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联合健康专业中高级临床实践的作用与发展:一项混合方法研究。

The Role and Development of Advanced Clinical Practice Within Allied Health Professions: A Mixed Method Study.

作者信息

Stewart-Lord Adéle, Beanlands Clare, Khine Ricardo, Shamah Shani, Sinclair Noreen, Woods Sandie, Woznitza Nick, Baillie Lesley

机构信息

Therapeutic Radiography Allied Health Sciences School of Health and Social Care London South Bank University, London, UK.

Occupational Therapy, Allied Health Sciences, London South Bank University, London, UK.

出版信息

J Multidiscip Healthc. 2020 Nov 25;13:1705-1715. doi: 10.2147/JMDH.S267083. eCollection 2020.

Abstract

OBJECTIVE

To investigate the profiles of advanced clinical practitioners (ACPs) in the allied health professions (AHPs) and their skills, attributes, experiences and involvement in new models of care.

METHODS

A 2 phase, cross sectional, mixed method survey of AHP ACPs across London was conducted in 2018-2019. Online questionnaires were completed by 127 AHP ACPs and then semi-structured interviews were conducted with 15 AHP ACPs.

RESULTS

The survey results gave a comprehensive overview of the attributes of AHPs in ACP roles across London. There was considerable variability between role titles, types and levels of qualification, and evolution of the roles. The respondents predominately worked in clinical practice, and less frequently in other ACP domains (research, leadership and management, education). The interview findings provided in-depth insights into the AHP ACP roles within four themes: being advanced, career pathways, outcomes of the advanced practitioner role and influencing and transforming. The "Being advanced" theme highlighted that expert practice comprised confident and autonomous practice, leadership, and applying specialist and expert decision-making skills. "Career pathways" highlighted the diversity within the participants' roles, titles, career opportunities and development. In the "Outcomes of the advanced clinical practitioner role" theme, the ACPs described their services as prompter, more accessible and providing an improved patient journey. The "Influencing and transforming" theme highlighted networking and dissemination and ideas for innovation, influencing and transforming services.

CONCLUSION

This is the first comprehensive profile of ACP roles across AHPs and indicates that these roles are already having a positive impact on healthcare services and supporting new models of care. However, establishing the necessary infrastructure, standardization and governance for ACP roles across sectors, along with the career pathways, funding, sustainability and education, could increase impact in the future.

摘要

目的

调查联合健康专业(AHPs)中高级临床从业者(ACPs)的概况及其技能、特质、经验以及在新型护理模式中的参与情况。

方法

2018 - 2019年对伦敦各地的AHPs领域的ACPs进行了一项分为两个阶段的横断面混合方法调查。127名AHPs领域的ACPs完成了在线问卷,随后对15名AHPs领域的ACPs进行了半结构化访谈。

结果

调查结果全面概述了伦敦各地担任ACPs角色的AHPs的特质。角色头衔、资格类型和级别以及角色演变之间存在很大差异。受访者主要从事临床实践,较少在其他ACPs领域(研究、领导与管理、教育)工作。访谈结果在四个主题中对AHPs领域的ACPs角色提供了深入见解:成为高级从业者、职业发展路径、高级从业者角色的成果以及影响与变革。“成为高级从业者”主题强调专家实践包括自信且自主的实践、领导力以及运用专业和专家决策技能。“职业发展路径”突出了参与者角色、头衔、职业机会和发展的多样性。在“高级临床从业者角色的成果”主题中,ACPs将他们的服务描述为更及时、更易获得且能改善患者就医体验。“影响与变革”主题强调了网络联系、传播以及创新、影响和变革服务的想法。

结论

这是首份关于AHPs领域ACPs角色的全面概况,表明这些角色已对医疗服务产生积极影响并支持新型护理模式。然而,为跨部门的ACPs角色建立必要的基础设施、标准化和治理机制,以及职业发展路径、资金、可持续性和教育,未来可能会增加其影响力。

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