Allied Health research

Since late 2016 the Bupa Research Fellow (Allied Health) John Parsons and the Bupa (Allied Health) Research Associate Laura Stratton (Victoria Donoghue August 2017 - May 2018)  have been actively engaged in fostering a research culture within allied health through

• Facilitating and conducting research projects within Allied Health

• Promoting research amongst Allied Health clinicians and the broader Waikato DHB community

• Providing research education opportunities to allied health clinicians and advising and supporting Allied Health clinicians interested in undertaking higher education in research

• Encouraging and supporting Allied Health Clinicians to disseminate results of research activities through conference presentations and publications.

In total there are 24 research projects being undertaken within allied health currently. Some of these projects are:

Developing a vision for the future. 
Exploring and looking at the development of the Allied Health workforce.

What is the scope of practice for the social worker in the acute setting to facilitate the patient's social and emotional wellbeing in health.
Research which focuses on improving the quality and timeliness of referral to social work for patients acutely admitted to Waikato Hospital

The role and perceived function of the acute medical physiotherapist within the multidisciplinary team at Waikato Hospital.
This research will look at the role of the physiotherapist and therapy assistants but distinguish the current culture and responsibility of initiating and maintaining mobility for patients admitted to the acute medical wards.

Swallow function in acute lymphoblastic lymphoma and graft vs Host disease: the effects of total body radiation therapy. 
A case study being completed by the Speech Language Therapy team

A prospective randomized control trial evaluating the clinical efficacy and patient satisfaction scores of a novel adjustable wrist splint (Zero-Cast) for the treatment of distal radius fractures. 
Zero Cast is an experimental no cast wrist splint that will be trialled in the over 65 population presenting with undisplaced distal radius fractures.

Clinician knowledge in amputee rehabilitation at Waikato District Health Board.
This research examines physiotherapists and occupational therapists knowledge of both upper and lower amputation post prosthesis amputee rehabilitation across the care continuum.

Early mobility in ICU ventilated patients and physiotherapy practice.
This research aims to identify the current culture for early mobilisation and explore enablers and barriers to change in practice.

Communication accessible environments.
This is an evaluation of a training package which was designed and delivered on OPR4. It emphasized the importance of communication access in the wards and how this can be integrated into daily practice.

An exploratory study to examine the facilitators and barriers that influence patients with non-cystic fibrosis bronchiectasis attending the physiotherapy outpatient respiratory clinic.
This study will examine both health inequities for people living in rural communities and also Maori health outcomes as outlined in Waikato DHB's strategy.

If you would like to discuss any of this research or ideas for other research, please contact Laura Stratton, Research Associate on Laura.Stratton@waikatodhb.health.nz  or Associate Professor John Parsons, Research Fellow on j.parsons@auckland.ac.nz 

Clinician knowledge in amputee rehabilitation at Waikato District Health Board

This study aims to examine physiotherapists and occupational therapists knowledge of both upper and lower post prosthesis amputee rehabilitation across the care continuum within Waikato District Health Board. Determining the knowledge base and identifying any barriers to implementing best practice will inform future educational opportunities and initiatives to deliver quality patient care across service provision.

Factors associated with length of stay of bariatric patients in Waikato DHB

Aims: The study aimed to explore how factors impacted prolonged hospital length of stay amongst people considered having bariatric needs, or extreme obesity within a New Zealand tertiary hospital.
Outcomes: Thematic analysis defined three main themes impacting LOS, these were Insufficient Equipment, Medical complications, and Skin injuries.
Recommendations: Identifying the factors which are associated with prolonged LOS among patients who have bariatric inpatient needs provide useful insights into a bariatric inpatient population profile in a NZ tertiary hospital and could initiate future pre-planning efforts to enhance the quality and safety of healthcare for at-risk patient group.

Enhanced recovery after surgery: an evaluation of pre-operative education provided by the OT service

Aims: This study’s aims were to evaluate the pre-operative educational intervention versus no pre-operative educational intervention for patients who had elective hip and knee surgery.
Outcome: Low response rate to patient survey. Only 44% of elective hip/knee patients attended the pre surgery education. Findings demonstrated that education was well received by patients whether received pre or post operatively. There were no differences in length of stay for those who received pre-operative education.
Recommendations: To review the pre-operative service provision pathway across OT and identify clear clinical questions for review of service efficacy.

Does attendance to the memory and fatigue clinic improve patient outcomes?

This project aims to review the efficacy of the memory and fatigue clinic provided by the older persons and rehabilitation OT and psychology services.

Enhanced recovery after surgery: an evaluation of pre-operative education provided by the OT service

Aims: This study’s aims were to evaluate the pre-operative educational intervention versus no pre-operative educational intervention for patients who had elective hip and knee surgery.
Outcome: Low response rate to patient survey. Only 44% of elective hip/knee patients attended the pre surgery education. Findings demonstrated that education was well received by patients whether received pre or post operatively. There were no differences in length of stay for those who received pre-operative education.
Recommendations: To review the pre-operative service provision pathway across OT and identify clear clinical questions for review of service efficacy.

A prospective randomised control trial evaluating the clinical efficacy and patient satisfaction scores of a novel adjustable wrist splint (ZeroCast) for the treatment of distal radius fractures.

