"I had to have a couple of days off work to get there": Stakeholder perspectives in developing an occupational therapy burns telehealth service.

Abstract

Telehealth models have the potential to help overcome challenges associated with the provision of in-person adult occupational therapy (OT) burn care. This study aimed to examine clinician and consumer perceptions of in-person adult burn care within a large adult burns service and explore the key features required to develop and implement an adult OT burns telehealth (OT TeleBurns) model of care. Interviews were conducted with adults after burn injury (n=23), and occupational therapists providing burn care to patients at their local facilities (n=18). Data were analysed first qualitatively to identify challenges with current in-person services, then coded using the Consolidated Framework for Implementation Research (CFIR) 2.0, to identify barriers and facilitators for implementing an adult OT TeleBurns service. Patient travel, local clinical expertise, communication across facilities, and patient attendance were key challenges of in-person services. CFIR constructs identified as strong facilitators for an OT TeleBurns service were the tension to change from in-person services, the relative advantage of telehealth services, and the proposed service's adaptability to the local context and ability to meet participants' needs. Perceived implementation facilitators were ensuring choice of appointment type, building local clinician capability, optimising communication methods, and establishing service governance and clear operational processes. Findings highlight strong support for developing an OT TeleBurns service given significant challenges with in-person care. Existing facilitators indicate high feasibility for implementation with clear clinical pathways and service procedures critical to ensuring an effective and sustainable model. Findings will be used to guide telehealth service development.