Statewide Scale-Up of a Demand Management Model Reduced Waiting Times in Community Health: A RE-AIM Evaluation

Abstract

Background

Long waits for outpatient and Community Health Services are common and associated with adverse outcomes. The Specific Timely Assessment and Triage (STAT) model provides an evidence-based approach to managing demand and is effective in reducing waiting times in controlled trials. A statewide initiative supporting its implementation in Community Health Services provided an opportunity to test scalability.

Aim

To evaluate outcomes of a statewide strategy to support scale-up of the STAT model across the community health sector in Victoria, Australia, using the RE-AIM framework.

Methods

An observational cohort study was conducted alongside a statewide scale-up strategy that included STAT training workshops, online resources and assistance to audit waiting lists. Data were collected through workshop registration records, follow-up questionnaires and organisational websites. Descriptive data were used to evaluate the RE-AIM domains of reach, adoption, implementation, and maintenance. Effectiveness was estimated by comparing organisation-reported waiting list data collected at baseline and 6-month follow-up.

Results

A total of 298 participants from 59 Community Health Services attended training, representing reach of 73% of eligible organisations. Of these, 120 participants (48%) from 45 organisations (76%) provided data at 6-month follow-up. Adoption was widespread, with 89% of organisations reporting at least partial implementation. In terms of effectiveness, mean waiting time decreased at follow-up from 3.9 to 2.6 months, an approximate 33% reduction (mean reduction 1.3 months, 95% CI 0.75–1.82, p < 0.001). Key implementation facilitators included structured resources and leadership support, while barriers included staffing constraints and service demand pressures. Participants reported mixed expectations regarding maintenance of STAT-related changes.

Conclusions

A statewide initiative to support implementation of the STAT model across Victorian Community Health Services led to widespread adoption and waiting time reductions comparable to those seen in controlled trials, providing evidence for scalability.