Dysphagia screening using an allied health assistant delegation model: service considerations for implementation.

Three facilities, involved in introducing a model of Allied Health Assistant (AHA) delegated dysphagia screening, examined barriers and facilitators to service implementation. The 3 facilities varied in size, services and location. AHAs (n = 4) and speech-language therapists (SLTs; n = 4) directly i...

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Publicado en:Disability & Rehabilitation Vol. 44; no. 8; pp. 1275 - 1284
Autores principales: Schwarz, Maria, Ward, Elizabeth C., Cornwell, Petrea, Coccetti, Anne
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Apr2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2022
      vid: 44
      iid: 8
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/09638288.2020.1800109
        156897824
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        atl: Dysphagia screening using an allied health assistant delegation model: service considerations for implementation.
      aug:
        au:
          Schwarz, Maria
          Ward, Elizabeth C.
          Cornwell, Petrea
          Coccetti, Anne
        affil: Speech Pathology and Audiology Department, Logan Hospital, Meadowbrook, Australia
      sug:
        subj:
          Deglutition Disorders
          Health Screening
          Allied Health Personnel
          Delegation of Authority
          Health Care Delivery
          Models, Theoretical
          Health Facilities
          Hospital Programs
          Implementation Science
          Human
          Program Implementation
          Speech-Language Pathologists
          Semi-Structured Interview
          Attitude of Health Personnel
          Health Facility Administration
          Conceptual Framework
          Interview Guides
          Decision Making
          Consensus
      ab: Three facilities, involved in introducing a model of Allied Health Assistant (AHA) delegated dysphagia screening, examined barriers and facilitators to service implementation. The 3 facilities varied in size, services and location. AHAs (n = 4) and speech-language therapists (SLTs; n = 4) directly involved in implementation at each site completed semi-structured interviews exploring the implementation experience. Analysis was guided by the Consolidated Framework for Implementation Research (CFIR). There was differential implementation across the sites. Facilitators to implementation fell within the CFIR Innovation Characteristic domain, with the "relative advantage" of the model and "design, quality and packaging" of the training and implementation resources being key facilitators. Barriers related to the Innovation Characteristic domain, regarding the tool's "adaptability" in terms of screening tools selected and the implementation environment. Issues with the Inner Setting domain, specifically the "structural characteristics," the "compatibility" of the model and the "relative priority" of the model's implementation within other organizational priorities were also barriers. Although the service model was perceived to have relative advantage, compatibility with local work-flow priorities and service needs must be thoroughly considered if AHA delegated dysphagia screening is to be beneficial as a service model to address increasing dysphagia referral demands. Dysphagia is a disabling condition which may result in medical, social and operational complications. The demands of screening, assessing, managing and providing rehabilitation for dysphagia are increasing, therefore alternative models of service delivery including delegation are increasingly being considered and implemented. This study provides evidence regarding the context and facilitators of successful AHA dysphagia screening model implementation. This evidence contributes to a growing knowledge base of delegation practices for the management of staffing resources and building of capacity for rehabilitation service delivery.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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