Mapping of allied health service capacity for maternity and neonatal services in the southern Queensland health service district

2013 ◽  
Vol 37 (5) ◽  
pp. 614 ◽  
Author(s):  
Shelley A. Wilkinson ◽  
Leyanne Duncan ◽  
Catherine Barrett ◽  
Robin Turnbull ◽  
Sally McCray
Keyword(s):  
Health Service ◽  
Allied Health ◽  
Models Of Care ◽  
Service Planning ◽  
Support Networks ◽  
Clinical Services ◽  
Staffing Levels ◽  
Positive Effects ◽  
Queensland Health ◽  
Specific Support

Objective Allied health professionals (AHPs) in maternity and neonatology services are essential for quality care and outcomes, reflected in the minimum service delivery requirements in the Queensland Health clinical services capability framework (CSCF). However, allied health (AH) capacity across the Southern Queensland Health Service Districts (SQHSD) is not known. The aim of this project was to redress this knowledge gap to inform ongoing service planning and delivery. Methods Maternity and neonatal AH clinicians in all birthing facilities in SQHSD were surveyed between October and December 2011 to investigate AHP staffing, practices and models of care. The professions surveyed included dietitians, occupational therapists, physiotherapists, psychologists, social workers and speech pathologists. Results were grouped per question, with stratification by CSCF and/or profession. Results Fifty-five valid surveys from the 16 facilities were received. All professions were represented. Gaps in maternity AH services were identified. Awareness and use of evidence-based practices were more likely to be reported where higher full-time equivalents (FTE) were allocated. Conclusion Very low staffing levels have been recorded in all Maternity and Neonatology Services AHPs in the SQHSD. Gaps exist between actual and recommended CSCF staffing standards across all levels and professions. The results indicate that profession-specific support networks for AHPs have positive effects in the spreading of information, and continued promotion, support and involvement in these profession-specific networks is suggested for all facilities. What is known about the topic? Maternity and neonatology service allied health (AH) professionals provide essential services for quality maternal and infant care and outcomes, reflected in their inclusion in several Queensland Health maternity and neonatal clinical guidelines. Queensland Health has also released a clinical services capability framework, which outlines minimum requirements for the provision of health services in Queensland public facilities, including minimum service and workforce structure. These include AH staff in the provision of key elements of care. What does the paper add? Staffing levels and description of models of care for AH professionals across the (former) Southern Queensland Health Service District is not known. This paper describes the outcome of a mapping process that provides a clear picture of AH staffing levels and service gaps, models of care in use, and models of care or resources that may be shared within the network for the professions of nutrition and dietetics, occupational therapy, physiotherapy, psychology, social work and speech pathology. What are the implications for practitioners? This profile of AH practitioners across the district provides a baseline reference that may prove useful for future planning of maternity and neonatology services in Queensland Health. Very low levels of staffing were identified and the staffing requirements outlined in the clinical services capability framework was not met at some sites. The results indicate that profession-specific support networks for AH practitioners have positive effects in the spreading of information; in addition, the continued promotion, support and involvement in these profession-specific networks are suggested for all facilities.

scholarly journals The Queensland Health Ministerial Taskforce on health practitioners’ expanded scope of practice: consultation findings

2015 ◽  
Vol 39 (3) ◽  
pp. 249 ◽  
Author(s):  
Gretchen Young ◽  
Julie Hulcombe ◽  
Andrea Hurwood ◽  
Susan Nancarrow
Keyword(s):  
Health Service ◽  
Health Professionals ◽  
Large Scale ◽  
Allied Health ◽  
Scope Of Practice ◽  
Allied Health Professionals ◽  
Health Service Provision ◽  
Stakeholder Consultation ◽  
Queensland Health ◽  
High Level

