The challenges confronting clinicians in rural acute care settings: a participatory research project.
BACKGROUND
In Australia, as in many other developed countries, the current healthcare environment is characterised by increasing differentiation and patient acuity, aging of patients and workforce, staff shortages and a varied professional skills mix, and this is particularly so in rural areas. Rural healthcare clinicians are confronted with a broad range of challenges in their daily practice. Within this context, the challenges faced by rural acute care clinicians were explored and innovative strategies suggested. This article reports the findings of a study that explored these challenges across disciplines in acute healthcare facilities in rural New South Wales (NSW), Australia.


METHODS
A mixed method approach, involving a consultative, participatory 3 stage data collection process was employed to engage with a range of healthcare clinicians from rural acute care facilities in NSW. Participants were invited to complete a survey, followed by focus group discussions and finally facilitated workshops using nominal group technique.


RESULTS
The survey findings identified the respondents' top ranked challenges. These were organised into four categories: (1) workforce issues; (2) access, equity and opportunity; (3) resources; and (4) contextual issues. Participants in the focus groups were provided with a summary of the survey findings to prompt discussion about the challenges identified and impact of these on their professional and personal lives. The results of the final workshop stage of the study used nominal group process to focus the discussion on identifying strategies to address identified challenges.


CONCLUSIONS
This study builds on research conducted in a large metropolitan tertiary referral hospital. While it was found that rural clinicians share some of the challenges identified by their metropolitan counterparts, some identified challenges and solutions were unique to the rural context and require the innovative solutions suggested by the participants. This article provides insight into the working world of rural healthcare clinicians and offers practical solutions to some of the identified issues. The findings of this study may assist rurally based healthcare services to attract and retain clinical staff.
School of Health, University of New England, Armidale, New South Wales, Australia. ppaliade@une.edu.au
Penny S
PS
Paliadelis
Glenda
G
Parmenter
Vicki
V
Parker
Michelle
M
Giles
Isabel
I
Higgins
D000208:Acute Disease / Q000534:rehabilitation / Q000628:therapy*; D000328:Adult; D001291:Attitude of Health Personnel; D055812:Community-Based Participatory Research; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D005260:Female; D017144:Focus Groups; D006281:Health Occupations / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D015279:Organizational Culture; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D010563:Personnel Turnover; D040841:Resource Allocation / Q000592:standards; D019035:Rural Health Services / Q000592:standards; D013192:Staff Development; D011795:Surveys and Questionnaires; D014195:Travel; D000078329:Workforce; D016526:Workload / Q000523:psychology