The use of a hub and spoke methodology to implement allied health expanded scope models of care 2014-16: Conditions for success

Liza-Jane McBride1, Catherine Barrett2, Belinda Gavaghan3

1Allied Health Professions’ Office Queensland, PO Box 2368, QLD, 4006, liza-jane.mcbride@health.qld.gov.au
2Allied Health Professions’ Office Queensland, PO Box 2368, QLD, 4006, catherine.barrett2@health.qld.gov.au
3Allied Health Professions’ Office Queensland, PO Box 2368, QLD, 4006, belinda.gavaghan@health.qld.gov.au

Background

Allied health expanded scope models of care have been shown to improve patient access to timely and high quality healthcare. Despite evidence of their effectiveness, these models have not been implemented consistently across Queensland public health services and are often not sustained over time. A key recommendation from the Ministerial Taskforce on health practitioner expanded scope of practice was to support the implementation of proven models of care that optimise scope of practice.

Methods

Two rounds of funding have been provided to Hospital and Health Services to replicate eight proven expanded scope models using hub and spoke methodology. Lead (hub) sites were required to assist nominated spoke sites to implement the existing model within the context of their own environment. A mixed-methods approach, including questionnaires and semi-structured focus groups, was used to evaluate project outcomes and explore clinician perceptions of the benefits and challenges of using hub and spoke methodology.

Results

Preliminary findings indicate that over 70% of models were replicated at the spoke sites. There was, however, considerable variability in the success of these models at these sites. A number of factors were identified to inhibit successful and timely implementation, including the maturity and sustainability of models at hub sites, readiness for new models at spoke sites and limited project timeframes.

Discussion

Hub and spoke methodology provides a valuable model to facilitate the rapid implementation of expanded scope models across multiple sites. Findings from this evaluation highlight the benefits and practical challenges to the application of this methodology. This, in turn, will inform future strategies to embed expanded scope of practice for allied health professionals.

Biography

Liza-Jane McBride is a team leader with the Allied Health Professions’ Office of Queensland, with statewide responsibility for allied health clinical education. Liza-Jane has a significant experience working in a variety of healthcare settings in Australia and the United Kingdom. She is a registered physiotherapist.