How do speech pathologists use the Australian Aphasia Rehabilitation Pathway to inform practice? A qualitative study

Background
Packaged evidence syntheses such as Best Practice Statements are important knowledge translation tools for improving healthcare provision. The Australian Aphasia Rehabilitation Pathway (AARP) is an online tool (www.aphasiapathway.com.au) based on the Aphasia Rehabilitation Best Practice Statements, developed to guide evidence-based aphasia services across the continuum of care. However, there has been no formal evaluation of the AARP’s implementation to date. Therefore, it is currently unknown whether and how speech pathologists use the AARP to guide their aphasia management practices, and how it can be enhanced to meet clinicians’ needs.

Aims
To explore Australian speech pathologists’ perceptions of (1) the usability and utility of the AARP, (2) how the AARP is currently used to inform aphasia management practices, (3) the potential impact of the AARP, and (4) how the AARP could be enhanced to meet clinicians’ identified needs.

Methods and Procedures
Semi-structured interviews guided by a framework for the development, implementation, evaluation, and reporting of online knowledge translation resources (Levac et al., 2015) were conducted with Australian speech pathologists working in aphasia services. Interviews were conducted via Zoom and accompanied by observations of participants’ self-navigation of the AARP. Qualitative content analysis of interview transcripts consisted of a combined deductive and inductive analytic approach.

Outcomes and Results
Eleven speech pathologists participated, who worked in predominantly public services in various clinical settings (acute, rehabilitation, and community) and had between 1 and 30 years of clinical experience. Cumulative AARP use over the previous 12-month period varied from 15 minutes to 10 hours. Participants identified a range of AARP benefits, such as being a source of knowledge and evidence, providing an overview of the patient journey, and providing resources. The AARP was used as a service improvement tool, a learning tool, and for accessing evidence, and was perceived to have direct and indirect impacts on knowledge and practice. Participants also recommended a number of enhancements to the AARP’s content and design to improve translation and clinical relevance, including updated recommendations, additional implementation resources, and improvements to layout and navigation.

Conclusions
The Australian Aphasia Rehabilitation Pathway was perceived as a valuable tool to inform evidence-based aphasia management. In order to remain relevant and useful, updated recommendations and links to clinically relevant resources are required. The suggested changes to content and design will inform an update of the AARP, which may in turn facilitate enhanced translation of evidence into practice and improve aphasia services.

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