Implementing participation-focused services: A study to develop the Method for using Audit and Feedback in...

Area of Science:

• Pediatric healthcare
• Implementation science
• Knowledge translation

Background:

• Children's services face challenges implementing participation-focused practice.
• Audit and feedback is an evidence-based strategy to improve practice implementation.
• This study introduces a method to support participation-focused practice in front-line services.

Purpose of the Study:

• To describe a method for using audit and feedback to implement participation-focused practice in children's services.
• To identify barriers to the implementation of participation-focused practice.
• To enable international benchmarking of implementation and barriers.

Main Methods:

• Developed a Method for Audit and feedback for Participation implementation (MAPi).
• Audited clinicians' observable participation-focused behaviors (targeting outcomes, involving child/parent, measuring progress).
• Used the Theoretical Domains Framework Questionnaire (TDFQ) to identify implementation barriers.

Main Results:

• MAPi audit revealed low rates of participation-focused practice: targeting outcomes (30.3%), involving child/parent (13.1%), measuring progress (19.7%).
• Key barriers included clinicians' skills, social processes, and behavioral regulation.
• Data on practice and barriers were fed back to clinicians and managers for action planning.

Conclusions:

• MAPi offers a practical method for services to assess and enhance participation-focused practice.
• MAPi facilitates consistent, comparable data collection across services for implementation benchmarking.
• This method can inform future strategies to overcome persistent implementation barriers.