Clinical care ratios: quantifying clinical versus non-clinical care for allied health professionalsCherie Hearn A B F , Adam Govier B C and Adam Ivan Semciw A D E
A Department of Physiotherapy, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Qld 4102, Australia.
B Australasian Allied Health Benchmarking Consortium, Australia and New Zealand.
C Physiotherapy Department, Central Adelaide Local Health Network, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. Email: email@example.com
D Centre for Functioning and Health Research, Queensland Health, Woolloongabba, Qld 4102, Australia.
E School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld 4072, Australia. Email: firstname.lastname@example.org
F Corresponding author. Email: email@example.com
Australian Health Review - http://dx.doi.org/10.1071/AH16017
Submitted: 22 January 2016 Accepted: 4 May 2016 Published online: 4 July 2016
Objective Clinical care ratios (CCRs) are a useful tool that can be used to quantify and benchmark the clinical and non-clinical workloads of allied health professionals. The purpose of this study was to determine if CCRs are influenced by level of seniority, type of role or profession. This will provide meaningful information for allied health service managers to better manage service demand and capacity.
Method Data was collected from 2036 allied health professionals from five professions across 11 Australian tertiary hospitals. Mean (95% confidence intervals) CCRs were calculated according to profession, seniority and role type. A two-way ANOVA was performed to assess the association of CCRs (dependent variable) with seniority level and profession (independent variables). Post-hoc pairwise comparisons identified where significant main or interaction effects occurred (α = 0.05).
Results Significant main effects for seniority level and profession were identified (P < 0.05), but there was no interaction effect. Post-hoc comparisons revealed significant differences between all tier combinations (P < 0.05) with more senior staff having the lowest CCRs.
Conclusion The direct and non-direct clinical components of the allied health professional’s workload can be quantified and benchmarked with like roles and according to seniority. The benchmarked CCRs for predominantly clinical roles will enable managers to compare and evaluate like roles and modify non-direct clinical components according to seniority and discipline.
What is known about the topic? CCRs are a useful tool to quantify, monitor and compare workloads of allied health professionals. They are thought to change with increased seniority of roles. The CCRs for different allied health professional roles has yet to be defined in the literature.
What does this paper add? CCRs decrease as level of seniority increases, indicating higher seniority increases non-clinical time. CCRs differ across professions, suggesting that benchmarking with CCRs must be profession specific.
What are the implications for practitioners? The direct and non-direct clinical components of a workload can be quantified, defined and benchmarked with like roles to ensure cost-effective and optimal service delivery and patient outcomes.
References Allied Health Professions Australia, Policy Paper: Australia’s Workforce of allied health professionals. 2013. Available at: http://www.ahpa.com.au/Portals/0/Representation/AHPA_Policy_Paper-Workforce-March_2013.pdf [Verified 1 June 2016].
 Scottish Executive National Health System. September 2006. Allied Health Professions Workload Measurement and Management. Available at: http://www.sehd.scot.nhs.uk/ahp/_documents/ahpworkloadmeasureandmanage.pdf [verified 11 August 2015].
 Adams R. Progress in the development of recommended staffing levels for rural physiotherapy services. Proceedings of the Services for Australian Rural and Remote Allied Health (SARRAH) National Conference, 26–28 August 2004, Alice Springs, NT. 2004. Available at http://www.researchgate.net/profile/Robyn_Adams/publications [verified 11 August 2015].
 National Allied Health Casemix Committee. Standards for Benchmarking Allied Health Services. 2003. Available at http://nahcc.org.au/pdfs/Allied%20Health%20Benchmarking%20Standard%20V1.pdf [verified 11 August 2015].
 Simmons NC, Kuys SS. Trial of an allied health workload allocation model. Aust Health Rev 2011; 35 168–75.
| Trial of an allied health workload allocation model.CrossRef | 21612729PubMed |
 Hulcombe J, Sturgess J, Souvlis T, Fitzgerald C. An approach to building research capacity for health practitioners in a public health environment: an organisational perspective. Aust Health Rev 2014; 38 252–8.
| An approach to building research capacity for health practitioners in a public health environment: an organisational perspective.CrossRef | 24785693PubMed |
 Schoo AM, Boyce RA, Ridoutt L, Santos T. Workload capacity measures for estimating allied health staffing requirements. Aust Health Rev 2008; 32 548–58.
| Workload capacity measures for estimating allied health staffing requirements.CrossRef | 18666884PubMed |
 Cartmill L, Comans TA, Clark MJ, Ash S, Sheppard L. Using staffing ratios for workforce planning: evidence on nine allied health professions. Hum Resour Health 2012; 10
| Using staffing ratios for workforce planning: evidence on nine allied health professions.CrossRef | 22293082PubMed |