A rapid review and expert identification of the Allied Health Professions' interventions as a contribution to public health outcomes.

Background and aim: In preparation for the Public Health England Impact Assessment of the 2014 AHP Public Health Strategy a follow up rapid literature review was commissioned. The aim was to identify primary studies in which Allied Health Professionals (AHP) contribute to public health outcomes, based on UK research evidence. This review was used to inform further UK policy and implementation for AHPs in the UK via Public Health England. Methods: A rapid mixed methods review was conducted, limiting the selection of studies to those published after December 2014 and recognising the same 12 Allied Health Professions that were used in the previous review. The rapid review included all age groups and patient populations but limited the searches to studies that reflected UK AHP practices and research outcomes. The literature search included title, abstract and full-text screening with data extraction of selected papers. A nominal group method invited expert AHPs to review and select the interventions for potential impact at population level. Results: 11 selected articles were grouped into two areas of interventions; health intervention/public health and secondary prevention/health improvement, based on the Public Health England Strategic Framework. AHP interventions were effective for Chronic Fatigue Syndrome and Osteoarthritis and specifically used to manage musculoskeletal conditions (e.g. frozen shoulder). AHPs leading vocational rehabilitation and falls management were also effective. These areas were additional to those previously identified and represented some additional specialist activity undertaken to affect health outcomes. Conclusions: This study also contributed to the UK AHP Public Health Strategic Framework 2019-2024 by appraising the UK evidence and impact of some AHP practices. Further improvement is required; for AHPs to measure the impact of their interventions which would demonstrate evidence of outcomes at population level.

The role of Allied Health Professions and Nursing Research Internships in developing a research culture: a mixed-methods exploration of stakeholder perspectives.

BACKGROUND: Developing research capability and capacity within the healthcare professions is a challenge throughout diverse international settings. Within England, the National Institute for Health Research aimed to address these challenges through the Integrated Clinical Academic (ICA) research careers escalator for nurses, midwives and allied health professionals. Poor academic progression has been identified in the advanced stages of the pathway, though progression from the earlier entry point (Internship) has not previously been investigated. A national evaluation of four completed Internship cohorts was undertaken to explore stakeholder perspectives and progression beyond the Internship programme. METHODS: A mixed methods project used sequential qualitative and quantitative data collection phases commencing with two stakeholder focus groups (n = 10); the findings informed the development of an online survey distributed to previous cohorts of interns (n = 104), their managers (n = 12) and academic mentors (n = 36). Eight semi-structured interviews subsequently explored the challenges and opportunities afforded by the internships. Thematic analysis was used to review qualitative data from focus groups and interviews, with survey data analysed and displayed using descriptive statistics. Synthesis of data from each phase is displayed within the four level evaluation framework outlined within the New World Kirkpatrick® Training Evaluation Model. RESULTS: Important regional differences exist yet the internships are highly valued by all stakeholders. Representation varied between different professions, with nursing and some service-based professions poorly represented. All interns successfully completed the programme (n = 104), with evidence of positive impacts on interns, colleagues and patient care. Balancing research commitments with clinical activity was challenging; middle managers were seen as gatekeepers to programme success. Progression to the next stage of the ICA pathway is highly competitive and was achieved by only a quarter of interns; access to mentors outside of the funded programme is vital for a successful transition. CONCLUSIONS: The Internship programme succeeds in providing a range of important early experiences in research, though progression beyond the programme is challenging due, in part, to a widening gap between Internship and the next level of the ICA framework. Vital mentorship support to bridge this gap is threatened by a lack of time and funding; therefore, the pursuit of a clinical-academic career will continue to be elusive for many nurses and allied health professionals. A partnership approach to clinical academic support at institutional level is needed with several international models offering alternative strategies for consideration.

Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

Objectives: The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. Study design: A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. Methods: A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Results: Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. Conclusions: This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level.

Quality care is reform priority.

How health system reform will finally "shake out" in Pennsylvania remains a mystery to us all. This month, we consider that mystery and reform's most important provision--quality care.

HCQII: sources of cooperative projects.

This is a continuation of a review of some of the various components of the Keystone Peer Review Organization's (KePRO's) Health Care Quality Improvement Initiative (HCQII). Last month's article dealt mainly with focused medical review and briefly referred to cooperative projects which are really the basis of the HCQII. Future articles will address the two kinds of cooperative projects, local and national. Here we will look at the major sources of cooperative projects and more of the HCQII process.

HCQII: focused review enhances analysis efforts.

Because the Health Care Quality Improvement Initiative (HCQII) is so important to the new direction of the Keystone Peer Review Organization (KePRO), and because it represents such a departure from previous PRO activities, we will devote this page, over the next few months, to explaining some of HCQII's major components. This month we look at focused medical review.