Realist evaluation of allied health management in Queensland: what works, in which contexts and why.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      518210 Data Processing, Hosting, and Related Services
      813920 Professional Organizations
      624310 Vocational Rehabilitation Services
      624190 Other Individual and Family Services
    • Abstract:
      Objective: Allied health structures and leadership positions vary throughout Australia and New Zealand in their design and implementation. It is not clear which organisational factors support allied health leaders and professionals to enhance clinical outcomes. The aim of this project was to identify key organisational contexts and corresponding mechanisms that influenced effective outcomes for allied health professionals. Methods: A qualitative realist evaluation was chosen to describe key aspects of allied health organisational structures, identify positive outcomes and describe how context and processes are operationalised to influence outcomes for the allied health workforce and the populations they serve. Results: A purposive sample of nine allied health leaders, five executives and 49 allied health professionals were interviewed individually and in focus groups, representing nine Queensland Health services. Marked differences exist in the title and focus of senior allied health leaders' roles. The use of a qualitative realist evaluation methodology enabled identification of the mechanisms that work to achieve effective and efficient outcomes, within specific contexts. Conclusions: The initial middle range theory of allied health organisational structures in Queensland was supported and extended to better understand which contexts were important and which key mechanisms were activated to achieve effective outcomes. Executive allied health leadership roles enable allied health leaders to use their influence in organisational planning and decision-making to ensure allied health professionals deliver successful patient care services. Professional governance systems embed the management and support of the clinical workforce most efficiently within professional disciplines. With consistent data management systems, allied health professional staff can be integrated within clinical teams that provide high-quality care. Interprofessional learning opportunities can enhance collaborative teamwork and, when allied health professionals are supported to understand and use research, they can deliver positive patient and business outcomes for the health service. What is known about the topic?: A collective allied health organisational structure encourages engagement of allied health professionals within healthcare organisations. Organisational structures commonly include management and leadership strategies and service delivery models. Allied health leaders in Queensland work across a range of senior management levels to ensure adequate resources for sufficient suitably skilled professional staff to meet patient needs. What does this paper add?: Literature to date has described how allied health professionals operate within organisational structures. This paper examines key aspects of allied health management, governance and leadership, together with mechanisms that support allied health professionals to deliver effective clinical and business outcomes for their local community. What are the implications for practitioners?: Health service executives and allied health leaders should consider supporting executive allied health leadership roles to influence strategic planning and decision-making, as well as to deliver outcomes that are important to the health service. When allied health leaders implement integrated professional and operational governance systems, executives described allied health professionals as influential in supporting team-based models of care that add value to the business and improve outcomes for patients. When allied health leaders use consistent data management, executives reinforced the benefit of aligning activity data with financial costs to monitor, recognise and reimburse appropriate clinical interventions for patients. When allied health leaders support allied health workforce capability through educational and research opportunities, clinicians can use research to inform their clinical practice. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Australian Health Review is the property of CSIRO Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Gold Coast Health, 1 Hospital Boulevard, Southport, Qld 4215, Australia.
      2Griffith Health, Gold Coast Campus, Parklands Drive, Southport, Qld 4222, Australia.
      3Allied Health Professions Office of Queensland, Department of Health, Queensland Government, 15 Butterfield Street, Herston, Qld 4006, Australia.
    • ISSN:
      0156-5788
    • Accession Number:
      10.1071/AH17265
    • Accession Number:
      137857787
  • Citations
    • ABNT:
      MICKAN, S.; DAWBER, J.; HULCOMBE, J. Realist evaluation of allied health management in Queensland: what works, in which contexts and why. Australian Health Review, [s. l.], v. 43, n. 4, p. 466–473, 2019. Disponível em: . Acesso em: 18 out. 2019.
    • AMA:
      Mickan S, Dawber J, Hulcombe J. Realist evaluation of allied health management in Queensland: what works, in which contexts and why. Australian Health Review. 2019;43(4):466-473. doi:10.1071/AH17265.
    • APA:
      Mickan, S., Dawber, J., & Hulcombe, J. (2019). Realist evaluation of allied health management in Queensland: what works, in which contexts and why. Australian Health Review, 43(4), 466–473. https://doi.org/10.1071/AH17265
    • Chicago/Turabian: Author-Date:
      Mickan, Sharon, Jessica Dawber, and Julie Hulcombe. 2019. “Realist Evaluation of Allied Health Management in Queensland: What Works, in Which Contexts and Why.” Australian Health Review 43 (4): 466–73. doi:10.1071/AH17265.
    • Harvard:
      Mickan, S., Dawber, J. and Hulcombe, J. (2019) ‘Realist evaluation of allied health management in Queensland: what works, in which contexts and why’, Australian Health Review, 43(4), pp. 466–473. doi: 10.1071/AH17265.
    • Harvard: Australian:
      Mickan, S, Dawber, J & Hulcombe, J 2019, ‘Realist evaluation of allied health management in Queensland: what works, in which contexts and why’, Australian Health Review, vol. 43, no. 4, pp. 466–473, viewed 18 October 2019, .
    • MLA:
      Mickan, Sharon, et al. “Realist Evaluation of Allied Health Management in Queensland: What Works, in Which Contexts and Why.” Australian Health Review, vol. 43, no. 4, July 2019, pp. 466–473. EBSCOhost, doi:10.1071/AH17265.
    • Chicago/Turabian: Humanities:
      Mickan, Sharon, Jessica Dawber, and Julie Hulcombe. “Realist Evaluation of Allied Health Management in Queensland: What Works, in Which Contexts and Why.” Australian Health Review 43, no. 4 (July 2019): 466–73. doi:10.1071/AH17265.
    • Vancouver/ICMJE:
      Mickan S, Dawber J, Hulcombe J. Realist evaluation of allied health management in Queensland: what works, in which contexts and why. Australian Health Review [Internet]. 2019 Jul [cited 2019 Oct 18];43(4):466–73. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=137857787&custid=s8280428