Process to establish 11 primary contact allied health pathways in a public health service

Abstract

Objective: Faced with longstanding and increasing demand for specialist out-patient appointments that was unable to be met through usual medical consultant led care, Metro North Hospital and Health Service in 2014–15 established 11 allied health primary contact out-patient models of care.

Methods: The models involved six different allied health professions and nine specialist out-patient departments.

Results: All the allied health models have been endorsed for continuation following demonstration of their contribution to managing demand on specialist out-patient services.

Conclusion: This paper describes key features of the allied health primary contact models of care and presents preliminary data including new case throughput, effect on wait times and enablers and challenges for clinic establishment.

What is known about the topic? Allied health clinics have been demonstrated to result in high patient, referrer and consultant satisfaction, and are a cost-effective management strategy for wait list demand. In Queensland, physiotherapy-led orthopaedic clinics have been operating since 2005.

What does this paper add? This paper describes the establishment of 11 allied health primary contact models of care in speciality out-patient areas including Ear, Nose and Throat, Gynaecology, Urology, Neurology, Neurosurgery, Orthopaedics and Plastic Surgery, and involving speech pathologists, audiologists, physiotherapists, occupational therapists and podiatrists as primary contact practitioners. Observations of enablers for and challenges to implementation are presented as key lessons.

What are the implications for practitioners? The new allied health primary contact models of care described in this paper should be considered by health service executives, allied health leaders and specialist out-patient departments as one strategy to address unacceptably long specialist wait lists.