Top

Published in:

Open Access 01-12-2018 | Study protocol

Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol

Authors: Mitchell N. Sarkies, Jennifer White, Meg E. Morris, Nicholas F. Taylor, Cylie Williams, Lisa O’Brien, Jenny Martin, Anne Bardoel, Anne E. Holland, Leeanne Carey, Elizabeth H. Skinner, Kelly-Ann Bowles, Kellie Grant, Kathleen Philip, Terry P. Haines

Published in: Implementation Science | Issue 1/2018

Abstract

Background

It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers.

Methods

This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up.

Discussion

Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice.

Trial registration

This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12618000029291). Universal Trial Number (UTN): U1111-1205-2621.

Available only for authorised users

Grol R. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001;39(8):II-46–54.

Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318(7182):527–30.CrossRefPubMedPubMedCentral

Slade SC, Philip K, Morris ME. Frameworks for embedding a research culture in allied health practice: a rapid review. Health Res Policy Syst. 2018;16(1):29. https://doi.org/10.1186/s12961-018-0304-2.CrossRefPubMedPubMedCentral

Hyder AA, Bloom G, Leach M, Syed SB, Peters DH, Future Health Systems: Innovations for E. Exploring health systems research and its influence on policy processes in low income countries. BMC Public Health. 2007;7:309. https://doi.org/10.1186/1471-2458-7-309.CrossRefPubMedPubMedCentral

Lane H, Sarkies M, Martin J, Haines T. Equity in healthcare resource allocation decision making: a systematic review. Soc Sci Med. 2016;175:11–27. https://doi.org/10.1016/j.socscimed.2016.12.012.CrossRefPubMed

Haines TP, Foster MM, Cornwell P, Fleming J, Tweedy S, Hart A, et al. Impact of enhanced primary care on equitable access to and economic efficiency of allied health services: a qualitative investigation. Aust Health Rev. 2010;34(1):30–5.CrossRefPubMed

Labonté R. Health systems governance for health equity: critical reflections. Revista de salud pública. 2010;12:62–76.CrossRefPubMed

Harding KE, Porter J, Horne-Thompson A, Donley E, Taylor NF. Not enough time or a low priority? Barriers to evidence-based practice for allied health clinicians. J Contin Educ Health Prof. 2014;34(4):224–31.CrossRefPubMed

Lizarondo L, Grimmer-Somers K, Kumar S. A systematic review of the individual determinants of research evidence use in allied health. J Multidiscip Healthc. 2011;4:261–72. https://doi.org/10.2147/JMDH.S23144.CrossRefPubMedPubMedCentral

10.

Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83(9):786–805.PubMed

11.

Stevenson K, Lewis M, Hay E. Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? J Eval Clin Pract. 2006;12(3):365–75.CrossRefPubMed

12.

Salls J, Dolhi C, Silverman L, Hansen M. The use of evidence-based practice by occupational therapists. Occup Ther Health Care. 2009;23(2):134–45.CrossRefPubMed

13.

Hanney SR, Castle-Clarke S, Grant J, Guthrie S, Henshall C, Mestre-Ferrandiz J, et al. How long does biomedical research take? Studying the time taken between biomedical and health research and its translation into products, policy, and practice. Health Res Policy Syst. 2015;13(1):1.CrossRefPubMedPubMedCentral

14.

Wallin L. Knowledge translation and implementation research in nursing. Int J Nurs Stud. 2009;46(4):576–87. https://doi.org/10.1016/j.ijnurstu.2008.05.006 CrossRefPubMed

15.

Westfall JM, Mold J, Fagnan L. Practice-based research—“Blue Highways” on the NIH roadmap. JAMA. 2007;297(4):403–6.CrossRefPubMed

16.

Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510–20.CrossRefPubMedPubMedCentral

17.

Metcalfe C, Lewin R, Wisher S, Perry S, Bannigan K, Moffett JK. Barriers to implementing the evidence base in four NHS therapies: dietitians, occupational therapists, physiotherapists, speech and language therapists. Physiotherapy. 2001;87(8):433–41.CrossRef

18.

Bennett S, Tooth L, McKenna K, Rodger S, Strong J, Ziviani J, et al. Perceptions of evidence-based practice: a survey of Australian occupational therapists. Aust Occup Ther J. 2003;50(1):13–22.CrossRef

19.

