Patchwork Of Scope-Of-Practice Regulations Prevent Allied Health Professionals From Fully Participating In Patient Care

2013 ◽  
Vol 32 (11) ◽  
pp. 1985-1989 ◽  
Author(s):  
Thomas W. Elwood
PEDIATRICS ◽  
1993 ◽  
Vol 92 (4) ◽  
pp. A80-A80
Author(s):  
J. F. L.

One of the most striking—and disturbing—changes under way in medicine is the rapid erosion of the physician's authority for managing the patient. More and more allied health professionals and organizations such as HMOs and PPOs clamor for the right to direct patient care. Yet when it comes to assuming some of the risk for malpractice suits, these groups want the burden to remain entirely on the doctor. Another claimant to knowing better than doctors what patients need: the utilization review firm. UR companies have made doctors' lives miserable by denying hospitalization, demanding earlier discharge, and generally questioning every aspect of patient management. When a malpractice suit arises, though, the UR firms all too often deny any responsibility. How? They say they're just interpreting the benefits a plan offers. This and other forms of legal hairsplitting leave the doctor holding the malpractice bag.


2015 ◽  
Vol 39 (3) ◽  
pp. 249 ◽  
Author(s):  
Gretchen Young ◽  
Julie Hulcombe ◽  
Andrea Hurwood ◽  
Susan Nancarrow

Objective Queensland Health established a Ministerial Taskforce to consult on and make recommendations for the expansion of the scope of practice of allied health roles. This paper describes the findings from the stakeholder consultation. Methods The Ministerial Taskforce was chaired by the Assistant Minister for Health and included high-level representation from allied health, nursing, medicine, unions, consumers and universities. Widespread engagement was undertaken with stakeholders representing staff from a wide cross-section of health service provision, training and unions. Participants also tendered evidence of models incorporating full-scope and extended scope tasks undertaken by allied health professionals. Results The consultation incorporated 444 written submissions and verbal feedback from over 200 participants. The findings suggest that full scope of practice is often restricted within the Queensland public health system, resulting in underuse of allied health capacity and workforce inefficiencies. However, numerous opportunities exist to enhance patient care by extending current roles, including prescribing and administering medications, requesting investigations, conducting procedures and reporting results. The support needed to realise these opportunities includes: designing patient-centred models of service delivery (including better hours of operation and delegation to support staff); leadership and culture change; funding incentives; appropriate education and training; and clarifying responsibility, accountability and liability for outcomes. The taskforce developed a series of recommendations and an implementation strategy to operationalise the changes. Conclusions The Ministerial Taskforce was an effective and efficient process for capturing broad-based engagement for workforce change while ensuring high-level support and involving potential adversaries in the decision-making processes. What is known about the topic? Anecdotal evidence exists to suggest that allied health professionals do not work to their full scope of practice and there is potential to enhance health service efficiencies by ensuring practitioners are supported to work to their full scope of practice. What does this paper add? This paper presents the findings from a large-scale consultation, endorsed by the highest level of state government, that reinforces the perceptions that allied health professionals do not work to full scope of practice, identifies several barriers to working to full scope and extended scope of practice, and opportunities for workforce efficiencies arising from expanding scope of practice. The top-down engagement process should expedite the implementation of workforce change. What are the implications for practitioners? High-level engagement and support is an effective and efficient way to broker change and overcome intraprofessional barriers to workforce change policies. However, practitioners are often prevented from expanding their roles through an implied need to ‘ask for permission’, when, in fact, the only barriers to extending their role are culture and historical practice.


2016 ◽  
Vol 46 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Tilley Pain ◽  
Gail Kingston ◽  
Janet Askern ◽  
Rebecca Smith ◽  
Sandra Phillips ◽  
...  

