Heart Failure Integrated Care Project: overcoming barriers encountered by primary health care providers in heart failure management.
ConclusionsThe HFICP identified several barriers to improving integrated management for HF patients in the Australian setting. These findings provide important insights into how an HF integrated care model can be implemented to strengthen the working relationship between hospitals and primary care providers in delivering better care to HF patients.What is known about the topic?Multidisciplinary HF programs are heterogeneous in their structures, they have low patient participation rates and a significant proportion of HF patients have further presentations to hospital with HF. Integrating the care of HF patients into the pr...
Source: Australian Health Review - January 8, 2020 Category: Hospital Management Authors: Hsieh V, Paull G, Hawkshaw B Tags: Aust Health Rev Source Type: research

eMental health service use among Australian youth: a cross-sectional survey framed by Andersen.
ConclusionseMental health is accessed by young people in Australia, yet more needs to be done to better integrate this service model into the healthcare system. This includes training and education for consumers and professionals about existing, effective programs.What is known about this topic?eMental health platforms can bridge the gap between technology and conventional mental health care. Despite its rapidly expanding evidence base, the implementation of eMental health into the Australian healthcare system remains slow. More work needs to be done to elucidate the factors underlying preferences for online help-seeking.W...
Source: Australian Health Review - December 16, 2019 Category: Hospital Management Authors: Leech T, Dorstyn DS, Li W Tags: Aust Health Rev Source Type: research

Development of a physiotherapy-led bronchoscopy service: a regional hospital perspective.
This report describes the development and implementation of a physiotherapy-led bronchoscopy service from a regional hospital perspective.What is known about the topic?Although ESoP and ASoP physiotherapy roles are well established in the UK, such services appear to be only just evolving in Australia. Clarity on the definitions of extended and advanced physiotherapy roles have been articulated by the Australian Physiotherapy Association. However, there is a paucity of evidence published on the practicalities of establishing advanced or extended scope cardiorespiratory physiotherapy services within Australian ICUs.What does...
Source: Australian Health Review - December 12, 2019 Category: Hospital Management Authors: Lockstone J, Boden I, Zalucki N, Darvas J, Parkes S Tags: Aust Health Rev Source Type: research

Liability and collaborative arrangements for nurse practitioner practice in Australia.
Abstract The purpose of this paper is to clarify the relationship between medical practitioners (MPs) and nurse practitioners (NPs) in general, and privately practising NPs (PPNPs) in particular, in relation to collaboration, control and supervision in Australia, as well as to explore the difficulties reported by PPNPs in establishing mandated collaborative arrangements with MPs in Australia. In order for the PPNPs to have access to the Medicare Benefit Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) in Australia, they are required, by law, to establish a collaborative arrangement with an MP or an entity t...
Source: Australian Health Review - December 5, 2019 Category: Hospital Management Authors: Chiarella M, Currie J, Wand T Tags: Aust Health Rev Source Type: research

Strengthening teamwork capability in allied health: implementation of a team development program in a metropolitan health service.
ConclusionsThe TMS program yielded positive effects on staff satisfaction, knowledge, team dynamics and team behaviours. These findings demonstrate the significant value of such initiatives to enhance the capability and effectiveness of interdisciplinary healthcare teams.What is known about the topic?Complex conditions, increasing comorbidities, specialisation and scarcity of resources mean healthcare workers need to work effectively in teams to achieve quality, safe, person centred patient care. There is some evidence of the effect of teamwork initiatives on knowledge or behaviour in specific clinical specialities, single...
Source: Australian Health Review - December 2, 2019 Category: Hospital Management Authors: Wood AJ, Grudzinskas K, Ross JA, Bailey S, Gordon GE, Burton C, Wishart LR Tags: Aust Health Rev Source Type: research

Evidence-based law making on voluntary assisted dying.
Abstract Voluntary assisted dying is a major social policy issue with significant implications for the health system, health and medical professionals and the wider community. Voluntary assisted dying is now lawful in Victoria in limited circumstances, and other states are likely to follow Victoria and legalise the practice. In the same way that we expect the making of health policy and the provision of health care to be evidence based, so too should we should expect evidence-based law making from our parliamentarians on this important topic.What is known about the topic?The importance of evidence when making heal...
Source: Australian Health Review - November 29, 2019 Category: Hospital Management Authors: White BP, Willmott L Tags: Aust Health Rev Source Type: research

