Developing a model of bereavement care in an adult tertiary hospital.
ConclusionsThis evidence-generated model of care promotes the provision of quality and systematic bereavement care in the acute hospital setting.What is known about the topic?Acute hospitals are the most common place to die in Australia, yet there is a lack of understanding of how bereavement care is or should be provided in these environments. The bereavement period is associated with increased use of health services and worse morbidity and mortality, and thus has significant implications for public health. The provision of bereavement care in acute hospitals is often sporadic, often involving untrained staff who may not ...
Source: Australian Health Review - December 23, 2020 Category: Hospital Management Authors: Grant M, Hudson P, Forrest A, Collins A, Israel F Tags: Aust Health Rev Source Type: research

Patient satisfaction with physiotherapists is not inferior to surgeons in an arthroplasty review clinic: non-inferiority study of an expanded scope model of care.
ConclusionThe satisfaction of patients attending a physiotherapy arthroplasty review clinic is not inferior to that of patients attending traditional surgeon clinics.What is known about the topic?A substitution model of care where an advanced practice physiotherapist reviews routine postarthroplasty patients instead of surgeons originated in the UK and has been adopted in Canada and Australia to address the increasingly overloaded public out-patient health services. Evidence of clinical and cost effectiveness has been demonstrated but, to the best of the authors' knowledge, only one paper has evaluated consumer engagement,...
Source: Australian Health Review - December 21, 2020 Category: Hospital Management Authors: Murphy MT, Radovanovic J Tags: Aust Health Rev Source Type: research

Measuring the economic impact of hospital-acquired complications on an acute health service.
ConclusionsThis study shows the economic impact of HACs from the perspective of an individual health service. The methodology used demonstrates how other health services could determine safety priorities corresponding to their own casemix.What is known about the topic?HACs are a major issue in Australian health care; however, their effect on cost and LOS at the individual health service level is not well quantified.What does this paper add?Additional cost and LOS implications for 16 high-priority HACs have been quantified within an Australian health service. There is substantial variation in terms of the number of HACs and...
Source: Australian Health Review - December 18, 2020 Category: Hospital Management Authors: Fernando-Canavan L, Gust A, Hsueh A, Tran-Duy A, Kirk M, Brooks P, Knight J Tags: Aust Health Rev Source Type: research

Collaboration between the intensive care unit and organ donation agency to achieve routine consideration of organ donation and comprehensive bereavement follow-up: an improvement project in a quaternary Australian hospital.
ConclusionsCollaboration between DLSA and the Royal Adelaide Hospital ICU achieved universal consideration of organ donation and high rates of structured bereavement follow-up. Follow-up calls were valued with areas for improvement identified.What is known about this topic?Death in the ICU is associated with significant psychopathology among bereaved family members, and bereavement follow-up is widely recommended. Opportunities to consider organ and tissue donation are commonly missed due to lack of consideration at end of life.What does this paper add?Collaboratively exploring donation and performing bereavement follow-up...
Source: Australian Health Review - December 15, 2020 Category: Hospital Management Authors: Yeo NYK, Reddi B, Kocher M, Wilson S, Jastrzebski N, Duncan K, Moodie S Tags: Aust Health Rev Source Type: research

Review of current pathways to wait-listing for kidney transplantation for Aboriginal and Torres Strait Islander peoples with end-stage kidney disease in the Top End of Northern Australia.
In conclusion, barriers to wait-listing for kidney transplantation for Aboriginal and Torres Strait Islander Australians are complex and can be addressed by redesigning healthcare provision, including increasing the Aboriginal and Torres Strait Islander workforce to provide education and patient navigation of the healthcare system and improve communication, streamlining investigations and coordinating specialist services.What is known about the topic?Access to wait-listing for kidney transplantation for Aboriginal and Torres Strait Islander Australians from the Northern Territory is poor. Barriers to wait-listing for kidne...
Source: Australian Health Review - December 8, 2020 Category: Hospital Management Authors: Majoni SW, Dole K, Hughes JT, Pain C Tags: Aust Health Rev Source Type: research

