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Trial registered on ANZCTR


Registration number
ACTRN12611000943943
Ethics application status
Approved
Date submitted
18/08/2011
Date registered
1/09/2011
Date last updated
8/05/2012
Type of registration
Retrospectively registered

Titles & IDs
Public title
Evaluation of a new model of triage for community rehabilitation services
Scientific title
Does a new model of access and triage involving protected assessment slots and early face to face clinical assessment improve waiting times for patients referred to community rehabilitation services, compared with a traditional "waitlist and triage" model?
Secondary ID [1] 262874 0
Nil
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Waiting lists for community rehabilitation services 270590 0
Condition category
Condition code
Physical Medicine / Rehabilitation 270762 270762 0 0
Other physical medicine / rehabilitation

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Many community rehabilitation programs manage access by placing patients on waiting lists, with clinicians taking on new pateints as appointments become available. Triage categories are often assigned to guide clinicians as to who should be seen first.
This trial aims to evaluate an alternative model, in which all patients receive a face to face assessment within a few days of referral, through the use of protected assessment appointments. Clinicians then take responsibility for triaging patient needs within their own clinical caseload. The new model will be trialled for all new referrals received over a 6 month period.
Intervention code [1] 269225 0
Other interventions
Comparator / control treatment
Traditional model of "waitlist and triage", in which patients are placed on a waitlist and referrals picked up by clinicians when spaces are available.
Control group
Active

Outcomes
Primary outcome [1] 279457 0
Waiting time (Days between referral date and first appointment)
Timepoint [1] 279457 0
Referral date and first appointment will be recorded prospectively. Waiting time for all subjects will be calculated at the end of the study.
Secondary outcome [1] 287682 0
Quality of life (EQ-5D)
Timepoint [1] 287682 0
Admission and discharge
Secondary outcome [2] 287683 0
Total length of stay (Days from first to last appointment)
Timepoint [2] 287683 0
Measured between first and last appointment
Secondary outcome [3] 287684 0
Total number of treatment sessions from first to last appointment
Timepoint [3] 287684 0
Number of sessions will be calculated at the time of discharge for each patient
Secondary outcome [4] 287685 0
Staff satisfaction using qualitative semi structured interviews
Timepoint [4] 287685 0
At the end of the 6 month trial period
Secondary outcome [5] 287686 0
Patient satisfaction using qualitative semi structured interviews
Timepoint [5] 287686 0
Within 2 weeks of discharge from the program

Eligibility
Key inclusion criteria
Patients referred to community rehabilition program at either Peter James Centre (all patients) or Wantirna Health (orthopaedic patients) from 1st February to July 31st 2011.
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Nil for quantitative measures.
Qualitative data - patients must be able to converse in English and provide informed consent.

Study design
Purpose of the study
Prevention
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Very similar Community Rehabilitation Programs are in operation at two sites within Eastern Health. The new model of care is being trialled at one (the Peter James Centre), with the Wantirna Health site continuing to provide care via the usual model. Both also operate two teams, one for orthopaedic patients and one for neurology patients.
Patients referred to the orthopaedic team at the Peter James Centre are therefore in the intervention group, and those in the neurology team at Peter James or referred to Wantirna are in the control group. Comparisons will also be made with baseline data from both sites collected in a previous observational study in 2010.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
NA
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
This is a controlled before and after study, with comparisons being made between the intervention group before and after the change to the model, and also the control groups during the same periods.
Phase
Not Applicable
Type of endpoint(s)
Safety/efficacy
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment postcode(s) [1] 4362 0
3151

Funding & Sponsors
Funding source category [1] 269691 0
Self funded/Unfunded
Name [1] 269691 0
Katherine Harding
Address [1] 269691 0
Level 2, 5 Arnold Street
Box Hill 3129
VIC
Country [1] 269691 0
Australia
Primary sponsor type
Hospital
Name
Eastern Health
Address
Allied Health Research Office
Eastern Health
Level 2, 5 Arnold St,
Box Hill, VICTORIA 3128
Country
Australia
Secondary sponsor category [1] 268728 0
University
Name [1] 268728 0
La Trobe University
Address [1] 268728 0
Kingsbury Drive,
Bundoora,
VICTORIA 3086
Country [1] 268728 0
Australia

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 271652 0
Eastern Health Research and Ethics Committee
Ethics committee address [1] 271652 0
5 Arnold Street
Box Hill 3129
VIC
Ethics committee country [1] 271652 0
Australia
Date submitted for ethics approval [1] 271652 0
Approval date [1] 271652 0
12/11/2010
Ethics approval number [1] 271652 0
LR33/1011
Ethics committee name [2] 271653 0
La Trobe University Faculty Research and Ethics Committe
Ethics committee address [2] 271653 0
Faculty of Health Sciences
La Trobe University
Kingsbury Drive,
Bundoora
VICTORIA 3086
Ethics committee country [2] 271653 0
Australia
Date submitted for ethics approval [2] 271653 0
Approval date [2] 271653 0
21/12/2010
Ethics approval number [2] 271653 0
FHEC10/266

Summary
Brief summary
Patients referred to the community rehabilitation programs (CRPs) at the Peter James Centre (PJC) and Wantirna Health (WH) have traditionally been placed on a waiting list and given a triage category, which guides clinicians as to who should be seen first when demand exceeds supply. This study is trialling an alternative model of triage within the orthopaedic team at the PJC CRP in which all patients are seen for a face to face assessment soon after referral, with a subsequent decision on priority and patient management made by the treating clinician. The aim of the trial is to compare the outcomes with the traditional model at WH, and determine whether the new model improves waiting times without negatively impacting on the quality of service received, patient outcomes or staff and patient satisfaction
Trial website
Nil
Trial related presentations / publications
Nil
Public notes

Contacts
Principal investigator
Name 33043 0
Address 33043 0
Country 33043 0
Phone 33043 0
Fax 33043 0
Email 33043 0
Contact person for public queries
Name 16290 0
Katherine Harding
Address 16290 0
Level 2, 5 Arnold Street
Box Hioll, VIC 3128
Country 16290 0
Australia
Phone 16290 0
+61 3 9091 8880
Fax 16290 0
+61 3 9899 6810
Email 16290 0
katherine.harding@easternhealth.org.au
Contact person for scientific queries
Name 7218 0
Katherine Harding
Address 7218 0
Level 2, 5 Arnold Street
Box Hioll, VIC 3128
Country 7218 0
Australia
Phone 7218 0
+61 3 9091 8880
Fax 7218 0
+61 3 9899 6810
Email 7218 0
katherine.harding@easternhealth.org.au

No information has been provided regarding IPD availability
Summary results
Have study results been published in a peer-reviewed journal?
Other publications
Have study results been made publicly available in another format?
Results – basic reporting
Results – plain English summary