Accuracy checking of dispensed medications by a pharmacy technician: a hospital case study.
Abstract Medication order accuracy checking is an integral and time-consuming component of the current Australian pharmacist's role. However, the pharmacy profession internationally has moved towards separating the checking task into two parts: a clinical check performed by the registered pharmacist and a technical accuracy check delegated to an appropriately trained pharmacy technician. This case study demonstrates that in an Australian hospital pharmacy context, appropriately trained pharmacy technicians have the potential to be more proficient and time efficient than pharmacists when undertaking accuracy checki...
Source: Australian Health Review - November 27, 2019 Category: Hospital Management Authors: Snoswell CL, Flor M, Tessier C, Ratanjee S, Hale A, Matthews A, Nissen L, Coombes I Tags: Aust Health Rev Source Type: research

Safeguarding injured Victorians: development and implementation of an evidence-informed system to manage therapeutic uncertainty and decision making in a compensable environment.
Abstract WorkSafe Victoria and the Transport Accident Commission are two Victorian government agencies that determine the policies that guide decisions to fund treatments and services provided to Victorians injured in transport or workplace accidents. These agencies identified that an internal system was required to manage requests for funding of new or emerging treatments. In particular, the agencies recognised a system that supported consistency in decision making in the context of therapeutic uncertainty and ensured the safety of injured Victorians was needed. The New, Emerging or Non-Established Treatments (NE...
Source: Australian Health Review - November 26, 2019 Category: Hospital Management Authors: Sherry LJ, Briggs AM, Pizzari T Tags: Aust Health Rev Source Type: research

'This is uncharted water for all of us.
ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels.What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation.What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased con...
Source: Australian Health Review - November 22, 2019 Category: Hospital Management Authors: McDougall R, Hayes B, Sellars M, Pratt B, Hutchinson A, Tacey M, Detering K, Shadbolt C, Ko D Tags: Aust Health Rev Source Type: research

Queensland Digital Health Clinical Charter: a clinical consensus statement on priorities for digital health in hospitals.
Abstract Digital transformation of Australian hospitals is occurring rapidly. Although the clinical community has had limited ability to influence high-level decision making and investments into digital health technologies, as these technologies increasingly transform the way patients are cared for, the clinical community must influence the digital health agenda and be an integral part of the decision-making process. This case study details the process and lessons learnt during the development of the state-wide consensus statement detailing the clinical requirements for digital health initiatives to form the Queen...
Source: Australian Health Review - November 20, 2019 Category: Hospital Management Authors: Sullivan C, Staib A, McNeil K, Rosengren D, Johnson I Tags: Aust Health Rev Source Type: research

First steps towards price transparency: comparability of online out-of-pocket tools from Australian private health funds.
ConclusionsThese funds have started to address the need for transparent out-of-pocket cost information, but the differences across these pages demonstrate complexities and the potential obfuscation of cost data.What is known about the topic?Out-of-pocket costs are highly variable and patient 'bill shock' is an increasing concern in Australia. Private insurance funds have created online tools to share procedure cost estimates based on their claims data.What does this paper add?This is the first review of Australian insurance funds' price transparency tools. The cost information is difficult to interpret both within funds (f...
Source: Australian Health Review - November 13, 2019 Category: Hospital Management Authors: Chalmers K, Elshaug AG, Larkin S Tags: Aust Health Rev Source Type: research

Guardianship in hospitals: a collaborative pilot project.
Abstract ObjectivesThis paper describes the development, implementation and preliminary results of a collaborative pilot project aimed at reducing the time hospital-based patients with cognitive impairments spend waiting for the allocation of legally appointed Advocate Guardian decision makers from the Office of the Public Advocate (OPA). The aim of the study was to investigate the effect of increased availability of public advocate guardians on guardian allocation waits, patient discharge outcomes and healthcare system demand.MethodsA multi-institutional pilot program created a dedicated hospital guardian team wi...
Source: Australian Health Review - November 7, 2019 Category: Hospital Management Authors: Hoffman R, Costar S, Kostopoulos T, Little J, Livingstone A, McAlinden F, Newland P, Re J, Watterson D, Haines TP Tags: Aust Health Rev Source Type: research

Patterns of health service utilisation among the Australian population with cancer compared with the general population.
ConclusionThe population with cancer used health services significantly more than the non-cancer population. Further studies are urgently needed to identify optimal approaches to delivery of care for this population, including barriers and enablers for their implementation.What is known about the topic?Multimorbidity is highly prevalent among the cancer population due to risk factors shared between cancer and other chronic diseases, and the development of new conditions resulting from cancer treatment and cancer complications. However, the Australian healthcare system is not set up optimally to address issues related to mu...
Source: Australian Health Review - November 7, 2019 Category: Hospital Management Authors: Ng HS, Koczwara B, Roder D, Chan RJ, Vitry A Tags: Aust Health Rev Source Type: research

