One of the most common concerns that allied health professionals raise about employing allied health assistants is a lack of clarity around who is responsible if things go wrong. In an increasingly risk averse and litigious society, this is understandable. As a result, however, many allied health professionals (and other health professionals) choose not to delegate work that could or should be done by others workers. At a time of enormous workforce shortages, the failure to fully and efficiently delegate care can result in longer patient waiting times and reduced overall access to health services.
The purpose of this article is to help to clarify the responsibilities of different workers in a delegated model of care. This is intended to be a guide only and should not be taken as legal advice. Every employer, profession and state is likely to have their own policies and employment law that will ultimately dictate the way that specific responsibilities are addressed, however there are some common principles that are likely to apply across most jurisdictions.
Every worker in Australia works within a range of legal frameworks. These include your contract of employment, your employment Award or Agreement, and your employer’s policies. It also includes a raft of legislation covering equal opportunity, discrimination, occupational health and safety, privacy and so on.
Allied health assistants (and most other support workers and care staff and several allied health profession groups) are not regulated by the Australian Health Practitioner Regulation Agency. If those workers are a member of a professional association, such as the Allied Health Assistant National Association, then they will have agreed to adhere to a professional Code of Conduct. The respective professional associations can take disciplinary action for breeches of the professional Code of Conduct.
Duty of care and negligence
If you are an allied health assistant and you are asked to do something that you do not feel safe doing, or you may consider to be dangerous or inappropriate, you should apply the ‘lawful and reasonable’ test. You do not have to comply with any employer instruction which is either unlawful or unreasonable.
Suppose an allied health assistant is responsible for assisting a physiotherapist in providing therapy to a patient with a spinal cord injury. During one of the therapy sessions, the AHA fails to properly secure the patient’s wheelchair, causing the patient to fall and sustain further injury. This would be considered a breach of duty of care, as the AHA had a responsibility to ensure the patient’s safety and failed to do so, resulting in harm to the patient.
If an allied health assistant is accused of a breach of duty of care, the burden of proof falls on the person making the claim to show that the assistant was negligent in their duties, and that this negligence caused harm or injury to the patient.
To prove that an allied health assistant breached their duty of care, the following elements would need to be established:
In a delegated workforce model, where different individuals or teams are responsible for different aspects of care, the ultimate responsibility for the outcomes of care lies with the healthcare organization or entity that oversees the model. This organization or entity is responsible for ensuring that appropriate training, resources, and oversight are provided to those individuals or teams who are delegated to provide care.
Individuals or teams who are delegated to provide care also have a responsibility to follow established protocols, guidelines, and procedures, and to communicate effectively with other members of the care team. However, their actions and decisions are ultimately overseen and accountable to the healthcare organization or entity that oversees the delegated workforce model.
If I delegate to someone else, am I responsible for the outcomes?
Yes, as a healthcare professional, if you delegate care to someone else, you are still ultimately responsible for the outcomes of that care. While you may not be directly providing the care, you have a responsibility to ensure that the person to whom you have delegated the care is appropriately trained and qualified to perform the task, and that they are following established protocols and guidelines.
You also have a responsibility to provide adequate supervision and oversight, and to intervene or take action if necessary to ensure that the care is being provided safely and effectively. Ultimately, as the healthcare professional who delegated the care, you are accountable for the outcomes and any adverse events that may occur.
It is important to note that delegating care is a complex process that requires careful consideration of various factors, including the competence of the person to whom care is being delegated, the complexity of the task, and the potential risks and benefits of delegation. It is important to follow established guidelines and protocols for delegation and to document the process and outcomes of delegated care.
If I delegate care to someone and they make a mistake, will I be held accountable?
As the healthcare professional who delegated care to someone else, you may still be held accountable if they make a mistake. This is because you have a responsibility to ensure that the person to whom you have delegated the care is appropriately trained and qualified to perform the task, and that they are following established protocols and guidelines.
However, the extent to which you will be held accountable will depend on the specific circumstances of the mistake, the actions you took to prevent it, and your overall role in the care of the patient. If it is determined that you failed to provide appropriate training, supervision, or oversight, or that you were aware of the risks associated with delegating the task and did not take appropriate action to mitigate those risks, you may be held accountable.
It is important to note that holding someone accountable does not necessarily mean that they will be punished or face disciplinary action. In some cases, accountability may involve taking corrective action, such as providing additional training or changing established protocols to prevent similar mistakes from occurring in the future.
To minimise the risk of being held accountable for mistakes made by someone else to whom you have delegated care, it is important to carefully consider the qualifications and competence of the person, provide adequate training and supervision, and document the process and outcomes of delegated care.
Some broad principles
Principles of safe delegation for allied health assistants
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