The STAT model improves access to sub-acute rehabilitation and outpatient services: A stepped wedge randomised controlled trial

Dr Katherine Harding1

1Eastern Health / La Trobe University, Box Hill, Australia

Abstract:

Aim:
Long wait lists for allied health services in ambulatory and community settings have negative health consequences. The STAT model (Specific Timely Appointments for Triage) was designed to improve access to these services using initial targeted strategies to reduce the existing wait list coupled with protected appointments for new patients that aim to maintain flow at the rate of demand.

This trial aimed to determine whether the STAT model could work beyond isolated pilot trials to reduce waiting time in a fully powered stepped wedge trial with multiple sites.

Method:
We conducted a stepped wedge cluster randomised controlled trial involving 8 sites (n=3116 patients), registered prospectively (ACTRN no. 12615001016527). The primary outcome was time from referral to first appointment; secondary outcomes included time to second appointment, rate of discharge at 12 weeks and number of appointments provided.

Results:
Median time from referral to first appointment reduced from 60 days pre-intervention to 36 days in the post-intervention period across all sites (IRR 0.66, 95% CI 0.52 to 0.85) with no change in secondary outcomes. Variation in waiting time was also reduced.

Significance of findings for Allied Health:
Allied Health professionals frequently provide services in community health and ambulatory settings with long waiting lists. Improvements in access to these services can be achieved by addressing inefficiencies and encouraging service providers to make priority decisions about service delivery in the context of demand.

Biography:

Katherine began her working life as an Occupational Therapist before completing a PhD in and shifting focus to the world of health services research.  She is a  Research Fellow with the Allied Health Research Office at Eastern Health, where she provides research support for allied health clinicians, promotes research activity and leads a range of projects. Katherine also holds an an adjunct position with La Trobe University and serves on the Executive Committee of the Health Services Research Association of Australia and New Zealand.