Mary Anne Silvers Achilles

1. The Health Roundtable New Zealand Development and Implementation of an Advanced Allied Health Assistant role in Acute Care (Occupational Therapy and Physiotherapy) Mary Anne Silvers Achilles Emma West, Manager Physiotherapy (03 95942257) emma.west@southernhealth.org.au

2. KEY PROBLEMS • Current PT and OT staff shortages and workload pressures • Activity of the AHA in the acute medical care unit was limited • Limited integration of PT and OT patient management by the AHA • AHA job satisfaction

3. INNOVATIONS IMPLEMENTED The additional tasks the Advanced AHA was trained to undertake included: • Perform an intervention prescribed by PT or OT • Progress as appropriate the intervention within and between sessions • Review performance of functional tasks • Attend unit meetings and report patient performance • Provide & educate patient prescribed OT equipment • Progress gait aid where appropriate (non complicated cases) • Organise patient hiring or purchase of equipment • Assist in education of OT prescribed equipment

4. RESULTS • No decline in functional outcome when comparing patients who received advanced AHA involvement with the group that received regular AHA input • Increase in the percentage of independent treatment OOS for patients seen individually by the advanced AHA • Advanced AHA role was very satisfying for the physiotherapist, OT, AHA and nurse unit manager

5. HOW WE DID IT • DHS funded pilot project • Project duration: 12 months • AHA recruitment (higher duty allowance of 10% in recognition of additional tasks for the life of the project) • Role development workshops undertaken to map current patient journey, identify opportunities for role change and develop competencies required for the amended role • Position description developed • Training needs identified • External training available was matched to competencies required for the amended role (In house training identified)

6. HOW WE DID IT cont. • Competencies chosen: • BSBMED303A - Maintain patient records • HLTAHAA - Deliver and monitor a client-specific lower limb exercise program • HLTAH1A - Assist with the provision of an Allied Health therapy program • HLTAP1 - Recognise healthy body systems in a health care context • Training package for role jointly developed by Chisholm Institute and SH (Competency assessment completed for 5 subjects) • Clinical training (functional activities for daily living retraining, balance exercises, gait training, knowledge of OT and PT aids and equipment)was provided in house by OT and PT • Training provided over a 4 week period • Competency assessment took place after the training period

7. LESSONS LEARNT • Limited external training available to meet identified healthcare needs • No validated functional outcome measures in the acute setting • Change in ward patient population and small patient numbers over the duration of the project made it difficult to draw firm conclusions regarding the impact of the role on clinicians time, patients functional outcome and LOS • AHA structure to support advanced AHA role