Is Australia.
Abstract Australia's clinical research communities responded quickly to COVID-19. Similarly, research funding to address the pandemic was appropriately fast-tracked and knowledge promptly disseminated. This swift and purposeful research response is encouraging and reflects thorough and meticulous training of the academic workforce; in particular the clinician scientist. Clinician scientists have formal clinical and research qualifications (primarily PhD), and are at the forefront of translating knowledge into health care. Yet in reality, advances in medical research are not rapid. Scientific discovery results from...
Source: Australian Health Review - December 8, 2020 Category: Hospital Management Authors: Eley DS, O'Leary SP, Young A, Buttrum P Tags: Aust Health Rev Source Type: research

Allied health primary contact services: results of a 2-year follow-up study of clinical effectiveness, safety, wait times and impact on medical specialist out-patient waitlists.
ConclusionsAllied health primary contact services provide safe, effective and timely care. The impact on medical specialist out-patient waitlists varied depending on service model and pathway characteristics.What is known about this topic?Most studies of allied health primary contact services have focused on the management of patients on orthopaedic specialist out-patient waitlists by a physiotherapist. These studies of either individual services or groups of services with the same model cite benefits, including reduced waiting times, high levels of patient and referrer satisfaction, improved conversion to surgery, cost-ef...
Source: Australian Health Review - December 4, 2020 Category: Hospital Management Authors: Stute M, Moretto N, Waters R, Raymer M, Sam S, Bhagwat M, Banks M, Comans T, Buttrum P Tags: Aust Health Rev Source Type: research

Building trust and transparency: health consumer organisation-pharmaceutical industry relationships.
PMID: 33264583 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - December 3, 2020 Category: Hospital Management Authors: Parker L, Brown A, Wells L Tags: Aust Health Rev Source Type: research

An age-old crisis? Now is the time for action.
PMID: 33264586 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Dixon A Tags: Aust Health Rev Source Type: research

Combatting Commission fatigue: what does real reform in mental health look like?
PMID: 33264587 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Rosenberg S Tags: Aust Health Rev Source Type: research

New Zealand's Cannabis Legalisation and Control Bill: a viable approach to drug law reform.
PMID: 33264588 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Boden JM Tags: Aust Health Rev Source Type: research

New Zealand votes on end of life choice and cannabis legalisation.
PMID: 33264589 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Geddis A Tags: Aust Health Rev Source Type: research

Introducing a clinically effective allied health rapid discharge team within a complex aged subacute in-patient cohort on a cost recovery basis: the Supported Patient centred Early Discharge (SPeED) initiative.
Abstract This case study reports the outcomes of an early supported discharge program. This model of care was trialled after Victoria introduced subacute weighted inlier equivalent separations funding to subacute in-patients in 2016. An allied health team (Supported Patient centred Early Discharge (SPeED)) managed patients suitable for assessment, intervention and early supported discharge (ESD). The SPeED cohort was compared to a matched historical control. Data included no advantage financially (NAF) days, length of stay (LOS), functional independence measure (FIM) scores and 30-day readmission rates. Staff and ...
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Hough P, Gleeson S, Shkuratova N, Coker F, Williams C Tags: Aust Health Rev Source Type: research

Corrigendum to: Who uses residential aged care now, how has it changed and what does it mean for the future?
ConclusionChanging trends in residential aged care use, when combined with key trends in the broader population of older Australians, offer useful insights in planning for the future.What is known about the topic?Trends in the changing characteristics of permanent aged care residents and patterns of use of Australian residential aged care have received sparse attention in scholarly journals. Government reports and databases contain useful statistics, but they do not provide a coherent analysis and interpretation of the implications of these trends or situate them in broader population patterns.What does this paper add?The ...
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Gibson D Tags: Aust Health Rev Source Type: research

Staffing policy in aged care must look beyond the numbers.
Abstract The COVID-19 pandemic has highlighted an aged care system struggling to meet the needs of vulnerable Australians. Staffing levels and skill mix in aged care have declined, whereas the health and social needs of an older and more clinically complex population have risen. Increasing staff and improving personal care workers' skills and education are essential steps to quality aged care in Australia, but it will not be possible without funding models that foster secure employment, development opportunities and long-term career pathways. PMID: 33256893 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Wise S Tags: Aust Health Rev Source Type: research

