Mechanisms for the effective implementation of an allied health assistant trainee: a qualitative study of a speech language pathology assistant
Susan A. Nancarrow A D , Anna Moran B and Rebecca Sullivan CA Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
B Charles Sturt University, School of Community Health, PO Box 789, Albury, NSW 2640, Australia. Email: amoran@csu.edu.au
C Eastern Health, Arnold Street, Box Hill, Vic. 3128, Australia. Email: Rebecca.sullivan@easternhealth.org.au
D Corresponding author. Email: Susan.nancarrow@scu.edu.au
Australian Health Review 39(1) 101-108 https://doi.org/10.1071/AH14053
Submitted: 23 March 2014 Accepted: 29 September 2014 Published: 11 December 2014
Abstract
Objective This paper explores the impact and mechanisms for successful implementation of a speech language pathology assistant (SLPA) role into a rehabilitation setting using a traineeship approach.
Methods Multiple data sources were used, including interviews with key stakeholders, documentary evidence and a workload audit.
Results The SLPA role increased clinical service capacity by 28 h per week across the service and required a total of 3 h per week of supervision input (the equivalent of 38 min per speech and language pathologist (SLP)). The SLPA used non-clinical time for training and administration. Mechanisms that facilitated the implementation of the SLPA role were: support for existing staff; formal knowledge and skills in training; consultation and engagement; access to a competency framework; close working with the registered training organisation; clearly defined role and delegation boundaries; clear supervision structures; confidence in own role; supportive organisational culture; vision for expansion of the role; engaging the SLPs in training and development; and a targeted recruitment approach.
Conclusion The development and implementation of a new trainee SLPA role using a traineeship approach required a large amount of supervision and training input from the SLPs. However, it was perceived that these efforts were offset by the increased service capacity provided by the introduction of a trainee role and the high levels of satisfaction with the new role.
What is known about this topic? Efficient delegation to assistants requires supervising staff to have a clear understanding of the roles and experience of assistants. There has been little evaluation of assistant training models to date.
What does this paper add? The net benefit of an allied health assistant in speech pathology far outweighs the input required to provide training and supervision. The paper identifies a range of mechanisms to facilitate the implementation and efficient use of the assistant role.
What are the implications for practitioners? The implementation of assistant roles requires support for both the assistant and the supervising staff member. Engaging the supervising staff in training the assistant enhances role understanding and effective delegation to the assistant staff member. Although the role development requires a great deal of local investment, there is potential for more efficient implementation of new roles through sharing of resources, such as competencies, assessments and training tools.
Additional keywords: roles, training, apprenticeship.
References
[1] Productivity Commission. Australia’s health workforce, Research Report. Canberra: Productivity Commission; 2005. Available online at: http://www.pc.gov.au/__data/assets/pdf_file/0003/9480/healthworkforce.pdf [verified November 2014].[2] Moran A, Nancarrow S, Enderby P, Bradburn M. Are we using support workers effectively? The relationship between patient and team characteristics and support worker utilisation in older people’s community-based rehabilitation services in England. Health Soc Care Community 2012; 20 537–49.
| Are we using support workers effectively? The relationship between patient and team characteristics and support worker utilisation in older people’s community-based rehabilitation services in England.Crossref | GoogleScholarGoogle Scholar | 22607390PubMed |
[3] Nancarrow SA, Roots A, Grace S, Moran AM, Vanniekerk-Lyons K. Implementing large-scale workforce change: learning from 55 pilot sites of allied health workforce redesign in Queensland, Australia. Hum Resour Health 2013; 11 66
| Implementing large-scale workforce change: learning from 55 pilot sites of allied health workforce redesign in Queensland, Australia.Crossref | GoogleScholarGoogle Scholar | 24330616PubMed |
[4] Nancarrow S, Enderby P, Moran A, Dixon S, Parker SG, Bradburn M, Mitchell C, John A, McClimens A. The relationship between workforce flexibility and the costs and outcomes of older peoples services. London: National Institute of Health Research, Service Delivery and Organisation Program; 2010.
