Early experience with a dietitian-led gastroenterology clinic in a regional Queensland hospital suggests many patients can be satisfactorily managed by a dietitian.
A majority (78%) of the 82 patients seen at the outpatient clinic during a 15-month pilot were managed exclusively by the dietitian during initial and review appointments.
The dietitian was locally credentialed to request pathology, colonoscopies and scans however all patient management strategies were approved by a gastroenterologist prior to implementation.
Dietitian Dominique Ryan, lead author on an article describing the model of care, said a lot more research was required before dietitians would be working autonomously in GE clinics.
“The dietitian involved had experienced extended scope of practice models in the UK and was a strong advocate for the program here.”
“However there has not been a lot of research regarding extended scope of practice for dietitians compared to other health professionals,” she said.
As with nurse endoscopy and other initiatives, the main arguments for extended scope of practice include a more efficient health service with improved access to patient care.
Participants were category 2 and 3 patients with conditions including suspected or confirmed coeliac disease or IBD, undiagnosed low heamoglobin, gastroesophageal reflux disease and malnutrition.
Collectively, their average wait time was 148 days however it is unclear whether the clinic resulted in improved patient flow. Recommended time frames for category 2 and 3 gastroenterology outpatients in Queensland are 90 and 365 days respectively.
Ms Ryan said patient satisfaction was almost 100% with patients reporting satisfaction with the consultation outcomes and overall clinic experience. Only a few patient complaints regarding administration matters were reported.
The health professionals involved in the program also reported that the project enhanced the multidisciplinary team.
“My initial interest in extended scope of practice was from the point of view of improving the efficiency of health services but this has opened my eyes to the potential,” Ms Ryan said.
“Patients benefit, dieticians benefit and, importantly, it strengthens professional networks and helps share knowledge.”