Background
Methods
Setting
Survey design
Questions | Response categories |
---|---|
Task delegation | |
Who is typically undertaking the following task regarding diagnosing of patients with COPD in your practice? Select one or more answers | GP, including GP trainee/Nurse/Medical laboratory technician/Secretary or other staff member Not performed/Performed elsewhere/Do not know |
Who is typically undertaking the following task regarding annual check-ups of patients with COPD in your practice? Select one or more answers | GP, including GP trainee/Nurse/Medical laboratory technician/Secretary or other staff member Not performed/Performed elsewhere/Do not know |
Who is typically undertaking the following task regarding semiannual and quarterly check-ups of patients with COPD in your practice? Select one or more answers | GP, including GP trainee/Nurse/Medical laboratory technician/Secretary or other staff member Not performed/Performed elsewhere/Do not know |
Who is typically undertaking the following task regarding exacerbations in patients with COPD in your practice? Select one or more answers | GP, including GP trainee/Nurse/Medical laboratory technician/Secretary or other staff member Not performed/Performed elsewhere/Do not know |
Job satisfaction | |
How satisfied are you with the challenges in your work? | Very satisfied/satisfied/unsatisfied/very unsatisfied |
How satisfied are you with the general working environment in your practice? | Very satisfied/satisfied/unsatisfied/very unsatisfied |
How satisfied are you with your job as a whole, everything taken into consideration? | Very satisfied/satisfied/unsatisfied/very unsatisfied |
Participants
Measures
Degree of task delegation | Definition of the degree of task delegation | Content of delegated tasks | GPs N (%) | Staff N (%) |
---|---|---|---|---|
Minimal degree: | No responsibility for assessment in treatment or for decision making regarding further treatment. | Staff manages laboratory tasks and clinical procedures such as drawing blood samples and measuring blood pressure. | 832 (66.83) | 355 (56.26) |
Medium degree: | Delegated responsibility for assessment in treatment, but no responsibility for decision making regarding further treatment. | Staff performs more complex tasks such as assessment of functional level, e.g. using an MRC scale, or manages independent consultations, e.g. counselling with regard to smoking cessation or diet and exercise. | 294 (23.61) | 164 (25.99) |
Maximal degree: | Delegated responsibility for assessment in treatment and/or decision making regarding further treatment. | Staff performs highly complex tasks such as assessment of needs for initiating or adjusting COPD medication or assessment of indication for use of antibiotics. | 119 (9.56) | 112 (17.75) |
Total | 1245 (100) | 631 (100) |
Data analysis
Satisfaction | |||||
---|---|---|---|---|---|
Healthcare professional | Satisfaction variable | Very satisfied | Satisfied | Unsatisfied | Very Unsatisfied |
GPs
N = 1245 | Overall satisfaction | 423 (33.98%) | 724 (58.15%) | 88 (7.07%) | 10 (0.80%) |
Challenges in work | 595 (47.79%) | 600 (48.19%) | 46 (3.69%) | 4 (0.32%) | |
Working environment | 538 (43.21%) | 617 (49.56%) | 78 (6.27%) | 12 (0.96%) | |
Staff
N = 631 | Overall satisfaction | 291 (46.12%) | 322 (51.03%) | 18 (2.85%) | 0 (0%) |
Challenges in work | 289 (45.80%) | 318 (50.40%) | 22 (3.49%) | 2 (0.32%) | |
Working environment | 215 (34.07%) | 350 (55.47%) | 60 (9.51%) | 6 (0.95%) |
Results
Task delegation and the staff’s job satisfaction
Job satisfaction | |||||||
---|---|---|---|---|---|---|---|
Healthcare professional | Degree of delegation | Overall job satisfaction | Challenges in work | Working environment | |||
OR adj. (95% CI) |
p
| OR adj. (95% CI) |
p
| OR adj. (95% CI) |
p
| ||
Staff
N = 631 | Minimal | 1.23 (0.75;2.02) | 0.401 | 0.98 (0.62;1.55) | 0.935 | 2.21 (0.62;7.86) | 0.222 |
Medium | 1 | - | 1 | 1 | |||
Maximal | 1.88 (1.00;3.51)**
| 0.048 | 1.26 (0.71;2.21) | 0.431 | 4.33 (0.78;24.08)*
| 0.094 | |
GPs
N = 1245 | Minimal | 1.08 (0.80;1.45) | 0.618 | 1.00 (0.76;1.31) | 0.976 | 1.03 (0.75;1.42) | 0.832 |
Medium | 1 | - | 1 | 1 | |||
Maximal | 1.57 (0.97;2.53)*
| 0.067 | 1.46 (0.94;2.27)*
| 0.090 | 1.61 (0.96;2.68)*
| 0.069 |
Degrees of task delegation and GPs’ job satisfaction
Discussion
Strengths and limitations of the study
Practice characteristics | Number of healthcare professionals | |
---|---|---|
GPs | Staff | |
N (%) |
N (%) | |
Practice type | ||
Singlehanded | 198 (15.9%) | 91 (14.4%) |
Partnership | 1047 (84.1%) | 540 (85.6%) |
Gender | ||
Male | 597 (48.0%) | n.a.a
|
Female | 648 (52.0%) | n.a.a
|
Age | ||
≤34 | 26 (4.1%) | |
35–44 | 291 (23.4%) | 185 (29.3%) |
45–54 | 393 (31.6%) | 262 (41.5%) |
55–64 | 477 (38.3%) | 154 (24.4%) |
≥65 | 84 (6.7%) | 4 (0.6%) |
Time pressure | ||
Very often | 332 (26.7%) | 29 (4.6%) |
Often | 512 (41.1%) | 149 (23.6%) |
Sometimes | 346 (27.8%) | 355 (56.3%) |
Not so often | 55 (4.4%) | 98 (15.5%) |
Occupation | ||
Nurse | n.a. | 444 (70.4%) |
Medical laboratory technician | n.a. | 30 (4.8%) |
Healthcare worker | n.a. | 24 (3.8%) |
Secretary | n.a. | 109 (17.3%) |
Other | n.a. | 24 (3.8%) |
Total | 1245 (100) | 631 (100%) |