Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.

Objective Delegation and skill sharing are emerging service strategies for allied health (AH) professionals working in Queensland regional cancer care services. The aim of the present study was to describe the consistency between two services for the types and frequency of tasks provided and the agreement between teams in the decision to delegate or skill share clinical tasks, thereby determining the potential applicability to other services. Methods Datasets provided by two similar services were collated. Descriptive statistical analyses were used to assess the extent of agreement. Results In all, 214 tasks were identified as being undertaken by the services (92% agreement). Across the services, 70 tasks were identified as high frequency (equal to or more frequently than weekly) and 29 as not high frequency (46% agreement). Of the 68 tasks that were risk assessed, agreement was 66% for delegation and 60% for skill sharing, with high-frequency and intervention tasks more likely to be delegated. Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate. What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to which decisions about task safety and appropriateness for delegation or skill sharing can be generalised across services has not been investigated. What does this paper add? This study investigated the level of clinical task consistency between two similar AH cancer care teams in regional centres. It also examined the level of agreement with regard to delegation and skill sharing to provide an indication of the level of local service influence on workforce and service model decisions. What are the implications for practitioners? Local factors have a modest influence on delegation and skill sharing decisions of AH teams. Practitioners need to be actively engaged in decision making at the local level to ensure the clinical service model meets local needs. However, teams should also capitalise on commonalities between settings to limit duplication of training and resource development through collaborative networks.

Workforce profile for allied health professions in Queensland Public Health cancer care services with linear accelerators.

PURPOSE: This article profiles staffing levels for all allied health professionals in Queensland Public Health cancer care services to determine whether linear accelerator hours per clinical day are a potentially useful predictor of workforce requirements. Currently, radiation therapists and radiation oncology medical physicists have developed professional guidelines for calculating staffing full-time equivalents (FTEs) related to linear accelerator hours per clinical day. METHODS: Queensland Public Health service managers were surveyed using a self-reported standardized data collection tool, requesting the FTE allied health staff provided for a number of services, including cancer care. Linear accelerator hours per clinical day were also collected. A linear regression model was employed to determine the relationship with the allied health workforce FTEs at linear accelerator sites. RESULTS: High correlations existed between linear accelerator hours per clinical day and radiation therapists (0.99), radiation oncology medical physicists (0.95), pharmacy services (pharmacists and assistants combined; 0.91), and rehabilitation allied health staff (> 0.95). A linear regression model was employed to determine the allied health pharmacy service and rehabilitation workforce FTEs. CONCLUSION: In the four Queensland Public Health cancer care services with linear accelerators, radiation therapists, radiation oncology medical physicists, pharmacy services, and rehabilitation allied health staff, cancer care staff are highly correlated with linear accelerator hours per clinical day. The findings support identifying and establishing alternative denominators for allied health workforce requirements in cancer care beyond those of expert knowledge, opinion, and consensus.