Faster, fairer, stronger: Subacute physiotherapy workforce redesign – methodology, implementation and outcomes

Alana Jacob1, Uyen Phan1, Katherine  Hodgson1, Dr. Catherine Granger1,2

1Allied Health, Physiotherapy, Melbourne Health, Melbourne, Australia, 2Physiotherapy Department, The University of Melbourne, Melbourne, Australia

Background: Physiotherapy services face multiple competing demands including increasing patient numbers and complexity, with finite staffing resources. This project aimed to implement a comprehensive subacute workforce redesign at Melbourne Health using existing resources. The target was to improve patient and staff outcomes primarily through responsive allocation of resources (right patient, right care, right time).

Method: Implementation involved establishment of governance and steering committees including organisational key stakeholders; pre/post patient and staff satisfaction surveys with focus on frustration lists and areas for improvement; mapping of current and future processes; service benchmarking; and review of staff workload. Data were utilised to inform the new model for implementation.

Results: Prior to implementation, 77 patients were surveyed and the main area for improvement identified was ‘time waiting for therapy’, 39 staff (physiotherapists, EP’s and AHA) were surveyed and main areas for improvement identified were ‘job satisfaction’, ‘stress and fatigue’, and ‘communication’. Top staff frustrations were ‘limited leave cover’, ‘leave planning’, and ‘duplication of paperwork’. Based on findings, a new model was implemented across 2018. Changes included: a standardised prioritisation tool across inpatients and community therapy service; an ‘early starter staff role’ and team huddles to improve communication regarding staffing and workload across the department; creation of workflow processes for staff to assist across teams; streamlined processes and paperwork to reduce duplication; enhanced electronic communication systems for management of leave and improved mechanisms for requesting and offering assistance.

Discussion: Innovative workforce models are required to meet the changing demands. A comprehensive redesign of subacute services, utilising a ‘ground-up’ approach was implemented. Preliminary results indicate staff and patient areas for improvement were met. Evaluation is currently in progress and full post-evaluation results will be presented at the conference. The learnings from the development and implementation of this redesign could be applied to other disciplines and organisations.


Alana Jacob is the Manager of Physiotherapy and Exercise Physiology at The Royal Melbourne Hospital. She has extensive experience managing acute and subacute inpatient and outpatient services across the public and private sector. Alana has a clinical background as a Physiotherapist and has completed a MBA majoring in Health and Human Services Management. Alana has a passion for improving patient outcomes by working with teams to improve systems and processes within the healthcare network.

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