Addressing Changing Healthcare Needs: A Realist-Inspired Review of Innovative Rehabilitation Care Models

Abstract

Rationale/Objectives

Canadian healthcare is facing an aging population, an increasing prevalence of chronic disease and related disability, and rising healthcare costs. Integrating innovative rehabilitation models of care may help bolster health systems by shifting to a longer-term approach to addressing health and wellbeing. However, little is known about how these care models may look and what is needed to ensure their effective operationalization in practice.

Methods

This realist-inspired narrative review explored how, when, and in what circumstances innovative models of care have been successfully implemented and sustained in rehabilitation. The peer-reviewed and grey literature was searched and subsequently screened by title, abstract, and full text. Data extracted from included articles focused on identifying contexts, mechanisms, and outcomes. A numerical analysis of quantitative data and a conventional content analysis of qualitative abstractions was conducted.

Results

Twenty-six documents published between 2014 and 2021 were uncovered predominantly from Australia and Canada. Overall, for new care models to be successfully implemented and sustained, they need to: (1) have clearly articulated goals, (2) have access to short- and long-term funding, (3) align with key legislative changes to optimise buy-in, (4) take a multidisciplinary approach that is supported by management, and (5) include educational and outreach strategies that can be implemented amongst all interested parties.

Conclusions

The heterogeneity of studies and limitations in their reporting precluded the identification of context-mechanism-outcome configurations typically found in realist reviews. Future implementation research should draw on relevant reporting guidelines to report their findings.