Article

Clinicians' actions impact the patient care process and pathway. This
study identified clinicians' actions associated with successful care processes in
one community healthcare setting, children's occupational therapy. METHOD: A
secondary analysis in a form of a quantitative content analysis was conducted of
47 interview transcripts, describing outcomes and therapists' (n = 25)
self-reported actions in 25 "successful" and 22 "unsuccessful" care processes.
The successful processes were those with positive outcomes (clear and coherent
process with easy discharge; achieved patient goals and positive
patient-clinician relationships). The transcripts were coded for presence of
therapists' actions and non-actions using content analysis; and actions
associated with success of the process were identified by Pearson Chi-square
test. RESULTS: In total 207 actions were identified. These clustered around six
areas: assessment, setting goals and planning actions, treatment, review,
discharging, and managing processes and relationships. The key actions associated
with successful processes were: gather perspectives from others at assessment
(chi(2) = 6.65, p < 0.01); identify therapy goals (13.16, p < 0.01);
agree/communicate plans, roles and responsibilities (9.10, p < 0.01); involve the
child and parents in treatment (6.36, p = 0.01); adapt physical environment
(6.01, p = 0.01) and make comparisons between the baseline, current and target
levels when reviewing progress (6.36, p = 0.01). CONCLUSIONS: The actions
identified are congruent with literatures about patient involvement and goal
achievement. Specific hypotheses about the mechanisms by which the identified
actions may relate to care process are presented.

Langue : ANGLAIS