scholarly journals General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care

2019 ◽  
Vol 69 (682) ◽  
pp. e304-e313 ◽  
Author(s):  
Bethany F Anthony ◽  
Alun Surgey ◽  
Julia Hiscock ◽  
Nefyn H Williams ◽  
Joanna M Charles
Keyword(s):  
Primary Care ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Allied Health ◽  
Cost Effective ◽  
Chronic Fatigue ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
Economic Evidence ◽  
Allied Health Professionals

BackgroundPrevious systematic reviews have found that nurses and pharmacists can provide equivalent, or higher, quality of care for some tasks performed by GPs in primary care. There is a lack of economic evidence for this substitution.AimTo explore the costs and outcomes of role substitution between GPs and nurses, pharmacists, and allied health professionals in primary care.Design and settingA systematic review of economic evaluations exploring role substitution of allied health professionals in primary care was conducted. Role substitution was defined as ‘the substitution of work that was previously completed by a GP in the past and is now completed by a nurse or allied health professional’.MethodThe following databases were searched: Ovid MEDLINE, CINAHL, Cochrane Library, National Institute for Health and Care Excellence (NICE), and the Centre for Reviews and Dissemination. The review followed guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsSix economic evaluations were identified. There was some limited evidence that nurse-led care for common minor health problems was cost-effective compared with GP care, and that nurse-led interventions for chronic fatigue syndrome and pharmacy-led services for the medicines management of coronary heart disease and chronic pain were not. In South Korea, community health practitioners delivered primary care services for half the cost of physicians. The review did not identify studies for other allied health professionals such as physiotherapists and occupational therapists.ConclusionThere is limited economic evidence for role substitution in primary care; more economic evaluations are needed.

scholarly journals Does Enhanced Primary Care enhance primary care? Policy‐induced dilemmas for allied health professionals

2008 ◽  
Vol 188 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Michele M Foster ◽  
Geoffrey Mitchell ◽  
Terry Haines ◽  
Sean Tweedy ◽  
Petrea Cornwell ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Allied Health ◽  
Care Policy ◽  
Allied Health Professionals

scholarly journals Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: a Systematic Narrative Review

2020 ◽  
Author(s):  
Jacinta Sheehan ◽  
Kate Laver ◽  
Anoo Bhopti ◽  
Miia Rahja ◽  
Tim Usherwood ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Professionals ◽  
Information Technologies ◽  
Allied Health ◽  
Allied Health Professionals ◽  
Multidisciplinary Communication ◽  
Gold Standard Method ◽  
Health Information Technologies ◽  
Primary Care Practitioners

Abstract Background There is a compelling rationale that effective communication between hospital allied health professionals and primary care practitioners could improve quality and continuity of patient care. It is not known which methods of communication are used, nor how effectively they facilitate the transition of care when a patient is discharged home from hospital. Our systematic review aims to investigate the methods and effectiveness of communication between hospital allied health professionals and primary care practitioners. Method Systematic review of quantitative and qualitative studies with narrative synthesis. Medline, CINAHL, EMBASE, PsycInfo and Proquest Nursing and Allied Health Sources were searched from January 2003 until January 2020 for studies that examined hospital allied health professionals communicating with primary care practitioners. Risk of bias in the different study designs were appraised using recognised tools and a content analysis conducted of the methodologies used. Results From the located 12,281 papers (duplicates removed), 24 studies met the inclusion criteria with hospital allied health professionals communicating in some form with primary care practitioners. There was, however, limited literature investigating the methods and/or the effectiveness of communication between hospital allied health professionals and primary care practitioners.Conclusion There is currently no 'gold standard' method or measure of communication between hospital allied health professionals and primary care practitioners. There is an urgent need to develop and evaluate multidisciplinary communication with enhanced health information technologies to improve collaboration across healthcare settings and facilitate continuity of integrated people-centred care.Registration: www.crd.york.uk PROSPERO CRD42019120410

scholarly journals Psychometric properties of leadership scales for health professionals: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Melissa A. Carlson ◽  
Sarah Morris ◽  
Fiona Day ◽  
Ann Dadich ◽  
Annika Ryan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Allied Health ◽  
Psychometric Testing ◽  
Test Reliability ◽  
Original Research ◽  
Science Literature ◽  
Leadership Traits ◽  
Allied Health Professionals