Objective Queensland Health established a Ministerial Taskforce to consult on and make recommendations for the expansion of the scope of practice of allied health roles. This paper describes the findings from the stakeholder consultation. Methods The Ministerial Taskforce was chaired by the Assistant Minister for Health and included high-level representation from allied health, nursing, medicine, unions, consumers and universities. Widespread engagement was undertaken with stakeholders representing staff from a wide cross-section of health service provision, training and unions. Participants also tendered evidence of models incorporating full-scope and extended scope tasks undertaken by allied health professionals. Results The consultation incorporated 444 written submissions and verbal feedback from over 200 participants. The findings suggest that full scope of practice is often restricted within the Queensland public health system, resulting in underuse of allied health capacity and workforce inefficiencies. However, numerous opportunities exist to enhance patient care by extending current roles, including prescribing and administering medications, requesting investigations, conducting procedures and reporting results. The support needed to realise these opportunities includes: designing patient-centred models of service delivery (including better hours of operation and delegation to support staff); leadership and culture change; funding incentives; appropriate education and training; and clarifying responsibility, accountability and liability for outcomes. The taskforce developed a series of recommendations and an implementation strategy to operationalise the changes. Conclusions The Ministerial Taskforce was an effective and efficient process for capturing broad-based engagement for workforce change while ensuring high-level support and involving potential adversaries in the decision-making processes. What is known about the topic? Anecdotal evidence exists to suggest that allied health professionals do not work to their full scope of practice and there is potential to enhance health service efficiencies by ensuring practitioners are supported to work to their full scope of practice. What does this paper add? This paper presents the findings from a large-scale consultation, endorsed by the highest level of state government, that reinforces the perceptions that allied health professionals do not work to full scope of practice, identifies several barriers to working to full scope and extended scope of practice, and opportunities for workforce efficiencies arising from expanding scope of practice. The top-down engagement process should expedite the implementation of workforce change. What are the implications for practitioners? High-level engagement and support is an effective and efficient way to broker change and overcome intraprofessional barriers to workforce change policies. However, practitioners are often prevented from expanding their roles through an implied need to ‘ask for permission’, when, in fact, the only barriers to extending their role are culture and historical practice.

scholarly journals Profiling the allied health staffing of Queensland Health inpatient general rehabilitation units

2015 ◽  
Vol 39 (1) ◽  
pp. 89 ◽  
Author(s):  
Catherine Barrett ◽  
Catherine Stephens ◽  
Julie Hulcombe ◽  
Brian McEvoy
Keyword(s):  
Allied Health ◽  
Workforce Planning ◽  
Functional Independence ◽  
Rehabilitation Services ◽  
Poor Correlation ◽  
Full Time ◽  
Staffing Levels ◽  
Published Evidence ◽  
Queensland Health ◽  
General Rehabilitation

Objective The purpose of this paper was to profile staffing levels for allied health (AH) professional and support staff in Queensland Health inpatient general rehabilitation services (at a given point-in-time) and compare them against established profession-specific standards and guidelines in order to provide a reference for future workforce planning for these services. Methods A statewide analysis of AH staffing in Queensland Health inpatient general rehabilitation services was undertaken during June–August 2011. Reported full-time equivalent positions (FTE) were compared to several established national and international benchmarks. Patient activity data was used to calculate the average length of stay (ALOS) and Functional Independence Measure (FIM) scores on admission. Results Sixteen facilities reported 202 FTE for a total of 466 general rehabilitation beds, with a resultant average workforce ratio of 0.43 FTE/bed. While several professional groups within specific services met established benchmarks, the majority failed to reach recommended staffing ratios. More than half the workforce (53%) was entry-level or consolidating clinicians. The FTE/bed ratios were compared against both patient ALOS and FIM scores on admission and showed a poor correlation. Conclusion Across all included services statewide, there was significant variance in AH staffing levels and diversity in skill mix for inpatient general rehabilitation services. What is known about the topic? The AH workforce faces several challenges to delivering effective, efficient and responsive services including balancing the high and escalating demand for services with managing staff costs. While several different workload capacity measures have been used successfully for medical and nursing professions, there is currently little published evidence about effective workforce allocation for AH professionals (AHPs) in rehabilitation settings. What does this paper add? This paper describes AH staffing levels in Queensland Health inpatient general rehabilitation services. It includes the outcome of analysis of data collected from AHPs and allied health assistants (AHAs) and comparison with established benchmarks. What are the implications for practitioners? The workforce ratios identified can assist with future workforce planning when introducing new services and reviewing service delivery models. They should be considered in conjunction with other relevant standards and planning tools, and it is recommended that further work be undertaken to investigate links between staffing levels and patient outcomes, as many of the current benchmarks rely heavily on professional opinion.

