Passfield Juanine, Nielsen Ilsa, Brebner Neil, Johnstone Cara
Central Integrated Regional Cancer Services, Queensland Health Corporate Office, GPO Box 48, Brisbane, Qld 4001, Australia.
Allied Health Professions' Office of Queensland, Level 6, Building 2, William McCormack Place II, 5B Sheridan Street, Cairns, Qld 4870, Australia. Email.
Aust Health Rev. 2018 Dec;42(6):656-660. doi: 10.1071/AH16160.
Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services. Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement. Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated. Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate. What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to delegation and skill sharing to provide an indication of the level of local service influence on workforce and service model decisions. What are the implications for practitioners? Local factors have a modest influence on delegation and skill sharing decisions of AH teams. Practitioners need to be actively engaged in decision making at the local level to ensure the clinical service model meets local needs. However, teams should also capitalise on commonalities between settings to limit duplication of training and resource development through collaborative networks.
目的 委托和技能共享是昆士兰地区癌症护理服务领域联合健康（AH）专业人员正在采用的新兴服务策略。本研究的目的是描述两项服务在提供任务的类型和频率方面的一致性，以及团队在决定委托或共享临床任务方面的一致性，从而确定其对其他服务的潜在适用性。方法 整理了两项类似服务提供的数据集。使用描述性统计分析来评估一致性程度。结果 总共确定有214项任务由这些服务承担（一致性为92%）。在各项服务中，70项任务被确定为高频任务（每周或更频繁），29项为非高频任务（一致性为46%）。在68项经过风险评估的任务中，委托的一致性为66%，技能共享的一致性为60%，高频任务和干预性任务更有可能被委托。结论 两个癌症护理AH团队承担的临床任务具有明显的强一致性，在执行任务的频率方面有中等程度的一致性。尽管在任务层面存在明显差异，但被认为适合技能共享和/或委托的任务比例相似。有必要进行进一步研究，以考察影响技能共享或委托决策的一系列因素。关于该主题已知的情况是什么？关于在癌症护理服务中为AH使用技能共享和委托服务模式的研究证据有限。特别是，关于任务安全性以及委托或技能共享的适当性的决策在不同服务之间能够在多大程度上推广，尚未得到研究。本文补充了什么内容？本研究调查了地区中心两个类似的AH癌症护理团队之间临床任务的一致性水平。它还考察了在委托和技能共享方面的一致性水平，以表明当地服务对劳动力和服务模式决策的影响程度。对从业者有何启示？当地因素对AH团队的委托和技能共享决策有一定影响。从业者需要积极参与地方层面的决策，以确保临床服务模式满足当地需求。然而，各团队也应利用不同环境之间的共性，通过协作网络限制培训和资源开发的重复。
