None listed
Conditions
Brief summary
This study aims to find out if this evidence-based alternative to the traditional use of triaged waiting lists reduces waiting time for a variety of community health and sub-acute ambulatory care services. It is hypothesised that this will be achieved without detrimental effects on service quality, patient outcomes, patient satisfaction or service cost.
Interventions
The STAT model is a new approach to access and triage for ambulatory services. Clinicians schedule a specified number of appointments for triage and assessment of new referrals in their weekly schedule, based on analysis of supply and demand. All patients are assessed in the first available time slot, and the clinician then prioritises the patient within the context of his/her caseload. Unlike traditional triage systems, clinicians are able to consider the relative priority of both new patients
The STAT model is a new approach to access and triage for ambulatory services. Clinicians schedule a specified number of appointments for triage and assessment of new referrals in their weekly schedule, based on analysis of supply and demand. All patients are assessed in the first available time slot, and the clinician then prioritises the patient within the context of his/her caseload. Unlike traditional triage systems, clinicians are able to consider the relative priority of both new patients and those already under their care, and the system drives clinicians to seek efficiencies in patient management and make decisions in response to demand. Each site will have a 12 week period in which to implement the new model, before post intervention data collection commences. Sites will be supported to make the change through 2 x 90 minute workshops, occurring within the first 4 weeks of the intervention period, approximately 1 week apart. Additional meetings will be held with key personal at the sites and project staff during the implementation period as required. The initial workshop will involve group training in the theory behind the model and how it works in practice, as well as an interactive component in which participants anticipate potential barriers, challenges and other issues that may arise in applying the model to the specific service in question. The second workshop is entirely interactive, and provides an opportunity to work through all the issues raised in the first workshop and develop strategies and contingency plans for each one, as well as a detailed implementation plan specific to the needs of the service. A small allocation of funds will be available to contribute to reduction in the backlog of patients waiting prior to introducing the new model, but no ongoing additional resources will be available to the services. Project staff will meet with key clinicians and managers in the service approximately monthly to monitor adherence to the model throughout the post intervention period.
Sponsors
La Trobe University
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject)
Eligibility
Sex/Gender
All
Healthy volunteers
No
Inclusion criteria
Services are eligible for inclusion in the trial if they: Are under the auspices of Eastern Health, Victoria. Provide services to outpatients either in the community or at treatment centres. Provide services that typically take the form of a series of appointments rather than a single occasion of service. Currently utilise a waiting list and triage system for managing demand. The service usage data (eg waiting time, number of appointments, non-arrival rates etc) will be included for all clients who have a first face to face appointment with included services during the data period. Potential participants will be invited to participate in consecutive order of arrival at the service until the required sample size is reached. Clients will be invited to participate in data collection for the subgroup of 40 participants pre and post intervention at each site if they: -commence services during the inclusion period -consent to participate -are accompanied by someone who can consent on their behalf in the case of children or people whose capacity to conesnt is compromised
Exclusion criteria
Services will be excluded if they are: Non Eastern Health services. Services that do not have a waiting list at the time of recruitment. Clients will be excluded from the inclusion in the subgroup of 40 patients pre/post at each service it they do not consent to participate, or do not have capacity to give consent (eg due to language barriers, age or cognitive impairment) and are not accompanied by someone who can consent on their behalf. Note that interpreters will sought wherever possible.
Outcome results
None listed