Academic journal article Australian Health Review

Allied Health: Integral to Transforming Health

Academic journal article Australian Health Review

Allied Health: Integral to Transforming Health

Article excerpt

Introduction

Transforming health in South Australia

South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system.1 Radical 'transforming health' strategies have been proposed1 following consultation with consumers, community organisations and health professionals across sectors to produce an integrated, evidence-based, patient-centred healthcare system. Transforming healthcare in South Australia will require fundamental change at all levels (system, organisation, discipline, health professional and patient).2 This will enable the South Australian healthcare system to counterrisingcosts, andincreasing demand onservices, by being more responsive, evidence based, consumer focused, flexible and equitable than ever before.

It has been predicted that the lifespan of Australians will increase by 5 years, on average, within the next decade and that they will live with diseases from which, in the past, they would have died.3 Consequently, future Australian healthcare will need to address acute problems, tertiary care and community-based chronic disease management. Given the rising costs of acute hospital beds and residential places, it is incumbent on all healthcare providers to ensure that Australians are provided with the care they need to live safely and independently in the community for as long as they desire, with optimum quality of life.4,5

Role of allied health

'Allied health' is an umbrella term used to describe health disciplines and ancillary services that are not medicine or nursing.6,7 Common allied health disciplines include dietetics, occupational therapy, physiotherapy, podiatry, psychology, speech pathology, social work, audiology, radiography and dietetics and nutrition.

Allied health contributes across acute, subacute and primary care sectors 'from needs assessment, health promotion and community development, through to direct provision of specialist treatment and rehabilitation services'.8 Allied health professionals engage patients in care decisions and assist them to set and achieve goals that optimise function, maintain or improve quality of life and achieve safe and independent community living.6,9 In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to the looming healthcare challenges that motivated the transforming health agenda in South Australia.

Proposed clinician-driven strategies for maximising value of Australian healthcare

A recent narrative by Scott proposed 10 strategies to assist in maximising value and sustainability of healthcare in Australia.10 The strategies were derived from Scott's lengthy experiences in specialist clinical practice, evidence-based medicine and quality improvement. Scott's strategies were to:

1. minimise errors in diagnosis

2. discontinue low- or no-value practices that provide little benefit or cause harm

3. defer the use of unproven interventions

4. select care options according to comparative costeffectiveness

5. target clinical interventions to those who derive the greatest benefit

6. adopt a more conservative approach nearing the end of life

7. actively involve patients in shared decision making and selfmanagement

8. minimise day-to-day operational waste

9. convert health care institutions into rapidly learning organisations

10. advocate for integrated systems of care that maximise value.

We sought the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health, and identified the roles that allied health could play in transforming healthcare practices by operationalising relevant strategies.

Methods

Research approach

A survey instrument was developed to capture allied health perspectives on Scott's strategies. …

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