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. 2021 Jan-Dec:18:14799731211017895.
doi: 10.1177/14799731211017895.

Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

Kathleen Hall  1   2   3 , Lyndal Maxwell  1 , Robyn Cobb  2   3 , Michael Steele  1   4 , Rebecca Chambers  2   3 , Mark Roll  3 , Scott Cameron Bell  3   5   6 , Suzanne Kuys  1
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Physiotherapy service provision in a specialist adult cystic fibrosis service: A pre-post design study with the inclusion of an allied health assistant

Kathleen Hall et al. Chron Respir Dis. 2021 Jan-Dec.

Abstract

What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in an acute respiratory service? A pragmatic pre-post design study examined physiotherapy services across two 3-month periods: current service delivery [P1] and current service delivery plus AHA [P2]. Clinical and non-clinical activity quantified as number, type and duration (per day) of all staff activity categorised for skill level (AHA, junior, senior). Physiotherapy service delivery increased in P2 compared to P1 (n = 4730 vs n = 3048). Physiotherapists undertook fewer respiratory (p < 0.001) and exercise treatments (p < 0.001) but increased reviews for inpatients (p < 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p < 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient-related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%), delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities (11%). No adverse events were reported. AHA inclusion in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers sustainable options for enhancing physiotherapy service provision in acute respiratory care.

Keywords: Allied health assistants; cystic fibrosis; delivery of healthcare; physiotherapy; scope of practice; skill mix.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Perceived effectiveness of the physiotherapy care delivery in each phase of the study, rated on a five-category Likert-type scale. Mean ranks: 43 for P1 and 33 for P2, Mann-Whitney U = 508, p = 0.024.
See this image and copyright information in PMC

References

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