Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia.
Academic Unit, Peninsula Health, Frankston, VIC, Australia.
BMC Health Serv Res. 2022 Oct 24;22(1):1280. doi: 10.1186/s12913-022-08642-7.
Allied health assistants (AHAs) are support staff who complete patient and non-patient related tasks under the delegation of an allied health professional. Delegating patient related tasks to AHAs can benefit patients and allied health professionals. However, it is unclear whether the AHA workforce is utilised optimally in the provision of patient care. The purpose of this study was to determine the proportion of time AHAs spend on patient related tasks during their working day and any differences across level of AHA experience, clinical setting, and profession delegating the task.
A time motion study was conducted using a self-report, task predominance work sampling method. AHAs were recruited from four publicly-funded health organisations in Victoria, Australia. AHAs worked with dietitians, occupational therapists, physiotherapists, podiatrists, social workers, speech pathologists, psychologists, and exercise physiologists. The primary outcome was quantity of time spent by AHAs on individual task-categories. Tasks were grouped into two main categories: patient or non-patient related activities. Data were collected from July 2020 to May 2021 using an activity capture proforma specifically designed for this study. Logistic mixed-models were used to investigate the extent to which level of experience, setting, and delegating profession were associated with time spent on patient related tasks.
Data from 51 AHAs showed that AHAs spent more time on patient related tasks (293 min/day, 64%) than non-patient related tasks (167 min/day, 36%). Time spent in community settings had lower odds of being delegated to patient related tasks than time in the acute hospital setting (OR 0.44, 95%CI 0.28 to 0.69, P < 0.001). Time delegated by exercise physiologists and dietitians was more likely to involve patient related tasks than time delegated by physiotherapists (exercise physiology: OR 3.77, 95% 1.90 to 7.70, P < 0.001; dietetics: OR 2.60, 95%CI 1.40 to 1.90, P = 0.003). Time delegated by other professions (e.g. podiatry, psychology) had lower odds of involving patient related tasks than physiotherapy (OR 0.37, 95%CI 0.16 to 0.85, P = 0.02).
AHAs may be underutilised in community settings, and by podiatrists and psychologists. These areas may be targeted to understand appropriateness of task delegation to optimise AHAs' role in providing patient care.
辅助医疗助理（AHA）是在辅助医疗专业人员的委托下完成患者和非患者相关任务的支持人员。将患者相关任务委托给 AHA 可以使患者和辅助医疗专业人员受益。然而，目前尚不清楚在提供患者护理方面，AHA 劳动力是否得到了最佳利用。本研究的目的是确定 AHA 在工作日内花费在患者相关任务上的时间比例，以及在 AHA 经验水平、临床环境和委托任务的专业人员方面是否存在差异。
采用自我报告、任务主导性工作抽样法进行时间运动研究。AHA 是从澳大利亚维多利亚州的四个公共资助的卫生组织招募的。AHA 与营养师、职业治疗师、物理治疗师、足病医生、社会工作者、言语病理学家、心理学家和运动生理学家一起工作。主要结果是 AHA 花费在个别任务类别的时间量。任务分为两类：患者或非患者相关活动。数据于 2020 年 7 月至 2021 年 5 月使用专为这项研究设计的活动捕获方案收集。使用逻辑混合模型来调查经验水平、环境和委托专业人员与花费在患者相关任务上的时间之间的关联程度。
来自 51 名 AHA 的数据显示，AHA 花费在患者相关任务上的时间（293 分钟/天，64%）多于非患者相关任务（167 分钟/天，36%）。与急性医院环境相比，社区环境中的时间更有可能被委托给患者相关任务（OR 0.44，95%CI 0.28 至 0.69，P<0.001）。与物理治疗师相比，运动生理学家和营养师委托的时间更有可能涉及患者相关任务（运动生理学：OR 3.77，95%1.90 至 7.70，P<0.001；营养学：OR 2.60，95%CI 1.40 至 1.90，P=0.003）。其他专业人员（如足病学、心理学）委托的时间涉及患者相关任务的可能性低于物理治疗（OR 0.37，95%CI 0.16 至 0.85，P=0.02）。
AHA 在社区环境中，以及足病医生和心理学家中可能没有得到充分利用。这些领域可能需要针对任务委托的适当性进行研究，以优化 AHA 在提供患者护理方面的作用。
