title: Advanced Practice Coordinator: Role Extension or Advanced Practice? A Canadian Multi-Case Study.
Creators: name: Richardson, Sean
Publisher: name: University of Liverpool Repository
Year: 2020

description: Introduction: Increasing demands for medical services concurrent with the shortage of healthcare personnel has forced a change in the delivery of healthcare services. In response to these challenges, allied health professions began expanding and extending their practices into the realms of medicine. A number of these emerging practices have been branded as advanced practice. One such practice is the advanced practice coordinator role in Ontario Canada, successfully implemented at two health institutions but failed at another. This research explores whether the advanced practice coordinator role is advanced practice or role extension and whether it influences patient outcomes. Further, the research objectives also included the development of a framework to inform the development and implementation of emerging practices in medical imaging along with informing advanced radiographic practice curricula. Professional practice designation is important as it contributes to professional identity, builds the professions’ body of knowledge, and influences professions’ scopes of practice, practitioners’ satisfaction, staff retention, and patient satisfaction. Further, the explicit designation of professional practice is needed for practitioners to provide a clear, concrete and consistent explanation of their professional roles and responsibilities to patients, the general public, other healthcare workers and healthcare policymakers. This research, therefore, contributes to knowledge in the areas of health sciences and higher education by informing the development of emerging practice roles and practice curricula. Methods: Three healthcare sites were studied using a mixed-methods multi-case study research strategy. Program documents, interviews of key stakeholders, surveys of advanced practice coordinators, and measures of patient wait times were gathered and analysed. Each case was studied as an independent case with subsequent cross-case analysis performed. Results: The advanced practice coordinator role was developed out of the need to better utilise technologists’ skills and competencies and the need to facilitate enhanced hours of diagnostic imaging services. The role has enjoyed some amount of success with recorded reductions in patient wait times, improved patient education and improvement in patient satisfaction. Additionally, the role failed at a third institution owing to local labour laws restrictions, and incompatibility between department layout and role functionality. More importantly, interviewees felt that the role was more consistent with the emerging practices of role extension than advanced practice. Conclusions: The advanced practice coordinator role as practice at two healthcare institutions in Ontario Canada did not meet the criteria for advanced practice designation. The practice is consistent with role extension. Nonetheless, the role does influence patient outcomes. Moreover, the findings of this research also assist in shaping the radio-graphic research landscape and improving the evidence-base practice approach of the radiographic profession. The findings also can possibly contribute to the development of advanced radiographic practice curricula that compliments clinical practice by providing form and structure to radiographic role development. Further, this research suggests two emerging practice frameworks - a collaborative approach to role extension and a frame-work to inform advanced practice in medical imaging. Keywords: Emerging practice, Advanced practice, Role extension, Advanced radio-graphic practice, Advanced practice coordinator, Medical radiation technology, Collaborative approach to role extension, Advanced radiographic practice framework.