Health conditions for which patients are seeking care at one of the following eight medical specialist clinics: general neurology, movement disorders, cardiology, endocrinology, gastroenterology, gynaecology, paediatrics, respiratory Other
Conditions
Interventions
Stepped wedge cluster randomized controlled trial with four pairs (n = 8 clinics) of specialty medical outpatient clinics (clusters), with a 6-month pre-intervention period followed by sequential intr
Sponsors
La Trobe University
Eligibility
Sex/Gender
All
Age
18 Years to 120 Years
Inclusion criteria
Inclusion criteria: Quantitative data will be routinely collected data from health systems and will not require recruitment of participants. Qualitative data recruitment: Clinic Staff: All staff involved in the delivery of services at the participating clinic (estimated n = 4 to 8 per clinic) will be invited to participate in focus groups at three times during the trial, aligned with the stages of implementation (pre, during and post). Staff participants will include medical staff, clerical staff and other members of the team (such as nursing and/or allied health professionals) as appropriate for each clinic, as well as the relevant managers of the service. Consumers will be eligible for inclusion if they: 1. Attend a first appointment with the participating clinic during the period of interest 2. Are over 18 years of age 3. Are judged by the specialist they see in the clinic to have the capacity to provide consent 4. Have sufficient oral communication capacity to be able to participate in an interview of up to 45 minutes duration with a researcher (with an interpreter if required) Of those who express interest, participants will be purposively selected with the intention to include participants from all 8 clinics and diversity in relation to age, gender identity, cultural diversity and health status.
Exclusion criteria
Exclusion criteria: Does not meet the inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Waiting time measured as the time from referral to first appointment (in days) for all patients who receive a first appointment with a participating clinic during the pre- or post-implementation period of the trial | — |
Secondary
| Measure | Time frame |
|---|---|
| Patient-level health service outcomes: 1. Attendance is measured as attended or failed to attend for each index appointment (first appointment attended) for all new patients during the pre-implementation period and post-implementation period. 2. Appointment outcome as rebooked or discharged for each index appointment (first appointment attended) for all new patients during the pre-implementation period and post-implementation period. 3. Health service use (emergency visits) is measured as the number of presentations to the public Emergency Department servicing the local region, 6 months prior to and 6 months after the index appointment (collected for patients whose index appointment falls in the final 6 months of the pre-implementation period or the first 6 months of the post-implementation period at each clinic) 4. Health service use (hospital admissions) is measured as the number of admissions to public hospitals servicing the local region, 6 months prior to and 6 months after the index appointment (collected for patients whose index appointment falls in the final 6 months of the pre-implementation period or the first 6 months of the post-implementation period at each clinic) 5. Health service use (bed days) is measured as the number of nights spent in public hospitals servicing the local region, 6 months prior to and 6 months after the index appointment (collected for patients whose index appointment falls in the final 6 months of the pre-implementation period or the first 6 months of the post-implementation period at each clinic) Clinic outcomes: 1. Clinic supply is measured as the number of clinic appointments scheduled each week during the pre-implementation, implementation and post-implementation periods at each participating clinic 2. Clinic use is measured as the number of clinic appointments attended each week during the pre-implementation, implementation and post-implementation periods at each participating clinic 3. Allocation of clinic resources is mea | — |
Countries
Australia
Contacts
Public ContactKatherine Harding
Outcome results
None listed