School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
Eastern Health Allied Health Clinical Research Office, Box Hill, Australia.
Child Care Health Dev. 2024 Jan;50(1):e13154. doi: 10.1111/cch.13154. Epub 2023 Jul 24.
Waiting lists for community-based paediatric therapy services are common and lead to poorer health outcomes, anxiety and missed opportunities for treatment during crucial developmental stages. The Specific Timely Appointments for Triage (STAT) model has been shown to reduce waiting lists in a range of health settings.
To determine whether providing training and support in the STAT model to champions within five community health centres using a remote 'hub and spoke' approach could reduce waiting time from referral to first appointment.
Representatives from five community health centres providing paediatric therapy services (speech therapy, occupational therapy and other allied health services) participated in five online workshops over 6 months. They were guided sequentially through the steps of the STAT model: understanding supply and demand, reducing backlogs, preserving space for new patients based on demand and redesigning models of care to maintain flow. Waiting time was measured in three consecutive years (pre, during and post intervention) and compared using the Kruskal-Wallis test. Employee satisfaction and perception of the model were explored using surveys.
Data from 2564 children (mean age 3.2 years, 66% male) showed a 33% reduction in waiting time from the pre-intervention (median 57 days) to the post-intervention period (median 38 days, p < 0.01). The total number of children waiting was observed to reduce from 335 immediately prior to the intervention (mean per centre 67, SD 25.1) to 112 (mean 22, SD 13.6) after implementation (t[8] = 3.56, p < 0.01). There was no impact on employee satisfaction or other aspects of service delivery.
Waiting lists are a major challenge across the health system. STAT provides a practical, low-cost, data-driven approach to tackling waiting times. This study demonstrates its effectiveness in paediatric therapy services and provides evidence for a 'hub and spoke' approach to facilitate implementation that could be provided at scale.
社区儿科治疗服务的等候名单很常见，这会导致较差的健康结果、焦虑和错过关键发育阶段的治疗机会。特定及时预约分诊 (STAT) 模式已被证明可减少一系列卫生环境中的等候名单。
确定是否可以通过远程“中心辐射”方法向五家社区健康中心的拥护者提供 STAT 模式的培训和支持，从而减少从转介到首次预约的等待时间。
提供儿科治疗服务（言语治疗、职业治疗和其他联合健康服务）的五家社区健康中心的代表参加了五个为期 6 个月的在线研讨会。他们按照 STAT 模式的步骤顺序进行指导：了解供需情况、减少积压、根据需求为新患者保留空间和重新设计护理模式以保持流程。使用 Kruskal-Wallis 检验比较了三年（干预前、干预中和干预后）的等待时间。使用调查探索员工满意度和对模型的看法。
来自 2564 名儿童的数据（平均年龄 3.2 岁，66%为男性）显示，与干预前（中位数 57 天）相比，等待时间减少了 33%（中位数 38 天，p<0.01）。干预前，立即观察到等待的儿童总数从 335 人减少到 112 人（平均每中心 22 人，SD 13.6）（t[8] = 3.56，p<0.01）。这并没有影响员工满意度或服务提供的其他方面。
等候名单是整个卫生系统面临的重大挑战。STAT 提供了一种实用、低成本、数据驱动的方法来解决等待时间问题。本研究证明了它在儿科治疗服务中的有效性，并为促进实施的“中心辐射”方法提供了证据，该方法可以大规模实施。
