Providing high value care by optimizing interventions helping patients to choose the right service
Research Team: Mei Yee Tang, Jan Lecouturier, Dawn Craig, Louis Goffe, & Falko Sniehotta
When one experiences a health problem, there are different available health services that the individual can choose to access or attend (or choose on behalf of someone else, if caregiver) to address their problem.
Individuals make their own decisions as to the most appropriate service to access or attend. For best patient and NHS outcomes, it is important that service users choose the ‘right service’ at the ‘right time’ – i.e. the most appropriate service for their problem. There are interventions in the UK to match or help service users choose the most appropriate health service for their health problems. The most common type are triage interventions. Typically, triage interventions deliver advice to people either on the telephone or online to deal with the issue or refer to a particular health service (e.g. Accident & Emergency Department, if considered to be urgent). The NHS 111 in the UK is an example of a triage intervention. There are also awareness raising mass media interventions, such as the NHS ‘Choose Well’ campaign, where there are posters aimed at providing people with information on the most suitable service for the symptoms they are experiencing. Whilst both triage and targeted health campaigns try to influence individual decision making/behaviour, it is ultimately a choice as to which service to access or attend.
We do not know if these triage and non-triage (i.e. health awareness campaign) interventions are successful in matching or helping service users choose the most appropriate health service for their health problems. It is also unknown if there is a mismatch between what is currently in place and what the scientific evidence points to be effective.
Design and methods
We will address these questions through a series of evidence reviews. The first evidence review will identify and examine the interventions and policies that are currently available in the UK which help to match/encourage people to choose the most appropriate health service. As a number of systematic reviews (a type of literature review that uses systematic methods to collect data from research studies) have already been conducted on triage interventions, we will summarise the findings. For the second review on non-triage interventions, we will apply systematic review methods to look at primary studies. The findings from these reviews will be discussed in relation to the triage, educational and mass media type interventions currently available in the UK. This will provide us with knowledge on a) what works best (i.e. from the scientific literature), b) what is currently in place in the UK, and c) how do they compare. From this we will develop a logic model (a diagram to show how something works) to visualise the decision pathway, including the health system and psychological elements that play a role in shaping people’s behaviour.