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A mixed methods study of the integration of health and social care occupational therapy provision : the complexity of change

Introduction The aim of this study was to generate new knowledge in occupational therapy practice. The study explored the change management process employed to develop integration of health and social care, evaluate the waiting lists, identify the critical success factors and the barriers to successful implementation of integrated practice In NHS Highland. Methods Mixed methods were employed to examine the change process following integration. Staff perceptions have been explored through a survey and participation in semi-structured interviews. Quantitative data was generated in a survey using the Health and Safety Executive Work Related Stress Tool which is valid and reliable. The data was collected at two points in time and was subjected to statistical analysis (n=27 & 26 respectively). Details of the waiting lists were collected from each area at two points during the study. Interviews were undertaken with a purposive selection of occupational therapists (n=lO), five from health and five from the ex-local authority. The data from the interviews were thematically analysed using Interpretive Phenomenological Analysis. Results The superordinate themes identified in this study relate to communication issues and concerns for professional practice. Staff reported their main stressor to be the lack of effective leadership and their relationship with managers. Therapists have identified co-location, and shared learning to be positive factors for integration. Barriers are identified as incompatible computer systems, perceived incompetence, and lack of a shared vision. The waiting list reduced during the study period. This was due to changes in the referral process, which resulted in therapists and other health professionals being able to action services directly from providers, rather than through occupational therapists. Implications for practice Integrated health and social occupational therapy services have the potential to develop effective relationships, reduce duplication and provide co-ordinated services with a single point of access for service users. Staff require to be involved at all stages of the change process in order to implement the integration of health and social care within their locality. The results could have implications for improving the effectiveness of integrated services generally. Summary The results of this study will be used to increase understanding of the barriers and critical success factors to develop effective, collaborative relationships and integration of health and social care occupational therapy provision.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:687406
Date January 2015
CreatorsMacGregor, Susan
PublisherGlasgow Caledonian University
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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