Exploring Implementation of Reasonable Adjustments in Hospitals for People With Intellectual Disability: Using a Realist Lens.
Mairead Moloney, Laurence Taggart, Therese Hennessy and 1 others
PMID 39445654WHAT IT FOUND
Hospital staff valued pre-visit videos, health passports and family staying with patients, but said reasonable adjustments were mostly arranged case by case, not built into services.
Key findings
01All reported examples of reasonable adjustments were individual-level and often ad hoc, dependent on individual staff kindness, and arranged on request by family or carers.
02Participants reported a lack of system-level policies and integrated care pathways for people with intellectual disability in acute hospitals.
03Participants valued community hospital liaison nurses but said acute hospitals lacked liaison and advocacy roles specific to intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included a small sample of healthcare professionals from one region, so the themes may not transfer to other settings. No people with intellectual disability or family members were interviewed, so the findings are staff perspectives only. No patient outcomes were measured, so the study does not show that reasonable adjustments improve health or hospital experience. The authors note that not all settings have intellectual disability nursing roles or PALS teams, limiting transferability.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the examples as proof that reasonable adjustments improve patient outcomes. This study reports staff views about implementation, not patient results.