Revision of professional roles and quality improvement A review of the evidence
February 2010
Key points
- There is no detrimental effect of revising or extending the roles of non-medical professionals
- In some cases, there is a positive effect on the quality of patient care.
- Gains in service efficiency may be achieved if doctors stop providing the services that are transferred to other health professionals and instead invest their time in activities that they alone can perform.
This Quality Enhancing Intervention report considers the impact of professional role revision on quality of care.
The report considers the impact of professional role revision on quality of care and outcomes. It focuses on two types of changes to professional roles:
- Substitution – exchanging one type of professional for another.
- Supplementation – extending the range of service provision within one health delivery system.
This report focuses on the revision of roles between doctors and:
- advanced practice nurses such as nurse practitioners, specialist nurses, clinical nurses and practice nurses
- physician assistants pharmacists
- allied healthcare professionals such as physical therapists (referred to as physiotherapists in this review), speech and language therapists, dietitians and paramedics.
Professional role revision has a number of aims: to reduce the medical workload; to increase capacity and extend the range of services available to patients; to improve the quality of care; and/or to reduce costs.
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