"The right people at the right time": process evaluation of a novel allied health hospital in the home service for people with cancer

“在合适的时间安排合适的人”:一项针对癌症患者居家服务的新型辅助医疗医院的流程评估

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Abstract

PURPOSE: To perform a process evaluation of the acceptability, adoption, costs, feasibility, safety, timeliness, and satisfaction of a novel allied health program in Hospital in the Home (HITH) cancer services. METHOD: A mixed-methods process evaluation using the proctor model for implementation was completed. Quantitative data from routinely collected service data, patient satisfaction surveys, and qualitative focus group data from cancer services' staff over a 6-month period were analysed. Quantitative data were described, and qualitative data thematically analysed and mapped to seven key domains: acceptability, adoption, costs, feasibility, safety, timeliness, and satisfaction. RESULTS: A total of 90 adults with cancer were referred to the allied health program in HITH cancer services, of which 69 (77%) participated. There were no major adverse events, and entry to the service was timely (median wait time: 5 days). Patients were satisfied with the service. Clinical staff reported the service "added value" by preventing hospital readmission and improving patient outcomes. The cost of the service was $518 AUD per patient contact (comparable inpatient stay: $5000 AUD). CONCLUSION: A timely home-based allied health cancer service can be achieved with adequate resources, communication, and collaboration. Future home-based models of allied health care for people with cancer should consider employing skilled staff and strategically aligning programs with health service priorities.

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