Forum describes guidelines to help providers of psychiatric services to support safe driving practices among consumers. The guidelines were developed over seven years with contributions from a wide range of stakeholders. They include key principles for conducting screening and initial assessment, obtaining a detailed driving history, and performing risk assessment. The guidelines include information about process (how to assess) and content (what information to seek) of driving assessment. Because driving is regulated by local jurisdictions and national legislation, the guidelines provide a general framework for addressing questions about driving practices among consumers of mental health services. They are intended to complement, rather than replace, existing guidelines, by providing a focus on the occupation of driving. In so doing, they provide principled information to embed driving assessment and intervention as part of psychiatric services.