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Table 3 The logic model and developing theories of change

From: Implementing large-scale workforce change: learning from 55 pilot sites of allied health workforce redesign in Queensland, Australia

Drivers Contexts Mechanisms Outputs Outcomes
Workforce drivers Support from existing workforce Engagement   Workforce outcomes
Workforce recruitment and retention, skills shortages, workforce participation rates (particularly in rural areas), inefficient use of staff, improved models of care, improved quality Support from ‘powerful elites’, inter-disciplinary support, inter-institutional support, willingness to delegate, organizational culture that is supportive of change. Team buy in, corporate sponsorship and senior management support, medical support, engagement of staff/clinicians   Working to full scope of practice, wider uptake of role, enhanced team processes/working, engagement of rural practitioners, improved relationships
Policy drivers Clarity of role definition, supportive human resource (HR) policies, appropriate legislative scaffolding, funding secured, clear strategic direction, governance structures established Resources to facilitate new roles New resources to support the development and implementation of new roles, Codified processes, Training, Creation of new positions. Service outcomes
Industrial agreements, Productivity Commission health workforce position paper, need to meet national targets Sufficient funding, data quality and compatibility, dedicated resources and facilities, sufficient staffing, sufficient time, appropriate tools to support implementation, access to training and support, Calderdale Framework, evidence of success from other areas (literature/other sites) and resources. Implementation of new roles and ability to work to full scope of practice, acceptance of new roles, better understanding of roles, improved service efficiencies increased service capacity, reduced waiting lists, cost savings,
Population drivers   Engagement   Population/patient outcomes
Demographics of the population, changing health needs, changing patient expectations, need to increase patient safety, need to increase accessibility.   Local engagement, patient engagement.   Improved patient satisfaction & functional outcomes, improved pathways of care, improved diagnostic accuracy, Improved accessibility.
Service drivers
Waiting lists, address service gaps, improved patient outcomes, improved efficiency of services, meeting demand/overcoming shortages
  Remove strategic uncertainty Project management   Sustainability and transfer of learning, other service redesign spin-offs, organizational learning, understanding the change process.
  Minimize disruption from organizational changes, limit competing projects/priorities, limit implementation of new roles in times of substantial changes. Clearly defined problem and scope, realistic project expectations, consistent expectations, skilled project management, project manager on site and connected to management and reporting structures.