Evidence map›Paper›PMID 27506923›Full record

Trial reportBMC health services research2016

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

Katherine E Harding, Jennifer J Watts, Leila Karimi, Mary O'Reilly, Bridie Kent, Michelle Kotis, Sandra G Leggat, Jackie Kearney, Nicholas F Taylor

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Review
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katherine E HardingLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia. Katherine.harding@easternhealth.org.au.
Jennifer J WattsDeakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
Leila KarimiLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
Mary O'ReillyEastern Health, 5 Arnold Street, Box Hill, VIC, 3128, Australia.
Bridie KentPlymouth University, Drake Circus, Plymouth, Devon, PL4 8AA, UK.
Michelle KotisVictorian Department of Health and Community Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia.
Sandra G LeggatLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
Jackie KearneyVictorian Department of Health and Community Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia.
Nicholas F TaylorLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWaiting 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/

designA 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.

trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12615001016527 . Approved 15/9/2015.

Indexed as

Ambulatory CareAppointments and SchedulesAustraliaCommunity Health ServicesCost-Benefit AnalysisHealth Services AccessibilityHumansModels, OrganizationalNew ZealandPatient SatisfactionProspective StudiesQuality ImprovementReferral and ConsultationTriageWaiting Lists

Identifiers

PMID27506923
PMCPMC4977711

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.