Mental health of animal hoarders: a study of consecutive cases in New South Wales.
ConclusionsAnimal hoarding is largely attributable to psychological and psychiatric problems. It is recommended that clinical services work alongside animal welfare inspectorates, assessing (and, where appropriate, treating) such problems.What is known about the topic?Animal hoarding is believed to be partly attributable to the hoarders having psychiatric or psychological problems, but relevant mental health assessment of hoarders is not usually arranged. Recidivism after removal of animals is nearly 100%.What does this paper add?The study confirms that animal hoarders commonly have mental health issues. However, RSPCA ins...
Source: Australian Health Review - November 7, 2019 Category: Hospital Management Authors: Snowdon J, Halliday G, Elliott R, Hunt GE, Coleman S Tags: Aust Health Rev Source Type: research

Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010-17.
ConclusionTribunal cases reflected complaint data in that: (1) male practitioners were greatly over-represented as respondents; (2) outcomes were most severe for sexual misconduct and least severe for clinical care; and (3) doctors faced less severe outcomes than other professions. There were also significant variations in severity of outcome by jurisdiction. Variations were more pronounced when deregistration was the focus of analysis.What is known about this topic?Existing research on complaints data under the National Law in place since 2010 has suggested that doctors may be receiving less severe outcomes than other pro...
Source: Australian Health Review - November 1, 2019 Category: Hospital Management Authors: Millbank J Tags: Aust Health Rev Source Type: research

Framework for community-based models for treating hepatitis C virus.
ConclusionThis framework for understanding the components of models of community-based HCV treatment may be used as a guide for designing, implementing and evaluating models of care in support of HCV elimination. HCV care providers and patients need to be supported to improve their engagement with the provision of community-based treatment. In addition, evidence-based strategies to facilitate service delivery need to be included.What is known about the topic?Community-based models for treating HCV are widely recognised as having the advantage of reaching more people who require treatment. These types of models aim to remov...
Source: Australian Health Review - November 1, 2019 Category: Hospital Management Authors: Pourmarzi D, Hall L, Smirnov A, Hepworth J, Rahman T, FitzGerald G Tags: Aust Health Rev Source Type: research

Stepped care mental health service in Australian primary care: codesign and feasibility study.
ConclusionsPreliminary data suggest that StepCare may be acceptable and feasible in Australian general practice, helping GPs identify and manage common mental health problems in their patients. The study provides implications for policy and practice, and points the way to future translational research into stepped mental health care.What is known about the topic?Depression and anxiety are common illnesses in primary care and GPs are ideally placed to implement stepped care approaches enabling early detection and accessible, effective care.What does this paper add?Developed in and for general practice, StepCare is the first...
Source: Australian Health Review - October 30, 2019 Category: Hospital Management Authors: Anderson J, O'Moore K, Faraj M, Proudfoot J Tags: Aust Health Rev Source Type: research

Profile of the most common complaints for five health professions in Australia.
Abstract ObjectiveThe aims of this study were to profile the most common complaints and to examine whether any demographic factors are associated with receiving a complaint for five health professions in Australia.MethodsA national cohort study was conducted for all complaints received for medicine, nursing/midwifery, dentistry, pharmacy and psychology from 1 July 2012 to 31 December 2013 (18 months). Data were collected from the Australian Health Practitioner Regulation Agency (AHPRA), the New South Wales (NSW) Health Professional Councils' Authority and the NSW Health Care Complaints Commission. The frequency an...
Source: Australian Health Review - October 29, 2019 Category: Hospital Management Authors: Walton M, Kelly PJ, Chiarella EM, Carney T, Bennett B, Nagy M, Pierce S Tags: Aust Health Rev Source Type: research

Cost-benefit analysis of enhancing the uptake of long-acting reversible contraception in Australia.
ConclusionGreater use of LARC would result in a net gain in economic benefits to Australia. These benefits are largely driven by women switching from an OCP to LARC who have reduced costs, as well as women wishing to avoid pregnancy who choose to use LARC rather than no method. This evidence will support women making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.What is known about the topic?LARC is the most effective form of reversible contraception, but uptake in Australia is relatively low.What does this paper add?There are economic benefits to society for women who switch fr...
Source: Australian Health Review - October 28, 2019 Category: Hospital Management Authors: Concepcion K, Lacey S, McGeechan K, Estoesta J, Bateson D, Botfield J Tags: Aust Health Rev Source Type: research

