Benchmarking service provision, scope of practice, and skill mix for physiotherapists in adult cystic fibrosis care delivery

Hall, Kathleen; Maxwell, Lyndal; Cobb, Robyn; Chambers, Rebecca; Roll, Mark; Bell, S. C.; Kuys, Suzanne

doi:10.1080/09593985.2020.1777606

Cited by 2 publications

(12 citation statements)

References 11 publications

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“…In conjunction with delegation of suitable tasks to the AHA, it would appear physiotherapy service delivery in this centre moved closer to benchmarking standards recommended in clinical practice guidelines, with increased exercise testing and physiotherapy activity in clinics. 7,8 These findings describe a redesigned acute care respiratory physiotherapy service with increased capability, comprising a new skill mix of an AHA and junior and senior physiotherapists. Similar service delivery models have been shown to improve patients outcomes in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Staff recorded all direct and non-direct clinical and non-clinical activity daily to quantify physiotherapy service delivery using a portable scanning system (Chappell Dean Pty Limited). Data included date, time, location (ward, multidisciplinary outpatient clinics), activity type using a predetermined code list, 7 number and duration of each activity, and staffing level (junior, senior, AHA in phase 2).…”

Section: Methodsmentioning

confidence: 99%

“…7 Key aspects of CF physiotherapy treatment (respiratory and exercise treatments) met recommended guidelines. 7,8 However, aspects of care such as exercise testing and detailed clinical care review did not. 7,8 Many other adult CF services appear equally under resourced to deliver adult CF care 4 and likely facing challenges to provide ongoing physiotherapy service delivery and future sustainability of care 1,4 .…”

Section: Introductionmentioning

confidence: 99%

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Physiotherapy service provision in a specialist adult cystic fibrosis service: a pre-post design study with the inclusion of an allied health assistant

Hall

Maxwell

Cobb

et al. 2020

Preprint

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Question(s)What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in terms of service provision, scope of practice and skill mix changes in an acute respiratory service?DesignA pragmatic pre-post design study examined physiotherapy services across two three-month periods: current service delivery [P1] and current service delivery plus AHA [P2].Outcome measuresClinical and non-clinical activity contributing to physiotherapy services delivery quantified as number, type and duration (per day) of all staff activity, and categorised for skill level (AHA, junior, senior).ResultsOverall physiotherapy service delivery increased in P2 compared to P1 (n=4730 vs n=3048). Physiotherapists undertook fewer respiratory (p < 0.001) and exercise treatments (p < 0.001) but increased patient reviews for inpatients (p < 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p < 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%) and delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities such as statistics and ongoing training (11%). No adverse events were reported.ConclusionInclusion of an AHA in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers safe and sustainable options for enhancing physiotherapy service provision in acute respiratory care services.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Physiotherapy service provision in a specialist adult cystic fibrosis service: a pre-post design study with the inclusion of an allied health assistant

Hall

Maxwell

Cobb

et al. 2020

Preprint

Self Cite

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“…Senior physiotherapists completed the same number of exercise tests in P2 (Table 4), though approximately 16 minutes longer was spent completing each test (Supplement 1 Table B). Senior physiotherapists increased the number of inpatient reviews completed per day from 1.0 (SD1.3) 7 for a full description of activity code inclusions.…”

Section: Skill MIXmentioning

confidence: 99%

“… 7 Key aspects of CF physiotherapy treatment (respiratory and exercise treatments) met recommended guidelines. 7 , 8 However, aspects of care such as exercise testing and detailed clinical care review did not. 7 , 8 Other adult CF services appear similarly under resourced to deliver adult CF care 4 and likely facing challenges to provide ongoing physiotherapy service delivery and future sustainability of care.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

et al. 2021

Self Cite

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What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in an acute respiratory service? A pragmatic pre-post design study examined physiotherapy services across two 3-month periods: current service delivery [P1] and current service delivery plus AHA [P2]. Clinical and non-clinical activity quantified as number, type and duration (per day) of all staff activity categorised for skill level (AHA, junior, senior). Physiotherapy service delivery increased in P2 compared to P1 (n = 4730 vs n = 3048). Physiotherapists undertook fewer respiratory (p < 0.001) and exercise treatments (p < 0.001) but increased reviews for inpatients (p < 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p < 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient-related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%), delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities (11%). No adverse events were reported. AHA inclusion in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers sustainable options for enhancing physiotherapy service provision in acute respiratory care.

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Benchmarking service provision, scope of practice, and skill mix for physiotherapists in adult cystic fibrosis care delivery

Cited by 2 publications

References 11 publications

Physiotherapy service provision in a specialist adult cystic fibrosis service: a pre-post design study with the inclusion of an allied health assistant

Physiotherapy service provision in a specialist adult cystic fibrosis service: a pre-post design study with the inclusion of an allied health assistant

Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

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