Implementing a direct access care model to mitigate injuries in career firefighters: A mixed methods study protocol

Abstract

Abstract Purpose and Aims: A successful model for managing MSI in occupational settings is direct access and early intervention from integrated health care practitioners (HCPs). There is no widespread implementation of this model among fire departments. Subsequently, limited information is available to illustrate the benefit of HCPs integrated into the fire service. The barriers to the implementation of this model must be explored to address the currently limited adoption. Therefore, the purposes of this study include examining the mechanisms of MSI sustained by firefighters, establishing the impact that HCPs have in mitigating time loss from MSI, and identifying barriers to future implementation of the HCP direct access model. Methods: A mixed-methods study will be conducted using convenience sampling of career firefighter departments across the United States. Qualitative interviews will explore the lived experiences of firefighters and HCPs to identify MSI mechanisms of injured firefighters. Data on MSI-related time loss and financial outcomes will be compiled and compared across departments with and without direct access to HCPs. Qualitative interviews will also be used to identify critical barriers to implementing the direct access model from key stakeholders in the Fire Service. Profiles of departments with and without direct access to HCPs will be discussed, integrating the subjective and objective findings. Discussion: Insight from firefighters and HCPs on the mechanisms of MSI will provide a key platform to improve time-loss injury mitigation. Compiled objective data will indicate a potential improvement in MSI-related time-loss and financial burden in fire departments with direct access to HCPs over those without. Barriers to implementing an HCP access model will also be identified to facilitate future adoption. Collectively, these findings will lead to developing an evidence-based model for improving healthcare delivery and occupational injury in the fire service and related populations.