Aim: To explore the main facilitators and barriers to task reallocation.
Background: One of the innovative approaches to dealing with the anticipated shortage of physicians is to reallocate tasks from the professional domain of medicine to the nursing domain. Various (cost-)effectiveness studies demonstrate that nurse practitioners can deliver as high quality care as physicians and can achieve as good outcomes. However, these studies do not examine what factors may facilitate or hinder such task reallocation.
Method: A systematic literature review of PubMed and Web of Knowledge supplemented with a snowball research method. The principles of thematic analysis were followed.
Results: The 13 identified relevant papers address a broad spectrum of task reallocation (delegation, substitution and complementary care). Thematic analysis revealed four categories of facilitators and barriers: (1) knowledge and capabilities, (2) professional boundaries, (3) organisational environment, and (4) institutional environment.
Conclusion: Introducing nurse practitioners in healthcare requires organisational redesign and the reframing of professional boundaries. Especially the facilitators and barriers in the analytical themes of 'professional boundaries' and 'organisational environment' should be considered when reallocating tasks. If not, these factors might hamper the cost-effectiveness of task reallocation in practice.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.healthpol.2014.04.016 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identifying Adolescent and Young Adults' Preferences for Oncology Symptom Management Clinical Trial Participation.
Cancer Nurs
January 2025
Author Affiliations: Department of Health and Clinical Sciences, University of Michigan School of Nursing (Dr Knoerl and Mss Smener and Grandinetti); Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School (Drs Fecher, Henry, Karimi, Pettit, and Schuetze); Pediatric Hematology/Oncology, C.S. Mott Children's Hospital (Dr Walling); and School of Social Work, University of Michigan (Dr Zhang), Ann Arbor; and College of Nursing, The University of Tennessee, Knoxville (Dr Barton).
Background: Most studies to date exploring facilitators and barriers to adolescent and young adults' (AYAs') participation in clinical trials have been focused on external factors to AYAs' participation or recruitment strategies.
Objective: The purpose of this mixed-methods study was to determine AYA cancer survivors' preferences for oncology symptom management clinical trial participation.
Methods: Semistructured interviews and conjoint analysis were conducted to clarify potential attributes (eg, characteristics) and levels (eg, value of the characteristic) that may be important to AYA cancer survivors when considering clinical trial participation (n = 19).
Electronic Health Record Data Collection Practices to Advance Standardization and Interoperability of Patient Preferences for Interpretation Services: Qualitative Study.
J Med Internet Res
January 2025
NORC at the University of Chicago, Chicago, IL, United States.
Background: Poor health outcomes are well documented among patients with a non-English language preference (NELP). The use of interpreters can improve the quality of care for patients with NELP. Despite a growing and unmet need for interpretation services in the US health care system, rates of interpreter use in the care setting are consistently low.
View Article and Find Full Text PDFBarriers and facilitators to treat-to-target in axial spondyloarthritis in clinical practice: a mixed methods study.
Rheumatol Int
January 2025
Department of Rheumatology, Maastricht University Medical Centre+, P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands.
This study aimed to explore the perceptions of patients and rheumatologists about a treat-to-target (T2T) strategy in axial spondyloarthritis (axSpA) and identify the barriers and facilitators to its implementation in clinical practice. A mixed methods design was applied. Patients with axSpA who visited the outpatient clinic with active disease (AxSpA Disease Activity Score [ASDAS] ≥ 2.
View Article and Find Full Text PDFElevated SPARC Disrupts the Intestinal Barrier Integrity in Crohn's Disease by Interacting with OTUD4 and Activating the MYD88/NF-κB Pathway.
Adv Sci (Weinh)
January 2025
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, China.
Disruption of the intestinal epithelial barrier results in increased permeability and is a key factor in the onset and progression of Crohn's disease (CD). The protein SPARC is primarily involved in cell interaction and migration, but its specific role in the intestinal epithelial barrier remains unclear. This study demonstrates that SPARC is significantly overexpressed in both CD patients and murine models of colitis.
View Article and Find Full Text PDFRational Design of Natural Xanthones Against Gram-negative Bacteria.
Adv Sci (Weinh)
January 2025
National Key Laboratory of Veterinary Public Health and Safety, College of Veterinary Medicine, China Agricultural University, No.2 Yuanmingyuan West Road, Beijing, 100193, China.
Most antibiotics are ineffective against Gram-negative bacteria owing to the existence of the outer membrane (OM) barrier. The rational design of compounds to expand their antibacterial spectra of antibiotics solely targeting Gram-positive pathogens remains challenging. Here, the design of skeletons from natural products to penetrate the OM are deciphered.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!