Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.11851/1619
Title: Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe
Authors: de Bont, Antoinette
van Exel, Job
Coretti, Silvia
Ökem, Zeynep Güldem
Janssen, Maarten
Hope, Kristin Lofthus
Ludwicki, Tomasz
Zander, Britta
Zvonickova, Marie
Bond, Christine
Wallenburg, Iris
192696
Keywords: Skill mix
Health workforce
Europe
Extended roles
Advanced roles
Comparative study
Health care teams
Issue Date: 2016
Publisher: BMC
Source: de Bont, A., van Exel, J., Coretti, S., Ökem, Z. G., Janssen, M., Hope, K. L., ... & Wallenburg, I. (2016). Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe. BMC health services research, 16(1), 637.
Abstract: Background: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change. The research questions guiding this study were: What extended professional roles are emerging on health care teams? How are extended professional roles created? What main drivers explain the observed differences, if any, in extended roles in and between countries? Methods: We performed a case-based comparison of the extended roles in care pathways for breast cancer, heart disease and type 2 diabetes. We conducted 16 case studies in eight European countries, including in total 160 interviews with physicians, nurses and other health care professionals in new roles and 600+ hours of observation in health care clinics. Results: The results show a relatively diverse composition of roles in the three care pathways. We identified specialised roles for physicians, extended roles for nurses and technicians, and independent roles for advanced nurse practitioners and physician associates. The development of extended roles depends upon the willingness of physicians to delegate tasks, developments in medical technology and service (re) design. Academic training and setting a formal scope of practice for new roles have less impact upon the development of new roles. While specialised roles focus particularly on a well-specified technical or clinical domain, the generic roles concentrate on organising and integrating care and cure. Conclusion: There are considerable differences in the number and kind of extended roles between both countries and care pathways. The main drivers for new roles reside in the technological development of medical treatment and the need for more generic competencies. Extended roles develop in two directions: 1) specialised roles and 2) generic roles.
URI: https://doi.org/10.1186/s12913-016-1898-0
https://hdl.handle.net/20.500.11851/1619
ISSN: 1472-6963
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Uluslararası Girişimcilik Bölümü / Department of International Entrepreneurship
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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