Iles R, Davidson M. Evidence based practice: a survey of physiotherapists’ current practice. Physiother Res Int. 2006;11(2):93–103.CrossRefPubMed

20.

Döpp CM, Graff MJ, Rikkert MGO, van der Sanden MWN, Vernooij-Dassen MJ. Determinants for the effectiveness of implementing an occupational therapy intervention in routine dementia care. Implement Sci. 2013;8(1):1.CrossRef

21.

Skinner EH, Hough J, Wang YT, Hough CR, Southby A, Snowdon DA, et al. Physiotherapy departments in Australian tertiary hospitals regularly participate in and disseminate research results despite a lack of allocated staff: a prospective cross-sectional survey. Physiother Theory Pract. 2015;31(3):200–6.CrossRefPubMed

22.

Skinner EH, Williams CM, Haines TP. Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities. Aust Health Rev. 2015;39(3):312–4.CrossRefPubMed

23.

Sarkies MN, Bowles K-A, Skinner EH, Haas R, Lane H, Haines TP. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review. Implement Sci. 2017;12(1):132. https://doi.org/10.1186/s13012-017-0662-0.CrossRefPubMedPubMedCentral

24.

Borkowski D, McKinstry C, Cotchett M, Williams C, Haines T. Research culture in allied health: a systematic review. Aust J Prim Health. 2016;22(4):294–303.CrossRefPubMed

25.

Williams C, Miyazaki K, Borkowski D, McKinstry C, Cotchet M, Haines T. Research capacity and culture of the Victorian public health allied health workforce is influenced by key research support staff and location. Aust Health Rev. 2015;39(3):303–11.CrossRefPubMed

26.

Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implementation Sci. 2012;7(1):50.CrossRef

27.

Scott SD, Albrecht L, O’Leary K, Ball G, Hartling L, Hofmeyer A, et al. Systematic review of knowledge translation strategies in the allied health professions. Implement Sci. 2012;7(1):70.CrossRefPubMedPubMedCentral

28.

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. https://doi.org/10.1186/1748-5908-4-50.CrossRefPubMedPubMedCentral

29.

Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, et al. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Asses. 2004;8(6):iii–v. 1-72CrossRef

30.

Beynon P, Chapoy C, Gaarder M, Masset E. What difference does a policy brief make? Full report of an IDS, 3ie, Norad study. New Delhi: Institute of Development Studies and the International Initiative for Impact Evaluation (3ie); 2012. http://www.3ieimpact.org/media/filer_public/2012/08/22/fullreport_what_difference_does_a_policy_brief_make__2pdf_-_adobe_acrobat_pro.pdf.

31.

Jones N, Walsh C. Policy briefs as a communication tool for development research: Overseas development institute (ODI). London; 2008.

32.

LaRocca R, Yost J, Dobbins M, Ciliska D, Butt M. The effectiveness of knowledge translation strategies used in public health: a systematic review. BMC Public Health. 2012;12:751. https://doi.org/10.1186/1471-2458-12-751.CrossRefPubMedPubMedCentral

33.

Dobbins M, Hanna SE, Ciliska D, Manske S, Cameron R, Mercer SL, et al. A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009;4(1):1–16. https://doi.org/10.1186/1748-5908-4-61.CrossRef

34.

Bornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci. 2015;10(1):1–12. https://doi.org/10.1186/s13012-015-0351-9.CrossRef

35.

Dagenais C, Laurendeau M-C, Briand-Lamarche M. Knowledge brokering in public health: a critical analysis of the results of a qualitative evaluation. Eval Program Plann. 2015;53:10–7. https://doi.org/10.1016/j.evalprogplan.2015.07.003 CrossRefPubMed

36.

Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O’Mara L. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009;4 https://doi.org/10.1186/1748-5908-4-23.

37.

Haines TP, O’Brien L, Mitchell D, Bowles K-A, Haas R, Markham D, et al. Study protocol for two randomized controlled trials examining the effectiveness and safety of current weekend allied health services and a new stakeholder-driven model for acute medical/surgical patients versus no weekend allied health services. Trials. 2015;16(1):1.CrossRef

38.

Haines T, Bowles K, Mitchell D, O’Brien L, Markham D, Plumb S, et al. Impact of disinvestment from weekend allied health services across acute medical and surgical wards: 2 stepped-wedge cluster randomised controlled trials. PLoS Med. 2017;14(10):e1002412.CrossRefPubMedPubMedCentral

39.