Strengthening teamwork capability in allied health: implementation of a team development program in a metropolitan health service

2020 ◽  
Vol 44 (3) ◽  
pp. 443 ◽  
Author(s):  
Angela J. Wood ◽  
Kathy Grudzinskas ◽  
Julie-Anne Ross ◽  
Sarah Bailey ◽  
Gail E. Gordon ◽  
...  
Keyword(s):  
Health Service ◽  
Patient Outcomes ◽  
Allied Health ◽  
Audit Quality ◽  
Evaluation Model ◽  
Development Program ◽  
Team Development ◽  
Health Staff ◽  
Positive Effects ◽  
Structure Evaluation

ObjectiveCollaborative practice is critical to optimising patient outcomes in contemporary healthcare settings. Evidence suggests interprofessional learning is an effective way to develop teamwork capabilities, yet these skills are traditionally developed in professional silos, or not at all. This study evaluated the implementation of a team development program, the Team Management Systems (TMS) program, for allied health staff within a large metropolitan health service. MethodsA mixed-methods audit–quality improvement study was conducted, using Kirkpatrick’s four-level evaluation model to structure evaluation of the program. Semistructured questionnaire and workforce survey data were retrieved immediately, 6 months and 1–2 years after training and applied to each level of the model (Reaction, Learning, Behaviour, Results). ResultsIn all, 886 staff participated in the TMS program from 2014 to 2018. High satisfaction with the program was observed. Knowledge of what constitutes effective teamwork improved significantly (P=0.008) in TMS participants compared with a matched untrained cohort. Participants reported positive behaviour change and continued engagement with TMS principles 6 months after training. Perceived impact of the program on patient and/or organisational outcomes was evident, although less compelling than the changes to knowledge and behaviour. ConclusionsThe TMS program yielded positive effects on staff satisfaction, knowledge, team dynamics and team behaviours. These findings demonstrate the significant value of such initiatives to enhance the capability and effectiveness of interdisciplinary healthcare teams. What is known about the topic?Complex conditions, increasing comorbidities, specialisation and scarcity of resources mean healthcare workers need to work effectively in teams to achieve quality, safe, person centred patient care. There is some evidence of the effect of teamwork initiatives on knowledge or behaviour in specific clinical specialities, single services or single professions, but limited research is available regarding the effects of teamwork programs across multiple professions, including allied health professions, and on patient and organisational outcomes. What does this paper add?This paper describes the effect of a large-scale teamwork program implemented across multiple professions, including enablers and barriers. It presents outcomes at all four levels of Kirkpatrick’s evaluation model, including the less studied behaviour and results levels. What are the implications for practitioners?This paper supports health service leaders to consider developing and implementing interprofessional teamwork programs to foster essential teamwork capabilities. Learning together about teamwork, across professional silos, will lead to collaborative, patient-centred care, which leads to safe, quality patient outcomes.

Process to establish 11 primary contact allied health pathways in a public health service

2018 ◽  
Vol 42 (3) ◽  
pp. 258 ◽  
Author(s):  
Michelle Stute ◽  
Nicole Moretto ◽  
Maree Raymer ◽  
Merrilyn Banks ◽  
Peter Buttrum ◽  
...  
Keyword(s):  
Health Service ◽  
Allied Health ◽  
Occupational Therapists ◽  
Cost Effective ◽  
Models Of Care ◽  
Allied Health Professions ◽  
Health Clinics ◽  
Primary Contact ◽  
Contact Models ◽  
Increasing Demand

