Decision-making processes for the deployment of registered dietitians during the COVID-19 pandemic in Canada

What the paper says

Background/Aims In major crises, such as the COVID-19 pandemic, healthcare leaders may need to make rapid, complex decisions regarding the redeployment of staff. This study aimed to identify key factors relating to the institutional and organisational decision-making processes involved in the deployment of registered dietitians during the pandemic in Canada, and provide recommendations for optimising allied health professional deployment during future public health emergencies. Methods Semi-structured interviews were held with nine healthcare leaders, representing four Canadian provinces, who had been involved in decision making related to deployment of dietitians during the pandemic. Additional information were also gathered from media reports and documents shared by participants (e.g. emails, internal memos, policies etc). These data were used to create nine process maps, which were then analysed to identify similarities and differences in decision-making processes across organisations and provinces. Results The process maps indicated that dietitians were redeployed for at least 2 years after the onset of the pandemic, often into roles that had no relation to their specific skills. There were more similarities than differences between provinces and organisations in terms of deployment decision-making processes, with more differences being observed between public health and clinical services. These processes appeared to be more formalised in larger organisations and became increasingly structured as the pandemic progressed. Conclusions Decision-making processes for deployment of dietitians seem to have been affected more by type of healthcare setting than region or organisation. In the early stages of a crisis, the need for rapid adaptation of services may lead to less formalised deployment processes, which then become more formal over time. Implications for practice In future public health emergencies, transparent and specialisation-appropriate deployment strategies for dietitians and other allied health professionals should be implemented. Researchers should consider conducting sub-analyses by clinical profession and setting to explore differences experiences of the pandemic.