Evidence map›Paper›PMID 33087110›Full record

Trial reportBMC health services research2020

Sustainable waiting time reductions after introducing the STAT model for access and triage: 12-month follow up of a stepped wedge cluster randomised controlled trial.

Katherine E Harding, David A Snowdon, Luke Prendergast, Annie K Lewis, Bridie Kent, Sandy F Leggat, Nicholas F Taylor

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

Trial report in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
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

7 authors.

Katherine E HardingAllied Health Clinical Rsearch Office, Eastern Health, Level 2/5 Arnold Street, Box Hill, VIC, 3128, Australia. katherine.harding@easternhealth.org.au.ORCID http://orcid.org/0000-0003-0207-7071
David A SnowdonAllied Health Clinical Rsearch Office, Eastern Health, Level 2/5 Arnold Street, Box Hill, VIC, 3128, Australia.
Luke PrendergastLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
Annie K LewisAllied Health Clinical Rsearch Office, Eastern Health, Level 2/5 Arnold Street, Box Hill, VIC, 3128, Australia.
Bridie KentDrake Circus, Plymouth University, Plymouth, Devon, PL4 8AA, UK.
Sandy F LeggatLa Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
Nicholas F TaylorAllied Health Clinical Rsearch Office, Eastern Health, Level 2/5 Arnold Street, Box Hill, VIC, 3128, Australia.

Funding

Department of Health, State Government of Victoria NANational Health and Medical Research Council 1076777
6 · The paper itself

Abstract

backgroundTimely access is a challenge for providers of outpatient and community-based health services, as seen by the often lengthy waiting lists to manage demand. The Specific Timely Appointments for Triage (STAT) model, an alternative approach for managing access and triage, reduced waiting time by 34% in a stepped wedge cluster randomised controlled trial involving 8 services and more than 3000 participants. Follow up periods ranged from 3 to 10 months across the participating services in accordance with the stepped wedge design. This study aimed to determine whether outcomes were sustained for a full 12 months after implementation of the STAT model at each site.

methodsRoutinely collected service data were obtained for a total of 12 months following implementation of the STAT model at each of the 8 services that participated in a stepped wedge cluster randomised controlled trial. The primary outcome was time to first appointment. Secondary outcomes included non-attendance rates, time to second appointment and service use over 12 weeks. Outcomes were compared to pre-intervention data from the original trial, modelled using generalised linear mixed effects models accounting for clustering of sites.

resultsA 29% reduction in waiting time could be attributed to STAT over 12 months, compared to 34% in the original trial. A reduction in variability in waiting time was sustained. There were no significant changes in time to second appointment or in the number of missed appointments in the extended follow up period.

conclusionsSTAT is an effective strategy for reducing waiting time in community-based outpatient services. At 12 months, small reductions in the overall effect are apparent, but reductions in variability are sustained, suggesting that people who previously waited the longest benefit most from the STAT model.

trial registrationThis is a 12-month follow up of a stepped wedge cluster randomised controlled trial that was registered with the Australia and New Zealand Clinical Trials Registry ( ACTRN12615001016527 ).

Indexed as

Waiting ListsAdultAgedAmbulatory CareAustraliaCommunity Health ServicesFemaleFollow-Up StudiesHealth Services AccessibilityHumansMaleMiddle AgedModels, OrganizationalTime FactorsTriageAppointments and schedulesCommunity healthOutpatientsTriageWaiting lists

Identifiers

PMID33087110
PMCPMC7579912

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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.