Category | Theme | Data (Codes) |
---|---|---|
The challenges of working in rehabilitation units | 1. The complex nature of the client group | - Patients’ relationships with staff |
- Difficulties engaging patients | ||
2. Impact of inappropriate referrals of patients prematurely transferred or with longer term needs | - Difficult to motivate patients | |
- Lack of support for staff | ||
- Referrals of chronic patients | ||
3. Inadequate rehabilitation-focused leadership and staffing | - Lack of formal structures | |
- Management | ||
- Resources | ||
- Workload | ||
- Staff held views on activity | ||
Impact of the GetREAL intervention | 1. Planning and reflection | - Provided structure and direction |
- Time management | ||
- Coordinate and organise activities | ||
2. External and alternative perspectives | - Taking interest in patients | |
- Insight into patients | ||
- Interaction with patients | ||
- New ideas, tools and practices | ||
3. Dissolving role boundaries | - Changed work practices | |
- Culture of rehabilitation | ||
- Flexibility | ||
- attitudes | ||
4. Collective working and responsibility | - Team working | |
- Shared responsibility | ||
- Change in ward atmosphere | ||
5. Motivation | - Staff confidence | |
- Accountability | ||
- Prioritising activity | ||
Barriers to Sustainability | Intervention-related: | - lack of information |
1. Insufficient preparation | - practicalities | |
2. Brevity of engagement with the intervention team | - Length of intervention | |
- Top-up session | ||
- Lack of follow up | ||
3. Misunderstanding of the aims of the intervention | - Accountability | |
- Staff focused versus patient focused intervention | ||
- Not sustaining changed practices | ||
Contextual issues: | - Workload | |
4. resources | - Staffing | |
5. Role boundaries | - management | |
- rigidity | ||
- Permission | ||
- Defending roles and responsibilities | ||
6. Leadership | - Lack of rehabilitation focus | |
- Paperwork driven | ||
- Lack of formal structures | ||
7. Competing priorities | - Low importance of activity in organisation | |
- External targets |