The construction of delegation in the utilisation of physiotherapy assistants

This research studies delegation in outpatient physiotherapy and attempts to solve its deficiency by designing a theoretical model of constructive delegation (CD model). The CD model is functional and uses a systematic and rational approach to plan the level of delegation by using task and cost-benefit analysis and it supports delegation dynamically by organising training, working partnerships, communications and the working environment. An initial survey of tasks carried out by physiotherapists and assistants at ten sites found inconsistent approaches to delegation, with 80% of physiotherapists expressing concerns. This mirrored similar experiences in the literature where there was evidence of some delegation of technical clinical tasks, but also resistance within the profession. Generally in the literature delegation was defined and eluded to, but was not constructed in order to provide a planned system. The CD model was offered as a tool to, by construction, implement delegation safely and without loss of quality to ensure appropriate skills for appropriate tasks and to analyse current practice and implicitly suggest improvements....cont'd.