Are you struggling to meet your allied health service demand? This article is aimed at allied health service leaders, managers, directors and CEOs who are considering employing an allied health assistant to increase their service capacity. We describe the five key systems and structures that will help you to plan for smooth and successful implementation of a new allied health assistant role.
- Allied health assistants as a solution to allied health workforce capacity issues?
- The risk of introducing allied health assistants without considering systems and resources first
- The essential ingredients to successfully introduce allied health assistants
- 5 systems and structures to consider when introducing an allied health assistant
Allied health assistants as a solution to allied health workforce capacity issues?
Many organisations and business are at breaking point with difficulties servicing current levels of demand. With significant workforce shortages for allied health professionals (AHPs), one solution some workplaces are pursuing is allied health assistants (AHAs). However, implementing allied health assistants into your workplace is a resource intensive solution that can place extra strain on an already stretched workforce, particularly if your current workforce is burnt out.
Worldwide, we have seen a significant increase in demand for allied health services. Yet as we have written in this article, increasing the supply of allied health professionals through training or skilled migration is slow and depends on several influences that can be beyond your control.
Consequently, we are seeing significant pressure being on existing allied health services to meet the needs of the individuals and communities they serve. Our research and our clients tell us that this manifests in the following ways:
- Individuals and communities are missing out on vital services to improve their quality of life
- There are long waiting lists
- Staff are frustrated and demoralized because there is insufficient capacity to provide the frequency or intensity of therapy required for clients to achieve their goals
- Staff are burnt out
- Staff are leaving their jobs and their profession
- Businesses can ‘t grow
- Managers are frustrated and demoralized
- Recruitment advertisements are ineffective
- There are ongoing job vacancies
The risk of introducing allied health assistants without considering systems and resources first
In such a resource constrained environment, it is imperative that the workforce you DO have is cared for, nurtured and retained so that you can maximise their capacity to deliver high quality care without burning them out. This is a difficult balance to achieve.
From years of examining the allied health workforce, we know that if you don’t have the right understanding of the resource implications of introducing an allied health assistant into your workplace, you will add more workload to your already stretched staff and risk pushing your staff into burnout.
The essential ingredients to successfully introduce allied health assistants
Our research into the roles of allied health assistants over the past two decades demonstrates that AHAs can positively influence patient outcomes as well as increase service capacity; provide more direct care; enable more quality improvement activities; increase time for staff development; improve continuity of care within services; allow for more flexibility within the workforce; and provide more and better client centred care.
However the achievement of these outcomes is directly related to how well the roles are designed, implemented and then organised and overseen.
Specifically, the culmination of our work in this field has led to a clear understanding that sustainable and successful implementation of new (assistant) roles requires:
- Strategic support, engagement and direction from everyone in the organisation who is likely to be impacted by the new role;
- That the role is appropriate to the context (local, geographic, population, clinical, professional, regulatory);
- Legal structures to be in place to reinforce the new role;
- Clearly defined and understood, unambiguous delegatory processes;
- Delegating practitioners to have confidence in delegation which comes from them understanding the roles, training and competencies of the practitioners to whom they are delegating; and
- Systematising processes of implementation.
In the twenty years we have been researching the allied health workforce and assistant models of care, we know that implementing new roles without adhering to these principles can lead to much less successful outcomes and can compound inefficiencies rather than address them.
In fact one study we conducted with 20 allied health services in the UK, examining the outcomes of almost 2000 clients, demonstrated that due to the input required to develop, implement and support allied health assistant roles it was more expensive to use a high proportion of assistant staff in a team to deliver care than a low proportion of assistant staff. Yet, by codifying practices and applying these to future planning, it should be possible to increase the efficiency and effectiveness of the introduction of the new roles in any future circumstances or contexts.
5 systems and structures to consider when introducing an allied health assistant
Considering the following 5 key systems and structures before you implement your allied health assistant role will help you to fully realise the contribution allied health assistants can make to enhancing your service and workforce capacity.
1. Devise your implementation plan
As we have written here, it is worth investing time and energy into planning out this process thoroughly. When you can specifically identify the problem you are trying to address, you can clearly identify the roadmap you need to follow to address the problem effectively. And, we are all time poor so having a clear plan will also help you to execute the implementation efficiently. Helping AHPs to develop workforce capacity roadmaps is something we specialise in here at AHP Workforce.
Ask yourself – have you put aside time and resources to clearly identify the workforce problem you are trying to address and to develop your overarching roadmap to implement an allied health assistant?
2. Get your staff on board
As we have described in previous research (1, 2, 3, 4) successful implementation of allied health assistants relies heavily on the buy in and engagement of your staff. Staff need to be engaged in the following kinds of activities in order for the implementation of an allied health assistant role to be successful:
- identifying what gaps an allied health assistant will fill in the team/service
- identifying tasks that could be delegated
- identifying clients that would benefit from allied health assistant input
- identifying how, when and by whom supervision needs to happen
- identifying who will take responsibility for producing systems
Ask yourself – how you are going to engage your allied health professional staff to engage in the development of the allied health assistant role? How will you guarantee and quarantine sufficient time for staff to engage in the process?
