title: Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.
abstract: Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.
authors.affiliation: The Physiotherapy Department, The Canberra Hospital, ACT Health, Canberra, ACT, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Morris
authors.affiliation: International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Grimmer
authors.affiliation: The Physiotherapy Department, The Canberra Hospital, ACT Health, Canberra, ACT, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gilmore
authors.affiliation: Department of Rheumatology, The Canberra Hospital, Canberra, ACT, Australia.
authors.forename: Chandima
authors.initials: C
authors.lastname: Perera
authors.affiliation: The Faculty of Health, University of Canberra, Canberra, ACT, Australia.
authors.forename: Gordon
authors.initials: G
authors.lastname: Waddington
authors.affiliation: The Faculty of Health, University of Canberra, Canberra, ACT, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Kyle
authors.affiliation: Department of Surgical Services, The Canberra Hospital, Canberra, ACT, Australia.
authors.forename: Bryan
authors.initials: B
authors.lastname: Ashman
authors.affiliation: Office of Allied Health Advisor, ACT Health, Canberra, ACT, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Murphy
keywords: business case development; extended scope physiotherapy; models of care; role redesign; workforce reform enablers