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Title: Establishing Clinical Swallowing Assessment Services via Telepractice: A Multisite Implementation Evaluation
Authors: Ward, Elizabeth C
Burns, Clare L
Gray, Amy
Baker, Lisa
Cowie, Brooke 
Winter, Natalie
Rusch, Rukmani
Saxon, Robyn
Barnes, Sarah
Turvey, Jodie
Issue Date: 2021
Source: Ward EC, Burns CL, Gray A, Baker L, Cowie B, Winter N, Rusch R, Saxon R, Barnes S, Turvey J. Establishing Clinical Swallowing Assessment Services via Telepractice: A Multisite Implementation Evaluation. Am J Speech Lang Pathol. 2021 Nov 4;30(6):2456-2464. doi: 10.1044/2021_AJSLP-21-00109. Epub 2021 Aug 25. PMID: 34432993.
Journal: American journal of speech-language pathology
Abstract: Purpose While research has confirmed the feasibility and validity of delivering clinical swallowing evaluations (CSEs) via telepractice, challenges exist for clinical implementation. Using an implementation framework, strategies that supported implementation of CSE services via telepractice within 18 regional/rural sites across five health services were examined. Method A coordinated implementation strategy involving remote training and support was provided to 18 sites across five health services (five hub and spoke services) that had identified a need to implement CSEs via telepractice. Experiences of all 10 speech-language pathologists involved at the hub sites were examined via interviews 1 year post implementation. Interview content was coded using the Consolidated Framework for Implementation Research (CFIR) and constructs were rated for strength and direction of influence, using published CFIR coding conventions. Results Services were established and are ongoing at all sites. Although there were site-specific differences, 10 CFIR constructs were positive influencing factors at all five sites. The telepractice model was perceived to provide clear advantages for the service, and clinicians were motivated by positive patient response. Strategies used to support implementation, including having a well-organized implementation resource and an external facilitator who worked closely with the local champions, were highly valued. Two CFIR constructs, Structural Characteristics and Available Resources, were challenges for all sites. Conclusions A complex interplay of factors influenced service implementation at each site. A strong local commitment to improving patient care, and the assistance of targeted strategies to support local implementation were viewed as central to enabling implementation.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Natalie Winter, Rukmani Rusch.
DOI: 10.1044/2021_AJSLP-21-00109
Keywords: Deglutition Disorders -- Diagnosis;Telehealth -- Utilization;Human;Multicenter Studies;Program Evaluation;Deglutition Disorders -- Education;Telehealth -- Education;Speech-Language Pathologists -- Education;Interviews;Program Implementation;Geographic Factors;Rural Areas;Funding Source
Type: Article
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