scholarly journals A Survey to Guide the Emerging Role of Allied Health Teams in a Regional Tertiary Hospital Emergency Department

Author(s):  
Bede Ashley ◽  
Tilley Pain ◽  
Heidi Clark ◽  
Ellen O'Connor ◽  
Liana Schnierer ◽  
...  

Purpose: A multidisciplinary allied health team has worked in The Townsville Hospital Emergency Department for seven years. Patients are referred to the allied health team by medical and nursing staff with the aim of reducing patient admission and improving patient outcomes. However, the type and number of referrals received by the allied health team suggest there is a lack of detailed interdisciplinary knowledge by the referrers. Therefore, the Emergency Department Allied Health Team surveyed other emergency department health professionals to ascertain their knowledge of allied health roles. The results will be used to develop education sessions to fill gaps in knowledge. Methods: A cross-sectional survey consisting of 22 true/false statements and demographic questions was developed by the Emergency Department Allied Health Team. Questions described some of the common triggers for referral to physiotherapy, occupational therapy, social work, and pharmacy staff in the emergency department at the Townsville Hospital. The survey was distributed opportunistically to nursing, medical and physician assistant staff at handover or education sessions. Descriptive statistics were used to describe the data and comparisons used chi squared tests. Results: The response rate for the survey was 63% (n=154), including 52 doctors (65%), 95 (59%) nursing staff, 3 physician assistants (100%), and 4 who did not state their discipline. Preferred responses were low for questions about occupational therapy’s ability to do home visits up to four weeks post emergency department discharge (37.7%), physiotherapists’ necessity to perform mobility assessments (24.7%), identifying APINCH acronym as mnemonic for high risk drugs (35.7%) and the correct application of “close the gap” prescriptions (27.9%). Staff with more experience and prescribers were more likely to give the preferred response. Conclusions: Some gaps exist in doctors’, nurses’, and physician assistants’ knowledge of the roles of allied health in an emergency department. The knowledge gap decreases as staff experience in emergency departments increases. Therefore, for the allied health team in our emergency department to work at full scope of practice, these knowledge gaps need to be addressed. Our challenge now is to provide sustainable education on the role of allied health in a busy emergency department full of shift working and rotating staff being pulled by a myriad of contrasting priorities.

Author(s):  
Thierry Morineau ◽  
Mounia Djenidi-Delfour ◽  
Fabrice Arnault

This study describes the concept of affordance-based procedure and its implementation in a triage station in a hospital emergency department. Rather than seeking to increase operators’ adherence to procedures, an affordance-based procedure (1) aims to induce task steps using affordances that also (2) support degrees of freedom for action. The design of this procedure was guided by the application of an extended version of cognitive work analysis, named “heuristic cognitive work analysis.” This design process produced a new procedural document: a reception card. Ten months after its implementation, a qualitative evaluation with 10 triage nurses shows that the reception card is viewed as supporting coordination between the different nurses’ tasks and providing an external memory to cope with frequent interruptions during high patient inflow, even though the document is used for convenience and with unexpected and partial uses of its items. The document assessed also afforded emerging benefits, that is, acceleration of ambulance release, higher level of confidentiality, assistance for staff hand-overs. Finally, novice triage nurses are particularly sensitive to the benefits brought by this affordance-based procedure.


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