Abstract Background The important role of leaders in the translation of health research is acknowledged in the implementation science literature. However, the accurate measurement of leadership traits and behaviours in health professionals has not been directly addressed. This review aimed to identify whether scales which measure leadership traits and behaviours have been found to be reliable and valid for use with health professionals. Methods A systematic review was conducted. MEDLINE, EMBASE, PsycINFO, Cochrane, CINAHL, Scopus, ABI/INFORMIT and Business Source Ultimate were searched to identify publications which reported original research testing the reliability, validity or acceptability of a leadership-related scale with health professionals. Results Of 2814 records, a total of 39 studies met the inclusion criteria, from which 33 scales were identified as having undergone some form of psychometric testing with health professionals. The most commonly used was the Implementation Leadership Scale (n = 5) and the Multifactor Leadership Questionnaire (n = 3). Of the 33 scales, the majority of scales were validated in English speaking countries including the USA (n = 15) and Canada (n = 4), but also with some translations and use in Europe and Asia, predominantly with samples of nurses (n = 27) or allied health professionals (n = 10). Only two validation studies included physicians. Content validity and internal consistency were evident for most scales (n = 30 and 29, respectively). Only 20 of the 33 scales were found to satisfy the acceptable thresholds for good construct validity. Very limited testing occurred in relation to test-re-test reliability, responsiveness, acceptability, cross-cultural revalidation, convergent validity, discriminant validity and criterion validity. Conclusions Seven scales may be sufficiently sound to be used with professionals, primarily with nurses. There is an absence of validation of leadership scales with regard to physicians. Given that physicians, along with nurses and allied health professionals have a leadership role in driving the implementation of evidence-based healthcare, this constitutes a clear gap in the psychometric testing of leadership scales for use in healthcare implementation research and practice. Trial registration This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (see Additional File 1) (PLoS Medicine. 6:e1000097, 2009) and the associated protocol has been registered with the PROSPERO International Prospective Register of Systematic Reviews (Registration Number CRD42019121544).

scholarly journals Making fall prevention routine in primary care practice: perspectives of allied health professionals

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jeannine Liddle ◽  
Meryl Lovarini ◽  
Lindy Clemson ◽  
Lynette Mackenzie ◽  
Amy Tan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Fall Prevention ◽  
Allied Health ◽  
Primary Care Practice ◽  
Care Practice ◽  
Allied Health Professionals

scholarly journals Improving access to allied health professionals through the Champlain BASE™eConsult service: a cross-sectional study in Canada

2017 ◽  
Vol 67 (664) ◽  
pp. e757-e763 ◽  
Author(s):  
Fanny McKellips ◽  
Erin Keely ◽  
Amir Afkham ◽  
Clare Liddy
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Health Professionals ◽  
Allied Health ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Medical Specialties

BackgroundAllied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs).AimTo assess the eConsult service’s ability to improve access to advice from AHPs.Design and settingA cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016. The service covers Ottawa, Canada, and its surrounding rural communities.MethodA descriptive overview of all cases submitted to allied health services was conducted. Utilisation and survey metrics for AHP eConsults were compared with those sent to medical specialties, in order to understand the potential differences and generalisability of eConsult access beyond the traditional medical specialty referral.ResultsPCPs submitted 127 cases to nine allied health specialties during the study period. The most popular specialty was clinical pharmacist, which received an average of 1.5 cases per month. The median specialist response time was 2.1 days (interquartile range [IQR] 0.7–5.3 days, range 0.01–14.2 days) versus 0.9 days (IQR 0.2–3.4 days, range 0–49.5 days) for medical specialties. PCPs received advice for a new or additional course of action in 70% (versus 58% for medical specialties) of cases. They rated the service as being of high or very high value for their patients in 88% of cases (versus 93% for medical specialties), and for themselves in 89% (94% for medical specialties) of cases.ConclusionThe eConsult service has demonstrated the ability to support prompt communication between PCPs and AHPs, improving patients’ access to AHP care. Given the importance of AHPs in providing primary care, allied health services should be offered in the menu of specialties available through electronic consultation services.

