A Quasi‐Experimental Retrospective Cohort Study Evaluating Demand, Utilisation and Efficiency of a Pilot 7‐Day Multidisciplinary Allied Health Assistant Model of Care in a Regional Australian General Medical Ward

OBJECTIVE: To evaluate a 7 day multidisciplinary allied health assistant (mAHA) model of care in an acute general medical setting as a strategy to support service sustainability in the context of hospital bed block. BACKGROUND: Regional and rural hospitals face challenges delivering timely allied health (AH) care due to workforce shortages, limited weekend coverage and increasing patient complexity. mAHAs may support service sustainability; however, evidence for acute 7-day models is limited. METHODS: Analysis of 1615 delegations (pilot n = 594; BAU n = 1021) compared a 5 day business-as-usual (BAU) service (1/10/2021-28/2/2022) with a pilot 7-day model (1/10/2022-28/2/2023) servicing 56 acute beds. Outcomes assessed demand, utilisation and care efficiency. DESIGN: A quasi-experimental evaluation of an organisational intervention. SETTING: Regional hospital. MAIN OUTCOME MEASURES: Outcomes included measures of demand (delegations, occasions of service (OOS), therapy time), utilisation (by profession, day of week), and care efficiency (OOS/delegations per rostered day, time/OOS per delegation). RESULTS: The 7-day model delivered increased delegations (81.9%, p < 0.0001), occasions of service (61.2%, p < 0.0001), and therapy time (127.4%, p < 0.0001), primarily for physiotherapy. The 7-day service model improved load-levelling, reducing early-week demand. Care efficiency improved, with more OOS and delegations per rostered day (p < 0.0001), shorter time per OOS (p < 0.0001) and greater therapy time per admission (p < 0.0001). These improvements occurred without additional AH productive FTE. Utilisation remained physiotherapy-led. CONCLUSIONS: In regional hospitals experiencing hospital bed block, a 7-day mAHA model improved access to and efficiency of AH services without the need for additional AH staffing. Limited uptake by non-physiotherapy disciplines constrained full multidisciplinary benefit and warrants further investigation.