Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia: a mixed methods study protocol

John Wakerman, John Humphreys, Lisa Bourke, Terry Dunbar, Michael Jones, Timothy A Carey, Steven Guthridge, Deborah Russell, David Lyle, Yuejen Zhao, Lorna Murakami-Gold

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: Remote Australia is a complex environment characterized by workforce shortages, isolated practice, a large resident Indigenous population, high levels of health need, and limited access to services. In recent years, there has been an increasing trend of utilizing a short-term visiting (fly-in/fly-out) health workforce in many remote areas. However, there is a dearth of evidence relating to the impact of this transitory workforce on the existing resident workforce, consumer satisfaction, and the effectiveness of current services.

OBJECTIVE: This study aims to provide rigorous empirical data by addressing the following objectives: (1) to identify the impact of short-term health staff on the workload, professional satisfaction, and retention of resident health teams in remote areas; (2) to identify the impact of short-term health staff on the quality, safety, and continuity of patient care; and (3) to identify the impact of short-term health staff on service cost and effectiveness.

METHODS: Mixed methods will be used. Administrative data will be extracted that relates to all 54 remote clinics managed by the Northern Territory Department of Health, covering a population of 35,800. The study period will be 2010 to 2014. All 18 Aboriginal Community-Controlled Health Services in the Northern Territory will also be invited to participate. We will use these quantitative data to describe staffing stability and turnover in these communities, and then utilize multiple regression analyses to determine associations between the key independent variables of interest (resident staff turnover, stability or median survival, and socioeconomic status, community size, and per capita funding) and dependent variables related to patient care, service cost, quality, and effectiveness. The qualitative component of the study will involve in-depth interviews and focus groups with staff and patients, respectively, in six remote communities. Three communities will be high staff turnover communities and three characterized by low turnover. This will provide information on service quality, impact on resident and visiting staff, and patient satisfaction with the services. The research team will work with staff, patients, and a key stakeholder group of senior policymakers to develop workforce strategies to maintain or attain remote health workforce stability.

RESULTS: The study commenced in 2015. As of October 2016, fieldwork has been almost completed and quantitative analysis has commenced. Results are expected to be published in 2017.

CONCLUSIONS: The study has commenced, but it is too early to provide results or conclusions.

LanguageEnglish
Pagese135-e142
Number of pages8
JournalJMIR research protocols
Volume5
Issue number4
DOIs
Publication statusPublished - 3 Oct 2016

Fingerprint

Health Manpower
Costs and Cost Analysis
Northern Territory
Health
Diptera
Cost-Benefit Analysis
Community Health Services
Continuity of Patient Care
Information Services
Workload
Focus Groups
Patient Satisfaction
Population Groups
Social Class
Health Status
Patient Care
Regression Analysis
Interviews
Safety
Survival

Keywords

  • remote health
  • rural workforce
  • fly-in/fly-out
  • rural health services
  • Indigenous health services

Cite this

Wakerman, John ; Humphreys, John ; Bourke, Lisa ; Dunbar, Terry ; Jones, Michael ; Carey, Timothy A ; Guthridge, Steven ; Russell, Deborah ; Lyle, David ; Zhao, Yuejen ; Murakami-Gold, Lorna. / Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia : a mixed methods study protocol. In: JMIR research protocols. 2016 ; Vol. 5, No. 4. pp. e135-e142.
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title = "Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia: a mixed methods study protocol",
abstract = "BACKGROUND: Remote Australia is a complex environment characterized by workforce shortages, isolated practice, a large resident Indigenous population, high levels of health need, and limited access to services. In recent years, there has been an increasing trend of utilizing a short-term visiting (fly-in/fly-out) health workforce in many remote areas. However, there is a dearth of evidence relating to the impact of this transitory workforce on the existing resident workforce, consumer satisfaction, and the effectiveness of current services.OBJECTIVE: This study aims to provide rigorous empirical data by addressing the following objectives: (1) to identify the impact of short-term health staff on the workload, professional satisfaction, and retention of resident health teams in remote areas; (2) to identify the impact of short-term health staff on the quality, safety, and continuity of patient care; and (3) to identify the impact of short-term health staff on service cost and effectiveness.METHODS: Mixed methods will be used. Administrative data will be extracted that relates to all 54 remote clinics managed by the Northern Territory Department of Health, covering a population of 35,800. The study period will be 2010 to 2014. All 18 Aboriginal Community-Controlled Health Services in the Northern Territory will also be invited to participate. We will use these quantitative data to describe staffing stability and turnover in these communities, and then utilize multiple regression analyses to determine associations between the key independent variables of interest (resident staff turnover, stability or median survival, and socioeconomic status, community size, and per capita funding) and dependent variables related to patient care, service cost, quality, and effectiveness. The qualitative component of the study will involve in-depth interviews and focus groups with staff and patients, respectively, in six remote communities. Three communities will be high staff turnover communities and three characterized by low turnover. This will provide information on service quality, impact on resident and visiting staff, and patient satisfaction with the services. The research team will work with staff, patients, and a key stakeholder group of senior policymakers to develop workforce strategies to maintain or attain remote health workforce stability.RESULTS: The study commenced in 2015. As of October 2016, fieldwork has been almost completed and quantitative analysis has commenced. Results are expected to be published in 2017.CONCLUSIONS: The study has commenced, but it is too early to provide results or conclusions.",
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Wakerman, J, Humphreys, J, Bourke, L, Dunbar, T, Jones, M, Carey, TA, Guthridge, S, Russell, D, Lyle, D, Zhao, Y & Murakami-Gold, L 2016, 'Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia: a mixed methods study protocol', JMIR research protocols, vol. 5, no. 4, pp. e135-e142. https://doi.org/10.2196/resprot.5831

Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia : a mixed methods study protocol. / Wakerman, John; Humphreys, John; Bourke, Lisa; Dunbar, Terry; Jones, Michael; Carey, Timothy A; Guthridge, Steven; Russell, Deborah; Lyle, David; Zhao, Yuejen; Murakami-Gold, Lorna.

