IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v119y2015i12p1627-1635.html
   My bibliography  Save this article

The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia

Author

Listed:
  • Maier, Claudia B.

Abstract

Task-shifting from physicians to nurses is increasing worldwide; however, research on how it is governed is scarce. This international study assessed task-shifting governance models and implications on practice, based on a literature scoping review; and a survey with 93 country experts in 39 countries (response rate: 85.3%). Governance was assessed by several indicators, regulation of titles, scope of practice, prescriptive authority, and registration policies. This policy analysis focused on eleven countries with task-shifting at the Advanced Practice Nursing/Nurse Practitioner (APN/NP) level. Governance models ranged from national, decentralized to no regulation, but at the discretion of employers and settings. In countries with national or decentralized regulation, restrictive scope of practice laws were shown as barrier, up-to-date laws as enablers to advanced practice. Countries with decentralized regulation resulted in uneven levels of practice. In countries leaving governance to individual settings, practice variations existed, moreover data availability and role clarity was limited. Policy options include periodic reviews to ensure laws are up to date, minimum harmonization in decentralized contexts, harmonized educational and practice-level requirements to reduce practice variation and ensure quality. From a European Union (EU) perspective, regulation is preferred over non-regulation as a first step toward the recognition of qualifications in countries with similar levels of advanced practice. Countries early on in the process need to be aware that different governance models can influence practice.