Retrospective analysis of utilisation of the Australian Child Dental Benefit Scheme.
ConclusionThe utilisation of CDBS is considered to be low.What is known about the topic?Previous government dental schemes in Australia resulted in inequalities in utilisation of the scheme by targeted groups. The CDBS was implemented with an extension of eligibility criteria and services offered as a means to improve access to dental care.What does this paper add?There is no information available on the utilisation and cost patterns of the CDBS; hence, this study analysed the pattern of utilisation and the cost of the CDBS over the first 2 years of operation.What are the implications for practitioners?It is important that...
Source: Australian Health Review - October 25, 2019 Category: Hospital Management Authors: Putri DE, Kruger E, Tennant M Tags: Aust Health Rev Source Type: research

Adequacy of Australia.
ConclusionsThe number of GP clinical hours worked decreased, and clinical demand increased. Ongoing efforts are required to ensure the supply of GPs to meet the clinical demand of Australia's aging population.What is known about this topic?For the past three decades there has been concern about the supply of GPs in Australia. In recent years the Australian Government has taken several steps to improve access to GP services by increasing the overall supply of GPs and encouraging a more even distribution of GPs across Australia. A 2011 Australian study calculated average annual GP service utilisation and predicted the number...
Source: Australian Health Review - October 23, 2019 Category: Hospital Management Authors: Dingwall S, Henderson J, Britt H, Harrison C Tags: Aust Health Rev Source Type: research

Digital transformation of the emergency department-inpatient interface (EDii): integration for future innovation.
The objective of this case study was to describe the impact of digital transformation of the ED-in-patient interface (EDii) of a large tertiary hospital on process measures and clinical outcomes for patients requiring emergency admission to hospital. Data were collected from routine clinical and administrative information systems to measure process and clinical outcome measures, including ED length of stay, compliance with the 4-h rule and in-patient mortality between 28 November 2014 and 28 February 2017. The 4-h rule compliance for all patients, as well as for the EDii group (admitted to hospital excluding short stay war...
Source: Australian Health Review - October 23, 2019 Category: Hospital Management Authors: Staib A, Sullivan C, Cabilan CJ, Cattell R, Eley R Tags: Aust Health Rev Source Type: research

How do cancer care services in Australia take care of their patients when they require emergency care? We need more evidence.
Abstract A letter to the editor on cancer patients accessing emergency care. PMID: 31619319 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - October 17, 2019 Category: Hospital Management Authors: Button E, Northfield S, Smith M, Wyld D, Nasato G, Yates P Tags: Aust Health Rev Source Type: research

Governance of skilled migration and registration of internationally qualified health practitioners: an Australian policy perspective.
Abstract This paper presents a policy perspective on the topical issue of migration and registration of internationally qualified health practitioners (IQHPs), with a focus on international medical graduates and internationally qualified nurses and midwives. Current views, regulatory governance and recommendations affecting skilled migration and registration of IQHPs were examined, specifically whether current and proposed practices are transparent, consistent, equitable, robust, cost-effective and assist in ensuring IQHPs demonstrate the necessary qualifications and experience for protection of the Australian pub...
Source: Australian Health Review - October 14, 2019 Category: Hospital Management Authors: Cooper M, Rasmussen P, Magarey J Tags: Aust Health Rev Source Type: research

National cost savings from an ambulatory program for low-risk febrile neutropenia patients in Australia.
ConclusionsThe wider implementation of a safe and effective ambulatory program to manage low-risk FN patients can result in significant return-on-investment for the healthcare system by eliminating avoidable costs due to unnecessary lengthy hospital admissions.What is known about the topic?There is strong evidence demonstrating out-patient treatment of low-risk FN patients to be an effective and cost-effective strategy compared with continued in-patient hospitalisation.What does this paper add?This study demonstrates the sustainability of the ambulatory program in ensuring cost benefits and in-patient beds through real-lif...
Source: Australian Health Review - September 17, 2019 Category: Hospital Management Authors: Tew M, Forster D, Teh BW, Dalziel K Tags: Aust Health Rev Source Type: research

