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How To Optimise The Impact Of Allied Health Assistants In Your Workforce

If you have allied health assistants in your organisation, do you know exactly what they are trying to achieve? How do know whether or not you are using your your allied health assistant workforce effectively and efficiently to address the needs of your service users and to have the greatest impact?

Impact indicators provide a way to monitor and continually improve the care we provide to the individuals and communities we serve. But many of us don’t know how to determine them. This article describes the importance of clearly identifying the problems you are trying to address with your allied health assistant workforce so you can identify meaningful ways to measure their impact.

Making the most of allied health resources to meet demand

All businesses, not-for-profit organisations and public sector services that employ allied health professionals have one thing in common: they need to make the most of their staffing resources.

Organisations that receive a fixed amount of funding to deliver services, such as public health settings, often have limited flexibility to expand staffing to meet growing demand. These organisations often need to be creative with their available funding and staffing to ensure that they optimise the volume and quality of services with their finite resources.

Conversely, in a fee-for-service funding model, particularly in a for-profit environment, there is greater flexibility to increase staffing resources in response to growing service demand. However, resources need to be monitored to ensure costs to the business are minimised and revenue generated by staff is optimised.

Both models have the same ultimate goal, to serve their clients through delivery of more and better client centred care. So, finding the “sweet spot” where staffing resources are optimised and the amount and quality of care is maximised is a juggling act for all.

In the current workforce climate where we are seeing levels of demand for allied health professionals and services outstrip supply, the need to do more with less is very real for all.

Allied health assistants have been used internationally for many years now to address this issue: to optimise staffing resources to maximise access to care. However, the input required to develop and support allied health assistant roles can actually make these models of care expensive to use. So if you use allied health assistants then it is a good idea to determine how you are going to ensure your workforce is as effective as it can be.

We have written about how to maximise the efficiency of your allied health assistant workforce here, but the question remains: what should you measure so you know what you need to improve?!

1. What is the problem you are trying to solve?

The first and most important step in understanding what you need to measure to determine the impact of allied health assistants in your workplace, is to clearly identify the problem you are trying to address through using them. Even if you have had them on your team for a while.

At AHP Workforce we coach our clients to look at the problems they are trying to address using the I-O-G framework, which explores the following perspectives:

  • Individual perspective: problems from a client or staff perspective (Individual perspective);
  • Organisational perspective; and
  • Global perspective: problems from the broader community’s perspective

You can read more about the I-O-G framework here. We recommend working through our PEASI framework to clearly identify the problem you are trying to solve before introducing an allied health assistant workforce.

If you are already using allied health assistants, the best way to retrospectively identify the problems you have been trying to solve is to first examine exactly what we know allied health assistants are highly effective at helping us to do!

2. Where is the impact of allied health assistants greatest?

We undertook a study a while ago now, that to date is the largest ever study that has examined the impact of different types of allied health workforce configurations on client outcomes. I was particularly fortunate to do my PhD as part of this enormous programme of research. My PhD specifically focussed on the impact of allied health assistant models of care on client, staff and service outcomes.

In a nut shell, we gathered baseline and follow up data on over 2000 clients from across 20 multidisciplinary health and social care teams in the UK. We also gathered staff, team and organisational level outcomes data over the same time period.

Here’s what we found for individual clients, staff and organisations.

In multidisciplinary teams that employed allied health assistants, factors associated with improved client outcomes included:

  • Greater time spent with an assistant;
  • Greater proportion of input provided by an assistant; and
  • The type of care delivered by an assistant.

That is, teams that had a higher proportion of assistant staff who delivered a greater proportion of face to face care, saw greater improvements in the outcomes of care. We also found that these improvements were brought about by the type of care and support assistants delivered – namely repetitive rehabilitation that was matched to the needs of the client, enablement, friendship, emotional support, social support, motivation and advocacy.

At a staff level, we (and others) found that AHAs are effective at freeing up AH professional staff time to enable:

  • AH professionals to work to full or expanded scope of practice
  • AH professionals to see more clients
  • AH professionals to better focus their skills on assessment or therapy for more complex clients
  • AH professionals to pursue research or quality improvement activities.

And that these activities in turn improved AH professional satisfaction and retention.

Finally, at an organisational level, we found that allied health assistants, in combination with allied health professionals were effective at enabling:

  • Greater client throughput
  • Reduced waiting times for therapy
  • Advanced career opportunities for allied health staff
  • Greater continuity of care

And that these activities in turn improved organisational capacity to better meet the needs of their community.

So, now that you know exactly what allied health assistants are demonstrably good at doing, you can now identify the kinds of problems you know allied health assistants will be able to effectively address.

3. What problems are you trying to address from your client’s perspective and what are the impact indicators?

This step might look something like this:

Problem Solution Best possible outcome Impact Indicator
Our clients can’t undertake their therapy independently. They need someone who can help them undertake the therapy their allied health professional prescribed so they can achieve their goals. AHA More clients with low level needs are supported to complete their therapy program / achieve their goals. Number of clients completing therapy program / achieving their goals
Our clients would like to be able to live independently at home but need someone who can help them do things around their house. AHA More clients are supported to live independently at home. Number of clients supported to live independently at home
Our clients would like to get back to getting out and about in the community but have lost their confidence. AHA More clients are confidently participating in the community. Number of clients are supported to participate in their community

4. What problems you are trying to address from your staff’s perspective and what are the impact indicators?

This step might look something like this:

Problem Solution Best possible outcome Impact Indicator
Our staff rarely use their full scope of practice for their clients AHA More staff working to full scope of practice. Number of staff working to full scope of practice.
Our staff have so many clients to see that they can’t see their clients as many times as they need for them to obtain their goals AHA Staff are able to ensure client goals are achieved. Number of clients who achieve their goals.
Our staff don’t ever have time to participate in quality improvement activities in our service/organisation because they are always seeing clients AHA More staff are able to participate in quality improvement activities. Number of staff who have participated in quality improvement activities

5. What problems you are trying to address from your organisation’s perspective, and what are the impact indicators?

This step might look something like this:

Problem Solution Best possible outcome Impact Indicator
We have a large waiting list for our service AHA The waiting list is reduced. Number of clients on waiting list is reduced.
We have very little capacity in our service to see our clients as frequently as they need AHA There is capacity within the service to see clients as frequently as they require. Number of clients who are able to be seen as frequently as their care plan identifies they require care.
We have very little capacity in our service for quality improvement activities AHA We are able to undertake quality improvement activities when we need to. Number of quality improvement activities undertaken increases.
Lack of bed space is a problem in our health service. Many of our clients could leave hospital early or be prevented from coming in to hospital but there is no support for them and our service hasn’t got sufficient staffing capacity to offer this level of input. AHA Improved throughput of clients through the health service. More clients supported to return home early. Number of clients supported to return home early increases.
Our business/service/organisation cannot grow while demand exceeds our capacity to supply services AHA Our business / organisation can grow and meets demand. Number of appointments / bookings for services increases.

Conclusion

The first step in being able to measure the impact of allied health assistants in your workforce is to understand the problems you want them to address. Once you have clearly identified the problems your allied health assistants are trying to address, you can identify the indicators that demonstrate when and to what extent they have addressed the problem.

We always recommend starting with individual level problems before you move onto staff or organisational problems. Individual level problems are usually the easiest to address. See if this helps you to reframe your workforce impact indicators. We would love to hear from you about the kinds of indicators you use in your organisation! Head on over to our facebook page to leave us a comment.