Tools to assist in the implementation of Extended/Advanced Allied Health Roles
This starter pack has been developed by ACT Health and The International Centre for Allied Health Evidence (iCAHE) as a means of sharing our learnings in introducing extended scope allied health roles. This partnership has been in place since 2007 and this online resource represents the culmination of our journey into extended scope practice. The underpinning principles of this work are evidence-based practice, change management principles, policy work, human resource principles, training, education, legislative/legal principles, research and evaluation. The intention of this resource is to act as a guide to healthcare providers and managers considering introducing allied health extended scope practice roles. Whilst the starter packs (available in the physiotherapy chapter) are based on our experiences in extended scope physiotherapy roles, the majority of this work is relevant across disciplines and in multiple clinical settings.
Use of these documents will not result in an allied health worker being able to work outside their legislative scope of practice; this is intended to guide the processes around the introduction of a new role. The information on this website has been provided in good faith; users should cite ACT Health ownership and where appropriate the ISBN. We welcome users to reproduce the content of this website for their own purpose.
The resource is divided into chapters, with an explanatory paragraph of the content of the chapter.
Clinical Nutrition/Dietetics - Pending
Radiation Therapy - Pending
Advanced Allied Health Assistants - Pending
The following projects are initiative from the ACT Allied Health Advisors Office.
The Office of the Allied Health Advisor (ACT Health) delivers a range of services, information, advice and implementation of initiatives on a broad range of allied health issues. The Office supports and provides leadership for allied health workforce innovation and reform, capacity building, policy and regulation as well as education and research initiatives that build and contribute to the evidence base for workforce reform.
Orthoptics - Pending
Dedicated Clinical Educators Model - Pending
The ACT Health extended scope physiotherapy project commenced in 2007 with extensive planning work in collaboration with iCAHE. Implementation of Australia’s first extended scope physiotherapy roles started in orthopaedic outpatients in November 2010 and the emergency department (ED) in October 2011. In July 2012 the ACT Health was appointed as a lead organisation for the Health Workforce Australia (HWA) expanded scope practice physiotherapy in ED, supporting 3 implementation sites. Further information relating to the HWA project is available at the HWA website
The collaboration with iCAHE has continued throughout the life of the project and the extensive learnings from this project are available via the six following links:
1. Preparatory Documentation
2. Module 1 – Workforce Redesign
3. Module 2 – Implementation and Barrier Analysis
4. Module 3 – Education, Training and Credentialing
5. Module 4 – Research and Evaluation
6. Module 5 – Data collection examples
This section provides documentation that a health service workforce redesign team should consider when first embarking on extended scope practice, including the initial scoping work undertaken by the ACT Health project team in collaboration with iCAHE. There is an extensive checklist of preparatory thinking and planning, and documentation to assist with the early consideration of the appropriate remuneration and work level standard.
Starter Pack Module 1 - Workforce Redesign
This section explores the concepts of skills escalation, the principles of workforce redesign and provides recruitment documentation. Of practical assistance this module includes two group activities; the first is aimed to assist with role redesign, to be used with key stakeholders in the planning phase of a workforce redesign project, the second provides assistance with exploration of issues that may be encountered at a local level.
Starter Pack module 1 - Workforce Redesign (pdf 2Mb)
Starter Pack Module 2 - Implementation and Barrier Analysis
This module provides advice on the pre-planning required in order to minimise potential complications, this is undertaken using barrier analysis principles. This module includes numerous documents that will provide practical assistance in the introduction of an extended scope physiotherapy role, such as guidelines, procedures and protocols.
Starter Pack module 2 - Implementation and Barrier Analysis (pdf 5Mb)
Starter Pack Module 3 - Education, Training and Credentialing
This module provides information relating to the national and international research regarding the education, training and credentialing requirements for extended scope physiotherapy roles. It provides practical solutions in the form of clinical skills log-books, suggested programs of education and supervision guidelines.
Starter Pack module 3 - Education, Training and Credentialing (pdf 2Mb)
Starter Pack Module 4 - Research and Evaluation
This module provides extensive information regarding evaluation principles and strategies as they apply to the allied health workforce and workforce redesign concepts. Also included are risk management strategies and matters relating to the provision of high quality care, including the Institute of Medicine model (how it applies to allied health) and clinical leadership.
Starter Pack module 4 - Research and Evaluation (pdf 5Mb)
Starter Pack Module 5 - Data collection examples
This module provides practical examples of data collection that may assist with the introduction of an extended scope physiotherapy role.
Starter Pack module 5 - Data collection examples (pdf 5Mb)
Advanced Allied Health Assistants
A recent systematic review of the current literature of the effectiveness and implementation of advanced allied health assistant roles has been published in the open access Dove Press Journal of Multidisciplinary Healthcare.
Stanhope J, Pearce C (2013) Role, implementation, and effectiveness of advanced allied health assistants: a systematic review. Journal of Multidisciplinary Healthcare, 2013:6; 423 – 434. DOI: http://dx.doi.org/10.2147/JMDH.S50185
Background: The purpose of this systematic review was to determine the effectiveness and implementation of advanced allied health assistant roles.
Methods: A systematic search of seven databases and Google Scholar was conducted to identify studies published in English peer-reviewed journals from 2003 to 2013 and reporting on the effectiveness and implementation of advanced allied health assistant (A/AHA) roles. Reference lists were also screened to identify additional studies, and the authors’ personal collections of studies were searched. Studies were allocated to the National Health and Medical Research Council hierarchy of evidence, and appraisal of higher-level studies (III-1 and above) conducted using the Centre for Evidence Based Medicine Systematic Review Critical Appraisal Sheet for included systematic reviews or the PEDro scale for level II and III-1 studies. Data regarding country, A/AHA title, disciplines, competencies, tasks, level of autonomy, clients, training, and issues regarding the implementation of these roles were extracted, as were outcomes used and key findings for studies investigating their effectiveness.
Results: Fifty-three studies were included, and most because they reported background information rather than investigating A/AHA roles, this representing low-level information. A/AHAs work in a range of disciplines, with a variety of client groups, and in a number of different settings. Little was reported regarding the training available for A/AHAs. Four studies investigated the effectiveness of these roles, finding that they were generally well accepted by clients, and provided more therapy time. Issues in integrating these new roles into existing health systems were also reported.
Conclusion: A/AHA roles are being implemented in a range of settings, and appear to be effective in terms of process measures and stakeholder perceptions. Few studies have investigated these roles, indicating a need for research to be conducted in this area to enable policy-makers to consider the value of these positions and how they can best be utilized.
Keywords: allied health, assistant, advanced, systematic review, effectiveness, role
The text of this paper can be found at Dove Press, here.
Or download the PDF (323KB)
The appendices for this paper can be accessed here.
Dedicated Clinical Educators Model