James Bartholomew1, Tegan Dalla1, Julie McFarlane1
1Central Coast Local Health District, Gosford, Australia
Background: The introduction of an electronic nutrition risk screening process resulted in a 440% increase in referrals to the Dietitian and a 38% reduction in referral response rate. Many of these referrals were ‘false positives’ and reduced the efficiency of dietitians in diagnosing and treating patients with malnutrition. To address this, a modified screening process was developed by Nutrition Services using the scope of practice of a Dietitian Assistant (DA) workforce, with the goals of increasing efficiency in referral management processes and the delivery of better integrated patient care.
Methodology: The aim was to maximise utilisation of the DA scope of practice. This included development of a modified nutrition risk management pathway led by the DA, a training and assessment program to support implementation and a Departmental supervision framework to support new learner sustainability. The primary outcome measure was response time to referrals, with qualitative data collected on job satisfaction, implementation success and staff acceptability of the training and assessment program.
Results: Implementation of the pathway resulted in a 50% decrease in referral response time by dietitians (39 hours from 79 hours P<0.05) and a 321% reduction in inappropriate referrals being actioned. Implementation success scored moderate-high among both dietitians and DA’s and staff reported increased job satisfaction, empowerment and utilisation of their knowledge and capabilities post-implementation.
Discussion: A training and assessment pathway is an effective and accepted way to develop task capability within a DA workforce. This can positively contribute to the workload management of clinical dietitians and reduce response time to referrals which leads to efficient patient nutrition care. Integrated education and training is well received and can effectively support learning within a DA team as well as empower dietitians to take a leadership role in delivering integrated training and assessment. Sustained, supervisory sessions can ensure learners feel supported, and leads to better job satisfaction and commitment to excellence within an Allied Health Assistant workforce.
Tegan Dalla is a Senior Diabetes Dietitian working in the Central Coast Local Health District, and recently completed her Masters of Healthcare Leadership with Southern Cross University. Tegan has ten years of experience across a range of clinical areas in dietetics, specialising in diabetes for the past two years. With a special interest in education and training, she is passionate about lifelong learning and supporting early career staff development. Tegan has been involved in several quality improvement activities resulting in improved patient outcomes, and she led the development and implementation of the training and assessment pathway presented at this conference.