A transdisciplinary model of allied health services in an Australian special care nursery

Abstract

Neonatal allied health professionals have a critical role in providing vital therapies for vulnerable infants in neonatal units, such as a special care nursery (SCN) or a neonatal intensive care unit (NICU). The NICU is a high-stress environment for infants and their families. However, occupational therapists, physiotherapists and speech pathologists have the skills and knowledge to support the infant’s development and prevent long-term adverse outcomes.

Therapy services in hospitals are often provided in a multidisciplinary model of care, which consists of separate assessments and interventions that are delivered by allied health clinicians. By contrast, the transdisciplinary model of care involves one allied health keyworker providing comprehensive coordinated services to infants and their families using skills that can cross disciplinary-specific boundaries and address the infant’s needs through shared knowledge and role release.

The aim of this research project was to examine the two models of allied health care that currently operate in an Australian SCN. There were two research objectives: Research Objective 1’s intention was to describe the profile of the infants who had received services under both models of care; Research Objective 2’s intention was to describe the allied health services that these infants had received from the multidisciplinary and transdisciplinary models of care. The service information described includes reasons for a referral to each discipline, the referral source and the professionals providing a keyworker service. The service activities that have been described and compared were the length of the allied health services treatment period, the number of allied health sessions, and the number and types of allied health assessments and interventions.

A retrospective file review process was undertaken to extract the data from the medical records of 140 special care nursery infants who had received allied health services through either the multidisciplinary or transdisciplinary model of care between 2016 and 2020. Two sources of data were used for this project: the medical records for all infants who had received allied health services in the SCN and the allied health statistics program to confirm the number of sessions that had been provided to these infants. Descriptive statistics were used to characterise the infant demographic, medical and background information and inferential statistical analysis was used to compare service activities.

The results of this project produced four key findings. First, for the transdisciplinary model of care, the same number of allied health sessions were provided to infants and their families as for the multidisciplinary model of care but over a shorter period of time and with fewer professionals. This suggests that the transdisciplinary model was a more efficient model of care. Second, for the transdisciplinary model of care, the allied health professionals provided a wider range of assessments and interventions that aligned with best practice and clinical guidelines. Third, the allied health professionals played different roles in the services between the two models of care. Finally, there were few differences between the infants who had received multidisciplinary and transdisciplinary models of care.

The research conducted for this project was the first of its kind to explore the use of the transdisciplinary model of care in this unique neonatal setting. Recommendations have been provided for the creation of training opportunities for transdisciplinary health skills for allied health professionals; resources and structures to support allied health neonatal practices; and the development of Australian neonatal allied health practice guidelines.

Date of Award	2024
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Caroline Mills (Supervisor)