TO TASK SHIFT OR TASK SHARE DURING THE PANDEMIC?

Navigating nurse burnout in response to COVID-19 - MedCity News

The COVID-19 pandemic has caused a lot of strain in healthcare. You have seen an upsurge of numbers of patients, while the number of hospitals and staff has remained the same. These have led to putting up of temporary hospitals and hiring new staff. The measures have given some cushion however there is still a gap.

Focus turns to achieving high quality outcomes with the staff available. There are 2 concepts that can be used to achieve this. These are task shifting and task sharing in the healthcare system. Task shifting is transference of clinical autonomy from high qualified healthcare worker to those with shorter training and fewer qualification. Task sharing is tiered staffing model with collaborative teams of specialists and less-qualified cadres who share clinical responsibility and rely on iterative communication and training preserving high-quality outcomes.

Task shifting was developed during the HIV/AIDS epidemic, where the healthcare systems were not able to cope. Most developing countries have healthcare workers shortage. Staff with low cadre training were given basic training to fill the staff gap. For instance, community healthcare workers were trained to perform nursing tasks like counseling, patient follow up among others.

Task sharing refers to team work approach in healthcare. A team consisting of all specialties; medicine, nursing, physiotherapy, nutritionist, pharmacy etc. This is the best model however finding all at the same place is not easy. These teams are common in tertiary hospitals which are few. Primary healthcare hospitals which are more don’t have that luxury.

The COVID-19 pandemic has given the chance for both models to be implemented in different degrees. In areas with marked nurse staff shortages, some of their tasks are delegated. For instance; temperature taking, record keeping and counseling. This is being done to free up more nursing staff to do critical care nursing. This affects quality of service but frees up more nurses giving short term solutions. A huge dilemma.

The best approach should be a high breed model of both task shifting and sharing. The balance should be based on the setting and the number of specialty available. The major goal should be to achieve quality care. You should determine at the facility level what aspect to pick from the models. Staff competence and experience should guide the decision. There should be no pressure to stick to one model, but chose what works best for you from both. The availability of the models should not blind the focus from the major problem, staff shortage. The advocacy for employment of more staff should continue.

It’s not the time to debate which is better, the debate should be whether you are achieving high quality outcomes.

11 comments

  1. For implementation of this the team members have to be highly flexible and knowledgeable on their roles. Clearly identified roles for delegation to avoid the problem of over delegation. This is a concept that facilities should adopt if adopted allready, optimise it. Good stuff Mesh.

  2. This is really good! Both models are equally important depending on the healthcare setting. What's critical is the importance of having an adequate and well trained workforce.

  3. Good work. in developing economies healthcare systems especially primary facilities task sharing maybe a challenge. Task shifting may work best there. But other facilities both can work very well. This is a good piece. Going forward probably look at the effects of the two models on the nursing profession.

  4. Good work, in developing economies the health care system especially primary health facilities task sharing may be a challenge. Task shifting may work better. The question is what is the effect of these two models on nursing

  5. Thank you for reading.I agree totally with the concepts which are ingredients to task shifting and task sharing. Our individual and collective input is called for.

  6. Thank you for reading. What made us come up with the two concepts is the staff shortage experience across the world. Lets push for the shortage to be corrected. Until then task shift and task share depending on the set up.

  7. Thank you for reading.The effects of the two on nursing are immense, first task shifting put alot of strain on the nurse and the fact that most of the task will be delegated to less qualified staff may affect the quality of care. Task sharing on the other hand is the best approach though lack of specialities affect it. We just have to strike a balance.

  8. Good stuff, thought provoking. The question remains to delegate or not to delegate? Which model will be appropriate for policy makers in terms of budgeting, training and rewards?? Task shifting or task sharing?

  9. Good read Meshack, this is the way to go. Adoption of these models is the game changer in providing nursing care during this pandemic

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