Maria Schwarz1, Professor Elizabeth Ward2, Associate Professor Petrea Cornwell3, Mrs Anne Coccetti1
1Logan Hospital, Meadowbrook, Australia, 2Centre for Functioning and Health Research, Brisbane, Australia, 3School of Allied Health, Griffith University, Brisbane, Australia
As demands on Allied Health Practitioners grow within health services, delegation to Allied Health Assistants (AHAs) is increasingly being suggested as a management strategy to reduce demand and increase efficiency. Delegation to AHAs is reported to be an effective workforce solution in a number of areas of adult speech language pathology (SLP) practice. However, reports of AHA delegation in the area of dysphagia management are limited.
The aim of this study was to synthesise information from policy documents and current clinical practice to examine the nature of AHA delegation in dysphagia management.
A mixed method design involving a document review of 13 policy documents on AHA delegation, and a survey of 44 SLP managers regarding current delegation models was conducted.
Results indicate that policy and current practice were largely congruent. Despite policy support for AHA delegation, 77% reported using delegation models but only 26% used them fairly often/very often in dysphagia management. Both policy and survey findings support AHA training prior to task delegation, however, the nature of training was unspecified. Good governance is integral to successful delegation and managers recognised the need to increase standardisation of AHA capability assessment.
The Australian health service is moving towards a more consistent and defined scope of practice for AHAs, which is reflected in increased utilisation of AHAs for previously AHP specific tasks such as dysphagia management. There is growing interest in improved utilisation of AHAs, with an emerging literature of policy and position papers to support implementation of these positions in the healthcare setting. However, further clarification is required regarding the specific tasks AHAs are permitted to complete, how competency in these tasks will be measures and supervised and what training is required for AHP’s to successfully implement delegation practices into the workforce.
Maria is a clinical speech pathologist with experience in acute dysphagia management, as well as in training and supervising allied health assistants. She is currently completing a PhD at the University of Queensland investigating the expanding role of allied health assistants in dysphagia management within the acute hospital.