Building allied health workforce capacity: a strategic approach to workforce innovation

Objective The aim of the present study was to identify areas where allied health assistants (AHAs) are not working to their full scope of practice in order to improve the effectiveness of the allied health workforce.

Methods Qualitative data collected via focus groups identified suitable AHA tasks and a quantitative survey with allied health professionals (AHPs) measured the magnitude of work the current AHP workforce spends undertaking these tasks.

Results Quantification survey results indicate that Victoria’s AHP workforce spends up to 17% of time undertaking tasks that could be delegated to an AHA who has relevant training and adequate supervision. Over half this time is spent on clinical tasks.

Conclusions The skills of AHAs are not being optimally utilised. Significant opportunity exists to reform the current allied health workforce. Such reform should result in increased capacity of the workforce to meet future demands.

What is known about the topic? Increasing skill shortages across Australia’s health workforce necessitates that the capabilities of all healthcare team members should be used optimally. AHA roles are an important and growing response to current health workforce needs. Increasing workforce capacity will ensure the right health workers are matched to the right task by skill, experience and expertise.

What does this paper add? This paper presents a model that assists services to identify tasks suitable for delegation to an AHA by an AHP. The model is unique because it describes a process that quantifies the need for AHAs and it has been successfully implemented in rural, regional and metropolitan health services in Victoria.

What are the implications for practitioners? Working collaboratively, with executive support, will lead to a sustainable and integrated approach to support workforce capacity building. Altering the skill mix of healthcare teams through increasing the role of AHAs has benefits for AHPs, patients and the healthcare system.

Relationship between workplace reform and workforce participation

This thesis sought to advance understanding of the politics of workplace reform, explaining the respective roles of management and employees and how they relate. The literature on workplace reform usually argues that reform is predicated on greater workforce participation in managerial decisions. More specifically, different approaches to workplace reform can be aligned to different forms of participation. Thus quality management can be associated with direct forms of participation, institutional workplace reform may depend on representative forms, and best practice may require a combination of both. This thesis uses empirical evidence to explore this alignment between the different approaches to workplace reform and forms of participation. The period chosen for empirical study is approximately 1985-1992 - an era of rapid innovation in workplace reform for Australian manufacturing. Three workplaces were chosen for intensive study from automotive component manufacturers because that industry was itself a laboratory for workplace reform and also because these firms exemplified different approaches to competitiveness and reform. Three approaches to workplace reform - quality management, institutional workplace reform, and best practice - were distinguished to capture the range of Australian practice at that time. Similarly two approaches to workplace participation were distinguished - direct and representative - to reflect the range of observable practices at that time and to represent competing philosophies. Direct participation illustrated an approach founded in managerial context of the political status quo, whilst representative forms were considered to permit a pluralist shift of power to enable employees to manage in place of management. The three case studies depict companies sharing the competitive crisis of their industry. From this stems the impetus for workplace reform. At this point the firms diverged in their choice of competitive strategies for workplace reform. The case studies reveal, at the superficial level, a match between the chosen approaches to workplace reform and forms of participation. Basically, quality management is associated with direct employee participation, institutional workplace reform with collective bargaining and representative consultative committees, and best practice with both. However when the implementation of reform and participation are examined this match becomes less significant. One firm, Auto Air, achieved highly effective outcomes in both reform and participation. Another firm, Auto Electrical, failed in both. The thesis concluded that the relationship between forms of participation and reform is less significant than the effective implementation of policy. Unitarist or pluralist approaches to power distribution count less than managerial capacity to integrate successive reform initiatives and their commitment to workforce participation hi change.