Facilitators and barriers to implementing task shifting: Expanding the scope of practice of clinical technologists in the Netherlands

Haan, Maarten de; Eijk-Hustings, Yvonne van; Bessems-Beks, Monique; Dirksen, Carmen D.; Vrijhoef, Hubertus J. M.

doi:10.1016/j.healthpol.2019.07.003

Cited by 12 publications

(19 citation statements)

References 20 publications

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“…This study shows that resistance to changing working styles among medical professionals could impinge on new workers’ effective functioning. For the effective implementation of supportive workers such as doctor clerks, medical institutions and doctors should discuss their present work and ways doctor clerks can change their work styles effectively [ 27 , 28 ]. Future studies could investigate the effective implementation of doctor clerks and the effectiveness of their work in rural hospitals where medical professionals are lacking.…”

Section: Discussionmentioning

confidence: 99%

Doctor Clerk Implementation in Rural Community Hospitals for Effective Task Shifting of Doctors: A Grounded Theory Approach

Ohta¹,

Yawata²,

Sano

2022

IJERPH

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With the diversification of medical care and work reform, doctor clerks play a major role today and are recruited to mitigate the burden of doctors worldwide. Their recruitment can improve the working conditions of physicians, facilitate task shifting in rural community hospitals, improve patient care, and help address the lack of healthcare resources. This study used a qualitative method to investigate difficulties in the implementation of doctor clerks and ascertain the features of effective implementation by collecting ethnographic data through field notes and semi-structured interviews with workers. We observed and interviewed 4 doctor clerks, 10 physicians, 14 nurses, 2 pharmacists, 1 nutritionist, and 2 therapists for our study. We clarified the doctor clerk process in rural hospitals through four themes: initial challenge, balance between education and expansion, vision for work progression, and drive for quality of care. We further clarified effectiveness, difficulties, and enhancing factors in implementation. Doctor clerk recruitment and bridging of discrepancies among medical professionals can mitigate professional workloads and improve staff motivation, leading to better interprofessional collaboration and patient care.

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Section: Discussionmentioning

confidence: 99%

Doctor Clerk Implementation in Rural Community Hospitals for Effective Task Shifting of Doctors: A Grounded Theory Approach

Ohta¹,

Yawata²,

Sano

2022

IJERPH

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“…Other researchers have examined the various context-speci c facilitators and barriers to successful TS/S implementation. 19,20 This study builds on this research with a consensus from international TS/S scholars to advance a conceptual framework for TS/S programmes. A central strength of our study is the use of a high quality international Delphi process, with reproducible panel selection processes, prespeci ed consensus criteria, and a prespeci ed number of Delphi rounds.…”

Section: Discussionmentioning

confidence: 99%

Conceptual Framework for Task Shifting and Task Sharing: An International Delphi Study

Orkin

Rao

Venugopal³

et al. 2020

Preprint

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BackgroundTask shifting and sharing (TS/S) involves the redistribution of health tasks within workforces and communities. Conceptual frameworks lay out the key factors, constructs, and variables involved in a given phenomenon, as well as the relationships between those factors. Though TS/S is a leading strategy to address health worker shortages and improve access to services worldwide, a conceptual framework for this approach is lacking.MethodsWe used an online Delphi process to engage an international panel of scholars with experience in knowledge synthesis concerning TS/S and develop a conceptual framework for TS/S. We invited 55 prospective panellists to participate in a series of questionnaires exploring the purpose of TS/S and the characteristics of contexts amenable to TS/S programmes. Panellist responses were analysed and integrated through an iterative process to achieve consensus on the elements included in the conceptual framework. ResultsThe panel achieved consensus concerning the included concepts after three Delphi rounds among 15 panelists.The COATS Framework (Concepts and Opportunities to Advance Task Shifting and Task Sharing) offers a refined definition of TS/S and a general-purpose statement to guide TS/S programmes. COATS describes that opportunities for health system improvement arising from TS/S programmes depending on the implementation context, and enumerates eight essential conditions and important considerations for launching TS/S interventions.ConclusionThe COATS Framework offers an essential theoretical and conceptual model for TS/S programmes. The COATS Framework is comprehensive and adaptable, and can guide refinements in policy, programme development, evaluation, and research to improve TS/S globally.

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“…Technical Physicians (TPs) were introduced to make patient care more effective and efficient because medical technology would be used in innovative ways. 22 Trained to tailor technology use to patient-specific conditions and needs 19 , the TPs work in the medical domain. They provide direct patient care but also design new clinical protocols for diagnosis and treatment involving technology (indirect patient care, see e.g., Hummelink et al 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…Although TPs do not receive a traditional medical degree, they work on their own responsibility with patients (i.e., they do not require supervision by a physician) and are legally qualified to perform specified reserved medical procedures in the Netherlands. 19,22 However, there are still some barriers that might limit the effect of TPs in clinical practice. 22 This could be explained by the novelty of the discipline and the lack of a shared understanding of this new discipline.…”

Section: Introductionmentioning

confidence: 99%

“…19,22 However, there are still some barriers that might limit the effect of TPs in clinical practice. 22 This could be explained by the novelty of the discipline and the lack of a shared understanding of this new discipline. Emerging professions often lack recognition of their expertise by existing professionals which causes challenges in performing their daily work.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the impact of Technical Physicians on improving healthcare with personalized technology

Groenier¹,

Spijkerboer²,

Venix³

et al. 2022

Preprint

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IntroductionThe rapid introduction of technical innovations in healthcare requires that professionals are adequately prepared for correct clinical use of medical technology. In response to the technological transformation of healthcare, a new type of professional, the Technical Physician (TP), was created, and is trained to improve individual patient care using personalized technology. This study investigates the TPs’ impact on patient care in terms of innovation, efficiency, effectiveness, and patient safety. MethodSemi-structured, in-depth interviews with 30 TPs and 17 medical specialists (MSs) working in academic or teaching hospitals in the Netherlands were conducted. The pre-structured and open-ended interview questions focused on: 1) the perceived impact on efficiency, effectiveness, innovation, and safety, and 2) opportunities and challenges in daily work. ResultsTPs and MSs unanimously experienced that TPs contributed to innovation. A majority indicated that efficiency (TP 67%; MS 65%) and effectiveness (TP 57%; MS 71%) of clinical practice had increased. For safety, 87% of TPs but only 47% of MSs reported an increase. The main explanation given for the positive impact of TPs was combining medical and technical knowledge. Mainly organizational barriers were mentioned as a potential cause for a less visible contribution of TPs. DiscussionTPs and MSs unanimously agreed that TPs contributed to innovating patient care through their integrative medical and technical competencies. Most TPs and MSs also reported increased effectiveness, efficiency, and safety of patient care due to the TPs’ work. TPs and MSs expected that the positive effect of the TPs will be enhanced once organizational barriers are removed.

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Facilitators and barriers to implementing task shifting: Expanding the scope of practice of clinical technologists in the Netherlands

Cited by 12 publications

References 20 publications

Doctor Clerk Implementation in Rural Community Hospitals for Effective Task Shifting of Doctors: A Grounded Theory Approach

Doctor Clerk Implementation in Rural Community Hospitals for Effective Task Shifting of Doctors: A Grounded Theory Approach

Conceptual Framework for Task Shifting and Task Sharing: An International Delphi Study

Evaluation of the impact of Technical Physicians on improving healthcare with personalized technology

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