Understanding the work of case managers in Australian community aged care: a longitudinal time and motion study.
Abstract ObjectiveThe aim of this study was to quantify the work activities of community aged care case managers and assess changes following consumer-directed policy reforms.MethodsA longitudinal, time and motion study was performed, with direct observation (n=339h) of case managers undertaking work in the office or in the community. We compared the distribution of proportions of time spent across seven broad work task categories during May-August 2014 (P1) and May-October 2016 (P2).ResultsOffice time was primarily consumed by communication (43.7%) and documentation (33.3%) tasks. Documentation increased substant...
Source: Australian Health Review - December 1, 2020 Category: Hospital Management Authors: Prgomet M, Walter S, Jorgensen M, Georgiou A, Westbrook J Tags: Aust Health Rev Source Type: research

Sociocognitive approach to behaviour change for reducing low-value care.
Abstract Social and cognitive factors that predispose to low-value care (LVC), and strategies for countering them, may be underarticulated in campaigns aimed at reducing LVC. A sociocognitive approach, in addition to traditional knowledge translation strategies, may augment understanding and changing clinician behaviour underpinning LVC. PMID: 33250069 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - November 30, 2020 Category: Hospital Management Authors: Scott IA, McPhail SM Tags: Aust Health Rev Source Type: research

Everyone matters; everyone contributes; everyone grows: a pilot project cultivating psychological safety to promote growth-oriented service culture after the Oakden Report.
Abstract The development of positive workplace culture is important for health services, with implications for patient experience, staff wellbeing and service outcomes. The Oakden Report identified dysfunctional culture in the South Australian state-wide older persons' mental health service and established an agenda for change through a codesigned culture framework. An innovative culture change project was undertaken at Northgate House, a specialist service commissioned following the Oakden Report. The project built on the culture framework, with emphasis on developing psychological safety and employed principles ...
Source: Australian Health Review - November 30, 2020 Category: Hospital Management Authors: McKellar D, Renner D, Gower A, O'Brien S, Stevens A, DiNiro A Tags: Aust Health Rev Source Type: research

Appraisal of physical health guidelines for severe mental illness.
ConclusionsMost guidelines scored poorly when rated by the AGREE II Instrument. However, these guidelines may still be useful in assisting evidence-based clinical practice. The methodological rigour of future guidelines can be improved by ensuring the AGREE II domains are addressed during the development phase.What is known about the topic?Compared with the general population, people with SMI experience greater chronic disease morbidity and mortality. There is limited evidence from randomised controlled trials to guide physical health care monitoring for people with SMI. Current guidelines and practice are largely based on...
Source: Australian Health Review - November 30, 2020 Category: Hospital Management Tags: Aust Health Rev Source Type: research

Nature and outcomes of sanctioned medical misconduct in six international jurisdictions: a case series.
This study was a retrospective case series of 822 adverse medical tribunal determinations in Australia, New Zealand, Canada (Ontario, Alberta), Pennsylvania (USA), Singapore and Hong Kong in 2013-17.ResultsInappropriate medical care and illegal or unethical prescribing were the most common types of misconduct. Misconduct varied with practitioner sex, international medical graduate status, speciality and jurisdiction (P
Source: Australian Health Review - November 24, 2020 Category: Hospital Management Authors: Grant N, Valentine S, Majer J, Taylor DM Tags: Aust Health Rev Source Type: research

Identifying the gaps in public dental services locations for people living with a disability in metropolitan Australia: a geographic information system (GIS)-based approach.
ConclusionThis study highlights the areas where there is low access to a dental service, particularly access to a public dental service, for people living with a disability.What is known about the topic?The distribution of people with a disability is associated with area-level measures of socioeconomic disadvantage. Access to dental care is a function of affordability, availability, accessibility, accommodation and acceptability. Previous studies identified problems in relation to access to dental care for people living with a disability, including wait times, costs and physical access to buildings.What does this paper add...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Liu N, Kruger E, Tennant M Tags: Aust Health Rev Source Type: research