Objective Faced with longstanding and increasing demand for specialist out-patient appointments that was unable to be met through usual medical consultant led care, Metro North Hospital and Health Service in 2014–15 established 11 allied health primary contact out-patient models of care. Methods The models involved six different allied health professions and nine specialist out-patient departments. Results All the allied health models have been endorsed for continuation following demonstration of their contribution to managing demand on specialist out-patient services. Conclusion This paper describes key features of the allied health primary contact models of care and presents preliminary data including new case throughput, effect on wait times and enablers and challenges for clinic establishment. What is known about the topic? Allied health clinics have been demonstrated to result in high patient, referrer and consultant satisfaction, and are a cost-effective management strategy for wait list demand. In Queensland, physiotherapy-led orthopaedic clinics have been operating since 2005. What does this paper add? This paper describes the establishment of 11 allied health primary contact models of care in speciality out-patient areas including Ear, Nose and Throat, Gynaecology, Urology, Neurology, Neurosurgery, Orthopaedics and Plastic Surgery, and involving speech pathologists, audiologists, physiotherapists, occupational therapists and podiatrists as primary contact practitioners. Observations of enablers for and challenges to implementation are presented as key lessons. What are the implications for practitioners? The new allied health primary contact models of care described in this paper should be considered by health service executives, allied health leaders and specialist out-patient departments as one strategy to address unacceptably long specialist wait lists.

scholarly journals Effects and mechanisms of an allied health research position in a Queensland regional and rural health service: a descriptive case study

2018 ◽  
Vol 42 (6) ◽  
pp. 667 ◽  
Author(s):  
Rachel J. Wenke ◽  
Anna Tynan ◽  
Annette Scott ◽  
Sharon Mickan
Keyword(s):  
Health Service ◽  
Allied Health ◽  
Research Capacity ◽  
Research Culture ◽  
Building Research ◽  
Potential Value ◽  
Research Collaborations ◽  
Rural Health Service ◽  
Use Of Technology

The aim of the present case study is to illustrate the outcomes of a dedicated allied health (AH) research position within a large Queensland regional and rural health service. The secondary aim of the case study is to describe the enabling and hindering mechanisms to the success of the role. Semistructured interviews were conducted with the Executive Director of Allied Health and the current AH research fellow incumbent within the health service. A focus group was also undertaken with six stakeholders (e.g. clinicians, team leaders) who had engaged with the research position. Outcomes of the AH research fellow included clinical and service improvements, enhanced research culture and staff up-skilling, development of research infrastructure and the formation of strategic research collaborations. Despite being a sole position in a geographically expansive health service with constrained resources, key enabling mechanisms to the success of the role were identified, including strong advocacy and regular communication with the Executive. In conclusion, the case study highlights the potential value of an AH research position in building research capacity within a large non-metropolitan health service. Factors to facilitate ongoing success could include additional research and administrative funding, as well as increased use of technology and team-based research. What is known about the topic? Dedicated research positions embedded within health care settings are a well cited strategy to increase research capacity building of allied health professionals (AHPs). However the majority of these positions are within metropolitan health settings and unique challenges exist for these roles in regional and rural areas. Few studies have described the impact of dedicated AH research positions within regional health centres or the factors which facilitate or hinder their role. What does this paper add? Dedicated research positions within a non-metropolitan Australian health service may have a positive impact on AH clinical services, research culture, staff upskilling, research infrastructure and research collaborations. Key enabling mechanisms to support the role may include advocacy from higher level management, strong networks and communication channels. Additional research and administrative funding, the use of technology and team based research may enhance sustainability of such roles. What are the implications for practitioners? AH research positions have potential value in building research capacity within a large non-metropolitan health service. Health managers and researchers should be aware of the unique challenges to these roles and consider mechanisms that may best enhance and sustain outcomes of the positions including: the development of infrastructure (i.e. technology, website of resources), networks, and communication strategies (i.e. regular meetings with leadership and promotion internally).

scholarly journals Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature

2021 ◽  
Vol 10 (3) ◽  
pp. e001091
Author(s):  
Jenifer Olive Darr ◽  
Richard C Franklin ◽  
Kristin Emma McBain-Rigg ◽  
Sarah Larkins ◽  
Yvette Roe ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Management ◽  
Health Service ◽  
First Nations ◽  
Quality Management System ◽  
Grey Literature ◽  
Models Of Care ◽  
Clinical Governance ◽  
Aboriginal Community ◽  
Continuous Quality

BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.

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