Abstract
This mixed-methods study reports on the key stakeholders’ perspectives on the ear, nose, and throat (ENT) service redesign in remote Australia, using a participatory action research (PAR) approach. A primary health care (PHC) clinician survey was conducted to assess local needs and possible educational gaps in clinical knowledge. This was followed by an internal stakeholder forum and a follow-up survey with Torres and Cape Hospital and Health Service staff to gain their perspectives on current service delivery and table ideas for a new ENT health service model. Qualitative data were analyzed inductively and grouped in emerging themes. Quantitative data were imported into tables and analyzed descriptively. PAR allowed for input from 19 PHC clinicians, 10 face-to-face stakeholders perspectives, and 18 stakeholder follow-up survey respondents. Four themes emerged: 1. Training for health workers in ENT management; 2. Improved local service access; 3. New referral pathways to improve continuity of care; and 4. Introduction of telehealth. PAR engaged key stakeholders, identifying gaps in ENT service delivery, and guided the development of the new service model. The inclusion of stakeholders throughout the service redesign process is likely to create a more sustainable model of care which already has local “buy-in”.
Highlights
This paper reports on the key stakeholders’ perspectives on the ENT service redesign, using a participatory action research (PAR) approach
Participatory action research allowed for input from 19 primary health care (PHC) clinicians, 10 face-to-face stakeholders’ perspectives, and 18 stakeholder follow-up survey respondents in regard to the development of a new ENT model of care for Cape York
The use of PAR in this study enabled service redesign that has developed a more relevant and appropriate service model than would otherwise have been developed [14,15]
Summary
Health care delivery in rural and remote locations across Australia has established difficulties [1]. Residents of these areas experience challenges accessing health services and personal high out-of-pocket costs associated with transport to travel extensive distances [2,3]. It supports a population of over 11,000 people, of whom 58% are Aboriginal or Torres Strait Islander people (hereafter, respectfully, Indigenous) [4]. Stakeholders strongly supported the use of telehealth, as it has the ability for PHC clinicians to get second opinions or advice by sending images to specialist services or other clinicians
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