Direct to psychology stepped care model implementation in the multidisciplinary sleep service: study protocol

Area of Science:

• Sleep Medicine
• Psychology
• Healthcare Service Delivery

Background:

• Sleep disorders are prevalent and impose significant societal costs.
• Current guidelines recommend Cognitive Behaviour Therapy for Insomnia (CBTi) as a long-term treatment.
• Referral pathways and workforce shortages impede timely and efficient insomnia care.

Purpose of the Study:

• To implement and evaluate a redesigned care model for insomnia in a public multidisciplinary sleep service.
• To incorporate a Direct to Psychology referral pathway and a Stepped Care treatment approach.
• To assess the impact of the new model on patient outcomes, satisfaction, and service efficiency.

Main Methods:

• A single-site, multiphase, mixed methods study design.
• Implementation of a Direct to Psychology referral pathway and Stepped Care treatment, including digital interventions.
• Evaluation using the RE-AIM framework and StaRI guidelines, with pre- and post-implementation data collection.

Main Results:

• Quantitative data on clinical outcomes, patient/clinician satisfaction, and service efficiency will be collected.
• The study will compare outcomes of the new model against the previous service model.
• Anticipated results include stakeholder acceptability, non-inferior patient outcomes, and improved service efficiency.

Conclusions:

• The new Direct to Psychology Stepped Care Model aims to optimize insomnia treatment delivery.
• The model integrates a direct referral pathway with flexible, stepped care treatment options.
• Evaluation will determine the model's effectiveness in improving patient flow and service efficiency within a public hospital setting.