‘iIMPROVE PSP’ implementation science study to improve outcomes in primary spontaneous pneumothorax (PSP)
Quick facts
Prof Diana Egerton-Warburton
Professor Helena Teede, Associate Professor Joanne Enticott, Professor Julian Smith, Professor Peter Cameron, Professor Cathy Mihalopoulos, Professor Simon Craig, Professor Y C Gary Lee, Professor Simon Brown, Dr Sanjeevan Muruganandan, Professor Gerben Keijzers, Associate Professor Carolyn Hullick, Professor Timothy Baker, Associate Professor Benjamin Kwan, Dr Arash Badiei.
Associate Investigators
Associate Professor Lisa Kuhn, Professor Anne-Maree Kelly, Associate Professor Gerard O'Reilly, Dr Paul Buntine, Dr Long Le, Associate Professor Darren Mansfield, Dr Harshan Jeyakumar, Dr Trevor Chan, Associate Professor Peter Jones, Mr Ethan Bacon, Dr Jeremy Furyk, Dr Emma Ball, Professor Daniel Fatovich, Ms Frances Kinnear, Dr Robert Lee.
The project will involve four essential work packages:
- Stakeholder engagement, evidence synthesis and iIMPROVE PSP pathway development. The team will co-design, evidence-based, tailored, consumer-focused PSP care pathways based on their previous research, evidence synthesis and guidelines, developed by and with consumers using established behaviour change and Learning Health System (LHS) frameworks to answer how to implement high-value care in complex systems.
- A stepped wedge cluster randomised trial to determine the implementation effectiveness of iIMPROVE PSP pathway at scale. Evaluation will use the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework.
- Economic Evaluation of iIMPROVE PSP pathway. A within-trial cost-effectiveness analysis will provide a compelling case for scale-up and economic modelling for longer-term benefits.
- The roadmap for national scale-up will include a survey, implementation toolkits and National Clinical Care Standard co-designed with stakeholders including the Australian Commission for Safety and Quality in Healthcare. This will build legacy implementation research capacity in emergency and respiratory care and drive future collaborative research.
“This is an elegantly simple problem; we should be treating the vast majority of patients with primary spontaneous pneumothorax (PSP) with a watchful waiting approach and therefore avoid unnecessary, painful and costly interventions,” Professor Egerton-Warburton said. “High-level evidence clearly demonstrates that this approach is safe and will reduce iatrogenic harm, hospital admissions, recurrence, surgery and days off work. It will deliver high-value care that is better for consumers and the health system.”
Having two spontaneous pneumothoraxes, the project’s consumer lead investigator Ethan has personally experienced the pain of the typical treatment for PSP. His experience will offer the research team insight into the unnecessary harm that patients can experience when old, outdated guidelines are followed when providing care.
Ethan said that the chest-tube treatment he received caused more pain and discomfort than the collapsed lung itself. “I feel like the pain and scarring I experienced was due to a lack of evidence-informed practice,” he said. “I’m grateful that I have the opportunity to contribute to this research project, and that my experience can be used to improve care across Australia. I’m hopeful that through this research, people will receive more effective care for PSP, without unnecessary pain.”
