Purpose: In many rural places, health services struggle to maintain an adequate health workforce to meet their communities’ health care needs. Shortages of allied health professionals are of particular and growing concern. To address this challenge, a two-year Whole-of-Person Retention Improvement Project was developed involving a research partnership with two rural public health services in Victoria, Australia. This project was informed by the author’s Whole-of-Person Retention Improvement Framework (WoP-RIF), aimed to produce new knowledge for rural health services to attract, recruit, and improve the retention of allied health professionals. A set of evidence-informed and contextually relevant recommendations were made in the project’s initial observational phase to strengthen each service’s allied health workforce, 10 of which were shared. The objective of this phase of the project was to explore the challenges and enablers that two rural health services experienced in developing and implementing strategies for allied health workforce improvement. Method: The methodological approaches used for this intervention study were participatory action research and a realist evaluation. The data sources used for the realist evaluation included qualitative (focus group) and observational (project documents and fieldnotes). Results: The results outline the key responses made by the regional and rural health service to implement the 10 shared recommendations and are presented under their relevant WoP-RIF domains: workplace/organisational, role/career, and community/place. The key and shared contexts, drivers, mechanisms, outputs, and outcomes are presented under each recommendation, and where possible, an assessment is made regarding sustainability beyond the project period. Conclusions: The implementation of the recommendations is a complex process requiring whole-of-organisation support by the participating rural public health services. This study identifies five facilitators for successful implementation: 1) the project is considered a strategic human resources initiative and overseen by the executive; 2) it has strong champion(s) in the executive staff; 3) human resources is part of the strategic decision-making arrangements; 4) the change management process is facilitated and led by staff from the target clinical workforce(s); and 5) a partnership approach with local council is adopted for strategies requiring community support and engagement.

Author Bio(s)

Dr Catherine (Cath) Cosgrave PhD, MA, B.Com, Churchill Fellow 2018 is an adjunct Research Fellow at New England Institute of Healthcare Research, School of Rural Medicine, University of New England. Dr Cosgrave is a social scientist and qualitative researcher with internationally recognised expertise in rural health workforce.


Acknowledgements: Dr Cosgrave acknowledges the executive staff, allied health managers, and newly recruited allied health professionals who generously gave their time to participate in this study, and also the support of University of Melbourne – Department of Rural Health and the two Victorian public health services that participated. This project was funded under the Australian Government Department of Health Rural Health Multidisciplinary Training Program. The views expressed in this publication are those of the author and do not necessarily reflect the views of the funding agency. Dr Cosgrave wishes to thank Dr Christina Malatzky for providing feedback on early drafts of this manuscript, Joanna Dolan for editing, and Bruce Naylor for graphic design.




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