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Translation of evidence into practice in healthcare is challenging, particularly with new innovations. Indocyanine Green (ICG) lymphography is a novel innovation where the superficial lymphatics are imaged to provide information about lymphoedema diagnosis and to guide individualised therapy for a person's long‐term chronic management of lymphoedema, supporting care across the continuum to the community setting. Despite the unique information ICG lymphography provides, the technology itself is complex and highly specialised and currently has limited adoption in clinical practice. This paper sought to determine the barriers and enablers to establishing an ICG lymphography clinic within an outpatient lymphoedema service by exploring staff perceptions and experiences. An interpretive descriptive design was used with semi‐structured interviews of key staff participants from a quaternary public hospital six months after ICG lymphography clinic establishment. An interview guide was developed, underpinned by the Consolidated Framework for Implementation Research (CFIR), to guide the inquiry. Interview data were transcribed, inductively coded and analysed to identify themes. All eligible management, clinical and ancillary staff were included (N = 8). Four key themes were identified from the data as essential to implementation success. These were support is critical for implementation; beliefs about the technology; practicalities are achievable; and sustainability for ongoing success. Themes were found to be interrelated and centred around support from staff and the organisation as a critical process facilitator. The study demonstrated an ICG lymphography clinic can be successfully established as part of an outpatient lymphoedema service. Key enablers related to positive staff attitudes and beliefs about ICG lymphography and its application. Future implementation sites may consider that although the complexity of this innovation creates process challenges, the use of an implementation framework can assist in identifying determinants of success for effective implementation to practice. [ABSTRACT FROM AUTHOR]

This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods. [ABSTRACT FROM AUTHOR]

This research aimed to explore the needs, potential roles and implementation of Bilingual Community Navigators (BCNs) in providing navigation support for patients in general practice settings in Australia. A total of 19 participants (general practitioners, practice managers, practice nurses and receptionists) from five general practices in Sydney where most of the patients spoke a language other than English were interviewed about their views on needs, potential roles and implementation of BCNs in general practice settings. Data were collected between August 2019 and July 2020. The interview transcripts were inductively analysed for themes. Themes emerged across four broad categories: patients' barriers to access health and social care services; potential roles of BCNs; recruitment, training, and employment of BCNs and considerations and anticipated barriers to BCNs' role. Many barriers both at the patient and at the service provider levels in accessing healthcare and social care services were consistent with the Levesque et al. access framework including lack of understanding of the health system, language and cultural barriers, hesitancy to approach general practice and problems navigating services. Participants believed that BCNs would be able to help overcome these barriers through health education, support in booking appointments, arranging transport, providing language and cultural support and improving communication with the health services. Conditions for effective implementation of BCNs in practice included proper training of the navigators to ensure patient confidentiality and addressing organisational/system barriers such as lack of a funding mechanism, a clear role definition of BCNs and acceptance of BCNs by patients. BCNs potential role in facilitating access to appropriate care by culturally and linguistically diverse (CALD) patients in general practice warrants further evaluation in the context of the Australian healthcare system. [ABSTRACT FROM AUTHOR]

Partnering with consumers and patients and the community and public is a research and healthcare improvement imperative. Consumer and community involvement (CCI) requires behaviour change at the individual (researcher, health professional, manager), organisational (health service, university, medical research institute) and system level (funding policies, collaboration between organisations). To understand the barriers and enablers to meaningful CCI, a qualitative descriptive study was undertaken with researchers, health professionals, representatives from consumer organisations, and health services and ethics committees in Melbourne, Australia. Twenty‐eight semi‐structured interviews and one focus group were conducted in May–August 2019. Ethics approval was obtained. Thematic analysis was guided by the Capability, Opportunity and Motivation and Behaviour model (COM‐B). Training of researchers and health professionals in CCI, benefits and systems and processes to undertake CCI, alongside incorporating CCI as a requirement for funding were identified as enablers. Lack of time and resources for CCI, challenges in finding consumers for projects and a perceived lack of evidence of the impact of CCI were barriers. These identified barriers and enablers will inform strategies to build the capacity of CCI at the individual, organisation and system level within the Australian Health Research Alliance. [ABSTRACT FROM AUTHOR]