Health services research in a tertiary hospital setting: Can Allied Health clinicians adhere to the protocol to ensure research fidelity

Date & Time

Nov 10th at 2:50 PM until 3:05 PM

Track

Research & quality improvement projects 

Location

Rating ( votes)

Chairs: Peter Nuttman and Neville Turner

Kelly-Ann Bowles (1), Deb Mitchell (2), Mitchell Sarkies (1,2), Kerry May (2), Elizabeth Skinner (3), Terry Haines (1)

1 Monash University Physiotherapy Department and Monash Health Allied Health Research Unit kelly-ann.bowles@monash.edu
2 Allied Health Department, Monash Health
3 Department of Physiotherapy, Western Health


Background
There is an increased need for public health services to research their sustainability as financial pressures tighten, coinciding with an aging population and an increase in chronic disease rates. A perceived flaw in current health services research is the lack of internal validity as protocol requirements are difficult to control within a functioning health service. Establishing research fidelity not only assists in the interpretation of research findings, but can be used as an indication of confidence in the research results.

This project assessed the fidelity of a research protocol, investigating the effect of weekend Allied Health in
an acute public hospital setting.

Methods
A two phase stepped wedge trial design investigated the effect of disinvestment and modified reinvestment of weekend Allied Health staffing in an acute public hospital. The study site liaison and research assistant communicated with both Allied Health and other hospital staff regularly, informing them of the staffing time restrictions for each Allied Health discipline on each ward for each month of the trial. Allied Health staff occasions of service (OOS) were collated through the inpatient management system (iPM), with clinical exceptions approved as a part of the protocol collected from the hospital after-hours coordinator.

Results
Of the 3187 weekend Allied Health OOS from the project duration (14 months), 42 (0.01%) occurred in the time period designated to have no weekend Allied Health Service (50% = no protocol compliance). When work hours were reallocated in the reinvestment phase of the trial, clinicians did adhere to the timing requirements for the designated wards, when staffing was available.

Discussion
Despite the difficulties in conducting disinvestment and modified investment research in an acute hospital, Allied Health staff can adhere to research protocol, ensuring researcher confidence in results and promoting research accuracy and validity in functioning health service settings.