The study’s aims were to describe the outcomes of an extended scope of practice dietitian-led gastroenterology clinic located in a regional Queensland hospital, explore health professionals’ perceptions of the clinic, and develop a framework using a systems approach to facilitate extended scope models across various health settings. A descriptive, cross-sectional study was undertaken over 50 clinics involving 82 patients to describe clinic outcomes. Additionally, a qualitative investigation using semi-structured interviews with four health professionals involved in the clinic was conducted. A phenomenological framework was used to investigate interviewees’ lived experience of the clinic. An inductive approach was used to allow themes to emerge from data and reviewed collaboratively using triangulation. Subsequently, relationships between key themes were mapped to the Systems Engineering Initiative for Patient Safety (SEIPS) work system model. Health professionals identified various factors as vital inputs to the extended scope work system. These were categorised into four key elements: stakeholder support, resources, planning and the dietitian’s training and attributes. Clinic outcomes positively impacted on four key stakeholders: patients, the dietitian, the multidisciplinary team and the health system. Further development of extended scope roles for dietitians requires increased advocacy and support from governments, professional bodies, training institutions and dietitians as barriers to clinic implementation and clinic sustainability identified by interviewees included lack of government support, inadequate resources and poor succession planning. Based on these outcomes, we have developed an implementation framework which can be utilised by health professionals and organisations interested in pursuing an extended scope model of care.
33rd Dietitians Association of Australia National Conference, Melbourne, Australia 19-21 May 2016
Nutrition and Dietetics / Vol. 73, Supplement 1, pp.42