Exploring task shifting in hospitals: an application of the Theoretical Framework of Acceptability

Abstract Aim The Theoretical Framework of Acceptability (TFA) is an evidence-based multi-construct framework designed to assess acceptability of changes. We aimed to investigate the applicability of the TFA in assessing the acceptability of task shifting of clinical pharmacy services in hospital settings. Subject and methods We conducted a cross-sectional survey in Danish hospital departments and hospital pharmacies. Participants, including healthcare professionals and managers, completed an adapted version of the TFA questionnaire assessing acceptability of task shifting for medication dispensing (from nurses to pharmaconomists) and medication review (from physicians to clinical pharmacists). Participants responded before, during, or after implementation of changes. Results A total of 235 respondents completed the survey for medication dispensing, while 153 respondents completed the survey for medication review. For both clinical pharmacy service cases, increases in scores were observed over time during the implementation phases. Although certain specific items had low scores, these did not appear to impact the general acceptability of the implemented changes. Delegators (nurses, physicians, department managers) generally reported low mean acceptability scores before implementation, with scores increasing during the subsequent phases. In contrast, recipients (pharmaconomists, clinical pharmacists, pharmacy managers) generally reported high mean acceptability scores before implementation, which either increased slightly or remained steady throughout the implementation phases. Conclusion This study demonstrates the potential of the TFA as a tool to identify and address acceptability to task shifting in a hospital setting from temporal implementation phases. Our findings suggest that most acceptability items increases over time for both delegators and recipients during task-shifting initiatives.