The Medical Treatment Planning and Decisions Act 2016: what is the role for allied health professionals?

2020 ◽  
Vol 26 (5) ◽  
pp. 383
Author(s):  
Aidan Borthwick ◽  
Peter Higgs
Keyword(s):  
Primary Care ◽  
Medical Treatment ◽  
Advance Care Planning ◽  
Health Professionals ◽  
Allied Health ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Planning ◽  
Allied Health Professionals ◽  
Advance Care

Advance care planning is increasingly common practice in contemporary health care for individuals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients’ wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.

Influences on general practitioner referral to allied health professionals for fall prevention in primary care

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Jeannine Liddle ◽  
Lindy Clemson ◽  
Lynette Mackenzie ◽  
Meryl Lovarini ◽  
Amy Tan ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Health Professionals ◽  
Fall Prevention ◽  
Allied Health ◽  
Allied Health Professionals

Urban Australian general practitioners’ perceptions of falls risk screening, falls risk assessment, and referral practices for falls prevention: an exploratory cross-sectional survey study

2017 ◽  
Vol 41 (1) ◽  
pp. 111 ◽  
Author(s):  
Kajtek Kielich ◽  
Lynette Mackenzie ◽  
Meryl Lovarini ◽  
Lindy Clemson
Keyword(s):  
Primary Care ◽  
Older People ◽  
Health Professionals ◽  
Allied Health ◽  
Falls Prevention ◽  
Evidence Based ◽  
Allied Health Professionals ◽  
Falls Risk ◽  
Referral Practices ◽  
Prevention Interventions

Objective The study aimed to explore Australian general practitioners’ (GPs) perceptions of falls risk screening, assessment and their referral practices with older people living in the community, and to identify any barriers or facilitators to implementing evidence-based falls prevention practice. Methods Hardcopy surveys and a link to an online survey were distributed to 508 GPs working at one Medicare Local (now part of a Primary Care Network) located in Sydney, Australia. Data were analysed using descriptive statistics and key themes were identified from open text responses. Results A total of 37 GPs returned the survey. Only 10 (27%) GPs routinely asked older people about falls, and five (13.5%) asked about fear of falls during clinical consultations. Barriers to managing falls risk were identified. GPs estimated that they made few referrals to allied health professionals for falls interventions. Conclusions GPs were knowledgeable about falls risk factors but this did not result in consistent falls risk screening, assessment or referral practices. Due to the small sample, further research is needed with a larger sample to augment these results. What is known about the topic? Falls are a common and serious health issue for older people and fall prevention is vital, especially in the primary care setting. General practitioners (GPs) are key health professionals to identify older people at risk of falls and refer them to appropriate health professionals for intervention. Evidence-based falls prevention interventions exist but are not easily or routinely accessed by older people. What does this paper add? GPs believe that previous falls are an important falls risk factor but they do not routinely ask about falls or fear of falls in clinical practice with older people. GP referral rates to allied health professionals for falls prevention are low, despite evidence-based falls prevention interventions being provided by allied health professionals. There are several barriers to GPs providing falls prevention assessment and intervention referrals, particularly using the current primary health systems. What are the implications for practitioners? GPs need to recognise their potential significant contribution to falls prevention in the community and may require tailored training. Sustainable evidence-based referral pathways need to be developed so that older people can be referred to allied health professionals for falls prevention interventions in the primary care setting, and better local networks need to be developed to allow this to occur. Policy makers may have to address the identified barriers to multidisciplinary practice and funding of services to facilitate effective falls prevention programs in primary care.

