IIMPACT in Health, UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
PLoS One. 2024 Nov 12;19(11):e0312435. doi: 10.1371/journal.pone.0312435. eCollection 2024.
With the increasing demand on the global health system and the presence of persistent healthcare disparities, it becomes imperative to utilize the full potential of the healthcare workforce, including allied health professionals (AHPs). To date, no review has mapped the literature on clinical care ratios (CCRs) for AHPs. This information is vital in guiding future work-force planning to address healthcare issues such as understaffed and at capacity hospitals. This scoping review mapped available evidence to offer a comprehensive insight into current AHP CCRs, enabling evidence-based decision-making that ensures optimal care and enhanced system efficiency.
The scoping review was undertaken using the 'Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews' (PRISMA-ScR). The search was conducted using Ovid (MEDLINE, Embase, Emcare, PsycINFO), CINAHL, the Cochrane Library, Scopus, PEDro, OTseeker and grey literature. Two reviewers independently screened records, following which data extraction was completed for the included studies. Descriptive synthesis was used to summarize the data.
Of the 7670 records identified, 18 studies were included in this review. Whilst there was variability between AHPs on direct clinical time spent with patients, considerable amount of time was also spent on activities beyond direct clinical care. To offset this, literature highlights opportunities for allied health assistants and students to undertake tasks which would free-up AHPs to undertake more direct and higher-level tasks. However, limitations of findings (variability in measurement, lack of coverage of some professions) limits generalisability.
While the literature highlights considerable variability in CCRs among different AHP disciplines, it does appear nearly a nearly a third of time spent by AHPs are on tasks that are beyond direct clinical care. Future research could explore new workforce models which would free-up AHPs to undertake more direct and higher-level tasks.
随着全球卫生系统需求的增加和持续存在的医疗保健差距，利用医疗保健劳动力的全部潜力变得至关重要，包括辅助卫生专业人员 (AHPs)。迄今为止，尚无文献综述对 AHPs 的临床护理比值 (CCR) 进行综述。这些信息对于指导未来的劳动力规划至关重要，可用于解决医院人手不足和容量过大等医疗保健问题。本范围综述对现有证据进行了综述，全面深入地了解当前 AHP 的 CCR，从而为基于证据的决策提供了依据，确保了最佳护理和提高了系统效率。
使用“系统评价和荟萃分析扩展的首选报告项目用于范围综述” (PRISMA-ScR) 进行范围综述。使用 Ovid (MEDLINE、Embase、Emcare、PsycINFO)、CINAHL、Cochrane 图书馆、Scopus、PEDro、OTseeker 和灰色文献进行了检索。两名审查员独立筛选记录，然后对纳入的研究进行了数据提取。采用描述性综合方法对数据进行总结。
在确定的 7670 条记录中，有 18 项研究纳入本综述。尽管 AHPs 直接花在患者身上的临床时间存在差异，但他们也花费了大量时间从事直接临床护理以外的活动。为了弥补这一点，文献强调了让辅助卫生助理和学生承担任务的机会，以使 AHPs 有更多时间从事更直接和更高层次的任务。但是，由于发现的局限性（测量的变异性、某些专业未涵盖）限制了概括性。
尽管文献强调了不同 AHP 学科的 CCR 存在相当大的差异，但似乎有近三分之一的 AHP 时间用于直接临床护理以外的任务。未来的研究可以探索新的劳动力模式，以使 AHPs 有更多时间从事更直接和更高层次的任务。
