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Factors influencing task-shifting between rheumatologists and occupational therapists in hand osteoarthritis care: A
Silje Zink1,2, Marte Feiring1,2, Ingvild Kjeken1,2
1Health Service Research and Innovation Unit, REMEDY Center for Treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway.
Background:
Task-shifting in healthcare aims to increase access to quality care, control healthcare expenditures and increase efficiency. However, studies suggest that the success of task-shifting initiatives vary and is context sensitive.
Aim:
We aimed to explore facilitators and barriers to shifting first consultations of hand osteoarthritis (OA) patients from rheumatologists to occupational therapists (OTs) in a Norwegian hospital setting.
Material And Method:
Semi-structured interviews were conducted with ten rheumatologists and five OTs across two Norwegian hospitals. Data were transcribed verbatim and analysed using template analysis. Retrospective application of the Capability, Opportunity, and Motivation model of behaviour (COM-B) and the Theoretical Domains Framework version 2 (TDF) informed the analysis.
Results:
The analysis resulted in four themes capturing facilitators and barriers to task-shifting: Clinical understandings of hand OA shape task redistribution; Contextual infrastructure shapes opportunities for task-shifting; Communication and trust as foundations for collaboration and task redistribution; Aligning altered care models with patient expectations and preferences.
Conclusion:
Sustainable task shifting in secondary healthcare depends on professional competencies, interprofessional collaboration, and supportive organisational structures. Patient education and clear communication about provider roles are essential to address expectations, enhance satisfaction, and strengthen implementation.
