Co-creating an assistive technology peer-support community: learnings from AT Chat.

PURPOSE: Inclusion is a core philosophy for health practitioners and human service users, and co-production is a way to achieve inclusion. Australia's assistive technology (AT) community seeks to include and amplify the voices of service and product users at multiple levels. Implementation of genuine partnerships for inclusion is however challenging. This paper describes the iterative co-design process undertaken to structure and deliver a peer-led information and support program, enabling AT users and supporters to build their AT decision making capability and share their expertise with each other and the broader community. METHODS: A living labs approach was grounded in co-design principles and drew on the peer education, AT competency and capability-building knowledge base. Methods included embedding intersectional capabilities within the service, and the engagement of over 600 people in design thinking and program iterations through surveys, focus groups, journey mapping and think tanks. RESULTS: A national, peer-led, co-designed online community for AT users was established and has been running since 2017. The community of 5000 users contribute to a peer-led information and support initiative geared to share expertise and build AT decision making capability. CONCLUSIONS: Service delivery by the AT user community and for the AT user community requires a commitment to co-design, and an engagement with concepts of risk, competency, scope of practice and capability. The learnings from AT Chat have implications for AT services on this journey everywhere.Implications for rehabilitationActive co-design of AT services meets human rights and good practice benchmarks required by contemporary services.Foregrounding AT users within program design and delivery, brings a range of positive outcomes and possibilities for the way services are delivered.AT users have substantial untapped potential which brings tangible outcomes for other AT users, health professionals, service provider organizations and for society.Development of paid roles and pathways to recognize the skills of AT users, and indeed AT communities has potential to improve AT user self-efficacy as well as to contribute to the AT workforce.

The Evolution of Ambulatory Care Nursing: A Compelling Conversation.

In this month's Magnet Perspectives column, guest author Kathleen Martinez, MSN, RN, CPN, joins Rebecca Graystone, MS, MBA, RN, NE-BC, for an in-depth look at the explosive growth of ambulatory care nursing over the past decade. The authors take a deep dive into multiple factors contributing to this rapid evolution, the role of the Magnet Recognition Program in accelerating and supporting ambulatory care and the nurses who provide it, and the prospects for continued growth in the decade ahead.

Nursing-Sensitive Indicators in Ambulatory Care.

Ambulatory nursing care can be difficult to comprehend in all its complexity. In August 2013, the American Academy of Ambulatory Care Nursing commissioned a task force to identify nursing-sensitive indicators specific to ambulatory care settings. Given the great variation in settings, staff mix, patient populations, role dimensions, skill sets, documentation systems, and resources, determining metrics that apply across the entire continuum of care is a daunting task. However, it is incumbent upon nurse leaders to define the metrics that will promote the value of the registered nurse in ambulatory practice and care coordination. Once initial measures are identified, piloted, and validated, the infrastructure can be created for ongoing benchmarking and collaboration. The long-term goal is to leverage professional nursing practice, based in the ambulatory care setting, to improve quality, safety, and cost in health care.