In: JMIR research protocols, Vol. 5, No. 4, 03.10.2016, p. e135-e142.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Assessing the impact and cost of short-term health workforce in remote indigenous communities in Australia

T2 - JMIR research protocols

AU - Wakerman, John

AU - Humphreys, John

AU - Bourke, Lisa

AU - Dunbar, Terry

AU - Jones, Michael

AU - Carey, Timothy A

AU - Guthridge, Steven

AU - Russell, Deborah

AU - Lyle, David

AU - Zhao, Yuejen

AU - Murakami-Gold, Lorna

PY - 2016/10/3

Y1 - 2016/10/3

N2 - BACKGROUND: Remote Australia is a complex environment characterized by workforce shortages, isolated practice, a large resident Indigenous population, high levels of health need, and limited access to services. In recent years, there has been an increasing trend of utilizing a short-term visiting (fly-in/fly-out) health workforce in many remote areas. However, there is a dearth of evidence relating to the impact of this transitory workforce on the existing resident workforce, consumer satisfaction, and the effectiveness of current services.OBJECTIVE: This study aims to provide rigorous empirical data by addressing the following objectives: (1) to identify the impact of short-term health staff on the workload, professional satisfaction, and retention of resident health teams in remote areas; (2) to identify the impact of short-term health staff on the quality, safety, and continuity of patient care; and (3) to identify the impact of short-term health staff on service cost and effectiveness.METHODS: Mixed methods will be used. Administrative data will be extracted that relates to all 54 remote clinics managed by the Northern Territory Department of Health, covering a population of 35,800. The study period will be 2010 to 2014. All 18 Aboriginal Community-Controlled Health Services in the Northern Territory will also be invited to participate. We will use these quantitative data to describe staffing stability and turnover in these communities, and then utilize multiple regression analyses to determine associations between the key independent variables of interest (resident staff turnover, stability or median survival, and socioeconomic status, community size, and per capita funding) and dependent variables related to patient care, service cost, quality, and effectiveness. The qualitative component of the study will involve in-depth interviews and focus groups with staff and patients, respectively, in six remote communities. Three communities will be high staff turnover communities and three characterized by low turnover. This will provide information on service quality, impact on resident and visiting staff, and patient satisfaction with the services. The research team will work with staff, patients, and a key stakeholder group of senior policymakers to develop workforce strategies to maintain or attain remote health workforce stability.RESULTS: The study commenced in 2015. As of October 2016, fieldwork has been almost completed and quantitative analysis has commenced. Results are expected to be published in 2017.CONCLUSIONS: The study has commenced, but it is too early to provide results or conclusions.

AB - BACKGROUND: Remote Australia is a complex environment characterized by workforce shortages, isolated practice, a large resident Indigenous population, high levels of health need, and limited access to services. In recent years, there has been an increasing trend of utilizing a short-term visiting (fly-in/fly-out) health workforce in many remote areas. However, there is a dearth of evidence relating to the impact of this transitory workforce on the existing resident workforce, consumer satisfaction, and the effectiveness of current services.OBJECTIVE: This study aims to provide rigorous empirical data by addressing the following objectives: (1) to identify the impact of short-term health staff on the workload, professional satisfaction, and retention of resident health teams in remote areas; (2) to identify the impact of short-term health staff on the quality, safety, and continuity of patient care; and (3) to identify the impact of short-term health staff on service cost and effectiveness.METHODS: Mixed methods will be used. Administrative data will be extracted that relates to all 54 remote clinics managed by the Northern Territory Department of Health, covering a population of 35,800. The study period will be 2010 to 2014. All 18 Aboriginal Community-Controlled Health Services in the Northern Territory will also be invited to participate. We will use these quantitative data to describe staffing stability and turnover in these communities, and then utilize multiple regression analyses to determine associations between the key independent variables of interest (resident staff turnover, stability or median survival, and socioeconomic status, community size, and per capita funding) and dependent variables related to patient care, service cost, quality, and effectiveness. The qualitative component of the study will involve in-depth interviews and focus groups with staff and patients, respectively, in six remote communities. Three communities will be high staff turnover communities and three characterized by low turnover. This will provide information on service quality, impact on resident and visiting staff, and patient satisfaction with the services. The research team will work with staff, patients, and a key stakeholder group of senior policymakers to develop workforce strategies to maintain or attain remote health workforce stability.RESULTS: The study commenced in 2015. As of October 2016, fieldwork has been almost completed and quantitative analysis has commenced. Results are expected to be published in 2017.CONCLUSIONS: The study has commenced, but it is too early to provide results or conclusions.

KW - remote health

KW - rural workforce

KW - fly-in/fly-out

KW - rural health services

KW - Indigenous health services

U2 - 10.2196/resprot.5831

DO - 10.2196/resprot.5831

M3 - Article

VL - 5

SP - e135-e142

JO - JMIR research protocols

JF - JMIR research protocols

SN - 1929-0748

IS - 4

ER -