Suggested Citation

  • Maier, Claudia B., 2015. "The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia," Health Policy, Elsevier, vol. 119(12), pages 1627-1635.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:12:p:1627-1635
    DOI: 10.1016/j.healthpol.2015.09.002
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851015002249
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2015.09.002?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ognyanova, Diana & Maier, Claudia B. & Wismar, Matthias & Girasek, Edmond & Busse, Reinhard, 2012. "Mobility of health professionals pre and post 2004 and 2007 EU enlargements: Evidence from the EU project PROMeTHEUS," Health Policy, Elsevier, vol. 108(2), pages 122-132.
    2. Niezen, Maartje G.H. & Mathijssen, Jolanda J.P., 2014. "Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain," Health Policy, Elsevier, vol. 117(2), pages 151-169.
    3. Nahara Anani Martínez-González & Ryan Tandjung & Sima Djalali & Flore Huber-Geismann & Stefan Markun & Thomas Rosemann, 2014. "Effects of Physician-Nurse Substitution on Clinical Parameters: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-11, February.
    4. Steele, David & Cylus, Jonathan, 2012. "United Kingdom (Scotland): health system review," LSE Research Online Documents on Economics 49652, London School of Economics and Political Science, LSE Library.
    5. Marie-Laure Delamaire & Gaétan Lafortune, 2010. "Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries," OECD Health Working Papers 54, OECD Publishing.
    6. McCarthy, Carey F. & Kelley, Maureen A. & Verani, Andre R. & St. Louis, Michael E. & Riley, Patricia L., 2014. "Development of a framework to measure health profession regulation strengthening," Evaluation and Program Planning, Elsevier, vol. 46(C), pages 17-24.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Maier, Claudia B. & Batenburg, Ronald & Birch, Stephen & Zander, Britta & Elliott, Robert & Busse, Reinhard, 2018. "Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect?," Health Policy, Elsevier, vol. 122(10), pages 1085-1092.
    2. Pavolini, Emmanuele & Kuhlmann, Ellen, 2016. "Health workforce development in the European Union: A matrix for comparing trajectories of change in the professions," Health Policy, Elsevier, vol. 120(6), pages 654-664.
    3. Ryuichi Ohta & Miyuki Yawata & Chiaki Sano, 2022. "Doctor Clerk Implementation in Rural Community Hospitals for Effective Task Shifting of Doctors: A Grounded Theory Approach," IJERPH, MDPI, vol. 19(16), pages 1-13, August.
    4. Ferreira, Pedro L. & Raposo, Vitor & Tavares, Aida Isabel & Correia, Tiago, 2020. "Drivers for emigration among healthcare professionals: Testing an analytical model in a primary healthcare setting," Health Policy, Elsevier, vol. 124(7), pages 751-757.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Köppen, Julia & Maier, Claudia B. & Busse, Reinhard, 2018. "What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at breast cancer and acute myocardial ," Health Policy, Elsevier, vol. 122(10), pages 1118-1125.
    2. Sharon Barak & Tzlil Rabinovitz & Achinoam Ben Akiva-Maliniak & Rony Schenker & Lian Meiry & Riki Tesler, 2022. "An Individually Tailored Program to Increase Healthy Lifestyle Behaviors among the Elderly," IJERPH, MDPI, vol. 19(17), pages 1-12, September.
    3. Ruth Martin‐Misener & Faith Donald & Abigail Wickson‐Griffiths & Noori Akhtar‐Danesh & Jenny Ploeg & Kevin Brazil & Sharon Kaasalainen & Carrie McAiney & Nancy Carter & Lori Schindel Martin & Esther S, 2015. "A mixed methods study of the work patterns of full‐time nurse practitioners in nursing homes," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(9-10), pages 1327-1337, May.
    4. Patty Doran & Paul Bradshaw & Susan Morton & El-Shadan Tautolo & James Williams & Chris Cunningham, 2020. "Growing up Healthy in Families Across the Globe: Cross-Cultural Harmonisation of Childhood Risk-Factors Using Longitudinal Studies from Ireland, Scotland and New Zealand," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 13(6), pages 1921-1935, December.
    5. Bramesfeld, Anke & Wensing, Michel & Bartels, Paul & Bobzin, Henning & Grenier, Catherine & Heugren, Mona & Hirschfield, Dena Jaffe & Langenegger, Manfred & Lindelius, Birgitta & Lucet, Bruno & Manor,, 2016. "Mandatory national quality improvement systems using indicators: An initial assessment in Europe and Israel," Health Policy, Elsevier, vol. 120(11), pages 1256-1269.
    6. Yukari Hara & Kyoko Asakura & Takashi Asakura, 2020. "The Impact of Changes in Professional Autonomy and Occupational Commitment on Nurses’ Intention to Leave: A Two-Wave Longitudinal Study in Japan," IJERPH, MDPI, vol. 17(17), pages 1-14, August.
    7. Francisco Lupiañez-Villanueva & Alexandra Theben, 2015. "Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) TDP (United Kingdom) Case Study Report," JRC Research Reports JRC94496, Joint Research Centre.
    8. Júlia Varga, 2017. "Out-migration and attrition of physicians and dentists before and after EU accession (2003 and 2011): the case of Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1079-1093, December.
    9. Catrin Evans & Ruth Pearce & Sarah Greaves & Holly Blake, 2020. "Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation," IJERPH, MDPI, vol. 17(12), pages 1-19, June.
    10. Mary Ryder & Elisabeth Jacob & Joyce Hendricks, 2019. "An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(13-14), pages 2644-2658, July.
    11. Temido, Marta & Dussault, Gilles, 2015. "How can a country learn from the experience of another? Expanding nurses’ scope of practice in Portugal: Lessons from England," Health Policy, Elsevier, vol. 119(4), pages 475-487.
    12. Gerard M Fealy & Daniela Rohde & Mary Casey & Anne‐Marie Brady & Josephine Hegarty & Catriona Kennedy & Martin McNamara & Pauline O'Reilly & Geraldine Prizeman, 2015. "Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(23-24), pages 3615-3626, December.
    13. Agnes Higgins & Rebecca Murphy & Carmel Downes & Jarlath Varley & Cecily Begley & Naomi Elliott, 2020. "Factors influencing the implementation of Epilepsy Specialist Nurse role: Using the Consolidation Framework for Implementation Research," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(7-8), pages 1352-1364, April.
    14. Faith Donald & Kelley Kilpatrick & Kim Reid & Nancy Carter & Ruth Martin-Misener & Denise Bryant-Lukosius & Patricia Harbman & Sharon Kaasalainen & Deborah A. Marshall & Renee Charbonneau-Smith & Erin, 2014. "A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?," Nursing Research and Practice, Hindawi, vol. 2014, pages 1-28, September.
    15. Francisco Lupiañez-Villanueva & Alexandra Theben, 2015. "Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) SPARRA (United Kingdom) Case Study Report," JRC Research Reports JRC94495, Joint Research Centre.
    16. Anderson, Michael & O'Neill, Ciaran & Macleod Clark, Jill & Street, Andrew & Woods, Michael & Johnston-Webber, Charlotte & Charlesworth, Anita & Whyte, Moira & Foster, Margaret & Majeed, Azeem & Pitch, 2021. "Securing a sustainable and fit-for-purpose UK health and care workforce," LSE Research Online Documents on Economics 110809, London School of Economics and Political Science, LSE Library.
    17. Ruggeri, Matteo & Drago, Carlo & Moramarco, Vincenzo & Coretti, Silvia & Köppen, Julia & Islam, Muhammad Kamrul & Gibson, Jonathan & Busse, Reinhard & van Exel, Job & Sutton, Matthew & Askildsen, Jan , 2018. "New professional roles and patient satisfaction: Evidence from a European survey along three clinical pathways," Health Policy, Elsevier, vol. 122(10), pages 1078-1084.
    18. Marlene Carvalho & Filomena Gaspar & Teresa Potra & Pedro Lucas, 2022. "Translation, Adaptation, and Validation of the Self-Efficacy Scale for Clinical Nurse Leaders for the Portuguese Culture," IJERPH, MDPI, vol. 19(14), pages 1-12, July.
    19. Berardi, Chiara & Schut, Frederik & Paolucci, Francesco, 2024. "The dynamics of international health system reforms: Evidence of a new wave in response to the 2008 economic crisis and the COVID-19 pandemic?," Health Policy, Elsevier, vol. 143(C).
    20. Kelley Kilpatrick & Mira Jabbour & Chantal Fortin, 2016. "Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(5-6), pages 619-630, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:119:y:2015:i:12:p:1627-1635. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.