Dr Mitchell Sarkies1, Dr Lauren Robins2, Ms Megan Jepson2, A/Prof Cylie Williams2, Prof Nicholas Taylor3,4, A/Prof Lisa O’Brien2, Prof Jenny Martin5, Prof Anne Bardoel6, Prof Meg Morris4,7, Prof Leeanne Carey4,8, Prof Anne Holland2,9, Dr Katrina Long2, Prof Terry Haines2
1Macquarie University, Sydney, Australia, 2Monash University, Melbourne, Australia, 3Eastern Health, Melbourne, Australia, 4La Trobe University, Melbourne, Australia, 5Federation University, Ballarat , Australia, 6Swinburne University , VIC, Australia, 7Healthscope, Melbourne, Australia, 8The Florey Institute , Melbourne, Australia, 9Alfred Health, Melbourne, Australia
Background: This study aimed to determine the effectiveness of two research implementation strategies to facilitate evidence-informed healthcare management decisions for the provision of inpatient weekend allied health services.
Methods: This multicentre, single-blinded, three-group parallel cluster randomised controlled trial with concealed allocation was conducted in Australian and New Zealand hospitals between February 2018 and January 2020. Hospital managers who were responsible for inpatient weekend allied health resource allocation decisions were eligible to receive the interventions. Randomisation took place at the level of individual hospitals or hospital networks. Three conditions were compared over a 12-month period: 1) usual practice waitlist control; 2) dissemination of evidence-based practice recommendations; and 3) access to a knowledge broker in addition to the recommendations. The primary outcome was the alignment of weekend allied health provision with practice recommendations at the cluster- and ward-levels.
Findings: A total of 45 clusters (n=833 wards, n=204 hospital managers) were randomised to either control (n=15), recommendation (n=16) or knowledge broker (n=14) conditions. Four (9%) did not provide follow up data. No significant effect was found with either implementation strategy for the primary or secondary outcomes at cluster- or ward-level. None of the control or knowledge broker clusters transitioned to partial or full alignment with the recommendations. Three (20%) of the clusters who only received the written recommendations transitioned from nonalignment to partial alignment.
Conclusions: The knowledge broker strategy was no more effective than dissemination of recommendations or usual practice for the promotion of evidence-informed resource allocation to inpatient weekend allied health services.
Dr Mitchell Sarkies, is a post-doctoral research fellow at the Centre for Healthcare Resilience and Implementation Science within the Australian Institute of Health Innovation, Macquarie University. He holds a Bachelor of Applied Science (Physiotherapy) from the University of Sydney and a PhD from Monash University focusing on health services research, implementation science, and health economics. His current work is exploring approaches to harness implementation science and complexity science to scale-up value-based healthcare initiatives for people with chronic conditions.