<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jhp00146_s_006_w2aab3b7c52b1b6b1aab1c14b1Aa"><h3>Background</h3><p>In patients with haemophilia, evidence suggests that the physical examination alone is not sensitive enough to detect small amounts of blood within a joint. Attention has shifted to methods of improving the sensitivity of the physical examination through adding diagnostic modalities such as point-of-care ultrasonography (POC-US). Proficiency with the physical examination and understanding of the role of POC-US are important competencies for physiotherapists. Despite training, implementation of POC-US by physiotherapists in haemophilia treatment centres in Canada has been mixed.</p></sec><sec id="j_jhp00146_s_007_w2aab3b7c52b1b6b1aab1c14b2Aa"><h3>Aim</h3><p>Using a theory-based approach, the aim of the current study is to achieve expert consensus regarding the barriers to physiotherapy performed POC-US in haemophilia treatment centres in Canada using a modified Delphi approach.</p></sec><sec id="j_jhp00146_s_008_w2aab3b7c52b1b6b1aab1c14b3Aa"><h3>Materials and Methods</h3><p>Using the Knowledge-to-Action Framework and the Consolidated Framework for Implementation Research (CFIR), a modified Delphi approach was completed using the Modified BARRIERS Scale (MBS). Participants were blinded and consensus was reached over three rounds at the Canadian Hemophilia Society’s annual three-day conference.</p></sec><sec id="j_jhp00146_s_009_w2aab3b7c52b1b6b1aab1c14b4Aa"><h3>Results</h3><p>Twenty-two physiotherapists participated; 20 participants completed Round 1, and 21 completed Rounds 2 and 3. Four items of the MBS reached consensus: 1) The physiotherapist does not have time to read research related to POC-US; 2) The physiotherapist is isolated from knowledgeable colleagues with whom to discuss POC-US; 3) Administration will not allow POC-US implementation; 4) There is insufficient time on the job to implement new ideas. All four consensus items can be mapped to one domain of the CFIR: the inner setting.</p></sec><sec id="j_jhp00146_s_010_w2aab3b7c52b1b6b1aab1c14b5Aa"><h3>Conclusion</h3><p>The haemophilia treatment centre within a healthcare organisation appears to be an important target for addressing barriers to the implementation of physiotherapy performed POC-US.</p></sec></abstract>

BackgroundIn patients with haemophilia, evidence suggests that the physical examination alone is not sensitive enough to detect small amounts of blood within a joint. Attention has shifted to methods of improving the sensitivity of the physical examination through adding diagnostic modalities such as point-of-care ultrasonography (POC-US). Proficiency with the physical examination and understanding of the role of POC-US are important competencies for physiotherapists. Despite training, implementation of POC-US by physiotherapists in haemophilia treatment centres in Canada has been mixed.AimUsing a theory-based approach, the aim of the current study is to achieve expert consensus regarding the barriers to physiotherapy performed POC-US in haemophilia treatment centres in Canada using a modified Delphi approach.Materials and MethodsUsing the Knowledge-to-Action Framework and the Consolidated Framework for Implementation Research (CFIR), a modified Delphi approach was completed using the Modified BARRIERS Scale (MBS). Participants were blinded and consensus was reached over three rounds at the Canadian Hemophilia Society’s annual three-day conference.ResultsTwenty-two physiotherapists participated; 20 participants completed Round 1, and 21 completed Rounds 2 and 3. Four items of the MBS reached consensus: 1) The physiotherapist does not have time to read research related to POC-US; 2) The physiotherapist is isolated from knowledgeable colleagues with whom to discuss POC-US; 3) Administration will not allow POC-US implementation; 4) There is insufficient time on the job to implement new ideas. All four consensus items can be mapped to one domain of the CFIR: the inner setting.ConclusionThe haemophilia treatment centre within a healthcare organisation appears to be an important target for addressing barriers to the implementation of physiotherapy performed POC-US.

Barriers to the implementation of point-of-care ultrasonography by physiotherapists in haemophilia treatment centres in Canada: a modified Delphi approach

School of Rehabilitation Science, Faculty of Health Science

Department of Kinesiology, Faculty of Applied Health Sciences

The Journal of Haemophilia Practice

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

BackgroundIn patients with haemophilia, evidence suggests that the physical examination alone is not sensitive enough to detect small amounts of blood within a...

Barriers to the implementation of point-of-care ultrasonography by physiotherapists in haemophilia treatment centres in Canada: a modified Delphi approach

Article Category: Clinical Research

Published Online: Nov 01, 2019

Page range: 29 - 41

DOI: https://doi.org/10.17225/jhp00146

Keywords
point-of-care systems, ultrasonography, haemophilia A, physiotherapy, implementation science, Delphi method

© 2019 Karen Strike, Anthony Chan, Monica R. Maly, Patricia Solomon, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Barriers to the implementation of point-of-care ultrasonography by physiotherapists in haemophilia treatment centres in Canada: a modified Delphi approach

Article Category: Clinical Research

Published Online: Nov 01, 2019

Page range: 29 - 41

DOI: https://doi.org/10.17225/jhp00146

Keywordspoint-of-care systems, ultrasonography, haemophilia A, physiotherapy, implementation science, Delphi method

© 2019 Karen Strike, Anthony Chan, Monica R. Maly, Patricia Solomon, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
point-of-care systems, ultrasonography, haemophilia A, physiotherapy, implementation science, Delphi method