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Greater patient satisfaction and improved processes thanks to task shifting

A new ZHAW study conducted on behalf of the Federal Office of Public Health shows that shifting certain tasks from doctors to other healthcare professionals can simplify processes and increase patient satisfaction.

Transferring selected tasks usually performed by doctors to other healthcare professionals (“task shifting”) contributes to improving processes within the healthcare system. In addition, it has a positive impact on patient satisfaction. These were the findings of a study conducted by the ZHAW School of Management and Law and the ZHAW School of Health Professions. The study was based on surveys and interviews, as well as the analysis of three case studies, and was conducted on behalf of the Federal Office of Public Health (FOPH).

More direct contact and greater continuity

One example of task shifting is when doctors at a hospital delegate the conducting of individual standard medical tasks to specially qualified nursing staff (clinical specialists), or to physiotherapists. Such tasks may include carrying out discharge discussions following an inpatient stay, or consultations to monitor progress after an orthopaedic procedure. “Clinical specialists with an extended area of responsibility, for example, can function as a kind of case manager within such a model. They ensure more intensive contact and greater continuity in the provision of care - aspects that are appreciated by the surveyed patients,” says Florian Liberatore, the head of the study. The stronger continuity also leads to smoother and simpler processes, where clinical specialists function as central point of contact for patients and relatives, as well as other experts. A further example of task shifting is the dispensing of prescription drugs by pharmacists, which has been possible since the revision of the Therapeutic Products Act in 2019. This has contributed to a simplification in the process for supplying people with medicine.

No cost savings

From the economic point of view, however, task shifting in the case studies examined has no significant impact. Almost no cost savings are achieved overall, either within the individual healthcare institutions or in the healthcare system as a whole. Task shifting also only provides relief for doctors to a limited extent, since the working time freed up by delegating tasks is offset by the additional need for consultation and coordination when task shifting. The central foundation for successful implementation is, furthermore, well-functioning interprofessional cooperation between all those involved. “This can prove challenging if the distribution of roles and authority in task shifting is not clear,” explains Liberatore.

In addition to analysing the effects of task shifting, the study’s authors also developed various recommendations as regards the longer-term implementation of such models. These include examining the possibility of adjusted billing options within the tariff systems, for example to remunerate healthcare professionals who take on extended roles. In addition, appropriate training and continuing education courses should be further developed.

Interdisciplinary analysis

The “Task shifting in interprofessional cooperation” study was conducted by the Winterthur Institute of Health Economics of the ZHAW School of Management and Law, together with the Institute of Physiotherapy and the Interprofessional Teaching and Practice Unit, both at the ZHAW School of Health Professions. The project is part of the “Interprofessionality in healthcare” support programme of the FOPH, which also financed the project. Researchers examined two task-shifting case studies at Winterthur Cantonal Hospital, as well as the dispensing of prescription drugs by pharmacists, for the study. They conducted interviews, expert workshops, surveys and economic analyses. The study took place between October 2018 and May 2020.

Link to website with study report (available in German, French and Italian only)

Contact

Florian Liberatore, ZHAW School of Management and Law, Winterthur Institute of Health Economics, phone 058 934 70 35, e-mail florian.liberatore@zhaw.ch

Jürg Hostettler, ZHAW School of Management and Law, Head of Communications, phone 058 934 66 63, e-mail juerg.hostettler@zhaw.ch