This RCT aims to assess the usability and efficacy of the Zerocast wrist splint for non-displaced radial fractures in people over 65.
The objectives are:

• To explore the views of older people (65+) who have suffered a wrist fracture and who utilise a wrist splint; 
• To explore the views of healthcare professionals (nurses and doctors) in relation to treating older people with wrist splints versus traditional methods;
• To assess the impact on function and pain in persons utilising the wrist splint; and
• To compare the outcomes of those utilising a wrist splint with expected outcomes.

What is the impact of a physiotherapy led paediatric gait clinic?

This project aims to review the impact of a physiotherapy led first specialist appointment (FSA) clinic on orthopaedic waitlists. It also aims to review both orthopaedic consultant and patient satisfaction with the service provided by the paediatric physiotherapists.

What is the impact of a physiotherapy-led paediatric gait clinic?

This project aims to review the impact of a physiotherapy led first specialist appointment (FSA) clinic on orthopaedic waitlists. It also aims to review both orthopaedic consultant and patient satisfaction with the service provided by the paediatric physiotherapists.

Has the implementation of the high risk infant pathway improved patient outcomes?

The high risk infant pathway was set up in March 2017 to improve the way infants are screened for developmental and neurological impairments, ensuring timely access to diagnosis-specific therapy intervention. The pathway involves high risk infants being assessed using the General Movements Assessment prior to NICU discharge and again at 12 weeks post-term age. This project aims to review the one year outcomes of these patients and their access to early intervention.

What is the impact of a physiotherapy-led paediatric gait clinic?

This project aims to review the impact of a physiotherapy led first specialist appointment (FSA) clinic on orthopaedic waitlists. It also aims to review both orthopaedic consultant and patient satisfaction with the service provided by the paediatric physiotherapists.

An exploratory study to examine the facilitators and barriers that influence patients with non-cystic fibrosis bronchiectasis attending the physiotherapy outpatient respiratory clinic.

This exploratory study will examine the motivating and influencing factors that contribute to attendance and non-attendance for patients with non- cystic fibrosis bronchiectasis who are referred to the physiotherapy outpatient respiratory clinic with the intention of facilitating improved patient outcomes by increased engagement and education on self-management.

The role and perceived function of the acute medical physiotherapist within the multidisciplinary team at Waikato Hospital

The aim of this study is to investigate the role and perceived function of the acute medical physiotherapist within the multidisciplinary team at Waikato Hospital with the intention of improving awareness of the role and scope of physiotherapy practice

Is the older persons and rehabilitation vestibular service provision effective?

Has the implementation of the high risk infant pathway improved patient outcomes?
The high risk infant pathway was set up in March 2017 to improve the way infants are screened for developmental and neurological impairments, ensuring timely access to diagnosis-specific therapy intervention. The pathway involves high risk infants being assessed using the General Movements Assessment prior to NICU discharge and again at 12 weeks post-term age. This project aims to review the one year outcomes of these patients and their access to early intervention.

The use of pessaries as a treatment adjunct by physiotherapists

This project is leading the way for DHB-provided Women’s Health physiotherapy. The team based at Waikato Hospital are the first NZ DHB employed physios to begin using pessaries as a treatment adjunct that they can complete themselves rather than a gynaecologist. Two of the Women’s Health physiotherapists have undertaken training to be able to offer this service which is fully supported by the Waikato gynae team. The Women’s Health physio team are also completing a study to look at the effectiveness and patient satisfaction of the implementation of this new service.

Does attendance to the memory and fatigue clinic improve patient outcomes?

This project aims to review the efficacy of the memory and fatigue clinic provided by the older persons and rehabilitation OT and psychology services.

Developing a communication accessible environment for people with aphasia.

This project aims to follow the communication access project completed by Simons-Mackie et al. (2007)-It “aims to improve the communicative access to information and decision making for people with aphasia” by increasing the OPR-4 stroke unit team’s knowledge of, and skills in providing communicative supports by facilitating implementation of facility- specific communicative access goals.” Additionally, it aims to develop audit guidelines for communicative access in Waikato DHB.

Developing a communication accessible environment for people with aphasia.

This project aims to follow the communication access project completed by Simons-Mackie et al. (2007). It “aims to improve the communicative access to information and decision making for people with aphasia” by increasing the OPR-4 stroke unit team’s knowledge of, and skills in providing communicative supports by facilitating implementation of facility- specific communicative access goals.” Additionally, it aims to develop audit guidelines for communicative access in Waikato DHB.

Health professional’s knowledge of driving restrictions following a cardiovascular event

This study being led by Waikato University aims to explore the driving-related advice health professionals provide to patients with after a cardiovascular event, and how they deliver this information to patients.

Implementing early family meetings during inpatient stroke rehabilitation

This implementation research is using a mixed methodology to develop and provide education and training to staff to become early family meeting facilitators. Once the early family meetings have been implemented patient and staff experience of these will be used along clinical data to establish the satisfaction and effectiveness of providing early family meetings during inpatient stroke rehabilitation.

What allied health services are provided in the first 6 months following stroke?

This piece of research aims to identify how much therapy is provided by which DHB provided services in the first 6 months post stroke and if this meets guideline recommendations. It also aims to explore if staff perceptions of the amount of therapy provided across the DHB services is in line with actual contact received by a patient.