Sarigiovannis P, Foster N E, Jowett S, Saunders B
Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, ST5 5BG, United Kingdom; Midlands Partnership NHS Foundation Trust, Newcastle Under Lyme, Staffordshire, ST5 1QG, United Kingdom.
Centre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, ST5 5BG, United Kingdom; STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Herston, Brisbane, Australia.
Musculoskelet Sci Pract. 2024 Aug;72:102977. doi: 10.1016/j.msksp.2024.102977. Epub 2024 May 18.
Delegation of clinical tasks from physiotherapists to physiotherapy support workers varies considerably in musculoskeletal outpatient physiotherapy services leading to variation in patient care. This study aimed to develop consensus amongst physiotherapists, support workers and managers about what components should be included in a future framework to guide effective and safe delegation of clinical tasks to physiotherapy support workers in United Kingdom's National Health Service musculoskeletal outpatient physiotherapy services.
A consensus study was carried out, using Nominal Group Technique. Seven physiotherapists, ten physiotherapy support workers and ten physiotherapy operational/clinical leads from 13 musculoskeletal physiotherapy services within United Kingdom's National Health Service were recruited through the Chartered Society of Physiotherapy's professional networks and social media. Three separate, role-specific consensus groups were convened, involving participants generating, discussing and rating on a Likert scale, components for inclusion in a future delegation framework.
32 out of 38 generated items reached consensus of ≥70%, i.e. a mean of ≥4.9 on a 7-point Likert scale, across the three groups. Items were grouped under five main categories: 1) training/Continuous Professional Development for physiotherapists and support workers; 2) need for a clear delegation process; 3) competencies 4) defining the role of support workers and 5) safety net.
Key stakeholder groups were able to reach consensus on five priority areas which will be developed into a best practice framework to standardise delegation and guide physiotherapists when delegating clinical tasks to support workers.
在肌肉骨骼门诊物理治疗服务中，物理治疗师将临床任务委托给物理治疗支持人员的情况差异很大，这导致患者护理出现差异。本研究旨在使物理治疗师、支持人员和管理人员就未来框架应包含的组成部分达成共识，该框架用于指导英国国民健康服务体系肌肉骨骼门诊物理治疗服务中向物理治疗支持人员有效且安全地委托临床任务。
采用名义群体技术进行了一项共识研究。通过物理治疗师特许协会的专业网络和社交媒体，从英国国民健康服务体系内的13个肌肉骨骼物理治疗服务机构中招募了7名物理治疗师、10名物理治疗支持人员和10名物理治疗运营/临床主管。召集了三个独立的、针对特定角色的共识小组，让参与者生成、讨论并以李克特量表对纳入未来委托框架的组成部分进行评分。
在三个小组中，38个生成项目中有32个达成了≥70%的共识，即在7分李克特量表上平均得分≥4.9。这些项目被归为五个主要类别：1）物理治疗师和支持人员的培训/持续专业发展；2）需要明确的委托流程；3）能力；4）界定支持人员的角色；5）安全网。
关键利益相关者群体能够就五个优先领域达成共识，这些领域将被制定成一个最佳实践框架，以规范委托行为，并在物理治疗师向支持人员委托临床任务时提供指导。
