Aboriginal and Torres Strait Islander women experience high rates of traumatic brain injury (TBI) as a result of violence. While healthcare access is critical for women who have experienced a TBI as it can support pre-screening, comprehensive diagnostic assessment, and referral pathways, little is known about the barriers for Aboriginal and Torres Strait Islander women in remote areas to access healthcare. To address this gap, this study focuses on the workforce barriers in one remote region in Australia. Semi-structured interviews and focus groups were conducted with 38 professionals from various sectors including health, crisis accommodation and support, disability, family violence, and legal services. Interviews and focus groups were audiotaped and transcribed verbatim and were analysed using thematic analysis. The results highlighted various workforce barriers that affected pre-screening and diagnostic assessment including limited access to specialist neuropsychology services and stable remote primary healthcare professionals with remote expertise. There were also low levels of TBI training and knowledge among community-based professionals. The addition of pre-screening questions together with professional training on TBI may improve how remote service systems respond to women with potential TBI. Further research to understand the perspectives of Aboriginal and Torres Strait Islander women living with TBI is needed.

Globally, there is growing recognition of the connection between violence and head injuries. At present, little qualitative research exists around how surviving this experience impacts everyday life for women, particularly Aboriginal and Torres Strait Islander women. This project aims to explore the nature and context of these women’s lives including living with the injury and to identify their needs and priorities during recovery. This 3-year exploratory project is being conducted across three Australian jurisdictions (Queensland, Northern Territory, and New South Wales). Qualitative interviews and discussion groups will be conducted with four key groups: Aboriginal and Torres Strait Islander women (aged 18+) who have acquired a head injury through family violence; their family members and/or carers; and hospital staff as well as government and non-government service providers who work with women who have experienced family violence. Nominated staff within community-based service providers will support the promotion of the project to women who have acquired a head injury through family violence. Hospital staff and service providers will be recruited using purposive and snowball sampling. Transcripts and fieldnotes will be analysed using narrative and descriptive phenomenological approaches. Reflection and research knowledge exchange and translation will be undertaken through service provider workshops.

Introduction: Obtaining patient input before healthcare redesign improves patient experience. The Townsville Hospital and Health Service, a regional Australian public health service, seeks to reduce the long wait list for medical specialist appointments by introducing allied health substitution models of care for low-acuity patients. This paper describes a best worst scaling survey conducted to refine attributes associated with outpatient appointments which will be used in a future discrete choice experiment (DCE). Methods: A literature review was conducted to identify attributes associated with medical specialist outpatient appointments and allied health substitution models. An object (or case 1) best worst scaling (BWS) survey was designed using blocks of a balanced incomplete block design and analysed using multinomial logit and mixed logit models. Patients waiting at local specialist outpatient clinics were invited to complete the survey via an iPad. The interviewer collected field notes, which were analysed using content analysis. Results: A total of 12 attributes were identified in the literature review and one from local discussion. The 167 completed responses demonstrated the ranking of attributes were diagnostic accuracy, symptom relief, continuity of care, satisfaction with care, healthcare professional, manner and communication, time on waitlist and onward referral. The least important attributes were reassurance offered, appointment wait time, cost and appointment duration. Conclusions: This BWS survey allows us to reduce the attributes for inclusion in the DCE from 13 to 8. Diagnostic accuracy and symptom relief were of most importance, and appointment wait time and duration were of least importance. This suggests that patients would be willing to be attend different models of care such as allied health primary contact model if clinical outcomes were equivalent to the current medical-led models.

Background/Aims: This study was conducted at a regional tertiary referral facility in Australia. It was part of a project to implement a new model of care for occupational therapy services on medical wards. Before the new model was implemented, focus groups were conducted to explore the perceived role of the occupational therapist on the acute medical ward, identify potential barriers to changing the service and garner support for the change in service. Methods: Three focus groups were held. The groups consisted of nursing, physiotherapy and speech pathology staff who worked on acute medical wards. Participants were asked for their perception of the role of occupational therapy on the acute medical ward. Audio-recordings of the groups were transcribed and analysed. Results: Qualitative content analysis highlighted the following themes: assessment of patient function; ‘safe discharge’; more than assessment; equipment and home modifications; collaboration and communication; delegating tasks to assistants; and specialist intervention strategies. Conclusions: Multidisciplinary team members' overriding perception is that occupational therapists in acute care settings provide assessment of patient function for the specific purpose of safe discharge. Some participants recalled that occupational therapists had a greater role in ensuring patients returned to their chosen function through rehabilitation and home visits, suggesting support for a change to our proposed post-acute model of care. Concerns highlighted by focus group members regarding increased workload for multidisciplinary team members and loss of communication need to be addressed to ensure the change in service is successful.

Emergency departments (EDs) are critical points of contact for treating and responding to the needs of Aboriginal and Torres Strait Islander women who have experienced traumatic brain injury (TBI) caused by violence. This study aimed to explore how care, support, and treatment can be improved for Aboriginal and Torres Strait Islander women who have experienced TBI caused by violence by drawing on the perspectives of ED staff in a regional hospital in Queensland (Australia). Using purposeful and snowballing sampling, 24 health professionals (including Indigenous hospital liaison officers and Aboriginal health workers and nursing, medical, and allied health staff) were recruited to participate in the study. Using reflexive thematic analysis, four key recommendations were identified: (1) development of a formalised pathway for head injury from family violence; (2) providing Aboriginal and Torres Strait Islander women with a timely acute-care-to-community pathway; (3) resourcing hospital- and community-based services for all Aboriginal and Torres Strait Islander women and their children; and (4) strengthening responses from health professionals to violence and head injury. The findings inform opportunities to strengthen ED and system-level responses to improve care and support for Aboriginal and Torres Strait Islander women who have experienced this injury.

Introduction: Consumer involvement is essential to ensure health service evaluations reflect what matters to those receiving care. This service improvement project describes how the evaluation of virtual reality (VR) in outpatient hand therapy was redesigned in partnership with consumers to better capture engagement with hand therapy. Method: The evaluation was undertaken in an outpatient hand therapy service. Initial evaluation relied on standardised quantitative measures, which did not address the original purpose of implementing VR in the treatment setting. Through collaboration with consumer partners and research mentors, the evaluation was redesigned using a value‐based care framework (comfort, capability and calm). Questionnaires using open and closed questions were developed in partnership with consumers and administered to both consumers attending the hand therapy unit and clinicians who worked in the unit. Results: Seven clinicians and 12 consumers participated. The redesigned evaluation identified that VR enhanced engagement with therapy by creating a low‐pressure and engaging environment. These findings would not have been captured in the original evaluation approach. Participants identified contextual factors (physical space, technology reliability, cultural and language considerations, and the importance of ‘hands‐on’ guidance) that influenced the successful use of VR. Conclusions: Co‐designing the evaluation of the service improvement project fundamentally changed what was measured and understood. This study demonstrates that involving consumers in how we evaluate projects can provide insights about engagement in therapeutic intervention. Partnering with consumers shaped this project and ensured outcomes reflected real‐world needs. This approach is encouraged across future hand therapy projects and research to ensure that innovation in clinical practice truly aligns with the people they are designed to support.