Background: Inpatient care is dependent upon the effective transfer of clinical information across multiple professions. However, documented patient clinical information generated by different professions is not always successfully transferred between them. One obstacle to successful information transfer may be the reader’s perception of the information, which is framed in a particular professional context, rather than the information per se. Objective: The aim of this research was to investigate how different health professionals perceive allied health documentation and to investigate how clinicians of all experience levels across medicine, nursing and allied health perceive and use allied health notes to inform their decision-making and treatment of patients. Method: The study used a qualitative approach. A total of 53 speech pathologists, nurses, doctors, occupational therapists, dieticians and social workers (8 males; 43 females) from an Australian regional tertiary hospital participated in eleven single discipline focus groups, conducted over 4 months in 2012. Discussions were recorded and transcribed verbatim and coded into themes by content analysis. Findings: Six themes contributing to the efficacy of clinical information transference emerged from the data: day-to-day care, patient function, discharge and discharge planning, impact of busy workloads, format and structure of allied health documentation and a holistic approach to patient care. Discussion: Other professions read and used allied health notes albeit with differences in focus and need. Readers searched for specific pieces of information to answer their own questions and professional needs, in a process akin to purposive sampling. Staff used allied health notes to explore specific aspects of patient function but did not obtain a holistic picture. Conclusion: Improving both the relationship between the various health professions and interpretation of other professions’ documented clinical information may reduce the frequency of communication errors, thereby improving patient care.


2003 ◽  
Vol 26 (2) ◽  
pp. 49 ◽  
Author(s):  
Hedley Peach

Recently published studies were systematically reviewed to determine whether use of research in clinical practice bynurses, managers and allied health professionals in hospitals is currently sub-optimal, the factors influencing this andpossible remedial strategies. The better studies confirmed that use of appropriate research is currently sub-optimal. Thenature of the research and access to it is partly responsible for this. However, adoption of research findings is alsocurrently hindered by factors inherent in hospitals and by the skills and attitudes of potential users of the research.Numerous remedial strategies have been suggested and hospitals could take responsibility for implementing many ofthem. However, most have yet to be evaluated. Studies into the use of research findings by nurses, managers and alliedhealth professionals in Australian hospitals and trials of remedial strategies are recommended.


Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S8
Author(s):  
Lauren Ashley Rousseau ◽  
Nicole M. Bourque ◽  
Tiffany Andrade ◽  
Megan E.B. Antonellis ◽  
Patrice Hoskins ◽  
...  

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Margaret Evans

Abstract Background Healthcare aims to promote good health and yet demonstrably contributes to climate change, which is purported to be ‘the biggest global health threat of the 21st century’. This is happening now, with healthcare as an industry representing 4.4% of global carbon dioxide emissions. Main body Climate change promotes health deficits from many angles; however, primarily it is the use of fossil fuels which increases atmospheric carbon dioxide (also nitrous oxide, and methane). These greenhouse gases prevent the earth from cooling, resulting in the higher temperatures and rising sea levels, which then cause ‘wild weather’ patterns, including floods, storms, and droughts. Particular vulnerability is afforded to those already health compromised (older people, pregnant women, children, wider health co-morbidities) as well as populations closer to equatorial zones, which encompasses many low-and-middle-income-countries. The paradox here, is that poorer nations by spending less on healthcare, have lower carbon emissions from health-related activity, and yet will suffer most from global warming effects, with scant resources to off-set the increasing health care needs. Global recognition has forged the Paris agreement, the United Nations sustainable developments goals, and the World Health Organisation climate change action plan. It is agreed that most healthcare impact comes from consumption of energy and resources, and the production of greenhouse gases into the environment. Many professional associations of medicine and allied health professionals are advocating for their members to lead on environmental sustainability; the Australian Podiatry Association is incorporating climate change into its strategic direction. Conclusion Podiatrists, as allied health professionals, have wide community engagement, and hence, can model positive environmental practices, which may be effective in changing wider community behaviours, as occurred last century when doctors stopped smoking. As foot health consumers, our patients are increasingly likely to expect more sustainable practices and products, including ‘green footwear’ options. Green Podiatry, as a part of sustainable healthcare, directs us to be responsible energy and product consumers, and reduce our workplace emissions.


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