Unpacking the Complexity of Implementing Robotic Technology for Multiple Disciplines: A Mixed Methods Study 4355

Abstract

Objectives

To study the integration of robotic technologies across inpatient, outpatient and community rehabilitation services.

Design

Mixed methods over a 12-month period, using descriptive statistics to analyze device usage data and thematic analysis of semistructured clinician interviews.

Setting

A rehabilitation center in Australia.

Participants

Clinicians from physiotherapy, occupational therapy, recreational therapy, speech pathology and dietetics, and allied health assistants working in inpatient, outpatient and community services.

Interventions

Not applicable.

Main Outcome Measures

Device-specific usage and multidisciplinary experiences and perceptions of introducing robotic rehabilitation technologies.

Results

Device usage increased from 219 to 511 uses per month 11 months later, totaling 4262 uses across 25 different devices by 271 patients with a range of neurological conditions across the year. In about 20% of therapy sessions multiple devices were used. The 25 interviewed clinicians understood that the new technologies were additions to their clinical toolkit requiring them to think and practice differently, but they struggled with discipline-technology fit and were overwhelmed by the volume of training required for each device. Early on, clinicians from disciplines that typically target impairments found it easier to integrate technology than disciplines with a dominant participation focus, but this changed over time as evidenced in increasing diversity of session goals and the clinicians’ stories. Although technology was found to enhance patient engagement, it also required many clinicians to upskill to effectively navigate patients’ high expectations of robotic technologies. Key factors in successful implementation were clinician buy-in, a well-designed staff training model, real time on the ground support, and responsiveness to differences between inpatient, outpatient and community services.

Conclusions

Ultimately, clinicians came to embrace technology's role in rehabilitation but emphasized its use alongside traditional therapy methods, guided by strong clinical reasoning and clear goals. This study adds value by using implementation science and including multiple perspectives.

Disclosures

none.