Campbell L, Bunston R, Colangelo S, Kim D, Nargi J, Hill K, et al. The provision of weekend physiotherapy services in tertiary-care hospitals in Canada. Physiother Can Physiother. 2010;62(4):347–54. https://doi.org/10.3138/physio.62.4.347.CrossRef

40.

Haas R, et al. Early commencement of physical therapy in the acute phase following elective lower limb arthroplasty produces favorable outcomes: a systematic review and meta-analysis examining allied health service models. Osteoarthritis Cartilage. 2016;24(10):1667–81.CrossRefPubMed

41.

Shaw KD, Taylor NF, Brusco NK. Physiotherapy services provided outside of business hours in Australian hospitals: a national survey. Physiother Res Int. 2013;18(2):115–23.CrossRefPubMed

42.

Scrivener K, Jones T, Schurr K, Graham PL, Dean CM. After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review. J Phys. 2015;61(2):61–7. https://doi.org/10.1016/j.jphys.2015.02.017.

43.

Peiris CL, Taylor NF, Shields N. Extra physical therapy reduces patient length of stay and improves functional outcomes and quality of life in people with acute or subacute conditions: a systematic review. Arch Phys Med Rehabil. 2012;92(9):1490–500. https://doi.org/10.1016/j.apmr.2011.04.005.CrossRef

44.

Kirkpatrick DL. Evaluating training programs: A collection of articles from the Journal of the American Society for Training and Development. American Society for Training and Development, Madison, Wisconsin: American Society for Training and Development; 1975.

45.

Kirkpatrick DL. Evaluating human relations programs for industrial foremen and supervisors. Madison: University of Wisconsin; 1954.

46.

Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348 https://doi.org/10.1136/bmj.g1687.

47.

Davies P. The state of evidence-based policy evaluation and its role in policy formation. Natl Inst Econ Rev. 2012;219(1):R41–52.CrossRef

48.

Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. https://doi.org/10.1186/1748-5908-6-42.CrossRefPubMedPubMedCentral

49.

Sarkies M, Bowles K-A, Skinner E, Mitchell D, Haas R, Ho M, et al. Data collection methods in health services research: hospital length of stay and discharge destination. Appl Clin Inform. 2015;6(1):96.CrossRefPubMedPubMedCentral

50.

Morgan M, Beech R. Variations in lengths of stay and rates of day case surgery: implications for the efficiency of surgical management. J Epidemiol Community Health. 1990;44(2):90–105.CrossRefPubMedPubMedCentral

51.

Shojania KG, Showstack J, Wachter RM. Assessing hospital quality: a review for clinicians. Eff Clin Pract. 2001;4(2):82–90.PubMed

52.

Brasel KJ, Lim HJ, Nirula R, Weigelt JA. Length of stay: an appropriate quality measure? Arch Surg. 2007;142(5):461–6.CrossRefPubMed

53.

Brusco NK, Shields N, Taylor NF, Paratz J. A Saturday physiotherapy service may decrease length of stay in patients undergoing rehabilitation in hospital: a randomised controlled trial. Aust J Physiother. 2007;53(2):75–81.CrossRefPubMed

54.

Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001;1(1):2. https://doi.org/10.1186/1471-2288-1-2.CrossRefPubMedPubMedCentral

55.

Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346 https://doi.org/10.1136/bmj.e7586.

56.

Victorian Department of Health and Human Services. Allied Health Staffing levels for health service inpatients in Victoria: Phase 1 - Macro Staffing Analysis. In: Services DoHaH, editor. Victoria; 2016.

57.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef

58.

Morse JM. Critical analysis of strategies for determining rigor in qualitative inquiry. Qual Health Res. 2015;25(9):1212–22.CrossRefPubMed

59.

Phelan T. National Statement on ethical conduct in research involving humans. Chisholm Health Ethics Bull. 1999;5(1):1.

60.

Orton L, Lloyd-Williams F, Taylor-Robinson D, O'Flaherty M, Capewell S. The use of research evidence in public health decision making processes: systematic review. PLoS One. 2011;6(7):e21704.CrossRefPubMedPubMedCentral

61.

Sackett DL, editor. Evidence-based medicine: Seminars in perinatology, Elsevier; 1997.

62.

Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther. 2005;85(11):1208–23. https://doi.org/10.1093/ptj/85.11.1208.PubMed

63.

Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother. 2006;52(4):241–8. https://doi.org/10.1016/S0004-9514(06)70003-4 CrossRefPubMed

64.

Harris JE, Eng JJ. Strength training improves upper-limb function in individuals with stroke. A Meta-Analysis. 2010;41(1):136–40. https://doi.org/10.1161/strokeaha.109.567438.

65.

Morris SL, Dodd KJ, Morris ME. Outcomes of progressive resistance strength training following stroke: a systematic review. Clin Rehabil. 2004;18(1):27–39.CrossRefPubMed

66.

Leeanne C, Richard M, Thomas AM. SENSe: study of the effectiveness of neurorehabilitation on sensation: a randomized controlled trial. Neurorehabil Neural Repair. 2011;25(4):304–13. https://doi.org/10.1177/1545968310397705.CrossRef

67.

Jansons P, Robins L, O'Brien L, Haines T. Gym-based exercise and home-based exercise with telephone support have similar outcomes when used as maintenance programs in adults with chronic health conditions: a randomised trial. J Phys. 2017;63(3):154–60. https://doi.org/10.1016/j.jphys.2017.05.018.

68.

Zwisler AD, Norton RJ, Dean SG, Dalal H, Tang LH, Wingham J, et al. Home-based cardiac rehabilitation for people with heart failure: a systematic review and meta-analysis. Int J Cardiol. 2016;221:963–9. https://doi.org/10.1016/j.ijcard.2016.06.207.CrossRefPubMed

69.

Holland AE, Mahal A, Hill CJ, Lee AL, Burge AT, Cox NS, et al. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax. 2016; https://doi.org/10.1136/thoraxjnl-2016-208514.

70.

Milat AJ, Bauman A, Redman S. Narrative review of models and success factors for scaling up public health interventions. Implement Sci. 2015;10(1):1–11. https://doi.org/10.1186/s13012-015-0301-6.CrossRef

71.

Milat AJ, Newson R, King L. Increasing the scale of population health interventions: a guide. North Sydney: NSW Ministry of Health; 2014.

72.

Elshaug AG, Moss JR, Littlejohns P, Karnon J, Merlin TL, Hiller JE. Identifying existing health care services that do not provide value for money. Med J Aust. 2009;190(5):269–73.PubMed

73.

Marion FW, Rebecca JF, Nicol K-B, Annie M, Leeanne MC. From what we know to what we do: translating stroke rehabilitation research into practice. Int J Stroke. 2012;8(1):11–7. https://doi.org/10.1111/j.1747-4949.2012.00974.x.

74.

Fisher RJ, Gaynor C, Kerr M, Langhorne P, Anderson C, Bautz-Holter E, et al. A consensus on stroke: early supported discharge. Stroke. 2011;42(5):1392–7. https://doi.org/10.1161/strokeaha.110.606285.CrossRefPubMed

75.

Rowley E, Morriss R, Currie G, Schneider J. Research into practice: Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Nottinghamshire, Derbyshire, Lincolnshire (NDL). Implement Sci. 2012;7:40. https://doi.org/10.1186/1748-5908-7-40.CrossRefPubMedPubMedCentral

76.

Menon A, Korner-Bitensky N, Kastner M, McKibbon KA, Straus S. Strategies for rehabilitation professionals to move evidence-based knowledge into practice: a systematic review. J Rehabil Med. 2009;41(13):1024–32. https://doi.org/10.2340/16501977-0451.CrossRefPubMed

Title: Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol
Authors: Mitchell N. Sarkies
Jennifer White
Meg E. Morris
Nicholas F. Taylor
Cylie Williams
Lisa O’Brien
Jenny Martin
Anne Bardoel
Anne E. Holland
Leeanne Carey
Elizabeth H. Skinner
Kelly-Ann Bowles
Kellie Grant
Kathleen Philip
Terry P. Haines
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Implementation Science / Issue 1/2018
Electronic ISSN: 1748-5908
DOI: https://doi.org/10.1186/s13012-018-0752-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol

Abstract

Background

Methods

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2018

To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis

Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes

De-implementation of low value castration for men with prostate cancer: protocol for a theory-based, mixed methods approach to minimizing low value androgen deprivation therapy (DeADT)

Contextualization of psychological treatments for government health systems in low-resource settings: group interpersonal psychotherapy for caregivers of children with nodding syndrome in Uganda

Correction to: Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial)

Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial)