The aim of this study was to explore physiotherapist and other allied health clinician experiences, perceptions and factors influencing uptake, implementation and sustainment of advanced technology use in rehabilitation.
A longitudinal qualitative study was conducted involving interviews with clinicians across three timepoints: (1) upon centre opening, (2) six-months after opening and (3) 12-months after opening. All allied health clinicians within the organisation (n=119) were invited to participate. Analysis was conducted by two researchers using an inductive thematic approach.
In total, 63 interviews were conducted with 25 clinicians across inpatient, outpatient and community rehabilitation services. Most study participants were female (≥75% at all timepoints), physiotherapists or occupational therapists (68-75% at each timepoint) and between 20-39 years of age (≥70% at all timepoints). Analysis resulted in three major themes and 13 sub-themes. (1) Technology integration involves cognitive and emotional labour for clinicians, who were determining the value-add of technology for their practice, juggling overwhelming learning and emotional demands, negotiating patients’ high expectations of advanced technology and confronting vulnerability while developing competence. (2) Contextual factors shape clinician access to, uptake and ongoing use of technology, including organisational culture and initiatives, professional discipline, rehabilitation setting, patient characteristics and device features. (3) Shared understanding and priorities across the organisation promote technology implementation and sustainment. These include understanding the role of advanced technology in relation to conventional therapy, creating a well-designed training model, equipping clinicians to manage patient expectations and maintaining a commitment to evidence-based practice. Ultimately, amidst the complexities of incorporating technology into practice, human interactions remained at the heart of rehabilitation with advanced technology.
Successful implementation of advanced technologies in rehabilitation relies upon an enabling person-centred context and careful planning. In addition to addressing contextual barriers, targeted initiatives, aligned priorities across the organisation, and a positive organisational culture with strong leadership are required to support clinicians through practice change.
Findings from this study provide practical considerations for physiotherapists, other clinicians, managers and rehabilitation organisations to facilitate the implementation and sustainment of advanced technology use in rehabilitation. Important elements include a comprehensive staff training model to develop clinicians’ technical, clinical reasoning and interpersonal skills. Other key initiatives include appointing a technology lead, fostering collaboration between clinicians and providing managerial recognition of clinician efforts.
Technology
Implementation Science