Evaluation of a program to assist usage of the Enhanced Primary Care case conferencing and care planning items: The allied health professionals' viewpoint

2004 ◽  
Vol 10 (1) ◽  
pp. 72 ◽  
Author(s):  
Jane Sims ◽  
Theonie Tacticos ◽  
Maria Patiriadis ◽  
Lucio Naccarella
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Health Professionals ◽  
Allied Health ◽  
Relationship Building ◽  
Care Planning ◽  
Appropriate Use ◽  
Allied Health Professionals ◽  
Education Support ◽  
Practice Education

The General Practice Education, Support and Community Linkages Program was introduced to formally support implementation and appropriate use of the Enhanced Primary Care Medicare Benefits Schedule items. This paper reports upon the Program?s implementation from the allied health professional?s perspective. Semi-structured interviews were conducted in 2002 with healthcare staff trained under the Program. While interviewees noted achievements in the items? uptake during the Program, allied health involvement in case conferencing and care planning had been impeded by GPs? limited adoption of the items. Allied health professionals were broadly interested in participating in care planning and case conferencing with GPs. The General Practice Education, Support and Community Linkages Program supported implementation and appropriate use of the Enhanced Primary Care Medicare Benefits Schedule items. While allied health professionals are generally interested in participating in care planning and case conferencing with GPs, such activity requires ongoing systems support and relationship building. Ample scope remains for awareness raising, relationship building and joint activities across the sector. Future item usage will need to be supported by resources and continued relationship building.

Clinical care ratios: quantifying clinical versus non-clinical care for allied health professionals

2017 ◽  
Vol 41 (3) ◽  
pp. 321 ◽  
Author(s):  
Cherie Hearn ◽  
Adam Govier ◽  
Adam Ivan Semciw
Keyword(s):  
Health Professionals ◽  
Allied Health ◽  
Clinical Care ◽  
Cost Effective ◽  
Allied Health Professionals ◽  
Service Demand ◽  
Optimal Service ◽  
Tertiary Hospitals ◽  
Post Hoc ◽  
Main Effects

Objective Clinical care ratios (CCRs) are a useful tool that can be used to quantify and benchmark the clinical and non-clinical workloads of allied health professionals. The purpose of this study was to determine if CCRs are influenced by level of seniority, type of role or profession. This will provide meaningful information for allied health service managers to better manage service demand and capacity. Method Data was collected from 2036 allied health professionals from five professions across 11 Australian tertiary hospitals. Mean (95% confidence intervals) CCRs were calculated according to profession, seniority and role type. A two-way ANOVA was performed to assess the association of CCRs (dependent variable) with seniority level and profession (independent variables). Post-hoc pairwise comparisons identified where significant main or interaction effects occurred (α = 0.05). Results Significant main effects for seniority level and profession were identified (P < 0.05), but there was no interaction effect. Post-hoc comparisons revealed significant differences between all tier combinations (P < 0.05) with more senior staff having the lowest CCRs. Conclusion The direct and non-direct clinical components of the allied health professional’s workload can be quantified and benchmarked with like roles and according to seniority. The benchmarked CCRs for predominantly clinical roles will enable managers to compare and evaluate like roles and modify non-direct clinical components according to seniority and discipline. What is known about the topic? CCRs are a useful tool to quantify, monitor and compare workloads of allied health professionals. They are thought to change with increased seniority of roles. The CCRs for different allied health professional roles has yet to be defined in the literature. What does this paper add? CCRs decrease as level of seniority increases, indicating higher seniority increases non-clinical time. CCRs differ across professions, suggesting that benchmarking with CCRs must be profession specific. What are the implications for practitioners? The direct and non-direct clinical components of a workload can be quantified, defined and benchmarked with like roles to ensure cost-effective and optimal service delivery and patient outcomes.

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