A review of staffing levels and activity in paediatric dietetics

Abstract

Background: The present study was undertaken to review how much time paediatric dietitians spend in direct contact with patients and to determine what levels of staffing are available throughout paediatric dietetic departments in Ireland and the UK. Methods: A work sampling tool was devised to capture paediatric dietetic activity for a period of 1 day. A semi-structured questionnaire was sent to paediatric dietitian managers to provide demographic information on their facility. Results: Fourteen questionnaires were returned by paediatric dietitian managers and 86 work sampling tools were returned for analysis by dietitians working in the various departments. Paediatric dietitians spend 23% of the working day in direct patient contact, although up to 58% of the day in direct patient-related activities, of which communication comprised 25.2%. Staffing levels are below clinical recommendations in four out of five specialties. National activity reports focus on the number of patient contacts but do not include information on the complexity of patient care. Conclusions: Work sampling is a useful tool in the assessment of activity in healthcare. Inadequate staff levels and limitations in activity reporting in paediatric dietetics will affect estimations for future service developments. Information obtained from the present study could contribute to the supply analysis of a workforce planning exercise in paediatric services in the future.

Trends, challenges, opportunities, and future needs of the dietetic workforce: a systematic scoping review

“…Inadequate staffing ratios were found to be common [43][44][45][46][47][48][49] and were described as a challenge due to reduced patient outcomes, 45 increased healthcare costs 44 and increased staff turnover due to burnout. 47 In addition, dietitians were more commonly found in metropolitan areas, 49 potentially resulting in lack of equitable access for individuals needing dietetic input.…”

Review of dietetic service provision and activity in spinal cord injury centres: a multicentre survey in the UK and Republic of Ireland

“…as writing clinical letters as direct patient activity, the adjusted total direct patient activity will be 49.1%. This is still low when compared with literature reporting paediatric dietitian (58.9% on direct patient's activity) 7 and the BDA that 75% of dietetic time is spent in actual direct patient contact 19 . Therefore, the BDA recommendation (75%) may not accurately reflect the proportion of time dietitians spend on indirect patient contact, nor indeed any other professionals.…”

“…A cross-sectional investigation of dietician practices was undertaken using a self-reported measurement tool. A questionnaire was developed by the Principal Investigator (SW) based on clinical expertise and previous literature 6,7 and was modified further by a team of multi-disciplinary professional working in SCICs.…”

“…2 The literature suggests that a multifaceted approach, including staff ratio allocation, time and motion study or work sampling methods, should be used by health and social care professionals to determine current staff and activity levels. [3][4][5] To date, there is a reported 'lack of basic and accurate information necessary to inform comprehensive workforce modelling supply' 6,7 and as, a report commissioned by the Scottish Executive 8 highlighted, there is a need for 'real time workforce data that is consistent, evidenced, relevant and meaningful'.…”

“…In dietetics, there is limited published evidence related to workforce measurement, staffing levels and activity 3,6,7,9,10 , and to date, there is no spinal cord injury (SCI) centre (SCIC) specific information available reporting dietetic workforce activity.…”