To investigate how frontline staff and managers have experienced task-shifting between physiotherapists, occupational therapists, and nurses at Aarhus University Hospital, including identifying barriers and facilitators for meaningful task transferTo investigate how frontline staff and managers have experienced task-shifting between physiotherapists, occupational therapists, and nurses at Aarhus University Hospital, including identifying barriers and facilitators for meaningful task-shifting.
The study is designed based on a mixed-method sequential exploratory design. Qualitative data were collected through participant observations, two focus group interviews with front line workers and head therapists and individual interviews with head nurses. Quantitative data were collected via questionnaires in six different hospital wards.
Based on an integrated analysis of the both qualitative and quantitative data, four main themes emerged with several sub-themes: "Lack of Common Ground," "Them and Us – A and B Roles," "Hope and Fear," and "Implementation between Vision and Practice." In all four themes, organizational, managerial, communicative, and professional factors could have both positive and negative impacts.
Although the majority of participants found task-shifting entailed benefits, such as an increased focus on patient activity levels and relief of the burden of tasks in the nurses, around 20% believed that the task-shifting from nurses to therapists could increase the risk of adverse events in patient treatment.
The most significant factors contributing to successful implementation were clear and consistent communication about the new task model, both at a meta-level and in day-to-day collaboration, clarity around expectations, roles, and frameworks, thorough introduction and training, and strong leadership cooperation.
The study showed that, when the right conditions are in place, task shifting from nurses to physiotherapists can add value by increasing patient activity levels, improving the quality of patient-centered tasks, and reducing the burden of shifts on nurses.
The study points to a number of important factors that both organizations, leaders, and frontline employees must keep in mind, when implementing new models of care including task-shifting, if the core competencies of physiotherapists are to create value in future health care systems. A presentation of the findings at WCPT will include 10 specific recommendations for implementation of task-shifting models of care.
Mixed methods design
Hospital setting
