Impacts of the Early COVID-19 Response on Allied Health Staff Within an Australian Tertiary Health Service: A Qualitative Study.

Purpose: Understanding the experiences and needs of healthcare workers is crucial in strengthening healthcare system resilience during times of change. We aimed to explore allied health (AH) professionals' perceptions of the impacts of the COVID-19 pandemic response on their work experiences. Participants and Methods: Qualitative descriptive study using thematic analysis of semi-structured interviews with AH professionals employed in a large Australian health service. Results: Four themes were conceptualized from interviews of 21 AH clinicians and consolidated with six AH managers. Impacts were at personal, service, and systems levels. An overarching theme of "acceptance of circumstances due to the pandemic" influenced experiences within each level. Service changes included service cessation, remote service delivery, new COVID-19 protocols and role or work location alterations. Some staff were empowered in making practice changes, while others lost research or career opportunities. Despite low COVID-19-related hospitalizations and fatalities, staff reported stresses from workload changes and fear for self or loved ones. Open, clear communication assisted in alleviating anxiety, while perceived involvement in decision making and administrative and/or technical support for implementation of new processes facilitated change management processes. Conclusion: The study demonstrates the impacts of the COVID-19 pandemic response on AH professionals. Gleaned in a context with limited community disease transmission and without the challenges of providing care for large numbers of COVID-19 patients, the findings have implications for change management within health services in any context in which rapid change is required. The wellbeing of the workforce should be forefront. Clear communication is critical, with staff involved in decision-making where possible. The needs of vulnerable staff should be considered with clear processes and eligibility guidelines to ensure provision of appropriate support and transparency of decision making. Workloads should be monitored, and adequate infrastructure, technical support and training provided for new initiatives or processes.

Exploring maturity of electronic medical record use among allied health professionals.

BACKGROUND: Electronic medical records (EMRs) have the potential to improve and streamline the quality and safety of patient care. Harnessing the full benefits of EMR implementation depends on the utilisation of advanced features, defined as "mature usage." At present, little is known about the maturity of EMR usage by allied health professionals (AHPs). OBJECTIVE: To examine current maturity of EMR use by AHPs and explore perceived barriers to mature EMR utilisation and optimisation. METHOD: AHPs were recruited from three health services. Participants completed a 27-question electronic questionnaire based on the EMR Adoption Framework, which measures clinician EMR utilisation (0 = paper chart, 5 = theoretical maximum) across 10 EMR feature categories. Interviews were conducted with both clinicians and managers to explore the nature of current EMR utilisation and perceived facilitators and barriers to mature usage. RESULTS: Questionnaire responses were obtained from 192 AHPs. The majority of questions (74%) showed a mean score of <3, indicating a lack of mature EMR use. Pockets of mature usage were identified in the categories of health information, referrals and administration processes. Interviews with 18 clinicians and managers revealed barriers to optimisation across three themes: (1) limited understanding of EMR opportunities; (2) complexity of the EMR change process and (3) end-user and environmental factors. CONCLUSION: Mature usage across EMR feature categories of the EMR Adoption Framework was low. However, questionnaire and qualitative interview data suggested pockets of mature utilisation. IMPLICATIONS: Achieving mature allied health EMR use will require strategies implemented at the clinician, EMR support, and service levels.

Identifying opportunities to optimise the electronic medical record for allied health professionals: a concept mapping study.

Objective To utilise a concept mapping process to identify key opportunities for electronic medical record (EMR) optimisation for allied health professionals (AHPs). Methods A total of 26 participants (allied health managers, clinicians and healthcare consumers) completed the concept mapping process, which included generating statements, and then subsequently sorting all statements into groups, and also ranking each statement for importance and changeability (0 = not important/changeable, 4 extremely important/changeable). Multivariate analysis and multidimensional scaling were then used to identify core priorities for digital optimisation. Results Participants generated 98 discrete statements that were grouped into 13 conceptual clusters. Of these, 36 statements were subsequently determined to fall within the 'green zone' on the Go-Zone plot of importance and changeability (changeability ≥2.44, importance ≥2.79), and formed the set of key optimisation priorities. Clusters with the most items in the Go-Zone plot were 'training and business rules ' and 'service statistics .' Conclusion Concept mapping facilitated identification of 36 key optimisation priorities considered both changeable and important to assist EMR optimisation for AHPs. Addressing these priorities requires action related to end-user skills and training, EMR system capacity, and streamlining of governance and collaboration for the optimisation process.

"Dealing with the Hospital has Become too Difficult for Us to Do Alone" - Developing an Integrated Care Program for Children with Medical Complexity (CMC).

INTRODUCTION: Children with medical complexity (CMC) require highly specialised care, often from multiple providers and over many years. This paper describes the first 18 months of development of the Kids Guided Personalised Services (GPS) Integrated Care Program (the Program). This Program aims to improve health care experience; communication and to streamline provision of care. DISCUSSION: Key enablers across the Program were put in place and 5 individual project streams were used to implement change. An extensive formative evaluation process was undertaken to truly understand all perspectives in developing the Program. CONCLUSION/KEY LESSONS: This Program supports families who are caring for CMC by developing shared care models that bring together local health services with the tertiary hospitals. The methodology used has resulted in comprehensive system change and transformation; reduced presentations to the Emergency Department (ED), avoidable admissions and travel time. A challenge remains in meaningfully engaging primary health care providers.