Direct to psychology for sleep disorders: Innovating models of care in the hospital and health service

Abstract

A ‘Direct to Psychology Insomnia’ pathway was developed for implementation within a multidisciplinary sleep disorders service in a tertiary hospital in Brisbane, Australia. The project was informed by implementation science principles and methodology to re-design the model of care (MoC). A consensus group workshop using the Nominal Group Technique (NGT) with 12 multidisciplinary staff was undertaken to develop the new MoC. The workshop explored inclusion and exclusion criteria for a Direct to Psychology pathway including patient flow and enablers. The team endorsed a MoC that was acceptable to stakeholders and addressed service-level imperatives. The findings highlighted that patient inclusion or exclusion should be overseen by the Sleep Physician team and an Advanced Psychologist with behavioural sleep medicine expertise. Continuum of care for patients referred via primary care providers was considered. Barriers and risks to the MoC changes were identified which informed the refinement of the MoC.