New professionals roles in Europe

Antoinette de Bont, Maarten Janssen, Iris Wallenburg Munros TeamErasmus University Rotterdam

Panel: Engaging Doctors and Health Professionals What Is It? Does It Matter?

21st March 2015

Allied ProfessionalsHeart Attack Breast Cancer Diabetes

Emergency physician Breast clinician Diabetes ward physician

Outpatient physician Ward physician Outpatient physician

Physician assistant Nurse practitioners Practice nurse

Emergency nurse Physician Assistant Podiatrist

Triage nurse Breast Care Nurses Food care technicians

Out-patient nurse Technical radiation assistant Neurophysiopathology technicians

Perfustionist Medical assistant Dieticians

Paramedic Ward Assistant Nutritionists

Technician Health care assistant

Resuscitator

Documentation assistant

Health care assistant

How do physicians, nurses and allied professionals control the work they do?– How do physicians, nurses and allied professionals

distributed and reclaim work?– What kind of work do they distributed and/or

reclaim?

Integrated care

Co-ordination of care delivery to a patient with new general professional roles within a care organization (e.g. expansion of services) and/or between care organizations (e.g. primary and secondary care)

Patient-centred care

Specialized, integrated care pathway

Traditional care delivery with one specialist within a care organization responsible for the care delivery to a patient, supported by general nursing, technical and/or administrative staff

Physician-centred care

Multiple specialists within a care organization involved in care

delivery to a patient, based on the required expertise, supported by

specialized nursing, technical and/or administrative staff

Expertise-centred care

SPECIALIZATION OF CARE Developments in medical technology and training

Developments in information technology

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-MIX CHANGE

Allied professionals and organized professionalism• Health Care Organizations provide the training for Allied

Professionals.• Allied professionals claim to fulfill organizational goals• patient centered care, productivity and transparency.

• Their competencies are defined by products and services of the organization

Yet, allied professionals are locked in organizations.

High status professionals are not the ones who distribute the work.High status professionals can not reclaim work at any time.The work that is delegated to allied professionals is not only lower status work.

We wish to thank the European Commission for funding this research programme ‘Health Care Reform: The iMpact on practice, oUtcomes and cost of New ROles for health profeSsionals (MUNROS), under the European Community’s Seventh Framework Programme (FP7 HEALTH-2012-INNOVATION-1) grant agreement number HEALTH-F3-2012-305467EC .