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Advanced musculoskeletal physiotherapy: Barriers and enablers to multi‐site implementation
Author(s) -
Shaw Bridget R.,
Heywood Sophie E.,
Page Carolyn J.,
Phan Uyen M.,
Harding Paula A.,
Walter Kerrie,
Terrill Desiree L.,
Granger Catherine L.
Publication year - 2018
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1358
Subject(s) - thematic analysis , workforce , medicine , health care , nursing , scale (ratio) , knowledge management , medical education , process management , qualitative research , business , sociology , computer science , economics , economic growth , social science , physics , quantum mechanics
Abstract Objectives Advanced musculoskeletal physiotherapy (AMP) services are a safe, effective model of care, but without broad‐scale healthcare implementation to date. The aim of the present study was to identify the barriers and enablers to implementation of 12 AMP services from the perspective of clinical staff. Methods In a qualitative study, 12 participants (physiotherapists), from 12 different healthcare networks (seven metropolitan, three regional, two rural), were included. Their departments implemented AMP services (orthopaedic postoperative joint replacement review, n = 10; general orthopaedic, n = 1; emergency, n = 1; and neurosurgery n = 1) over a 12‐month period. Participants completed a structured survey specifically designed for the study. Thematic analysis was used, with themes mapped to the validated Theoretical Domains Framework. Results Nine major themes emerged from the data regarding barriers and enablers to the implementation of the AMP services from the perspective of clinical staff. These were: demand/capacity; model of care; the organization; stakeholders; communication; planning and processes; evaluation; workforce; and learning and assessment framework. Important enablers included engagement and buy‐in from key stakeholders and medical staff, and well‐established AMP learning frameworks for training and operational frameworks. Barriers included competitive funding environment, and issues that hindered effective communication. The knowledge, skills, availability, motivation and experience of the advanced musculoskeletal physiotherapists had a large impact on the implementation. Conclusions The study identified a number of factors that should be considered for successful implementation of AMP services across healthcare services or wider healthcare networks.