Mrs Rachel Levine1,2,3, Dr Marie-Pier McSween1,2, Dr Jade Dignam1,2, A/Prof Annie Hill1,4, Prof David Copland1,2, Dr Kirstine Shrubsole1,2
1Queensland Aphasia Rehabilitation Centre (QARC), School of Rehabilitation Sciences, The University of Queensland, Herston, Australia, 2Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Australia, 3Speech Pathology & Audiology Department, Surgical Treatment and Rehabilitation Service (STARS), Metro North Health, Herston, Australia, 4Centre for Research Excellence in Aphasia Rehabilitation and Recovery, La Trobe University, La Trobe University, Australia
Biography:
Rachel is a senior speech pathologist at the Surgical, Treatment and Rehabilitation Service in Brisbane, Queensland. She has over nine years of clinical experience and has worked within adult subacute rehabilitation services since 2019. She is completing her PhD at The University of Queensland which has explored the feasibility, acceptability and potential effectiveness of implementing a structured and comprehensive treatment planning process for an intensive aphasia rehabilitation program, the Comprehensive, High-dose Aphasia Treatment (CHAT) program. Rachel has an ongoing interest in the implementation and sustainment of evidence-based practices within healthcare services, particularly public health settings.
Abstract:
Background/aims:
Structured and collaborative treatment planning processes to personalise aphasia rehabilitation, involving assessment, goal setting, treatment mapping and resource personalisation may support achievement of outcomes. However, this planning is not part of routine practice. We examined the feasibility of implementing a treatment planning process within rehabilitation settings.
Methods:
Mixed-methods implementation feasibility study informed by the Knowledge to Action framework with embedded process evaluation. Two speech pathology teams from hospital (n=6) and community rehabilitation (n=8) services in metropolitan Queensland implemented the treatment planning process. Tailored implementation interventions included training, resources and facilitation. Barriers and facilitators to implementation were captured through behavioural determinants surveys and focus groups. Factors identified were categorised against determinant frameworks and mapped to validated implementation strategies, informing recommendations for future implementation.
Results:
Implementation of the treatment planning process was feasible, and clinicians’ post-implementation behavioural determinants surveys identified increased knowledge and skills in treatment planning. A range of factors influenced the potential sustainability of this process. Social support was a facilitator to implementation but challenging to establish across geographically spread sites. Staffing availability, for example staff changeover and the time required to complete clinical planning, and perceptions about competing clinical priorities, which may take precedence over treatment planning, were identified as key barriers. Local facilitation via site champions may contribute to fewer perceived implementation barriers.
Discussion/conclusions:
The implementation intervention was successful in increasing clinicians’ knowledge and skills in personalised treatment planning for aphasia. However, ongoing barriers were reported to impact the feasibility of sustaining this approach in practice.