Barriers and Facilitators to Implementing Early Intervention Programmes in Compensable Settings: A Multi-stakeholder Qualitative Study in Australia.

IF 2.7 3区 医学 Q1 REHABILITATION
Alison Sim, Amy G McNeilage, Claire Richardson, Claire E Ashton-James
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引用次数: 0

Abstract

Purpose: This qualitative study aimed to explore the perspectives of researchers, insurance personnel, and regulators on the barriers and facilitators to implementing early intervention programmes in compensable settings in Australia.

Methods: Nineteen participants from across Australia were interviewed using a semi-structured format. Interviews were transcribed verbatim and thematic analysis was conducted.

Results: Through thematic analysis, five key themes were constructed: the knowing-doing gap: shared commitment but fragmented implementation; innovation versus inertia: organisational forces that shape implementation; evidence lost in practice: how low-value care undermines early intervention; bound by the system: legislative and bureaucratic barriers to early intervention; and invisible obstacles: why claims don't start when injuries do. These themes reveal that whilst early intervention is widely valued, its implementation is constrained by fragmented definitions, organisational resistance, misaligned clinical practices, legislative complexity, and delays in claim lodgement.

Conclusion: Findings suggest that achieving timely and effective early intervention requires more than clinical strategies; it demands system-level reform. Coordinated leadership, policy innovation, and streamlined processes are essential to overcome entrenched structural barriers. Initiatives such as public education, provider accreditation, and legislative reform may enhance access to evidence-based care and improve recovery outcomes for claimants.

在可补偿环境中实施早期干预方案的障碍和促进因素:澳大利亚多方利益相关者的定性研究。
目的:本定性研究旨在探讨研究人员、保险人员和监管机构对澳大利亚可补偿环境中实施早期干预计划的障碍和促进因素的看法。方法:采用半结构化格式对来自澳大利亚各地的19名参与者进行访谈。采访内容逐字抄录,并进行专题分析。结果:通过专题分析,构建了五个关键主题:知行差距、共同承诺、执行碎片化;创新与惯性:影响实施的组织力量;实践中丢失的证据:低价值护理如何破坏早期干预;受制度约束:早期干预的立法和官僚障碍;还有看不见的障碍:为什么当伤害发生时,索赔不会开始。这些主题表明,虽然早期干预被广泛重视,但其实施受到碎片化定义、组织阻力、不一致的临床实践、立法复杂性和索赔提交延迟的限制。结论:研究结果表明,实现及时有效的早期干预需要的不仅仅是临床策略;这需要系统层面的改革。协调领导、政策创新和精简流程对于克服根深蒂固的结构性障碍至关重要。诸如公共教育、提供者认证和立法改革等举措可能会增加获得循证护理的机会,并改善索赔人的康复结果。
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来源期刊
CiteScore
5.80
自引率
12.10%
发文量
64
期刊介绍: The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law.  A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.
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