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Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial

Harding, Katherine E., Watts, Jennifer J., Karimi, Leila, O'Reilly, Mary, Kent, Bridie, Kotis, Michelle, Leggat, Sandra G., Kearney, Jackie and Taylor, Nicholas F. 2016, Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial, BMC health services research, vol. 16, Article number: 364, pp. 1-8, doi: 10.1186/s12913-016-1611-3.

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Title Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial
Author(s) Harding, Katherine E.
Watts, Jennifer J.ORCID iD for Watts, Jennifer J. orcid.org/0000-0001-8095-8638
Karimi, Leila
O'Reilly, Mary
Kent, Bridie
Kotis, Michelle
Leggat, Sandra G.
Kearney, Jackie
Taylor, Nicholas F.
Journal name BMC health services research
Volume number 16
Season Article number: 364
Start page 1
End page 8
Total pages 8
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016
ISSN 1472-6963
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Summary BACKGROUND: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitlist and triage" model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction.

METHODS/DESIGN: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12 weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial.

DISCUSSION: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.
Language eng
DOI 10.1186/s12913-016-1611-3
Field of Research 111708 Health and Community Services
111709 Health Care Administration
1117 Public Health And Health Services
0807 Library And Information Studies
Socio Economic Objective 910499 Management and Productivity not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Grant ID NHMRC1076777
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085469

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.