Recent estimates of the out-of-pocket expenditure on health care in Australia.
ConclusionsOOP expenditure on health care as a proportion of the total household expenditure on all goods and services has increased by more than 25% between 2009-10 and 2015-16.What is known about the topic?Australian households incur OOP expenses for health care in Australia for a wide range of goods and services, such as copayments to doctors and other health professionals beyond the Medicare rebates, the cost of medicines and other pharmaceutical goods not covered entirely by the Pharmaceutical Benefits Scheme and PHI premiums. Although other estimates of OOP expenditure are available in official reports of the Austral...
Source: Australian Health Review - September 13, 2019 Category: Hospital Management Authors: Yusuf F, Leeder S Tags: Aust Health Rev Source Type: research

Performance-based pharmacy payment models: the case for change.
Abstract In response to rising healthcare costs, healthcare payers across the globe have been experimenting with performance-based payment models that link payments to providers with the quality of care that they provide. Community pharmacy in Australia has yet to be significantly affected by these changes. Initial steps have been taken to fund quality-linked interventions by pharmacists, such as the provision of medicines in dose administration aids, but funding for dispensing prescriptions remains solely based on a fee-for-service model. At the foundation of any performance-based payment model are measures that,...
Source: Australian Health Review - September 11, 2019 Category: Hospital Management Authors: Jackson J, Urick B Tags: Aust Health Rev Source Type: research

Digitising an Australian university hospital: qualitative analysis of staff-reported impacts.
ConclusionsThe overall positive perceptions of the effects of digitisation should give confidence to health services contemplating rapid digital transformation. Although existing literature provides a reliable framework for impact assessment, new effects are still emerging, and research and practice need to shift towards understanding how clinicians and hospitals can maximise the benefits of digital transformation.What is known about the topic?Hospitals outside the US are increasingly becoming engaged in eHealth transformations. Yet, the reported effects of these technologies are diverse and mixed with qualitative effects ...
Source: Australian Health Review - July 18, 2019 Category: Hospital Management Authors: Eden R, Burton-Jones A, Grant J, Collins R, Staib A, Sullivan C Tags: Aust Health Rev Source Type: research

Research as the gatekeeper: introduction ofrobotic-assisted surgery into the public sector.
ConclusionsThere is potential for this comprehensive governance framework to be transferred to other public hospitals commencing or with existing RAS programs and to be applied to the introduction of other new and expensive surgical technology.What is known about the topic?RAS is rapidly evolving and becoming increasingly prevalent across surgical specialities in major public hospitals. Consequently, it is important that this new technology is safely and appropriately implemented into the public health system.What does this paper add?This article describes the benefits and implementation challenges of a novel RAS approach,...
Source: Australian Health Review - July 16, 2019 Category: Hospital Management Authors: McBride KE, Steffens D, Solomon MJ, Anderson T, Young J, Leslie S, Thanigasalam R, Bannon PG Tags: Aust Health Rev Source Type: research

Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland.
ConclusionsThere was considerable variation in costs between hospital and health services in Queensland for the costs of delivering maternity care. Cost needs to be considered as an important additional element of monitoring programs.What is known about the topic?The Australian maternal care system delivers high-quality, safe care to Australian mothers. However, this comes at a considerable financial cost to the Australian public health system. It is known that there are variations in the cost of care depending upon the model of care a woman receives, and the type of delivery she has, with higher-cost treatment not necessa...
Source: Australian Health Review - July 15, 2019 Category: Hospital Management Authors: Callander EJ, Fenwick J, Donnellan-Fernandez R, Toohill J, Creedy DK, Gamble J, Fox H, Ellwood D Tags: Aust Health Rev Source Type: research

Public disclosure of hospital clinicians.
ConclusionsPublic reporting of identifiable individual healthcare clinicians' performance data is an issue that merits robust research and debate given the effects such reporting may have on doctors and on hospital quality and safety.What is known about the topic?The public reporting of individual clinician-level data is a mechanism used in some countries, but not in Australia, for increasing health care transparency and quality. Clinician-level public reporting of doctors' performance attracts contention and debate in Australia.What does this paper add?This paper informs debate around the public reporting of individual cl...
Source: Australian Health Review - July 12, 2019 Category: Hospital Management Authors: Canaway R, Prang KH, Bismark M, Dunt D, Kelaher M Tags: Aust Health Rev Source Type: research