[5] Dixon S, Kaambwa B, Nancarrow S, Martin GP, Bryan S. The relationship between staff skill mix, costs and outcomes in intermediate care services. BMC Health Serv Res 2010; 10 221
| The relationship between staff skill mix, costs and outcomes in intermediate care services.Crossref | GoogleScholarGoogle Scholar | 20670428PubMed |
[6] Goodale BJ, Spitz S, Beattie NJ, Lin IB. Training rural and remote therapy assistants in Western Australia. Rural Remote Health 2007; 7 774
| 1:STN:280:DC%2BD2srntlWrsQ%3D%3D&md5=53337945e09c4c97cc4b63406c83bc65CAS | 17894529PubMed |
[7] Greater Southern Area Health Service. Greater Southern Area Health Service, IRCST funded Rural allied health assistant project. 2011. Available at: http://www.ruralheti.health.nsw.gov.au/__documents/initiatives/rural-allied-health-project/gsahs_raha_for_ircst_website.pdf [verified 11 November 2011].
[8] Department of Health, Victoria. Central Gippsland Health Service Allied Health Assistant Traineeship Program: innovation story. Video Transcript. Available at: http://www.health.vic.gov.au/workforce/reform/dell-sale.htm [verified November 2014].
[9] Pullenayegum S, Fielding B, Du Plessis E, Peate I. The value of the role of the rehabilitation assistant. Br J Nurs 2005; 14 778–84.
| The value of the role of the rehabilitation assistant.Crossref | GoogleScholarGoogle Scholar | 16116384PubMed |
[10] Hancock H, Campbell S, Ramprogus V, Kilgour J. Role development in health care assistants: the impact of education on practice. J Eval Clin Pract 2005; 11 489–98.
| Role development in health care assistants: the impact of education on practice.Crossref | GoogleScholarGoogle Scholar | 16164591PubMed |
[11] Moran AM, Nancarrow SA, Wiseman L, Maher K, Boyce RA, Borthwick AM, Murphy K. Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach. J Foot Ankle Res 2012; 5 30
| Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach.Crossref | GoogleScholarGoogle Scholar | 23181834PubMed |
[12] O’Brien R, Byrne N, Mitchell R, Ferguson A. Rural speech-language pathologists’ perceptions of working with allied health assistants. Int J Speech LangPathol 2013; 15 613–22.
| Rural speech-language pathologists’ perceptions of working with allied health assistants.Crossref | GoogleScholarGoogle Scholar |
[13] Stanhope J, Pearce C. Role, implementation, and effectiveness of advanced allied health assistants: a systematic review. J Multidiscip Healthc 2013; 6 423–34.
| Role, implementation, and effectiveness of advanced allied health assistants: a systematic review.Crossref | GoogleScholarGoogle Scholar | 24324337PubMed |
[14] Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In Bryman A, Burgess RG, editors. Analyzing qualitative data. London: Routledge; 1995. pp. 174–94.
[15] Stute M, Hurwood A, Hulcombe J, Kuipers P. Defining the role and scope of practice of allied health assistants within Queensland public health services. Aust Health Rev 2013; 37 602–6.
| Defining the role and scope of practice of allied health assistants within Queensland public health services.Crossref | GoogleScholarGoogle Scholar | 24176133PubMed |
[16] Department of Human Services (Victoria). Allied health assistants final report. Melbourne : Department of Health; 2009.
[17] Hasson F, McKenna HP, Keeney S. A qualitative study exploring the impact of student nurses working part time as a health care assistant. Nurse Educ Today 2013; 33 873–9.
| A qualitative study exploring the impact of student nurses working part time as a health care assistant.Crossref | GoogleScholarGoogle Scholar | 23159073PubMed |
[18] Turbin J, Wintrup J, Fuller A. Finding their way into careers: an analysis of advanced apprenticeships and progression in healthcare. Faculty of Health Sciences: University of Southampton; 2013.
