Advancing support staff to allied health assistance has been established as a solution to improving the quality of health care in rural and remote locations. Health practitioners in these areas often practice over massive geographical distances. This places their patients at risk of delayed diagnosis and treatment, and diminishes their opportunity for the best possible health outcome. In the past, incentives have been offered to practitioners going into specific specialties or for relocating to specific locations. This has been largely unsuccessful, and the industry is now looking at new strategies known as “role substitution” and “task transference”.
Allied health assistants and dietetics
Research has been conducted into a number of specialties in remote areas, and how they can be supported by allied health assistants. One of these is the area of dietetics. This specialty is growing in demand faster than it is in qualified practitioners.
One study tested the utilisation of allied health assistants to conduct nutrition assessments on inpatients. This was proven successful and a valid potential alternative for patients waiting lengthy periods for assessments and treatments from dieticians.
In rural areas, dieticians are often forced to have early consultations via telephone. Understandably, these consultations don’t meet appropriate standards for diagnosing patients. Therefore, at-risk patients are denied the preventative care required. When this occurs, their condition may worsen, leading them to require more complex care. As this care is priorities, other patients are left with excessive wait times.
A way of managing this ripple effect is to task other practice or hospital staff with conducting the physical component of the assessment in the absence of the dietician.
Playing a vital role in efficient health care teams, allied health assistants complete delegated tasks for allied health professionals, maintaining a higher level of patient contact and care than would otherwise be possible.
The level of supervision they require while performing these tasks, depends on their qualifications and experience. They are trained and undertake competency assessments based on what is required of them at the service they work.
Research has confirmed that assessing for risks of malnutrition is within the capabilities of allied health assistants. In fact, allied health assistants completed the task with 84.4% consistency with dietitians. This is a similar level of consistency that occurs among dietitians, themselves. Research also confirmed that this level of consistency is likely to continuously improve.
Allied health and the ageing population
Another example can be seen as the solution to health care for the ageing population. Geriatrics is also a specialty in increasing demand that struggles to attract and retain employees.
Using “role substitution” and “task transference”, non-medical professionals such as allied health practitioners are able to perform geriatric-specific tasks, dependent on their individual expertise. Meanwhile, their allied health assistants compensate for their added responsibilities by performing additional delegated tasks, usually completed by the allied health practitioner.
While implementing these new models, patients are seen to quicker, then assessed and allocated to a more advanced professional if needed.
Advanced allied health assistants
Additional research in this field involved the introduction of the Certificate IV in Allied Health Assistance and evaluating the possibility for the advanced allied health assistant role.
Allied health assistants can be up-skilled, with specific skillsets, through practical workplace training. These skillsets may include physiotherapy, occupational therapy, podiatry, nutrition, speech pathology and exercise physiology. Specified skillsets allow allied health assistants to complete more advanced tasks with less supervision, freeing more time for allied health professionals.
Advanced allied health assistants can complete formal study and on the job training to add depth to this skillset in the form of expertise such as:
- initiative to make autonomous decisions and communicate with stakeholders directly,
- ability to conduct risk assessments,
- supervision skills, and
- ability to undertake a level of clinical decision-making.
Advanced allied health assistants possess leadership skills, though still support the work of allied health practitioners.
From an employee’s perspective, the advanced allied health assistant role is an opportunity for career progression. From an industry perspective, the role is part of the solution to ongoing issues within the health sector.
Training and up-skilling staff within a service appropriately, transpires into an efficient team, equipped to treat patients within their community and surrounding communities. The research conducted on “task transference” and “role substitution” indicated significant reductions in wait times and improved overall quality of care, despite an increased patient demand.
This article refers to research from the following sources
Pearce, C & Pagett, L 2015, ‘Advanced allied health assistants: an emerging workforce, Australian Health Review, vol. 29, no. 3, pp. 260-263.
Saxon, R L, Gray, M L & Oprescu, F I 2018, ‘Reducing geriatric outpatient waiting times: impact of an advanced health practitioner, Australian Journal of Ageing, vol. 37, no. 1, pp. 48–53.
Newman, C S, Cornwell, P L, Young, A M, Ward, E C & Mcerlain, A L 2018, ‘Accuracy and confidence of allied health assistants administering the subjective global assessment on inpatients in a rural setting: a preliminary feasibility study, Nutrition & Dietetics, vol. 75, no. 1, pp. 129-136.