Clinical indications treated with unregistered antimicrobials: regulatory challenges of antimicrobial resistance and access to effective treatment for patients.
ConclusionsAlthough the introduction of a new pathway has decreased the administrative burden when accessing unregistered antimicrobials, this study highlights the range of clinical conditions for which there are no registered drugs available in Australia.What is known about the topic?With increasing antimicrobial resistance and a paucity of novel antimicrobials entering the market, access to older, previously less-used antimicrobials is increasingly important in clinical practice. Accessing unregistered antimicrobials is common practice in Australian hospitals, but the range of clinical indications for which they are used...
Source: Australian Health Review - July 5, 2019 Category: Hospital Management Authors: Hillock NT, Paradiso L, Turnidge J, Karnon J, Merlin TL Tags: Aust Health Rev Source Type: research

Strategies to improve access to and uptake of dental care by people experiencing homelessness in Australia: a grey literature review.
ConclusionsTo improve access to and uptake of dental care by people experiencing homelessness, dental services need to be free and organised in collaboration with support organisations.What is known about the topic?The peer-reviewed literature describing strategies used to improve access to and uptake of dental care by people experiencing homelessness in Australia is limited. The authors could only locate two such studies, one based in Melbourne and one in Brisbane. Both programs had a similar aim, but used different strategies to achieve it, suggesting a lack of consensus about the best way to encourage dental visiting by...
Source: Australian Health Review - July 2, 2019 Category: Hospital Management Authors: Goode J, Hoang H, Crocombe L Tags: Aust Health Rev Source Type: research

Exploring information technology (IT) sophistication in New South Wales residential aged care facilities.
Abstract ObjectiveThe aim of this study was to determine baseline information technology (IT) sophistication in New South Wales (NSW), Australia, residential aged care facilities.MethodIT sophistication measures IT capabilities, extent of IT use and IT integration in two domains, resident care and clinical support. A survey was administered to all NSW residential aged care facilities (n = 876) between February and May 2017. A 15% response rate was achieved (130/876). Facilities were organised by organisational type, total residential places and remoteness. Using post-stratification weights, estimates of IT sophist...
Source: Australian Health Review - June 28, 2019 Category: Hospital Management Authors: Alexander GL, Georgiou A, Siette J, Madsen R, Livingstone A, Westbrook J, Deroche C Tags: Aust Health Rev Source Type: research

Defining 'specialist palliative care.
ConclusionsAreas of connection were identified: clinicians from disease-specific specialties should be more involved in leading discussions on futile or burdensome treatment and providing care to people in their last months and days of life, in collaboration with specialists in palliative care when required.What is known about the topic?At present there is no evidence-based definition or agreement about what constitutes specialist palliative care (as opposed to palliative care delivered by non-specialists) in the Australian Capital Territory. An agreed definition is needed to effectively determine the workforce required an...
Source: Australian Health Review - June 28, 2019 Category: Hospital Management Authors: Forbat L, Johnston N, Mitchell I Tags: Aust Health Rev Source Type: research

Analysis of sponsor hearings on health technology assessment decision making.
ConclusionThe PBAC considered approximately 45% of sponsor hearings to be informative or moderately informative whereas 18% were classed as uninformative.What is known about the topic?Although the sponsors of medicines being considered by the Pharmaceutical Benefits Advisory Committee (PBAC) for public subsidy have been able to give a 10 min presentation to the Committee at the time of decision making for several years, it is unknown whether these hearings are beneficial.What does this paper add?We present what is believed to be the results of the first analysis of PBAC sponsor hearings.What are the implications for practi...
Source: Australian Health Review - May 10, 2019 Category: Hospital Management Authors: Flowers M, Lybrand S, Wonder M Tags: Aust Health Rev Source Type: research

Aboriginal and Torres Strait Islander preferences for healthcare settings: effective use of design images in survey research.
ConclusionsThe multidisciplinary approach to developing an online survey instrument with images and the willingness of Indigenous people of all ages to engage with the images demonstrated the effectiveness of this method in providing robust evidence for the design of culturally appropriate healthcare spaces for Indigenous users.What is known about the topic?Evidence-based research influences the design of healthcare buildings, yet the field currently provides negligible evidence on cross-cultural perceptions or experiences of conventional modern hospitals and clinics. Although recent healthcare buildings show signs of ackn...
Source: Australian Health Review - April 23, 2019 Category: Hospital Management Authors: Haynes M, O'Rourke T, Nash D, Baffour B, York S, Chainey C, Betros G, Memmott P Tags: Aust Health Rev Source Type: research

