Abstract
Date Presented 04/22/2023
This poster presents a description of lessons learned and key considerations that were utilized by rehabilitation providers to facilitate the successful implementation and delivery of telerehabilitation services to veterans.
Primary Author and Speaker: Sharon Mburu
Additional Authors and Speakers: Consuelo Kreider
Contributing Authors: John C. Kramer, Kelsea LeBeau, Kimberly Findley, Keith J. Myers, Sergio Romero
The COVID-19 pandemic necessitated an urgent uptake in the provision of telerehabilitation (TR) services by providers within the Veterans Health Administration (VHA). The existing VHA Office of Rural Health funded TeleRehabilitation Enterprise Wide Initiative (TREWI) program, which was implemented across VHA sites, was used as a guiding model for quickly integrating TR into practice. TR delivery continues to grow, with the goal of increasing access to Veterans. This study describes factors that facilitated successful implementation and delivery of TR services to Veterans. A qualitative evaluation was conducted using an in-depth, semi-structured guide. Data were obtained from 2 focus groups and 8 individual interviews. Participants (n=15) were 4 program managers and 11 providers from 6 TREWI sites. Predetermined codes were developed from the REAIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework. Thematic analysis, coupled with the constant comparison method, was used to examine implementation differences across sites. Weekly discussion among coders were held to achieve consensus. Key themes included 1) Supportive leadership, 2) Leveraging partnerships, and 3) Having a vision. Supportive leadership entailed site administrators encouraging and facilitating a TR care delivery model. Leveraging partnerships entailed sites collaborating with community vendors and rural clinics to increase rural access to services through TR. Having a clear vision, such as established site goals and strategies for implementing and utilizing TR services, further facilitated site success. Findings provide three key considerations for the implementation and delivery of TR services. Impact: Rehabilitation providers, including Occupational Therapists, may adopt these considerations within their practice. VHA practices can inform providers across all healthcare systems as the VHA continues to refine and facilitate TR delivery.
References
Kreider, C. M., Hale-Gallardo, J., Kramer, J. C., Mburu, S., Slamka, M. R., Findley, K. E., Myers, K. J. & Romero, S. (2022). Providers’ Shift to Telerehabilitation at the U.S. Veterans Health Administration During COVID-19: Practical Applications. Front. Public Health 10:831762. https://doi.org/10.3389/fpubh.2022.831762
Glasgow, R. E., Battaglia, C., McCreight, M., Ayele, R. A. & Rabin, B. A. (2020). Making Implementation Science More Rapid: Use of the RE-AIM Framework for Mid-Course Adaptations Across Five Health Services Research Projects in the Veterans Health Administration. Front. Public Health 8:194. https://doi.org/10.3389/fpubh.2020.00194
Nilsen, P. Making sense of implementation theories, models and frameworks. Implementation Sci 10, 53 (2015). https://doi.org/10.1186/s13012-015-0242-0
