Abstract
BackgroundThere is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards.MethodsThis qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers. Data were collected from 210 hospital team members, including 17 medical, 97 nursing, and 96 allied health professionals from two Australian tertiary public hospitals. All were recorded and imported into nVivo 10 for analysis. Thematic analysis methods were used to develop a coding framework from the data and to identify emerging themes.ResultsKey themes identified were separated into issues perceived as being enablers or barriers to the effective or cost-effective delivery of weekend allied health services. Perceived enablers of effectiveness and cost-effectiveness included prioritizing interventions that prevent decline, the right person delivering the right service, improved access to the patient’s family, and ability to impact patient flow. Perceived barriers were employment of inexperienced weekend staff, insufficient investment to see tangible benefit, inefficiencies related to double-handling, unnecessary interventions and/or inappropriate referrals, and difficulty recruiting and retaining skilled staff.ConclusionsSuggestions for ensuring effective and cost effective weekend allied health care models include minimization of task duplication and targeting interventions so that the right patients receive the right interventions at the right time. Further research into the effectiveness and cost effectiveness of these services should factor in hidden costs, including those associated with managing the service.
Highlights
There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment
There is strong public support for acute hospital services to move to genuine 7-day models, with senior clinical decision makers available at all times, and multidisciplinary team assessment of all newly admitted patients within 14 h of admission [7,8,9]
Effects on length of stay, and resulting management pressure All participant groups expressed the belief that the presence of weekend allied health services positively contributed to patient flow through the hospital, and that length of stay would increase without it
Summary
There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. Acute public hospitals are 24 h, seven days per week services, with continuous demand for care. There is strong public support for acute hospital services to move to genuine 7-day models, with senior clinical decision makers available at all times, and multidisciplinary team assessment of all newly admitted patients within 14 h of admission [7,8,9]. Proponents of 7 days a week allied health services argue that patients admitted on a Friday afternoon can face delays up to 72 h before assessment and treatment, leading to “extended. There is evidence that delayed access to some allied health services could result in higher rates adverse events [19,20,21]
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