Incident haemodialysis and outcomes in the Top End of Australia.
ConclusionAKI in people with pre-existing CKD was a common cause of iHD. Health service planning and community health may benefit from AKI prevention strategies and the implementation of sustainable and permanent linkages with the datasets used to monitor prospective incident haemodialysis.What is known about the topic?AKI is a risk factor for CKD. The Northern Territory has the highest national incidence rates of dialysis-dependent end-stage kidney disease, but has no audit tool describing outcomes of dialysis-requiring AKI.What does this paper add?We audited all iHD and showed 25.6% mortality within the first 90 days of ...
Source: Australian Health Review - April 18, 2019 Category: Hospital Management Authors: Hughes JT, Majoni SW, Barzi F, Harris TM, Signal S, Lowah G, Kapojos J, Abeyaratne A, Sundaram M, Goldrick P, Jones SL, McFarlane R, Campbell LT, Stephens D, Cass A Tags: Aust Health Rev Source Type: research

Depression, suicide risk, and workplace bullying: a comparative study of fly-in, fly-out and residential resource workers in Australia.
ConclusionsInterventions should be delivered to reduce depression and hopelessness in Australian resource workers, particularly through addressing workplace bullying and enhancing social support.What is known about the topic?One-third of Australian resource workers experience psychosocial distress. Research examining factors that influence such distress is lacking.What does this paper add?The results of this study demonstrate that clinical depression and suicide risk were significantly higher in residential resource workers than in FIFO workers. Depression and suicide risk were directly associated with workplace bullying. ...
Source: Australian Health Review - April 18, 2019 Category: Hospital Management Authors: Miller P, Brook L, Stomski NJ, Ditchburn G, Morrison P Tags: Aust Health Rev Source Type: research

Implementation science approaches to enhance uptake of complex interventions in surgical settings.
Abstract Achieving practice change in the complex healthcare environment is difficult. Effective surgical care requires coordination of services across the continuum of care, involving interdisciplinary collaboration across multiple units, with systems and processes that may not connect effectively. Principles of enhanced recovery after surgery (ERAS) are increasingly being incorporated into facility policies and practice, but the literature reports challenges with both initial adherence and mid- to long-term sustainability. Greatest adherence is typically observed for the intraoperative elements, which are within...
Source: Australian Health Review - April 15, 2019 Category: Hospital Management Authors: Byrnes A, Mudge A, Clark D Tags: Aust Health Rev Source Type: research

Towards value-based healthcare - modelling an answer for cancer care delivery.
PMID: 30961790 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - April 1, 2019 Category: Hospital Management Authors: Saunders C Tags: Aust Health Rev Source Type: research

Local regional workforce returns on investment of a locally governed and delivered general practice vocational training program.
This study evaluated a program arising from the Commonwealth policy of regionalised training for general practice with regard to the outcomes for the region investing in the training program. A complete operational audit was performed of the outcomes of a training provider of the Commonwealth program, evaluating workforce contribution and retention in the region during and after training, stratified for the effects of locally contextualising, advanced skill training and origin of trainee. The local regional workforce contribution during training peaked at 130 full-time equivalents in 2015. Cumulatively, 53% of alumni remai...
Source: Australian Health Review - March 29, 2019 Category: Hospital Management Authors: Kitchener S Tags: Aust Health Rev Source Type: research

Robotic colorectal surgery in Australia: a cohort study examining clinical outcomes and cost.
Abstract Objective The aim of this study was to compare robotic versus laparoscopic colorectal operations for clinical outcomes, safety and cost.Methods A retrospective cohort study was performed of 213 elective colorectal operations (59 robotic, 154 laparoscopic), matched by surgeon and operation type.Results No differences in age, body mass index, median American Society of Anesthesiologists score or presence of cancer were observed between the laparoscopic or robotic surgery groups. However, patients undergoing robotic colorectal surgery were more frequently male (P = 0.004) with earlier T stage tumours (P = 0....
Source: Australian Health Review - March 29, 2019 Category: Hospital Management Authors: Wilkie B, Summers Z, Hiscock R, Wickramasinghe N, Warrier S, Smart P Tags: Aust Health Rev Source Type: research

Psychiatric morbidity, burnout and distress in Australian physician trainees.
ConclusionThe results demonstrate high levels of non-psychotic psychiatric morbidity among physician trainees and a need to improve their well-being. Workplace systems need to promote healthy work environments and support physician trainees through good mentorship and supervision.What is known about the topic?Doctors' health and patient care can be affected when doctors experience burnout and psychiatric morbidity.What does this paper add?This paper adds to the evidence of psychiatric morbidity, burnout, secondary trauma and increased demographic data on a cohort of junior doctors undertaking speciality training. In additi...
Source: Australian Health Review - March 25, 2019 Category: Hospital Management Authors: Axisa C, Nash L, Kelly P, Willcock S Tags: Aust Health Rev Source Type: research