Biobank networking and globalisation: perspectives and practices of Australian biobanks.
ConclusionsMany Australian biobanks are already active participants in various types of global biobanking. If biobanks are to expand and make the most of their involvement in global networks, then important barriers need to be overcome.What is known about the topic?Biobanks that store human tissue and associated data are increasingly forming local, national and global networks. These networks create opportunities for enhancing the utility and sustainability of biobanks, but also raise considerable technical, legal and ethical challenges.What does this paper add?This paper reports findings from a mixed-methods study of Aust...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Light E, Wiersma M, Dive L, Kerridge I, Lipworth W, Stewart C, Kowal E, Marlton P, Critchley C Tags: Aust Health Rev Source Type: research

Assessment of advance care planning documentation for residents of residential aged care facilities presenting to the emergency department.
ConclusionsJust under half (48.8%) of RACF residents presented to the ED with ACP documentation. There was limited coverage of core ACP components needed to guide clinical decision making.What is known about the topic?RACF residents are in the last years of their life and commonly lack capacity to make decisions regarding health care. Residents are at high risk of dying when acutely unwell in hospital. ACP documentation, when readily available, helps provide appropriate end-of-life care and improves both patient and family satisfaction.What does this paper add?Less than half the residents reporting to the ED from an RACF h...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Chua TH, Foong JR, Tan RR, Rukasha PN, Hullick C Tags: Aust Health Rev Source Type: research

Case for antimicrobial stewardship pharmacy technicians in Australian hospitals.
Abstract The pharmacist's role in hospital antimicrobial stewardship (AMS) programs is known to improve patient safety and the quality of care. Despite this, many Australian hospitals struggle to provide adequate pharmacy AMS program resourcing and need to explore newer models of care. The Pharmacy Board of Australia's Guidelines for Dispensing Medicines permit suitably qualified, competent and experienced pharmacy technicians to assist pharmacists in 'tasks in a pharmacy department'. The pharmacy technician workforce is expanding, and there is growing interest in career advancement and expansion of the pharmacy t...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Cheah R, Rajkhowa A, James R, Wangeman K, Koning S, Thursky K, Buising K Tags: Aust Health Rev Source Type: research

Inequalities in end-of-life palliative care by country of birth in New South Wales, Australia: a cohort study.
ConclusionsThere are differences in in-hospital palliative care at the end of life between population groups born in different countries living in Australia. The implementation of culturally sensitive palliative care programs may help reduce these inequalities. Further studies are needed to identify the determinants of the differences observed in this study and to investigate whether these differences persist in the community setting.What is known about the topic?International studies have reported inequities in access to palliative care between ethnic groups.What does this paper add?We observed differences in in-hospital ...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Möller H, Assareh H, Stubbs JM, Jalaludin B, Achat HM Tags: Aust Health Rev Source Type: research

Provision of home medicines reviews in Australia: linking population need with service provision and available pharmacist workforce.
ConclusionGiven that polypharmacy is a risk factor for medication-related problems, and that medication review is one of the few targeted strategies currently available to address medication-related problems in the population, service provision may be inadequate. Policy options to improve service provision could include interventions to increase workforce productivity and relaxing the current eligibility criteria for review, especially in rural and remote areas.What is known about the topic?Polypharmacy is a risk factor for medication-related problems, which can cause increased morbidity and mortality in the population.Wha...
Source: Australian Health Review - November 20, 2020 Category: Hospital Management Authors: Spinks J, Birch S, Wheeler AJ, Nissen L, Freeman C, Thai T, Byrnes J Tags: Aust Health Rev Source Type: research

Integrating patient complexity into health policy: a conceptual framework.
ConclusionThis framework, supported by the literature, provides a means for policy makers and health planners to conduct analyses of and for policy. Further work is required to better model complexity in a manner that integrates consumer needs and provider capabilities.What is known about the topic?There is a growing body of evidence regarding patient complexity and its impact on the delivery of health services, but there is little consideration of patient complexity in policy, which is an important consideration for service provision.What does this paper add?This paper presents an argument for the inclusion of patient com...
Source: Australian Health Review - November 19, 2020 Category: Hospital Management Authors: Maree P, Hughes R, Radford J, Stankovich J, Van Dam PJ Tags: Aust Health Rev Source Type: research

Survey of hospital Chief Executive Officer research and translation priorities.
PMID: 33203507 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - November 18, 2020 Category: Hospital Management Authors: Saxon L, Dalziel K, Story D Tags: Aust Health Rev Source Type: research

