Optimising Scopes of Practice and Team-Based Collaborative Care Through Task-Shifting and Task-Sharing in Mental...

Area of Science:

• Healthcare Management
• Implementation Science
• Interdisciplinary Teamwork

Background:

• Team-based collaborative models leverage diverse healthcare clinicians practicing at their full scope.
• Task-shifting within these models enhances patient care contributions and ensures high-quality outcomes.
• Optimizing skill mix in interdisciplinary inpatient teams is crucial for effective mental healthcare delivery.

Purpose of the Study:

• To implement and evaluate a Collaborative Patient Care (CPC) initiative in a Canadian mental health hospital.
• To optimize the skill and skill mix of interdisciplinary inpatient teams.
• To enhance patient care through service efficiencies and improved resource allocation.

Main Methods:

• Utilized the Exploration, Preparation, Implementation and Sustainment (EPIS) Framework to guide the initiative.
• Conducted qualitative and quantitative syntheses, analyses, and stakeholder engagement.
• Restructured a recreational therapy team, introduced 26 new positions across disciplines, and defined scopes of work.

Main Results:

• Successfully restructured a clinical team and introduced new roles including rehabilitation assistants, geriatric physiotherapists, occupational therapists, and social workers.
• Defined clear scopes of work to support differences between clinicians (e.g., RNs and RPNs) and designed team responsibilities for shared practices.
• Implemented an educational upskilling plan for regulated and unregulated clinicians to align with the new model's requirements.

Conclusions:

• The Collaborative Patient Care (CPC) initiative represents a comprehensive strategy for enhancing patient care and optimizing resource allocation.
• The project is currently in the Sustainment stage, indicating successful implementation and ongoing integration.
• CPC aims to foster a shared vision for delivering the right care, at the right time, by the right clinician to patients and families.