American Speech-Language-Hearing Association
This position statement is an official policy of the American Speech-Language-Hearing Association (ASHA). It was approved by ASHA's Legislative Council in November 1996.
It is the position of the American Speech- Language-Hearing Association that multiskilling is not a unidimensional concept and that it cannot be evenly applied across the diverse clinical workforce. Specifically, cross-training of clinical skills is not appropriate at the professional level of practice (i.e., audiologists or speech-language pathologists). Cross-training of basic patient care skills, professional nonclinical skills, and/or administrative skills is a reasonable option that clinical practitioners at all levels of practice may need to consider depending on the service delivery setting, geographic location, patient/client population, and clinical workforce resources. (See glossary for definition of terms used in this position statement. (For further clarification, please refer to American-Speech-Language-Hearing Association. [1996, Spring]. Technical report of the ad hoc committee on multiskilling. Asha, 38, Suppl. 16, pp. 53–61.)
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Cross-training of clinical skills: involves training practitioners in one discipline to perform services traditionally regarded as within the purview or scope of practice of another discipline in an attempt to more efficiently deploy the clinical workforce to meet the needs of the patient caseload as it fluctuates at any particular point in time. Examples include training respiratory therapists to perform EEGs (electroencephalograms), or medical technologists to perform certain radiological procedures.
Cross-training of basic patient care skills: includes routine, frequently provided, easily trainable, lowrisk procedures such as suctioning patients, monitoring vital signs, and transferring and positioning patients. Identifying a facility/agency/program-specific set of patient-care skills that can be performed by various practitioners in that particular setting may lead to less fragmented and less costly patient care (e.g., bedside treatment sessions do not have to be delayed waiting for another practitioner to suction the patient; home care patients' compliance with prescribed medications can be verified by clinicians already coming to the home on a regular basis; diabetic preschoolers' blood sugar levels can be monitored by on-site clinicians).
Cross-training of professional nonclinical skills: includes skills and services such as patient education, technical writing, team dynamics/communication/leadership, and such. Establishing competency standards for such skills across the workforce may enhance the overall quality, efficiency, and coordination of service delivery.
Cross-training of administrative skills: includes programmatic activities such as quality improvement, case management, systems design, and the management of clinical services. Increasingly, as organizations downsize, such responsibilities are moving from centralization in one or more “administrative positions” to distribution among clinical practitioners. Doing so may result in more efficient use of staff and better integration of these functions with clinical service delivery
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© Copyright 1997 American Speech-Language-Hearing Association. All rights reserved.
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