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Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles

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  • James Buchan
  • Lynn Calman

Abstract

An important potential contribution to the efficient use of the health workforce, is the possibility of ‘skill mix’ changes. ‘Skill mix’ is a relatively broad term which can refer to the mix of staff in the workforce or the demarcation of roles and activities among different categories of staff. Most of the policy attention on using skill-mix changes to improve health system performance has been on the mix between physicians and nurses. Skill-mix changes may involve a variety of developments including enhancement of skills among a particular group of staff, substitution1 between different groups, delegation up and down a unidiscipliniary ladder, and innovation in roles. Such changes may be driven by a variety of motives including service innovation, shortages of particular categories of worker (especially in inner cities or rural areas), quality improvement, and a desire to improve the cost- effectiveness of service delivery. There are large differences in reported physician/nurse ... Il existe un moyen susceptible de contribuer de manière importante à l’utilisation rationnelle des personnels de santé, à savoir la modification de « l’éventail des qualifications ». « L’éventail des qualifications » est un concept relativement vaste qui renvoie soit à l’éventail des personnels qualifiés, soit à la séparation des rôles et des activités réservés aux différentes catégories de personnel. Parmi les pistes envisagées dans l’utilisation des modifications de l’éventail des qualifications pour améliorer les performances des systèmes de santé, c’est la substitution du personnel infirmier aux médecins qui a le plus retenu l’attention. Les modifications de l’éventail des qualifications peuvent se traduire par des résultats divers, tels que le relèvement des qualifications au sein d’un groupe professionnel donné, une substitution2 entre différents groupes, une délégation des actes vers le haut et vers le haut au sein de la hiérarchie d’une même discipline ou des innovations au ...

Suggested Citation

  • James Buchan & Lynn Calman, 2005. "Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles," OECD Health Working Papers 17, OECD Publishing.
    • Handle: RePEc:oec:elsaad:17-en
    DOI: 10.1787/743610272486
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    Cited by:

    1. Wladyslawa J. Czuber‐Dochan & Christine G. Waterman & Heather A. Waterman, 2006. "Atrophy and anarchy: third national survey of nursing skill‐mix and advanced nursing practice in ophthalmology," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(12), pages 1480-1488, December.
    2. Simon Jean-Baptiste Combes & Alain Paraponaris & Yann Videau, 2019. "French GPs’ Willingness to Delegate Tasks: May Financial Incentives Balance Risk Aversion?," Working Papers halshs-02071522, HAL.
    3. repec:dau:papers:123456789/14979 is not listed on IDEAS
    4. Productivity Commission, 2006. "Australia's Health Workforce," Research Reports, Productivity Commission, Government of Australia, number 18.
    5. 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.
    6. Sandra Pol-Castañeda & Miguel Ángel Rodríguez-Calero & Concepción Zaforteza-Lallemand & Carlos Javier Villafáfila-Gomila & Ian Blanco-Mavillard & Francisco Ferrer-Cruz & Joan De Pedro-Gómez, 2020. "Moving Evidence into Practice by Advanced Practice Nurses in Hospitalization Wards. Protocol for a Multicentre Quasi-Experimental Study in Three Hospitals in Spain," IJERPH, MDPI, vol. 17(10), pages 1-14, May.
    7. Mousquès, Julien & Bourgueil, Yann & Le Fur, Philippe & Yilmaz, Engin, 2010. "Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care," Health Policy, Elsevier, vol. 98(2-3), pages 131-143, December.
    8. Kroezen, Marieke & Dussault, Gilles & Craveiro, Isabel & Dieleman, Marjolein & Jansen, Christel & Buchan, James & Barriball, Louise & Rafferty, Anne Marie & Bremner, Jeni & Sermeus, Walter, 2015. "Recruitment and retention of health professionals across Europe: A literature review and multiple case study research," Health Policy, Elsevier, vol. 119(12), pages 1517-1528.

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