Facilitators and barriers to implementing task shifting: Expanding the scope of practice of clinical technologists in the Netherlands. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: de Haan, Maarten; van Eijk-Hustings, Yvonne; Bessems-Beks, Monique; Dirksen, Carmen; Vrijhoef, Hubertus J.M.
• Is Part Of: Health policy. Volume 123:Issue 11(2019)
• Page Start: 1076
• Page End: 1082
• Publication Date: 2019-11
• Subjects: Task shifting -- Professional roles -- Implementation -- Evaluation research -- Health policy; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2019.07.003
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Despite research confirming its benefits, policymakers struggle to implement task shifting. Social features should be prioritized when implementing task shifting. Implementing task shifting with an emerging new professional group creates additional social barriers. Abstract: Despite recent studies confirming task shifting is both safe and effective, its implementation has proven difficult in practice. So too in the Netherlands, where legal barriers enforcing strict professional boundaries have historically limited task shifting. In recent years, Dutch policymakers have experimented with temporary expanded scopes of practice (ESP) for several professional groups, with the aim to facilitate task shifting in order to increase the overall effectiveness and efficiency of health care. The Clinical Technologist (CT), is an emerging new professional group that has received such a temporary ESP pending an evaluation. This paper reports the qualitative findings of the implementation process of providing CTs with an temporary ESP. Data collection consisted of 69 semi-structured interviews, 3 focus group interviews and 9 participant observations, conducted between September 2015 and October 2017. Analysis was conducted through an 'editing analysis style' whereby data were categorized using the conceptual framework of Grol & Wensing's implementation model. The study suggests that social features are of great importance when implementing task shifting. In situations with few social barriers, organizational and administrative barriers seem to be less dominant, thereby expediting the overall implementation process. Consequently, we recommend that policymakers should prioritize social features over organizational features when implementing task shifting.