Implementation of neurological group-based telerehabilitation within existing healthcare during the COVID-19 pandemic: a mixed methods evaluation.
| Title: | Implementation of neurological group-based telerehabilitation within existing healthcare during the COVID-19 pandemic: a mixed methods evaluation. |
|---|---|
| Authors: | Ackerley, Suzanne, Wilson, Neil, Boland, Paul, Read, Jessica, Connell, Louise |
| Source: | BMC Health Services Research; 6/21/2023, Vol. 23 Issue 1, p1-16, 16p, 1 Color Photograph, 1 Black and White Photograph, 1 Diagram, 6 Charts |
| Subject Terms: | COVID-19 pandemic, TELEREHABILITATION, EVALUATION methodology, MEDICAL care, NEUROREHABILITATION |
| Abstract: | Background: There is a need to evaluate if and how telerehabilitation approaches might co-exist within healthcare in the long-term. Our aim was to implement and evaluate a multidisciplinary group-based telerehabilitation approach for people engaging in neurological rehabilitation. Methods: NeuroRehabilitation OnLine (NROL) was adapted and implemented within an existing healthcare system as a programme of repeating six-week blocks. A robust evaluation was undertaken simultaneously using a convergent parallel design underpinned by implementation frameworks. This included service data, and patient and staff interviews. Implementation success was conceptualised using the outcomes of appropriateness, acceptability and sustainability. Results: Eight NROL blocks delivered 265 sessions with 1347 patient contacts, and NROL continues as part of standard practice. The approach was appropriate for varied demographics and had positive patient opinions and outcomes for many. Staff perceived NROL provided a compatible means to increase therapy and help meet targets, despite needing to mitigate some challenges when fitting the approach within the existing system. NROL was considered acceptable due to good attendance (68%), low drop-out (12%), and a good safety record (one non-injury fall). It was accepted as a new way of working across rehabilitation disciplines as an 'extra layer of therapy'. NROL had perceived advantages in terms of patient and staff resource (e.g. saving time, energy and travel). NROL provided staffing efficiencies (ratio 0.6) compared to one-to-one delivery. Technology difficulties and reluctance were surmountable with dedicated technology assistance. Leadership commitment was considered key to enable the efforts needed for implementation and sustained use. Conclusion: Pragmatic implementation of group-based telerehabilitation was possible as an adjunct to neurological rehabilitation within an existing healthcare system. The compelling advantages reported of having NROL as part of rehabilitation supports the continued use of this telerehabilitation approach. This project provides an exemplar of how evaluation can be run concurrently with implementation, applying a data driven rather than anecdotal approach to implementation. [ABSTRACT FROM AUTHOR] |
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| Database: | Complementary Index |
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| Items | – Name: Title Label: Title Group: Ti Data: Implementation of neurological group-based telerehabilitation within existing healthcare during the COVID-19 pandemic: a mixed methods evaluation. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Ackerley%2C+Suzanne%22">Ackerley, Suzanne</searchLink><br /><searchLink fieldCode="AR" term="%22Wilson%2C+Neil%22">Wilson, Neil</searchLink><br /><searchLink fieldCode="AR" term="%22Boland%2C+Paul%22">Boland, Paul</searchLink><br /><searchLink fieldCode="AR" term="%22Read%2C+Jessica%22">Read, Jessica</searchLink><br /><searchLink fieldCode="AR" term="%22Connell%2C+Louise%22">Connell, Louise</searchLink> – Name: TitleSource Label: Source Group: Src Data: BMC Health Services Research; 6/21/2023, Vol. 23 Issue 1, p1-16, 16p, 1 Color Photograph, 1 Black and White Photograph, 1 Diagram, 6 Charts – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22COVID-19+pandemic%22">COVID-19 pandemic</searchLink><br /><searchLink fieldCode="DE" term="%22TELEREHABILITATION%22">TELEREHABILITATION</searchLink><br /><searchLink fieldCode="DE" term="%22EVALUATION+methodology%22">EVALUATION methodology</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+care%22">MEDICAL care</searchLink><br /><searchLink fieldCode="DE" term="%22NEUROREHABILITATION%22">NEUROREHABILITATION</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: There is a need to evaluate if and how telerehabilitation approaches might co-exist within healthcare in the long-term. Our aim was to implement and evaluate a multidisciplinary group-based telerehabilitation approach for people engaging in neurological rehabilitation. Methods: NeuroRehabilitation OnLine (NROL) was adapted and implemented within an existing healthcare system as a programme of repeating six-week blocks. A robust evaluation was undertaken simultaneously using a convergent parallel design underpinned by implementation frameworks. This included service data, and patient and staff interviews. Implementation success was conceptualised using the outcomes of appropriateness, acceptability and sustainability. Results: Eight NROL blocks delivered 265 sessions with 1347 patient contacts, and NROL continues as part of standard practice. The approach was appropriate for varied demographics and had positive patient opinions and outcomes for many. Staff perceived NROL provided a compatible means to increase therapy and help meet targets, despite needing to mitigate some challenges when fitting the approach within the existing system. NROL was considered acceptable due to good attendance (68%), low drop-out (12%), and a good safety record (one non-injury fall). It was accepted as a new way of working across rehabilitation disciplines as an 'extra layer of therapy'. NROL had perceived advantages in terms of patient and staff resource (e.g. saving time, energy and travel). NROL provided staffing efficiencies (ratio 0.6) compared to one-to-one delivery. Technology difficulties and reluctance were surmountable with dedicated technology assistance. Leadership commitment was considered key to enable the efforts needed for implementation and sustained use. Conclusion: Pragmatic implementation of group-based telerehabilitation was possible as an adjunct to neurological rehabilitation within an existing healthcare system. The compelling advantages reported of having NROL as part of rehabilitation supports the continued use of this telerehabilitation approach. This project provides an exemplar of how evaluation can be run concurrently with implementation, applying a data driven rather than anecdotal approach to implementation. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Group: Ab Data: <i>Copyright of BMC Health Services Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1186/s12913-023-09635-w Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 16 StartPage: 1 Subjects: – SubjectFull: COVID-19 pandemic Type: general – SubjectFull: TELEREHABILITATION Type: general – SubjectFull: EVALUATION methodology Type: general – SubjectFull: MEDICAL care Type: general – SubjectFull: NEUROREHABILITATION Type: general Titles: – TitleFull: Implementation of neurological group-based telerehabilitation within existing healthcare during the COVID-19 pandemic: a mixed methods evaluation. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Ackerley, Suzanne – PersonEntity: Name: NameFull: Wilson, Neil – PersonEntity: Name: NameFull: Boland, Paul – PersonEntity: Name: NameFull: Read, Jessica – PersonEntity: Name: NameFull: Connell, Louise IsPartOfRelationships: – BibEntity: Dates: – D: 21 M: 06 Text: 6/21/2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 14726963 Numbering: – Type: volume Value: 23 – Type: issue Value: 1 Titles: – TitleFull: BMC Health Services Research Type: main |
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