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01.12.2012 | Study protocol | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Integrating evidence into policy and sustainable disability services delivery in western New South Wales, Australia: the 'wobbly hub and double spokes' project

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Craig Veitch, Michelle Lincoln, Anita Bundy, Gisselle Gallego, Angela Dew, Kim Bulkeley, Jennie Brentnall, Scott Griffiths
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-70) contains supplementary material, which is available to authorized users.

Competing interests

ADHC staff are involved in all aspects of this project. Two authors are ADHC staff.

Authors' contributions

CV is the principal investigator, led the study's conception and application for funding, chairs the project management group, is involved in all aspects of the study, and drafted the manuscript. ML was involved in the study's conception and application for funding, chairs the project reference group, and is involved in all aspects of the study. AB was involved in the study's conception and application for funding, and is involved in all aspects of the study. GG was involved in the study's conception and application for funding, designed the DCEs, and is involved in all aspects of the study. AD is the project manager, conducted focus groups and interviews, and is involved in all aspects of the study. KB, seconded from ADHC Central Office is the project officer, conducted focus groups and interviews, and is involved in all aspects of the study. JB was involved in the conception and development of the project, contributed to survey design, and is a member of the project working group. SG, Regional Director ADHC-WR, co-led the study's conception, co-chairs the project management group, provides input on disability services and regional characteristics. All authors read and approved the final manuscript.

Abstract

Background

Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia.

Methods/Design

The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability.
Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation.
Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences.
Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects.
Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted policies that arise from the preceding stages.

Discussion

The project will provide policy makers with research evidence to support consideration of the complex balance between: (i) the equitable allocation of scarce resources; (ii) the intent of current eligibility and prioritisation policies; (iii) workforce constraints (and strengths); and (iv) the most effective, evidence-based clinical practice.
Zusatzmaterial
Authors’ original file for figure 1
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