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dc.contributor.authorBandong, Aila Nica
dc.date.accessioned2019-08-06
dc.date.available2019-08-06
dc.date.issued2019-02-28
dc.identifier.urihttp://hdl.handle.net/2123/20845
dc.description.abstractBest practice recommendations for whiplash management have changed considerably over the past few decades; however, have not been widely adopted in clinical practice. Clinical pathways are a promising strategy to enable practice change. The aim of this thesis was to explore selected aspects of practice change to support the implementation of a clinical pathway of care for whiplash and the administration of a randomised controlled trial that tests the effectiveness of the pathway. This thesis used several research methods, including retrospective audit of insurer files, focus group discussions, process evaluation, and a clinical trial. The audit of files showed that many aspects of practice in whiplash management were inconsistent with the guidelines. Themes generated from the focus groups suggested that recommendations requiring significant change in practice were not well accepted, explaining an important potential barrier to adherence. Other barriers identified included lack of clarity in recommendations and perceived patient expectations about management. The focus groups also supported the potential for wider use of whiplash specialists in a peer review role by better meeting the needs of the referring health professional. This finding supports one of the key components of the clinical pathway of care for whiplash and strongly shaped the further development of the pathway as an intervention in the randomised controlled trial. The thesis delivered a new and acceptable online tool, My Whiplash Navigator, as a resource to promote best practice. Finally, the thesis provided preliminary evidence that implementation of the clinical pathway of care has enabled change in aspects of practice. This thesis generated new knowledge that informed the implementation and evaluation of the clinical pathway of care for whiplash. Further, this thesis identified mechanisms to enable best practice management of whiplash and more broadly other high burden musculoskeletal conditions.en_AU
dc.publisherUniversity of Sydneyen_AU
dc.publisherFaculty of Health Sciencesen_AU
dc.rightsThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
dc.subjectclinical pathwaysen_AU
dc.subjectbest practiceen_AU
dc.subjectprimary health careen_AU
dc.subjectservice deliveryen_AU
dc.subjectwhiplash injuriesen_AU
dc.subjectmusculoskeletalen_AU
dc.subject.otherincludes published articlesen_AU
dc.titleEnabling change in whiplash management through a clinical pathway of careen_AU
dc.typePhD Doctorateen_AU
dc.type.pubtypeDoctor of Philosophy Ph.D.en_AU
dc.description.disclaimerAccess is restricted to staff and students of the University of Sydney . UniKey credentials are required. Non university access may be obtained by visiting the University of Sydney Library.en_AU


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