Emergency general surgery models in Australia: a cross-sectional study.
ConclusionsASU or hybrid models of care may be more widespread than currently reported. The introduction of such structures is heavily dependent on hospital and staff size, trauma subspecialisation and EGS patient throughput.What is known about the topic?Traditionally, general surgical staff were rostered to elective operating and clinic duties, with emergency patients managed on an ad hoc basis. An ASU model, with a surgeon dedicated to EGS patients, has been associated with superior outcomes. However, the Australian uptake of this model is unknown.What does this paper add?This study enrolled 119 of 120 (99%) Australian p...
Source: Australian Health Review - November 18, 2020 Category: Hospital Management Authors: Kinnear N, Han J, Tran M, Herath M, Jolly S, Hennessey D, Dobbins C, Sammour T, Moore J Tags: Aust Health Rev Source Type: research

Evaluation of the nature, severity, likelihood and preventability of medication-related hospital-acquired complications.
ConclusionNot all patients who experience medication-related HACs were on causative medications. Of those who were, medications were probable causal agents in over 50% of cases. Only a small number of HACs were severe and under half of medication-related HACs were preventable.What is known about the topic?The relationship between pricing for safety and quality and improvements in patient outcomes has shown mixed results. Medication-related harm is a problem within Australia and system-wide changes should be considered to improve patient care.What does this paper add?This paper adds evidence to the use of medication-related...
Source: Australian Health Review - November 17, 2020 Category: Hospital Management Authors: Canning M, Lee CH, Bolitho R, Dunn E Tags: Aust Health Rev Source Type: research

Effect of mammography screening and sociodemographic factors on stage of female breast cancer at diagnosis in New South Wales.
ConclusionsThe strongest and most consistent predictor of earlier stage at diagnosis was BreastScreen NSW participation. Continued efforts to increase screening participation are important to achieve earlier stage at diagnosis, particularly for sociodemographic groups with more advanced disease.What is known about the topic?Earlier cancer stage at diagnosis is a prerequisite for mortality reduction from screening. Past research indicated that screening participation in New South Wales (NSW) was strongly associated with early stage at diagnosis and mortality reduction. More contemporary data are needed to monitor screening ...
Source: Australian Health Review - November 17, 2020 Category: Hospital Management Authors: Tong S, Warner-Smith M, McGill S, Roder D, Currow D Tags: Aust Health Rev Source Type: research

A health management competency framework for Australia.
ConclusionThe Management Competency Assessment Program competency framework summarises six competencies and associated behaviours that may be useful for guiding performance management and the education and training development of health service managers in Australia.What is known about the topic?The evidence suggests that competency-based approaches can enhance performance and talent management, and inform education and training needs, yet there has been no validated competency framework for Australian health service managers.What does the paper add?This paper explains the process of the finalisation of the first managemen...
Source: Australian Health Review - November 16, 2020 Category: Hospital Management Authors: Liang Z, Blackstock F, Howard P, Leggat G, Hughes A, Maddern J, Briggs D, Isouard G, North N, Leggat SG Tags: Aust Health Rev Source Type: research

Financial contributions made by patients towards dispensed medicines prescribed by Australian dentists from 2006 to 2018: a cost-analysis study.
Abstract ObjectiveThis cost-analysis study explored Pharmaceutical Benefits Scheme (PBS) data to determine the financial patient contribution (PC) towards dispensed medications prescribed by dentists and temporal trends in cost contributions.MethodsFor this study we used the PBS online dataset and only included concessional data in the analysis. Data on dental medications dispensed under the PBS from 2006 to 2018 were accessed. For all medicines aggregated to different pharmacological categories (antibiotics, analgesics and opiates, anti-inflammatories, antifungals, benzodiazepines, anticonvulsants and anti-emetic...
Source: Australian Health Review - November 12, 2020 Category: Hospital Management Authors: Park JS, Kruger E, Tennant M Tags: Aust Health Rev Source Type: research

