Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach

Article


Moran, Anna M., Nancarrow, Susan A., Wiseman, Leah, Maher, Kerryn, Boyce, Rosalie A., Borthwick, Alan M. and Murphy, Karen. 2012. "Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach." Journal of Foot and Ankle Research. 5, p. Article 30. https://doi.org/10.1186/1757-1146-5-30
Article Title

Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach

ERA Journal ID40107
Article CategoryArticle
AuthorsMoran, Anna M., Nancarrow, Susan A., Wiseman, Leah, Maher, Kerryn, Boyce, Rosalie A., Borthwick, Alan M. and Murphy, Karen
Journal TitleJournal of Foot and Ankle Research
Journal Citation5, p. Article 30
Number of Pages23
Year2012
Place of PublicationLondon, United Kingdom
ISSN1757-1146
Digital Object Identifier (DOI)https://doi.org/10.1186/1757-1146-5-30
Web Address (URL)http://www,jfootankleres.com/content/5/1/30
Abstract

Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographical areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate.

Method
A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach.

Results
Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing the Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted con communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly met the needs of the practitioners with whom they worked. However, the resource intensiveness of the traineeship model was acknowledged by most who participated in the programme.

Conclusions
This research has demonstrated that the implementation of a PA using a traineeship approach requires good coordination and communication with a number of agencies and staff and substantial resources to support training and supervision. There are added benefits of the new role to the podiatry service in terms of regaining control over podiatric services which was perceived to improve clinical governance and patient pathways.

Keywordstraineeships; foot care; podiatry services;
ANZSRC Field of Research 2020420305. Health and community services
Byline AffiliationsCharles Sturt University
Southern Cross University
Department of Health, Australian Capital Territory
Centre for Rural and Remote Area Health
University of Southampton, United Kingdom
Institution of OriginUniversity of Southern Queensland
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