Delegation by Allied Health Professionals to Allied Health Assistants: a mixed methods systematic review.

Adult Allied Health Personnel Cost-Benefit Analysis Humans Qualitative Research
Attitude Cost-Benefit Analysis Personnel Delegation Skill mix Treatment outcome

Journal

Physiotherapy
ISSN: 1873-1465
Titre abrégé: Physiotherapy
Pays: England
ID NLM: 0401223

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 23 01 2020
pubmed: 22 5 2021
medline: 29 10 2021
entrez: 21 5 2021
Statut: ppublish

Résumé

Delegation by Allied Health Professionals (AHPs) to Allied Health Assistants (AHAs) was introduced in response to various challenges affecting modern health care delivery. However, the clinical and cost-effectiveness of using AHAs is relatively unexplored. The aim of this review was to synthesise the available evidence on; firstly, the clinical and cost-effectiveness of interventions delegated by AHPs to AHAs and secondly, AHPs', AHAs' and patients' attitudes and beliefs towards delegation. MEDLINE, AMED, CINAHL, Cochrane Library, PsycINFO, PEDro, OTseeker and Web of Science databases were searched from inception until January 2019 without restrictions. Primary studies investigating the clinical and cost-effectiveness of any intervention delegated by an AHP, across the spectrum of clinical areas in relation to adult patients, as well as AHPs', AHAs' and patients' attitudes and beliefs about delegation. Data were extracted by pairs of reviewers. Thematic analysis and synthesis of descriptive and analytical themes was conducted. Thirteen publications of variable methodological quality were included. Three studies reported quantitative research and ten qualitative research. No study explored the cost-effectiveness. Only one study investigated clinical effectiveness. Training for both AHPs and AHAs and having clear processes in place were identified as important facilitators of delegation. Delegation is not standardised across AHPs or within each profession. There are clear knowledge gaps regarding the clinical and cost-effectiveness of delegation by AHPs and patients' attitudes and preferences. Further research is needed to facilitate the standardisation of delegation. PROSPERO CRD42019119557.

Sections du résumé

BACKGROUND BACKGROUND
Delegation by Allied Health Professionals (AHPs) to Allied Health Assistants (AHAs) was introduced in response to various challenges affecting modern health care delivery. However, the clinical and cost-effectiveness of using AHAs is relatively unexplored.
OBJECTIVES OBJECTIVE
The aim of this review was to synthesise the available evidence on; firstly, the clinical and cost-effectiveness of interventions delegated by AHPs to AHAs and secondly, AHPs', AHAs' and patients' attitudes and beliefs towards delegation.
DATA SOURCES METHODS
MEDLINE, AMED, CINAHL, Cochrane Library, PsycINFO, PEDro, OTseeker and Web of Science databases were searched from inception until January 2019 without restrictions.
STUDY SELECTION METHODS
Primary studies investigating the clinical and cost-effectiveness of any intervention delegated by an AHP, across the spectrum of clinical areas in relation to adult patients, as well as AHPs', AHAs' and patients' attitudes and beliefs about delegation.
DATA EXTRACTION & SYNTHESIS UNASSIGNED
Data were extracted by pairs of reviewers. Thematic analysis and synthesis of descriptive and analytical themes was conducted.
RESULTS RESULTS
Thirteen publications of variable methodological quality were included. Three studies reported quantitative research and ten qualitative research. No study explored the cost-effectiveness. Only one study investigated clinical effectiveness. Training for both AHPs and AHAs and having clear processes in place were identified as important facilitators of delegation.
CONCLUSION AND IMPLICATIONS OF KEY FINDINGS CONCLUSIONS
Delegation is not standardised across AHPs or within each profession. There are clear knowledge gaps regarding the clinical and cost-effectiveness of delegation by AHPs and patients' attitudes and preferences. Further research is needed to facilitate the standardisation of delegation.
SYSTEMATIC REVIEW REGISTRATION NUMBER UNASSIGNED
PROSPERO CRD42019119557.

Identifiants

DOI: 10.1016/j.physio.2020.10.002 PMID: 34020200
pubmed: 34020200
pii: S0031-9406(20)30412-0
doi: 10.1016/j.physio.2020.10.002
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

16-30

Informations de copyright

Copyright © 2021 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Auteurs

P Sarigiovannis (P)

Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, United Kingdom; Midlands Partnership NHS Foundation Trust, Newcastle under Lyme, Staffordshire ST5 2BQ, United Kingdom. Electronic address: p.sarigiovannis1@keele.ac.uk.

S Jowett (S)

Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, United Kingdom; Health Economics Unit, Institute of Applied Health Research, IOEM Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.

B Saunders (B)

Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, United Kingdom.

N Corp (N)

Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, United Kingdom.

A Bishop (A)

Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire ST5 5BG, United Kingdom.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Delegation by Allied Health Professionals to...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Auxiliaires de santé › Delegation by Allied Health Professionals to...
questionsmedicales.fr › Organisations et économie des soins de santé › Économie › Coûts et analyse des coûts › Analyse coût-bénéfice › Delegation by Allied Health Professionals to...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Delegation by Allied Health Professionals to...
questionsmedicales.fr › Disciplines des sciences naturelles › Science › Recherche › Recherche empirique › Recherche qualitative › Delegation by Allied Health Professionals to...