Lessons learned from a subsidised spectacles scheme aiming to improve eye health in Aboriginal people in Victoria, Australia.
Abstract The Victorian Aboriginal Spectacles Subsidy Scheme (VASSS) aimed to improve access to visual aids and eye care for Aboriginal and Torres Strait Islander Victorians. The VASSS started in July 2010 and has operated continually since. In 2016, we explored the collaborations, planning, adaptations and performance of the VASSS over the first 6 years by reviewing and analysing service data, as well as data from semistructured interviews, focus groups and surveys. An estimated 10853 VASSS cofunded visual aids were delivered over 6 years, and the mean annual number of comprehensive eye examinations provided withi...
Source: Australian Health Review - November 10, 2020 Category: Hospital Management Authors: Fricke TR, Brand C, Lovett L, Turner NW, Anjou MD, Bentley SA Tags: Aust Health Rev Source Type: research

Interprofessional, student-led community health clinic: expanding service provision and clinical education capacity.
Abstract Student-led interprofessional health clinics offer valuable opportunities for student learning and meeting the health care needs of the community. This case study describes the operation of a new interprofessional student-led community health service over its initial 13-month period of operation. This case study also presents an overview of the service provision, student placement opportunities and focuses on the challenges associated with the service and the impact on future planning.What is known about the topic?Interprofessional student-led clinics offer an opportunity to meet clinical placement demand...
Source: Australian Health Review - November 10, 2020 Category: Hospital Management Authors: Forbes R, Beckman E, Tower M, Mandrusiak A, Mitchell LK, Sexton CT, Cunningham B, Lewis PA Tags: Aust Health Rev Source Type: research

Exploring the measure of potentially avoidable general practitioner-type presentations to the emergency department in regional Queensland using linked, patient-perspective data.
Abstract ObjectiveTo explore measures of potentially avoidable general practitioner (PAGP)-type presentations to the emergency department (ED) of a large regional hospital in northern Queensland.MethodsLinkage of an ED administrative dataset to a face-to-face patient survey of local residents (n=1000); calculation of Australian Institute of Health and Welfare (AIHW) and Australasian College of Emergency Medicine (ACEM) measures of PAGP-type presentations to the ED; and exploration of these measures with patient-perspective linked data.ResultsPAGP-type presenters to the ED were younger in age (median age in years: ...
Source: Australian Health Review - October 30, 2020 Category: Hospital Management Authors: O'Loughlin M, Mills J, McDermott R, Harriss LR Tags: Aust Health Rev Source Type: research

The psychotherapeutic practice and potential of mental health nurses: an Australian survey.
ConclusionsCurrently, MHNs are not recognised in federal funding arrangements to procure psychotherapeutic intervention for members of the Australian population who require it. MHNs ought to be recognised as independent providers based on both the psychotherapeutic skills they possess and their specialist clinical skills of working with people across the spectrum of mental health problems. Appropriately qualified MHNs need to be funded to use their skills in psychotherapy via access to appropriate funding arrangements, such as Better Access and the National Disability Insurance Scheme.What is known about the topic?MHNs do ...
Source: Australian Health Review - October 30, 2020 Category: Hospital Management Authors: Lakeman R, Cashin A, Hurley J, Ryan T Tags: Aust Health Rev Source Type: research

Value of clinical engagement in the NSW Health response to COVID-19.
This article provides practical insights into the value of clinical leadership and engagement in a time of crisis. It describes the role of COVID-19 COPs, what they have achieved and their importance in supporting the ongoing pandemic response in New South Wales. PMID: 33091334 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - October 23, 2020 Category: Hospital Management Authors: Lyons N, Cox C, Clements V Tags: Aust Health Rev Source Type: research

General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: access and impact on health services.
We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation.MethodsThis data linkage study used a cohort of 10240 people from the 45 and Up Study who resided in CES and experienced an overnight hospitalisation in the 5 years following recruitment (2007-14). Characteristics of participants who saw a GP within 2 weeks of discharge were compared with those who did not using generalised linear models. Time to subsequent hospitalisation was compared for the two gro...
Source: Australian Health Review - October 22, 2020 Category: Hospital Management Authors: Barr ML, Welberry H, Hall J, Comino EJ, Harris E, Harris-Roxas BF, Jackson T, Donnelly D, Harris MF Tags: Aust Health Rev Source Type: research

