The tension between efficiency and effectiveness: a study of dietetic practice in primary care.


Journal

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
ISSN: 1365-277X
Titre abrégé: J Hum Nutr Diet
Pays: England
ID NLM: 8904840

Informations de publication

Date de publication:
04 2019
Historique:
pubmed: 4 1 2019
medline: 25 6 2020
entrez: 4 1 2019
Statut: ppublish

Résumé

Primary healthcare dietitians have a vital role to play in the prevention and management of chronic disease. Working in primary care requires efficient and effective management of practice to ensure client and practitioner needs are met. The present study aimed to explore the way in which primary care dietitians in Australia view the constructs of efficiency and effectiveness within the context of their practice. The study used an exploratory qualitative design within a pragmatist framework. Individual semi-structured telephone interviews were conducted with Australian primary care dietitians. All interviews were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. Twenty dietitians (17 females) working as private practitioners in primary care from three Australian states participated in the present study. Three themes emerged from the data. The first theme revealed that seeking efficiency and especially effectiveness were important to primary care dietitians and that there was a tension between the two. The second theme identified that efficiency and effectiveness are influenced by personal and structural factors. The final theme explored how dietitians are actively seeking ways to be more efficient and effective, including supportive networks, as well as the utilisation of technology. Achieving a balance between efficiency and effectiveness in primary care dietetics is challenging to practitioners, who may require further training and support to enhance productivity, time management and resource utilisation. Structured issues exist for the workface. Further studies are required to quantify these findings and to explore whether it is possible to optimise efficiency and effectiveness and achieve sustainability of the dietetic workforce in primary care.

Sections du résumé

BACKGROUND
Primary healthcare dietitians have a vital role to play in the prevention and management of chronic disease. Working in primary care requires efficient and effective management of practice to ensure client and practitioner needs are met. The present study aimed to explore the way in which primary care dietitians in Australia view the constructs of efficiency and effectiveness within the context of their practice.
METHODS
The study used an exploratory qualitative design within a pragmatist framework. Individual semi-structured telephone interviews were conducted with Australian primary care dietitians. All interviews were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach.
RESULTS
Twenty dietitians (17 females) working as private practitioners in primary care from three Australian states participated in the present study. Three themes emerged from the data. The first theme revealed that seeking efficiency and especially effectiveness were important to primary care dietitians and that there was a tension between the two. The second theme identified that efficiency and effectiveness are influenced by personal and structural factors. The final theme explored how dietitians are actively seeking ways to be more efficient and effective, including supportive networks, as well as the utilisation of technology.
CONCLUSIONS
Achieving a balance between efficiency and effectiveness in primary care dietetics is challenging to practitioners, who may require further training and support to enhance productivity, time management and resource utilisation. Structured issues exist for the workface. Further studies are required to quantify these findings and to explore whether it is possible to optimise efficiency and effectiveness and achieve sustainability of the dietetic workforce in primary care.

Identifiants

pubmed: 30604495
doi: 10.1111/jhn.12617
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

259-266

Informations de copyright

© 2019 The British Dietetic Association Ltd.

Auteurs

R O'Connor (R)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

K Slater (K)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

L Ball (L)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.

A Jones (A)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.

L Mitchell (L)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.

M E Rollo (ME)

Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia.
Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia.

L T Williams (LT)

Nutrition and Dietetics, School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.

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Classifications MeSH