3. Take advantage of local systems that are already in place
We know that the following processes are required to ensure allied health assistant roles are efficient and effective. Equally, all staff need to be engaged in these following activities in order for the implementation of an allied health assistant role to be successful:
- developing a recruitment profile and strategy
- developing an onboarding strategy
- developing supervision frameworks
- developing delegation frameworks
- developing communication frameworks
- developing training programs for allied health assistants and allied health professionals in delegation
- developing supervision programs for
- allied health assistants and allied health professionals in delegation
- developing training programs for allied health assistants to upskill and learn your service systems
- developing career pathways for allied health assistants and allied health professionals
- developing professional development programs for allied health assistants
Ask yourself – Do you have a well developed systems and structures in your organisation that can compliment those needed to successfully implement an allied health assistant role? How will you guarantee and quarantine sufficient time for you and your allied health professionals staff to produce the systems and structures required to implement an allied health assistant role?
4. Develop new implementation systems
We have seen amazing examples of supervision, communication, delegation and training programs that have been systemised so well that they can be implemented with allied health professionals and allied health assistants using minimal effort and minimal staff time. For example one disability provider in regional NSW uses an online Learning Management System to upskill all allied health professionals and allied health assistants in their local delegation processes for their organisation.
Whichever way you choose to implement and systemise these important activities, all staff will need sufficient quarantined time to:
- undertake or participate in on-barding your new allied health assistants
- undertake or participate in supervision of allied health assistants
- undertake delegation using the systems developed
- use appropriate communication strategies and systems to ensure excellent collaboration and seamless client journeys
- undertake or participate in training programs for allied health assistants and allied health professionals in delegation
- undertake or participate in supervision programs for allied health assistants and allied health professionals in delegation
- developing training programs for allied health assistants to upskill and learn your service systems
- work towards new career pathways
- undertake or participate in professional development programs for allied health assistants
Ask yourself – How will you ensure there is sufficient time for you and your allied health professional staff to implement and then engage in these systems and structures in your workplace?
5. Consider the systems that will enable you to check, review and improve your allied health assistant model
You can only improve what you measure.
Efficiency of your allied health assistant and allied health professional workforce is paramount in a resource constrained environment. Given these roles are resource intensive to implement, it is vital your systems are highly streamlined and working effectively. This will enable high efficiency of your workforce which in turn will increase your service capacity and the quality of the care you provide to your clients.
As we have identified in this article here there is always opportunity to improve the systems you have in place to increase the efficiency and effectiveness of your workforce.
Furthermore, all healthcare, disability, aged care and private providers have the same ultimate goal; to serve their customers or clients through delivery of more and better client centred care. So finding the “sweet spot” where staff resourcing is minimised and the quality of care is maximised is a juggling act for all.
Allied health assistants have been used internationally for many years now to achieve this balance: to drive down the cost of staffing while simultaneously increasing the delivery of care. However you will only know that you are achieving this if you have the right systems in place to measure how efficient and effective your whole workforce is as a result of introducing allied health assistants into your staffing mix.
Ensuring your new allied health assistant systems (and your allied health assistant roles) are working towards resolving your workforce capacity problems and achieving the success indicators you have established is vital to the ongoing effectiveness and sustainability of this model of care.
Ask yourself – How will you enable your allied health professional staff and allied health assistants to contribute to systemising, quality checking and continually upgrading the allied health assistant systems and structures that are in place?
We have seen over many years that allied health assistant models of care can be extremely helpful in allowing services to provide more and better care to their clients. However these models can be extremely resource intensive.
To optimise allied health assistant impact, a great deal of startup and ongoing input is required. This article helps you to understand and plan out the important steps you will need to take to successfully implement an allied health assistant role into your service!
As we have explained elsewhere, there may be a number of smaller, less resource intensive solutions you can implement before you are ready to implement an AHA role. Connect with us to let us know about your workforce problems or to learn more about what you can do to improve your allied health workforce capacity.
1 – Nancarrow SA, Moran A, Sullivan R. Mechanisms for the effective implementation of an allied health assistant trainee: a qualitative study of a speech language pathology assistant. Aust Health Rev. 2015 Feb;39(1):101-108. doi: 10.1071/AH14053.
2 – Moran, A.M., Nancarrow, S.A., Wiseman, L. et al. Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach. J Foot Ankle Res 5, 30 (2012). https://doi.org/10.1186/1757-1146-5-30
3 – Nancarrow S, Moran, Wiseman, Pighills A, Murphy K. Assessing the implementation process and outcomes of newly introduced assistant roles: a qualitative study to examine the utility of the Calderdale Framework as an appraisal tool. J Multidiscip Healthc. 2012;5:307-317
4 – Nancarrow, S.A., Roots, A., Grace, S. et al. Implementing large-scale workforce change: learning from 55 pilot sites of allied health workforce redesign in Queensland, Australia. Hum Resour Health 11, 66 (2013). https://doi.org/10.1186/1478-4491-11-66