Complementary medicines advertising policy Part II: unethical conduct in the Australian market after July 2018.
ConclusionsComplaint classification and actions taken by the TGA were inconsistent. The TGA's new compliance powers were rarely applied. The new complaint system is less transparent than the one it replaced. There is a high rate of advertising complaints and a low rate of effective regulatory response. Time-based KPIs should be based on outcome measures, not when a case is closed by a process measure. An urgent review of the new system is required. Comment on Australia's 2018 Royal Commission into Misconduct in Banking is equally applicable to the TGA: 'Essentially a failure to enforce the law undermines the authority of t...
Source: Australian Health Review - October 19, 2020 Category: Hospital Management Authors: Harvey K, Vickers M, Arnold BB Tags: Aust Health Rev Source Type: research

Complementary medicines advertising policy Part I: unethical conduct in the Australian market before July 2018.
ConclusionsNumerous complementary medicines (and medical devices) that were extensively advertised failed to meet real health needs, diverted consumers from more evidence-based treatment and wasted their money. The laws to protect consumers were adequate: the problem was lack of enforcement.What is known about the topic?The previous co-regulatory system for complementary medicines has been the subject of long-standing criticism; however, definitive data about the problems were largely unanalysed or disregarded.What does this paper add?This is the first analysis of the Complaints Resolution Panel's determinations over its e...
Source: Australian Health Review - October 19, 2020 Category: Hospital Management Authors: Vickers M, Harvey K Tags: Aust Health Rev Source Type: research

Evaluating the economic effects of genomic sequencing of pathogens to prioritise hospital patients competing for isolation beds.
ConclusionUsing WGS to inform infection control teams of pathogen transmission averts patients from isolation rooms and reduces significant resources involved in implementing contact precautions.What is known about the topic?There are an estimated 265000 hospital-acquired infections (HAI) in Australia each year. WGS can accurately identify the genetic lineage among HAIs and determine transmission clusters that can help infection control staff manage patients. Economic appraisals are lacking to inform whether pathogen genomics services should be adopted within already-stretched hospital budgets.What does this paper add?An i...
Source: Australian Health Review - October 14, 2020 Category: Hospital Management Authors: Elliott TM, Hare N, Hajkowicz K, Hurst T, Doidge M, Harris PN, Gordon LG Tags: Aust Health Rev Source Type: research

Effect of a 24/7 nursing presence in a police watch house on police presentations to the emergency department.
ConclusionFewer transfers from the police watch house to the ED were noted when there was a 24/7 nursing presence in the watch house. This model appears to be economically efficient, but further research is required.What is known about the topic?People detained in police custody are a vulnerable population with complex health needs, sometimes requiring emergency care.What does this paper add?Transfers from the police watch house to the ED were fewer when there was a 24/7 nursing presence in the police watch house (an economically efficient model). Nursing care provided to detainees in the watch house setting predominantly ...
Source: Australian Health Review - October 12, 2020 Category: Hospital Management Authors: Crilly J, Lincoln C, Scuffham P, Byrnes J, Timms J, Becker K, van Buuren N, Fisher A, Murphy D, Zhang P, Kinner S, Green D Tags: Aust Health Rev Source Type: research

Psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic.
This study assessed the psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic.MethodsAn anonymous online cross-sectional survey was conducted in a large metropolitan tertiary health service located in Melbourne, Australia. The survey was completed by nurses, midwives, doctors and allied health (AH) staff between 15 May and 10 June 2020. The Depression, Anxiety and Stress Scale - 21 items (DASS-21) assessed the psychological well-being of respondents in the previous week.ResultsIn all, 668 people responded to the survey (nurses/midwives, n=391; doctors, n=138; AH staff, n=139). Of these...
Source: Australian Health Review - October 9, 2020 Category: Hospital Management Authors: Holton S, Wynter K, Trueman M, Bruce S, Sweeney S, Crowe S, Dabscheck A, Eleftheriou P, Booth S, Hitch D, Said CM, Haines KJ, Rasmussen B Tags: Aust Health Rev Source Type: research

