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Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

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

Authors: Terry P Haines, Lisa O’Brien, Deb Mitchell, Kelly-Ann Bowles, Romi Haas, Donna Markham, Samantha Plumb, Timothy Chiu, Kerry May, Kathleen Philip, David Lescai, Fiona McDermott, Mitchell Sarkies, Marcelle Ghaly, Leonie Shaw, Genevieve Juj, Elizabeth H Skinner

Published in: Trials | Issue 1/2015

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Abstract

Background

Disinvestment from inefficient or ineffective health services is a growing priority for health care systems. Provision of allied health services over the weekend is now commonplace despite a relative paucity of evidence supporting their provision. The relatively high cost of providing this service combined with the paucity of evidence supporting its provision makes this a potential candidate for disinvestment so that resources consumed can be used in other areas.
This study aims to determine the effectiveness, cost-effectiveness and safety of the current model of weekend allied health service and a new stakeholder-driven model of weekend allied health service delivery on acute medical and surgical wards compared to having no weekend allied health service.

Methods/Design

Two stepped wedge, cluster randomised trials of weekend allied health services will be conducted in six acute medical/surgical wards across two public metropolitan hospitals in Melbourne (Australia). Wards have been chosen to participate by management teams at each hospital. The allied health services to be investigated will include physiotherapy, occupational therapy, speech therapy, dietetics, social work and allied health assistants. At baseline, all wards will be receiving weekend allied health services. Study 1 intervention will be the sequential disinvestment (roll-in) of the current weekend allied health service model from each participating ward in monthly intervals and study 2 will be the roll-out of a new stakeholder-driven model of weekend allied health service delivery. The order in which weekend allied health services will be rolled in and out amongst participating wards will be determined randomly. This trial will be conducted in each of the two participating hospitals at a different time interval. Primary outcomes will be length of stay, rate of unplanned hospital readmission within 28 days and rate of adverse events. Secondary outcomes will be number of complaints and compliments, staff absenteeism, and patient discharge destination, satisfaction, and functional independence at discharge.

Discussion

This is the world’s first application of the recently described non-inferiority (roll-in) stepped wedge trial design, and the largest investigation of the effectiveness of weekend allied health services on acute medical surgical wards to date.

Trial registration

Australian New Zealand Clinical Trials Registry.
Registration number: ACTRN12613001231​730 (first study) and ACTRN12613001361​796 (second study).
Was this trial prospectively registered?: Yes.
Date registered: 8 November 2013 (first study), 12 December 2013 (second study).
Anticipated completion: June 2015.
Protocol version: 1.
Role of trial sponsor: KP and DL are directly employed by one of the trial sponsors, their roles were: KP assisted with overall development of research design and assisted with overall project management; DL contributed to project management, administration and communications strategy.
Appendix
Available only for authorised users
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Metadata
Title
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
Authors
Terry P Haines
Lisa O’Brien
Deb Mitchell
Kelly-Ann Bowles
Romi Haas
Donna Markham
Samantha Plumb
Timothy Chiu
Kerry May
Kathleen Philip
David Lescai
Fiona McDermott
Mitchell Sarkies
Marcelle Ghaly
Leonie Shaw
Genevieve Juj
Elizabeth H Skinner
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0619-z

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