Table 2 WHO Global Competency and Outcomes Framework for UHC: practice activities [9] plus three sub-categories added for this study

Domain I: Individual Health Domain

Practice activities relating to the provision of health services for an individual

1.

Gathering information through interviewing and assessment

Tasks within this practice activity relate to gathering and confirming information through interviewing, taking a history and performing a cognitive, emotional, mental, physical or social assessment (NB excluding diagnostic testing)

2.

Formulating a judgement following a clinical encounter

Tasks within this activity relate to interpreting information and clinical decision-making; this is the process of making a diagnosis or classifying a condition or action plan, for example, based on a decision-making tree

3.

Managing conversations with individuals and their families

Tasks within this activity may include difficult conversations, such as discussing a diagnosis, prognosis or management plan. This is an overarching outcome relating to “managing the patient encounter” and is relevant to many other practice activities such as gathering information or developing the treatment plan; but it would duplicate the resource mapping

4.

Advocacy for individual health needs

Tasks within this practice activity include supporting the individual to access health services; this may include practical aspects of help, helping the individual increase their health literacy or representing the individual in decision-making about their care

5.

Providing information and support to impact individual health behaviours

Tasks towards this practice activity relate to health promotion and prevention goals of care; such as providing information about positive or harmful behaviours, distributing non-medical supplies such as bed nets, or monitoring and tracking behaviour change. Tasks within this practice activity may follow from an individual’s diagnosis and managing their health risks and so they are tailored to that individual, but they exclude post-procedural care or post-procedural counselling

6.

Gaining informed consent

Tasks within this practice activity comprise the component steps of sharing or clarifying information, addressing concerns, and confirming and documenting consent

7.

Ordering, administering and interpreting the results of diagnostic and screening procedures

Tasks within this practice activity relate to determining the need for a test or procedure, carrying that procedure out, and interpreting the results of the test. NB This is distinct from using those results to determine the implications of the results towards developing a treatment and management plan, in Practice Activity 8

8.

Developing and adjusting a management plan

Tasks within this practice activity are part of the process to interpret information about the individual and their health needs, and to determine with them the management plan. Tasks also reflect the process of implementing the management plan, including identifying resources and coordinating others’ roles; as well as interpreting monitoring information and revising and adjusting a plan, including the withdrawal or end of a plan

9.

Prescribing medications or therapeutics

Tasks within this practice activity reflect the decision-making process towards prescribing decisions, as well as the documentation of a prescription, and taking actions to ensure the follow-up or monitoring of the medications within a wider management plan

10.

Preparing and dispensing medications or therapeutics

Tasks within this practice activity describe any preparation or mixing of medications prior to dispensing to the individual; and the interaction of dispensing including providing information about self-administration and side-effects

11.

Administering medications or therapeutics

Tasks within this practice activity include any preparation for administration, the administration of medications/therapeutics, as well as monitoring for side-effects. NB This excludes self-administration; this describes the administration of a medication by the health workers

12.

Selecting assistive products

Tasks within this practice activity include the specific assessments to select and specify an assistive product, ordering the product and writing instructions for its use

13.

Providing assistive products

Tasks within this practice activity are the preparing, fitting and/or setting up of the product, as well as supporting the individual to use it. Tasks also include monitoring and follow-up, and basic maintenance and repairs or adaptations of the product

14.

Providing non-pharmacological health interventions

This includes all tasks (excluding medications or therapeutics) towards a single intervention, procedure or health service: this includes preparing the individual for the procedure; performing or assisting in the provision of a procedure; monitoring the individual’s response during or following the procedure including follow-up visits; and post-procedure counselling

15.

Providing treatment and care support to individuals

Tasks within this practice activity are related to the individual, rather than the provision of a procedure. This might include clinical support tasks such as wound care, often in a different setting to the preceding non-pharmacological interventions, e.g. surgery; or it might be education and training the individual in self-care; or providing emotional or psychological support for coping with a diagnosis or steps in a management plan

15a

Providing for an individual Emergency response

Additional sub-category

16.

Managing end-of-life and bereavement care

Tasks within this practice activity are specifically oriented towards end of life, including provision of palliative care, providing comfort and psychosocial support to the individual and their carers. It excludes signing a death certificate (part of Practice Activity 27: documentation)

16a

Providing a death declaration

Additional sub-category

16b

Managing hospice care

Additional sub-category

17.

Reporting notifiable diseases, conditions or events

Tasks within this practice activity relate to reporting and surveillance of an individual’s health status (disease, condition or event) in relation to reporting criteria

18.

Providing a clinical presentation to other health workers

Tasks within this practice activity encompass handovers and referrals for the purpose of transferring responsibility for care; it could take verbal or written form

19.

Moving and transporting individuals

Tasks within this practice activity describe the moving, handling and transporting of individuals, including planning, preparation of aids, monitoring the individual during the episode and returning equipment for subsequent use

20.

Coordinating transfer to another care environment

All practical tasks towards the transfer of care between environments—determining the basis for the transfer is part of Practice Activity 8: developing and adjusting a management plan. Tasks here include evaluating options, developing a transfer plan, making practical arrangements and care coordination

Domain II: Population Health Domain

Practice activities relating to the provision of health services for communities

21.

Assessing community health needs

Tasks within this practice activity relate to efforts to plan for an assessment, coordinate governance, collect and interpret information, propose options to address the findings, and report on the findings

22.

Planning and delivering community health programmes

Tasks within this practice activity are acting on the findings of a community health assessment, from planning a programme, preparing, implementing and evaluating the programme

23.

Managing public health communication

Tasks within this practice activity relate to public (mass) communications, from determining the need for communications, selecting the appropriate method, developing communications materials and content and evaluating the communications efforts

24.

Developing preparedness for health emergencies and disasters, including disease outbreaks

Tasks within this practice activity are around strengthening community preparedness in the case of an emergency or disaster, from assessing preparedness, participating in, planning or running preparedness activities, preparing resources, monitoring and evaluating preparedness, and monitoring and evaluating the risks of health emergencies and disasters according to health data

25.

Responding to health emergencies and disasters, including disease outbreaks

Tasks within this practice activity describe the efforts to respond to known emergencies or disaster events, including monitoring the situation, ensuring communications, organizing supplies and resources, monitoring, evaluating and coordinating the response, and developing recovery plans. NB This relates to the response as a collective effort but excludes tasks towards individual health services which are mapped to practice activities 1–20 in the Individual Health Domain

26.

Advocacy for community health needs

Tasks within this practice activity include the breadth of actions to advocate for and with a community, from developing an advocacy strategy, identifying stakeholders, mobilizing the community, taking actions and evaluating the impact

27.

Accessing and documenting information

Tasks towards accessing, documenting and validating information, including issuing legal documentation such as prescriptions or death certifications. More broadly, this practice activity also describes tasks towards developing information management structures

Domain III: Management and Organization Domain

Practice activities relating to the effective use of human, physical and financial resources

28.

Registering individuals for health services

Tasks within this practice activity include outreach to identify the individuals to be registered (for example, contact tracing), as well as conducting initial (non-clinical) triage, gathering information and inputting that information into a health information system

29.

Delivering quality improvement activities

Tasks within this practice activity include identifying areas of improvement, planning, implementing, coordinating, overseeing and evaluating impact of quality improvement initiatives

30.

Providing workplace-based learning and supervision

Tasks within this practice activity are those towards providing supervision, feedback, formal or informal workplace-based learning, and reporting on performance. NB Beyond the pre-service training pathway for health workers for 12–48 months (the lens through which this framework has been developed), this could be extended to include specialized education responsibilities including curricula design, development and implementation, assessment or standard-setting and developing curricula resources

31.

Managing human resources

Tasks within this practice activity are those towards coordinating, overseeing and planning for the performance of other health workers, such as performance management, estimating workforce needs, scheduling or taking actions to ensure safety and well-being in the workplace

32.

Managing financial resources

Tasks within this practice activity include managing a budget, making budget decisions, keeping financial records or processing payments or billing

33.

Managing physical resources

Tasks within this practice activity relate to the use of, storing or maintaining physical resources such as equipment or workspaces. This also includes making decisions around the use of physical resources and stock control

34.

Participating in evaluation and research

Tasks within this practice activity relate to sharing, collecting or recording information as it relates to research activities, as well as interpreting findings. NB Beyond the pre-service training pathway for health workers for 12–48 months (the lens through which this framework has been developed), this could be extended to include specialized research responsibilities including ethical approvals, research study design, conducting research, writing and disseminating findings

35.

Developing, evaluating and implementing local policies, procedures and guidelines

Tasks within this practice activity incorporate contributions to a collective policy-making process, from contributing information, gathering data, evaluating information, drafting text or translating a policy into local procedures; as well as piloting or monitoring implementation