Delegate before you detonate – Optimising use of the assistant workforce

Raymond Kopeshke1

1Mater Hospital Brisbane, South Brisbane , Australia


AHA assistants are increasingly being utilised to manage service demands and increasing pressures on resources. Such pressures lead to a review of the relevancy and comprehensiveness of the OTA competencies.

A conversation with an OT who queried ‘if’ and ‘how’ they could delegate a new task to an OTA, due to increasing service demands, prompted the project. Further investigation revealed that the OTA competencies had not undergone recent review and that OTA scope was potentially not being optimised.


This project was undertaken using the A3 improvement methodology. Extensive collaboration with both OTs and OTAs occurred throughout the process in either one-to-one or group formats. The aim of these sessions was to revise the existing competencies and identify additional tasks that could be delegated to the assistant workforce.


26 additional tasks were identified by the OT Department. Reasons for not delegating these tasks prior to this project were also identified to help understand the barriers to OTs delegating tasks as part of their standard practice. Such barriers included uncertainty regarding suitability of tasks for delegation, time required for training and lack of written competencies.


This project identified how to safely increase the scope of AHA’s in the OT setting. The methodology utilised, is generic and could be adopted for other professions.

The project has helped optimise OT/OTA efficiency, patient access to OT services and service sustainability. However, the operational inefficiency that results from waiting for an annual review to delegate new tasks is something that the OT department would like to avoid in the future.  Therefore future work will now focus on creating a standard work process for OTs to delegate new tasks as part of everyday practice.


Ray Kopeshke is the senior Occupational Therapist for Neurosciences at Mater Hospital Brisbane and has over 15 years clinical experience. As part of his current role at Mater Hospital, he coordinates a team of occupational therapy and allied health assistants and is responsible for their development and training in clinical-based competencies. A recent focus of his has been on expanding the scope of the assistant workforce to improve patient access, patient experience and quality of care.

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