Natalie Simmance1, Talya Cortinovis2, Caitlyn Green3, Kim Lunardi1, Michelle McPhee4, Belinda Steer5, Joseph Wai6, Tracey Martin2, Judi Porter7,8. 1. Nutrition Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia. 2. Nutrition & Dietetics Department, Northern Health, Melbourne, Victoria, Australia. 3. Nutrition & Dietetics Department, Austin Health, Melbourne, Victoria, Australia. 4. Nutrition Department, Alfred Health, Melbourne, Victoria, Australia. 5. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. 6. Nutrition & Dietetics Department, Barwon Health, Geelong, Victoria, Australia. 7. Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia. 8. Department of Nutrition, Dietetics & Food, Monash University, Melbourne, Victoria, Australia.
Abstract
AIM: The number of advanced practice roles in the Australian health-care system is growing alongside contemporary health-care reforms. The present study aimed to evaluate the impact of introducing novel advanced practice dietitian roles in gastrostomy tube (g-tube) management and develop a competency framework for progressing opportunities in dietetics practice and policy. METHODS: A questionnaire was distributed to service lead dietitians at six participating health-care networks at the completion of a dedicated advanced practice funding grant, and at 12-month follow up. Service changes (e.g. number of dietitians credentialed, service and adverse events, change in patient waiting times and staff satisfaction), enablers and barriers for the implementation of the novel roles (including pre-, during, and post-implementation), and clinical costing estimates to measure the financial impact on the health system were investigated. Participant feedback was also used to synthesise the development of an advanced scope of practice pathway to competency. RESULTS: Responses were received from all participating health-care networks. Five out of six sites successfully implemented an advanced practice role in g-tube management, with conservative health system savings estimated at $185 000. Ten dietitians were credentialed, with a further seven trainees in progress. Over 200 service events were recorded, including those diverted from other health professionals. Enabling factors for successful introduction included strong executive and stakeholder support, resources provided by grant funding, and established credentialing governance committees. Barriers included recruitment and governance processes. CONCLUSIONS: Opportunities exist for further expansion of advanced and extended practice roles for dietitians to meet future health-care demands.
AIM: The number of advanced practice roles in the Australian health-care system is growing alongside contemporary health-care reforms. The present study aimed to evaluate the impact of introducing novel advanced practice dietitian roles in gastrostomy tube (g-tube) management and develop a competency framework for progressing opportunities in dietetics practice and policy. METHODS: A questionnaire was distributed to service lead dietitians at six participating health-care networks at the completion of a dedicated advanced practice funding grant, and at 12-month follow up. Service changes (e.g. number of dietitians credentialed, service and adverse events, change in patient waiting times and staff satisfaction), enablers and barriers for the implementation of the novel roles (including pre-, during, and post-implementation), and clinical costing estimates to measure the financial impact on the health system were investigated. Participant feedback was also used to synthesise the development of an advanced scope of practice pathway to competency. RESULTS: Responses were received from all participating health-care networks. Five out of six sites successfully implemented an advanced practice role in g-tube management, with conservative health system savings estimated at $185 000. Ten dietitians were credentialed, with a further seven trainees in progress. Over 200 service events were recorded, including those diverted from other health professionals. Enabling factors for successful introduction included strong executive and stakeholder support, resources provided by grant funding, and established credentialing governance committees. Barriers included recruitment and governance processes. CONCLUSIONS: Opportunities exist for further expansion of advanced and extended practice roles for dietitians to meet future health-care demands.
Authors: Catrin Evans; Brenda Poku; Ruth Pearce; Jeanette Eldridge; Paul Hendrick; Roger Knaggs; John McLuskey; Philippa Tomczak; Ruaridh Thow; Peter Harris; Joy Conway; Richard Collier Journal: BMJ Open Date: 2020-05-20 Impact factor: 2.692