None listed
Conditions
Brief summary
Provision of allied health services over 7 days per week as opposed to 5 days per week for medical and surgical hospital inpatients is a practice inconsistently applied across health services in Australia. Presently, no evidence from randomised trials is available to guide service delivery for this population. These services have developed incrementally and in an ad hoc process at Monash, Western and Melbourne Health, in a similar experience to other health services around the state. It is possible that this is wasting resources that could be used for other purposes within these organisations. This study aims to examine whether removal and provision of weekend allied health services on general medical and surgical wards has an impact on length of stay on those wards, other indicators of quality and safety of service provision, and staff satisfaction. A novel research methodology will be applied using a stepped wedge cluster randomised controlled trial design to both incrementally remove existing services, then reintroduce services in a structured, stakeholder driven process (the 2nd phase is registered as a separate trial on ANZCTR). At Monash and Western Health, existing weekend allied health services will be incrementally removed across 6 wards over a 7 month period (5 wards over 6 months at Melbourne Health). Outcomes will be collected predominantly through existing data collection processes, although additional data will be collected through staff group and key informant interviews, and random sampling of patients.
Interventions
Current physiotherapy, occupational therapy, social work, nutrition and speech pathology weekend allied health service delivery. Services delivered are the same as those done on weekdays, although the intensity of weekend services is lower (fewer hours per ward) than weekday services. Services may include mobilization, chest physiotherapy, discharge planning, assessment and prescription of aids and equipment, swallowing assessment, dietary analysis and prescription, and counselling. The duration
Current physiotherapy, occupational therapy, social work, nutrition and speech pathology weekend allied health service delivery. Services delivered are the same as those done on weekdays, although the intensity of weekend services is lower (fewer hours per ward) than weekday services. Services may include mobilization, chest physiotherapy, discharge planning, assessment and prescription of aids and equipment, swallowing assessment, dietary analysis and prescription, and counselling. The duration of this intervention is 6 months: the current model of weekend allied health service delivery will be rolled-in across 6 acute medical and surgical units at Dandenong Hospital, 6 at Western Hospital and 5 at Royal Melbourne Hospital one-by-one on a monthly basis.
Sponsors
Department of Health, Victoria
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients admitted to participating acute medical / surgical wards at Dandenong Hospital, Western Hospital or Royal Melbourne Hospital during trial period
Exclusion criteria
Data from patients who are exposed to both control and intervention conditions will be excluded from the analyses.
Outcome results
None listed