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Implementing high value back pain care in private physiotherapy in Australia: a qualitative evaluation of physiotherapists who participated in an 'implementation to innovation' system

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dc.contributor.authorGardner, C.
dc.contributor.authorMoseley, G.L.
dc.contributor.authorKarran, E.L.
dc.contributor.authorWiles, L.K.
dc.contributor.authorHibbert, P.
dc.date.issued2020
dc.description.abstractObjectives: Many barriers exist to delivering high value care for people with low back pain. We have developed a multi-strategy implementation system to overcome these barriers. Here we describe a qualitative evaluation of the experiences of private sector physiotherapists of the system. Design: PRISM (Practice-based Innovation & Implementation System) is an iterative clinician-as-scientist implementation programme, tailored here for acute and sub-acute LBP. PRISM integrates strategies from behavioral change, implementation and educational science fields. Semi-structured interviews, group discussion forums and electronic questionnaires were used to collect data at multiple time points and analyzed using an interpretative descriptive approach. Setting: Private practice physiotherapy clinics. Participants: Six physiotherapists (purposive sample) in the Adelaide region, South Australia. Interventions: An educational pain science and care workshop incorporating self-regulated learning principles, a co-planned clinical pathway, an electronic decision-support tool, development and support of a community of practice, case study simulations, audit and feedback, and collaborative problem solving and innovation for physiotherapists. Results: Participants’ experiences and perceptions centered around five themes: (1) knowledge and skills training; (2) networking and mentoring; (3) a clear clinical pathway; (4) practical tools; and (5) data feedback. Participants appraised the implementation process positively although identified patient receptiveness as a challenge at times. Improvement suggestions included streamlining/automating data collection forms and processes and providing more simulation opportunities. Conclusions: PRISM appears to be a promising approach to overcoming several barriers that prevent people with back pain from receiving high value care. It consolidates and increases pain science knowledge, and increases physiotherapist confidence in delivering high value care. It appeared to legitimize some current practices, enhance clinical reasoning and communication skills, extend knowledge in line with contemporary pain science and facilitate the application of a biopsychosocial management approach. The high-level acceptance by participants provides a foundation for further research to test outcomes and delivery in different settings.
dc.identifier.citationCanadian Journal of Pain, 2020; 4(1):86-102
dc.identifier.doi10.1080/24740527.2020.1732808
dc.identifier.issn2474-0527
dc.identifier.issn2474-0527
dc.identifier.urihttps://hdl.handle.net/11541.2/141163
dc.language.isoen
dc.publisherTaylor & Francis
dc.relation.fundingNHMRC - Principal Research Fellowship 1061279
dc.rightsCopyright 2020 2020 The Author(s). Published with license by Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/)
dc.source.urihttps://doi.org/10.1080/24740527.2020.1732808
dc.subjectlow back pain
dc.subjectphysiotherapist perspectives
dc.subjectqualitative research
dc.subjectquality improvement
dc.subjectfeasibility study
dc.titleImplementing high value back pain care in private physiotherapy in Australia: a qualitative evaluation of physiotherapists who participated in an 'implementation to innovation' system
dc.typeJournal article
pubs.publication-statusPublished
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ror.fileinfo12214939840001831 13214939830001831 Implementing high value back pain care in private physiotherapy in Australia A qualitative evaluation of physiotherapists who participated in an
ror.mmsid9916379307601831

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