Customised approaches to vocational education can dramatically improve completion rates of Australian Aboriginal students.
Abstract ObjectiveCompletion rates in vocational education are typically poor for Aboriginal students (
Source: Australian Health Review - March 14, 2019 Category: Hospital Management Authors: Gwynne K, Rojas J, Hines M, Bulkeley K, Irving M, McCowen D, Lincoln M Tags: Aust Health Rev Source Type: research

Model for integrated care for chronic disease in the Australian context: Western Sydney Integrated Care Program.
ConclusionA model of integrated care has been successfully implemented and embedded into local practices. Preliminary data suggest that this is having an impact on the utilisation of hospital services.What is known about the topic?There is evidence that integrated models can improve cost-effectiveness and the quality of clinical care for people with chronic disease. However, most integrated models are small scale, focus on very specific populations and generally do not engage both primary care and acute hospitals.What does this paper add?This paper describes an effective partnership between state-funded hospital services i...
Source: Australian Health Review - March 13, 2019 Category: Hospital Management Authors: Cheung NW, Crampton M, Nesire V, Hng TM, Chow CK Tags: Aust Health Rev Source Type: research

Emerging role of the Australian private health insurance sector in providing chronic disease management programs: current activities, challenges and constraints.
ConclusionsDespite legislation permitting PHI funds to pay benefits for CDM services being in place for more than 10 years, insurers are still in an early stage of implementation and evaluation of CDM activities. Primarily due to the regulated scope of PHI coverage in Australia, participants reported several challenges in providing CDM services, including identifying target groups, evaluating service outcomes and collaborating with other healthcare providers. The effectiveness of the approach of PHI funds to CDM in terms of the groups targeted and outcomes of services provided still needs to be established because evidence...
Source: Australian Health Review - March 12, 2019 Category: Hospital Management Authors: Khoo J, Hasan H, Eagar K Tags: Aust Health Rev Source Type: research

End-of-life care in hospital: an audit of care against Australian national guidelines.
Abstract ObjectiveThe aim of this study was to map end-of-life care in acute hospital settings against Elements 1-5 of the Australian Commission on Safety and Quality in Health Care's (ACSQHC) Essential Elements for Safe and High-Quality End-of-Life Care.MethodsA retrospective medical record audit of deceased in-patients was conducted from 2016 at one public (n = 320) and one private (n = 132) hospital in Melbourne, Australia. Ten variables, key to end-of-life care according to the ACSQHC's Elements 1-5 were used to evaluate end-of-life care.ResultsMost patients (87.2%) had a limitation of medical treatment. In 91.97% (P
Source: Australian Health Review - March 5, 2019 Category: Hospital Management Authors: Bloomer MJ, Hutchinson AM, Botti M Tags: Aust Health Rev Source Type: research

Failure to access prescribed pharmaceuticals by older patients with chronic conditions.
ConclusionsAs for statins, the main financial determinant of adherence is cost in the form of prescribed copayments, suggesting that this may apply across many medications.What is known about the topic?Previous studies have shown patients' concern about the costs of pharmaceuticals, and more detailed studies of statins show that the lowest adherence relates to patients facing the highest copayments.What does this paper add?This paper provides support for the contention that the results found for statins broadly apply across more medications used by people with chronic conditions.What are the implications for practitioners?...
Source: Australian Health Review - March 4, 2019 Category: Hospital Management Authors: McRae I, van Gool K, Hall J, Yen L, Wright M Tags: Aust Health Rev Source Type: research

Trends in unplanned readmissions over 15 years: a regional Australian perspective.
ConclusionsThe decline in readmissions since 2010-11 suggests that the region has achieved improvements in discharge planning and in continuity between hospitals and community-based care. These improvements have occurred across broad patient groups. The longitudinal and linked data held in the IHIP provides a unique opportunity to examine patterns of service utilisation at a regional level.What is known about the topic?Published reports of longitudinal trends in readmissions are typically limited by short study periods and narrow criteria used to define study populations and readmissions. Australian longitudinal data sugge...
Source: Australian Health Review - March 4, 2019 Category: Hospital Management Authors: Westley-Wise V, Lago L, Mullan J, Facci F, Zingel R, Eagar K Tags: Aust Health Rev Source Type: research