The MIDI method applicated to healthcare services: the economic effect of a main organisational change in the healthcare services, estimated by RCTs and inspired by the foreign method Buurtzorg.

Last registered on July 22, 2021

Pre-Trial

Trial Information

General Information

Title
The MIDI method applicated to healthcare services: the economic effect of a main organisational change in the healthcare services, estimated by RCTs and inspired by the foreign method Buurtzorg.
RCT ID
AEARCTR-0007981
Initial registration date
July 20, 2021
Last updated
July 22, 2021, 1:42 PM EDT

Locations

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Primary Investigator

Affiliation
Université Paris I Panthéon-Sorbonne

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2021-09-01
End date
2022-10-01
Secondary IDs
Abstract
The MIDI project is inspired by the Buurtzorg, a Dutch firm. Its purpose is to give responsibility and autonomy to the care givers in France and to observe the economic effects. To reach this goal, I will use the randomized control trial method with a French firm.
This project reaches the responsibility and autonomy goals for the care givers by reorganizing the current business management and give a better answer to the client and workers' requests. Thus, by taking inspiration from Buurtzorg, I will organize care givers in teams of maximum 10 people on a geographic area. Among these care givers, only four of them will intervene in the care of a patient. Moreover, to increase cohesion and teamwork within a team, all the members will meet and during the meetings they will plan their next schedule, depending on their availability and the clients' requests. Thus, these two changes will create a new social bond within the team members and between the care givers and their patients, which do not exist anymore. Furthermore, the agency's manager will have a new mission, he will be a coach: he will have more time to visit the patients and will help teams to work together and to use new digital tools.
To make the experiment, we need to select randomly agencies within the firm, to have a representative sample of the firm. I choose the individuals of the sample following a statistic law (uniform probability law) to obtain a representative selection as most as possible, it will be the test group. Thus, I take into account the fact that some agencies are rural, close to a city or urban, following the French National Institute of Statistics (INSEE). The selected agencies and employees are informed about the experiment and I ask them their consent to participate. I explain to them all the details during meeting organize with them and then they have the choice to participate.
I will follow several variables to observe the economic effects on labor, efficiency and increasing quality. Some of these variables are the number of caregivers along a patient, of sick leaves, of day offs, of worked hours, etc. Some of these variables are directly observable through work softwares while others need a bigger work with the caregivers. Indeed, to measure some variables, I need to send questionnaires to the caregivers and to the patients. With these questionnaires, I can follow the evolution and the improvement of both the quality of their work and their quality of work life. These questionnaires are sent by three times to the test and the control groups, to follow the evolution of these variables.
Then, I deal with all the data and their are safely stocked on an extern hard disk, with an access code to protect them. The DPO also has the mission to protect these data and check if the General Data Protection Regulation (GDPR) is abided. All the GDPR regulation is abided and an information on it is given to all questioned people.
During the experiment, the caregivers will be followed by their local managers and myself. Thus, we check if they follow the new management rules and they make all their planed appointment. Moreover, we will provide formation to the caregivers to increase their involvement, their motivation and the implication in the experiment. All these things will increase the follow-up, the quality of work life and the efficiency.
The experiment takes place from the 1st October of 2021 to the 1st October of 2022. A delay is due to the COVID19.
External Link(s)

Registration Citation

Citation
Croiset, Solèn. 2021. "The MIDI method applicated to healthcare services: the economic effect of a main organisational change in the healthcare services, estimated by RCTs and inspired by the foreign method Buurtzorg.." AEA RCT Registry. July 22. https://doi.org/10.1257/rct.7981-1.0
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2021-10-01
Intervention End Date
2022-10-01

Primary Outcomes

Primary Outcomes (end points)
For the moment, the main variables I have identified are :
- The number of caregivers working along a patient.
- The number of sick leaves.
- The number of worked hours.
- The number of short-term contracts.
- The time spent at the patient's home.
- The care improvement.
- The autonomy improvement.
- The production measurement evolution.
- The importance of the family cares and the professionnal carers, relatively.
- The use of the digitals tools.
- The number of kilometers.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The purpose of the experiment is to compare the efficiency of the current French operational management model in health care and the one of the new kind of management model, inspired by the firm Buurtzorg.
To test the difference, we divide the sample in two sub-samples, one test and one control.
On the one hand, for the control group, we make no change and we try to keep secret the new management model, to avoid any biases that can modify the behaviour of the caregivers.
On the other hand, for the test group, we apply a new operational management model inspired by Buurtzorg. In this model, people will work in group of maximum 10 members and on a unique area. Moreover, we will organise meetings between the members of a team, to increase the social bond and to allow them to help each other. They will also have the possibility of changing their schedule if it is not made efficiently relatively to their professionnal and private appointments. Furthermore, only 4 individuals within a team will visit one patient, to limit the turnover at the patient's home and increase the social bond between a caregiver and a patient. Finally, they will have access to some tools that other employees in the firm cannot use.
Experimental Design Details
Not available
Randomization Method
I use a randomization method by using a uniform probability law. I also take care for the sampling of the representativeness of the sample. Indeed, we observe that French areas are very heterogeneous. Thus, the sampling is made by taking care of this heterogeneity (to have agencies in rural, urban and close to city area).
Randomization Unit
The level of randomization is the agency (sector level). Indeed, one agency works on one area, thus I have randomly selected some areas in France.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
6 agencies, which means around 200 employees.
Sample size: planned number of observations
6,000 employees in 12 months, thus around 72,000 observations. 116 agencies in 12 months, thus around 1,392 observations.
Sample size (or number of clusters) by treatment arms
Around 170 employees in 12 months, thus around 2,040 observations.
6 agencies in 12 months, thus around 72 observations.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
IRB PSE - Institutional Review Board Paris School of Economics
IRB Approval Date
2021-04-19
IRB Approval Number
2021-004