Abstract

Purpose: In many rural places, health services struggle to maintain an adequate health workforce to meet their communities’ health care needs. Shortages of allied health professionals are of particular and growing concern. To address this challenge, a two-year Whole-of-Person Retention Improvement Project was developed involving a research partnership with two rural public health services in Victoria, Australia. This project was informed by the author’s Whole-of-Person Retention Improvement Framework (WoP-RIF), aimed to produce new knowledge for rural health services to attract, recruit, and improve the retention of allied health professionals. A set of evidence-informed and contextually relevant recommendations were made in the project’s initial observational phase to strengthen each service’s allied health workforce, 10 of which were shared. The objective of this phase of the project was to explore the challenges and enablers that two rural health services experienced in developing and implementing strategies for allied health workforce improvement. Method: The methodological approaches used for this intervention study were participatory action research and a realist evaluation. The data sources used for the realist evaluation included qualitative (focus group) and observational (project documents and fieldnotes). Results: The results outline the key responses made by the regional and rural health service to implement the 10 shared recommendations and are presented under their relevant WoP-RIF domains: workplace/organisational, role/career, and community/place. The key and shared contexts, drivers, mechanisms, outputs, and outcomes are presented under each recommendation, and where possible, an assessment is made regarding sustainability beyond the project period. Conclusions: The implementation of the recommendations is a complex process requiring whole-of-organisation support by the participating rural public health services. This study identifies five facilitators for successful implementation: 1) the project is considered a strategic human resources initiative and overseen by the executive; 2) it has strong champion(s) in the executive staff; 3) human resources is part of the strategic decision-making arrangements; 4) the change management process is facilitated and led by staff from the target clinical workforce(s); and 5) a partnership approach with local council is adopted for strategies requiring community support and engagement.

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