Perceptions of allied health staff of the implementation of an integrated electronic medical record across regional and metropolitan settings.
ConclusionsThe results suggest an overall positive response to EMR implementation. Minimal staff reported effects such as stress or anxiety in the workplace related to EMR implementation, and a perception of 'comfort' was cited once EMR was part of usual practice. However, responders did not report a significant effect on speed, efficiency or quality of patient care following EMR implementation.What is known about the topic?A growing body of literature exists regarding the perceptions of staff (particularly medical officers) in moving towards EMRs, but there is limited evidence regarding the perceptions of AHPs, and the ba...
Source: Australian Health Review - October 9, 2020 Category: Hospital Management Authors: Schwarz M, Coccetti A, Draheim M, Gordon G Tags: Aust Health Rev Source Type: research

Using governance and patient flow strategies to improve healthcare service efficiency.
Abstract The aim of this case study was to share lessons learned regarding strategies likely to increase healthcare service efficiency. Following quality assurance review of statewide Hospital in the Home (HITH) average length of stay (ALOS) and readmission data, Queensland's Department of Health observed that for some of the highest volume diagnoses seen in Queensland's HITH services in 2017, services that used a public-private partnership (PPP) model of care achieved a shorter ALOS than services using a traditional public model of care without demonstrably poorer patient outcomes. To understand the reasons for t...
Source: Australian Health Review - October 8, 2020 Category: Hospital Management Authors: Kivic A, Hines L Tags: Aust Health Rev Source Type: research

Factors affecting procurement of wound care products: a qualitative study of hospital managers and clinicians.
ConclusionsSystematic and evidence-based approaches are needed to strengthen procurement and disinvestment decisions related to consumables such as wound care products and to minimise the purchasing of low-value products Decision-making frameworks should consider cost and clinical effectiveness and enable the identification of opportunities to disinvest from low-value products.What is known about the topic?High volume-low unit cost healthcare consumables such as wound care products are a major component of healthcare expenditure. Disinvestment from low-value wound care products has potential to improve patient outcomes and...
Source: Australian Health Review - October 8, 2020 Category: Hospital Management Authors: McInnes E, Harvey G, Hiller JE, Phillips R, Page T, Wiechula R Tags: Aust Health Rev Source Type: research

Private versus public? Examining hospital use by a privately insured population in New South Wales, Australia, using data linkage.
ConclusionsPeople with PHI make considerable use of public hospitals both as a public and a private patient. For this privately insured cohort, public hospitals are more frequently used for medical-related admissions and also for more resource-intensive admissions compared with private hospitals.What is known about the topic?There are multiple government incentives to encourage people to take out PHI policies in Australia. Although PHI is closely associated with private hospital utilisation, people with PHI can still use public hospitals as either a public patient, in which the service is fully government-funded, or as a p...
Source: Australian Health Review - October 4, 2020 Category: Hospital Management Authors: Khoo J, Hasan H, Eagar K Tags: Aust Health Rev Source Type: research

The 'Surgical Time.
Abstract ObjectiveIn Australia, 2.7 million surgical procedures were performed in the year 2016-17. This number is ever increasing and requires effective management of operating theatre (OT) time. Preoperative prediction of theatre time is one of the main constituents of OT scheduling, and anecdotal evidence suggests that surgeons grossly underestimate predicted surgical time. The aim of this study is to assess surgeons' accuracy at predicting OT times across different specialties and effective theatre scheduling.MethodsA database was created with de-identified patient information from a 3-month period (late 2016)...
Source: Australian Health Review - September 28, 2020 Category: Hospital Management Authors: Goel R, Kanhere H, Trochsler M Tags: Aust Health Rev Source Type: research

From benefits idealisation to value optimisation: application in the digital health context.
ConclusionThe current BM approach provides an inadequate basis for managing and reporting on the outcomes that ensue from a digital hospital initiative. A shift is needed from benefits idealisation to value optimisation.What is known about the topic?Health services are under increasing pressure to demonstrate that the benefits anticipated from digital health investments have been realised.What does this paper add?This paper informs the practice of benefits governance in EMR implementations. The results reveal inadequacies in current BM models and practice that are currently enshrined in policy despite a lack of evidence.Wh...
Source: Australian Health Review - September 27, 2020 Category: Hospital Management Authors: Smith N, Burton-Jones A, Sullivan C Tags: Aust Health Rev Source Type: research