A Systematic Approach to Delegation in Out-patient Physiotherapy

Abstract

Summary This paper describes the result of a pilot study carried out in a district general hospital to examine the effects of introducing a systematic approach to delegation in out-patient physiotherapy. Physiotherapists and assistants were set to work in teams. Both new and experienced assistants were trained to carry out the treatments found on analysis to be suitable for delegation, and formal communications were arranged. Measurements were taken before and during the pilot study of productivity, costs, outcomes and patient satisfaction and were compared. There was an increase in productivity per physiotherapist and a reduction in costs. There was no loss of clinical effectiveness or efficiency and patient satisfaction remained similar before and after the changes. The physiotherapists, after experiencing initial difficulties due to fears of loss of control of patients' care and feelings of guilt through giving up care, found the system operated successfully as they built up their trust in assistants.