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Background: Despite emerging evidence of validity and reliability, speech and language therapists' (SLT) uptake of telehealth has been limited and barriers remain to the effective and confident use of this service model. The COVID‐19 pandemic has caused significant disruption to essential health services, including speech and language therapy assessment and intervention, meaning that telehealth must now be considered as part of the suite of service delivery options for all clinicians. Aims: To explore the perceived barriers and facilitators of telehealth among community paediatric SLTs before and after their use of a telehealth platform with an embedded standardised assessment tool. Methods & Procedures: Mixed‐methods questionnaires were developed for this study and completed by SLTs before and after the 3‐month trial of the telehealth platform. A total of 38 SLTs completed the pre‐trial questionnaire and training in the use of telehealth platform (Coviu), including instruction in using a standardised, norm referenced language test as an integrated tool within the Coviu platform. A total of 27 SLTs went on to use the telehealth platform, and 25 of these completed the post‐trial questionnaire on which subsequent qualitative and quantitative analysis was completed. Outcomes & Results: Prior to using the platform, perceived barriers included technology issues, limited clinician experience and concerns around parent acceptance of the service. Potential facilitators included access to appropriate platforms, tools and resources as well as increased clinician confidence with telehealth. Following the trial, barriers to telehealth use continued to include technology barriers, particularly internet stability, and client issues, including suitability for telehealth services. Facilitators for future telehealth use included access to appropriate platforms for telehealth, stable and appropriate internet connectivity, and more extensive telehealth resources for both assessment and intervention for this mode of service delivery. Conclusions & Implications: This study provides insights into the perceptions of the barriers and facilitating factors for telehealth use among community‐based SLTs. This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery beyond the pandemic. What this paper adds: What is already known on the subject: Research about telehealth has shown that it is a reliable and valid way of delivering speech pathology services, yet many clinicians have been wary of its use and uptake of telehealth prior to COVID‐19 had been limited. We wanted to know what SLTs thought about using telehealth before and after participating in a 3‐month trial of a telehealth platform with an embedded formal language assessment. What this study adds to existing knowledge: This study indicates that technology issues including internet stability are a barrier to effective telehealth services, but that appropriate telehealth platforms, resources and experience are facilitators of uptake and successful use of telehealth. What are the potential or actual clinical implications of this work?: This information will be useful in developing strategies to promote uptake and effective and confident use of telehealth as a mode of service delivery for children during and beyond the pandemic, including those isolated by geographical or transport barriers. [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]

Objective: The need for more Remote Area Nurses in the Northern Territory is clear. This paper investigates the perspectives of Remote Area Nurse workforce issues among multiple stakeholders. The aim is to identify how Remote Area Nurse staffing issues are perceived by clinic managers, Remote Area Nurses themselves, Aboriginal colleagues and community members in seven remote communities in the Northern Territory. Design: This is a qualitative study that uses interviews and focus groups to identify key messages of local stakeholders about Remote Area Nurse workforce issues. A content analysis was used for data analysis. Setting: Seven diverse remote Aboriginal communities in the Northern Territory with government‐run health clinics were visited. Participants: Non‐random sampling techniques were used to target staff at the clinics at the time of field work. Staff and community members, who agreed to participate, were interviewed either individually or in groups. Interviews were conducted with 5 Managers, 29 Remote Area Nurses, 12 Aboriginal staff (some clinics did not have Aboriginal staff) and 56 community residents. Twelve focus groups were conducted with community members. Results: Content analysis revealed that participants thought having the "right" nurse was more important than having more nurses. Participants highlighted the need for Remote Area Nurses to have advanced clinical and cultural skills. While managers and, to a lesser extent, Remote Area Nurses prioritised clinical skills, Aboriginal staff and community residents prioritised cultural skills. Conclusions: Participants identified the importance of clinical and cultural skills and reiterated that getting the "right" Remote Area Nurse was more important than simply recruiting more nurses. Thus, retention strategies need to be more targeted and cultural skills prioritised in recruitment. [ABSTRACT FROM AUTHOR]

Introduction: Internationally, the adoption of technology into residential aged care settings has been slow and fraught with multiple challenges for residents, staff and service providers. The aim of this study was to evaluate the acceptability, efficiency, and quality of health information system implementation into aged care. Methods: Three‐stage, mixed‐methods participatory action research, concurrent with the natural experiment of a co‐designed health information system implementation into a 169‐bed aged care home in Australia. Data were collected pre‐, during, and post implementation between 2019 and 2021. Qualitative data included focus groups, interviews, and observations. Quantitative data included work observations, pedometers, record audits, incident reports and staff and resident surveys. There were 162 participants composed of 65 aged care residents, 90 staff, and 7 managers/consultants. Results: Improved work efficiency included reduced staff time searching for information (6%); reduced nurse time on documentation (20.4% to 6.4%), and 25% less steps. Documentation improvement included resident assessments (68% to 96%); resident‐focused goals (56% to 88%) and evaluations (31% to 88%). The staff reported being better equipped to manage the 'delicacies of dignity'. Conclusion: Implementation of a health information system into a residential aged care facility was associated with improved resident‐focused care and staff efficiency. Clinical relevance: Technology can support nurses and care staff to spend more time with residents in residential aged care homes, improve the quality of resident care, and assist meeting regulatory reporting requirements. Flexible and tailored co‐design strategies can enhance both effectiveness and success of technology implementation into residential aged care. [ABSTRACT FROM AUTHOR]