Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks
Juanine Passfield A E , Ilsa Nielsen B , Neil Brebner C and Cara Johnstone DA Central Integrated Regional Cancer Services, Queensland Health Corporate Office, GPO Box 48, Brisbane, Qld 4001, Australia.
B Allied Health Professions’ Office of Queensland, Level 6, Building 2, William McCormack Place II, 5B Sheridan Street, Cairns, Qld 4870, Australia. Email: Ilsa.Nielsen@health.qld.gov.au
C Cancer Care Support Team, Wide Bay Hospital and Health Service, PO Box 592, Hervey Bay, Qld 4655, Australia. Email: Neil.Brebner@health.qld.gov.au
D Cancer Care Team, Cairns and Hinterland Hospital and Health Service, Liz Plummer Cancer Centre, PO Box 902, Cairns, Qld 4870, Australia. Email: Cara.Johnstone@health.qld.gov.au
E Corresponding author. Email: Juanine.Passfield@health.qld.gov.au
Australian Health Review 42(6) 656-660 https://doi.org/10.1071/AH16160
Submitted: 19 July 2016 Accepted: 22 May 2017 Published: 24 July 2017
Journal Compilation © AHHA 2018 Open Access CC BY-NC-ND
Abstract
Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services.
Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement.
Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated.
Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate.
What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated.
What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to delegation and skill sharing to provide an indication of the level of local service influence on workforce and service model decisions.
What are the implications for practitioners? Local factors have a modest influence on delegation and skill sharing decisions of AH teams. Practitioners need to be actively engaged in decision making at the local level to ensure the clinical service model meets local needs. However, teams should also capitalise on commonalities between settings to limit duplication of training and resource development through collaborative networks.
References
[1] Queensland Health. Innovations in models of care for the health practitioner workforce in Queensland Health. Brisbane, Australia. Allied Health Workforce Advice and Coordination Unit, Queensland Government; 2011.[2] Duckett SJ. Health workforce design for the 21st century. Aust Health Rev 2005; 29 201–10.
| Health workforce design for the 21st century.Crossref | GoogleScholarGoogle Scholar |
[3] Nancarrow SA, Borthwick AM. Dynamic professional boundaries in the healthcare workforce. Sociol Health Illn 2005; 27 897–919.
| Dynamic professional boundaries in the healthcare workforce.Crossref | GoogleScholarGoogle Scholar |
[4] Leggat S. Changing health professionals’ scope of practice: how do we continue to make progress? 2014. Available at: http://ahha.asn.au/publication/issue-briefs/changing-health-professionals%E2%80%99-scope-practice-how-do-we-continue-make [verified 17 May 2016].
[5] Health Workforce Australia. National cancer workforce strategic framework. Australian Government Department of Health, Canberra, Australia 2013.
[6] Radiation Oncology Tripartite Committee. Planning for the best. Tripartite national strategic plan for radiation oncology 2012–2022. 2012. Available at: http://www.radiationoncology.com.au/ [verified 17 May 2015].
[7] Passfield J, McQueen L, Hulcombe J. Workforce profile for allied health professions in Queensland public health cancer care services with linear accelerators. J Oncol Pract 2014; 10 244–7.
| Workforce profile for allied health professions in Queensland public health cancer care services with linear accelerators.Crossref | GoogleScholarGoogle Scholar |
[8] Johnstone C, Johnson L, Cibau L, Harvey D, Nielsen I. Improving patient access: outcomes from an allied health cancer redesign project. In: Proceedings of the 11th National Allied Health Conference; 9–11 November 2015; Melbourne, Australia. 2015.
[9] Queensland Health. Governance guidelines for allied health assistants. Brisbane: Queensland Government; 2016.
[10] Thylefors I, Persson O, Hellström D. Team types, perceived efficiency and team climate in Swedish cross-professional teamwork. J Interprof Care 2005; 19 102–14.
| Team types, perceived efficiency and team climate in Swedish cross-professional teamwork.Crossref | GoogleScholarGoogle Scholar |
[11] Nancarrow S, Enderby P, Moran AM, Dixon S, Parker S, Bradburn M, Mitchell C, John A, McClimens A The relationship between workforce flexibility and the costs and outcomes of older peoples’ services. Report for the National Institute of Health Research Service Delivery and Organisation Programme. University of Sheffield, Sheffield, UK; 2010. Available at: http://www.sdo.nihr.ac.uk/projdetails.php?ref=08-1519-95# [verified 17 May 2015].
[12] State of Queensland (Queensland Health). Guidelines for skill sharing between allied health professionals. Workplace Instruction (WPI3) for allied health professionals. Brisbane: Queensland Government; 2013. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0020/155513/wpi-three.pdf [verified 22 June 2017].
[13] Bradford M. Patients’ experiences of healthcare systems: a qualitative study. Internal project report Mackay Hospital and Health Service. 2013.
[14] Smith R, Duffy J. The Calderdale Framework information sheet. 2015. Available at: https://www.health.qld.gov.au/ahwac/docs/calderdale-framework.pdf [verified 17 May 2015].
