Establishing an Allied Health Assistant role in an Adult Cystic Fibrosis Centre to remodel service delivery

Ms Kathleen Hall1,2, Ms Robyn Cobb2, Ms Rebecca Chambers2, Mr Mark Roll2, Dr Lyndal Maxwell1, Professor Suzanne Kuys1

1Physiotherapy, School of Allied Health, Australian Catholic University , Brisbane, Australia, 2Physiotherapy, Adult Cystic Fibrosis center, The Prince Charles Hospital, Brisbane, Australia

Background/AIM: The exponential rise in numbers and complexity of care for adult cystic fibrosis patients (CF) requires solutions to address service delivery.  This study aimed to develop and trial a model of acute care service delivery incorporating an allied health assistant (AHA) role into clinical and non-clinical areas within a CF physiotherapy team.

Methods: Workforce redesign to determine, train and establish delegated clinical and non-clinical activities for the AHA was undertaken using the Calderdale framework.  A multiphase pragmatic study evaluating service delivery prior to and following implementation of the AHA role was conducted alongside the redesign over two three-month periods.  Comprehensive analysis of the service was completed. Clinical and non-clinical tasks able to be delegated to an AHA were identified. Training and competency certification for the AHA role was completed. Delegation training was also included as part of the redesign. Both physiotherapy and AHA staff were involved in all processes. A pragmatic approach to running the stages of the framework was adopted to meet the needs of a busy clinical service. Workload data for physiotherapists and the AHA (occasions of service and types of clinical activities) and safety outcomes were collected prospectively, and patient and staff satisfaction surveys undertaken.

Results: Local delegation competency training documents for a range of airway clearance and exercise treatment supervision and exercise testing were developed and applied. Outcomes to date include successful establishment of the role with the AHA undertaking delegated respiratory and exercise treatments and exercise testing.  There have been no adverse events. Patients perceived the quality of care was unchanged and physiotherapy service delivery was improved. Multidisciplinary staff reported improvements in direct care and research activities by the physiotherapists.

Conclusions:  Remodelling service delivery with the establishment of an AHA role potentially offers sustainable options for enhancing physiotherapy service delivery that is safe and acceptable to staff and patients. Use of a systematic workforce redesign tool underpinned the successful process. The model has the potential to be translatable to other professions and to other services.

Biography: To be confirmed

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