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Hearn C.1,2, Govier A.3,4, Semciw A.I.1,5,6
1Princess Alexandra Hospital, Physiotherapy, Brisbane, Australia, 2Australasian Allied Health Benchmarking Consortium, Brisbane, Australia, 3Central Adelaide Local Health Network, Royal Adelaide Hospital, Physiotherapy, Adelaide, Australia, 4Australasian Allied Health Benchmarking Consortium, Adelaide, Australia, 5The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, 6Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
Background: Workforce planning for professions such as physiotherapy is vital for planning the new models of care required to support the changing healthcare environment. The absence of established systems to support this workforce planning prevents accurate costing of safe and effective services. Current literature on allied health including physiotherapy workforce planning and modelling is limited, but there is support for its importance. Despite this, staffing of physiotherapy services is often based on historical allocation, Additionally there is often an assumption that 100% of an allied health professional's caseload is direct clinical care, with a lack of acknowledgement of the non-direct clinical hours essential to meet service requirements, such as hospital safety and quality standards, student training, professional development and service improvement.
One such measure is the Clinical Care Ratio (CCR), a tool that measure the time spend on direct clinical activities compared with the time spent on non-direct clinical activities expressed as a percentage of total time worked.
One such measure is the Clinical Care Ratio (CCR), a tool that measure the time spend on direct clinical activities compared with the time spent on non-direct clinical activities expressed as a percentage of total time worked.
Purpose: The project aimed to determine how much non-direct clinical time is being reported by allied health professionals. This project was undertaken by the Australasian Allied Health Benchmarking Consortium a group of 15 tertiary teaching hospitals. This study sought to:
(1) Quantify and recommend CCRs according to seniority level and role type.
(2) Assess whether CCRs are associated with seniority level and profession.
(1) Quantify and recommend CCRs according to seniority level and role type.
(2) Assess whether CCRs are associated with seniority level and profession.
Methods: Data was collected from 2036 allied health professionals from five professions (physiotherapy, occupational therapy, social work, speech pathology and dietetics) across 11 Australian tertiary hospitals. Mean (95% confidence intervals) CCRs were calculated according to profession, seniority and role type. A two- way ANOVA was performed to assess the association of CCRs (dependent variable) with seniority level and profession (independent variables). Post-hoc pairwise comparisons identified where significant main or interaction effects occurred.
Results: The two-way ANOVA identified significant main effects for seniority level (F2, 191 = 15.997; P 0.001) and profession (F4, 191 = 5.241; P = 0.001) but no interaction effect (F8, 191 = 1.145; P = 0.335; Post-hoc comparisons for the main effect of seniority level revealed significant differences between all combinations (P 0.05) with more senior staff having the lowest clinical time percentage i.e. CCR. Post-hoc comparisons for profession revealed higher CCRs for physiotherapy compared with all other professions (P 0.05), and lower CCRs for nutrition and dietetics compared with all other professions. There was no significant difference in CCRs between speech pathology, social work and occupational therapy (P > 0.05).
Conclusion(s): The direct and non-direct clinical components of the allied health professionals workload can be quantified and benchmarked with like roles and according to seniority. The benchmarked CCRs for predominantly clinical roles will enable managers to compare and evaluate like roles and modify non-direct clinical components according to seniority and discipline.
Implications: Physiotherapy workloads can be quantified, defined and benchmarked with like roles to ensure cost-effective and optimal service delivery and patient outcomes.
Funding acknowledgements: Australasian Allied Health Benchmarking Consortium
Topic: Professional issues
Ethics approval: Metro South Human Research Ethics Committee- letter received stating exemption for HREC review (Reference number: HREC/15/QPAH/215
All authors, affiliations and abstracts have been published as submitted.
