Author reply: exploring the implications of a fixed budget for new medicines: a study of reimbursement of new medicines in Australia and New Zealand.
PMID: 26254890 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - August 10, 2015 Category: Hospital Management Authors: Taylor CB, Wonder M Tags: Aust Health Rev Source Type: research

Relationship between organisational commitment and burnout syndrome: a canonical correlation approach.
Conclusions The results of the present study indicate that affective commitment is the primary determinant of burnout syndrome in healthcare professionals.What is known about the topic? Organisational commitment and burnout syndrome are the most important criteria in predicting health workforce performance. An increasing number of studies in recent years have clearly indicated the field's continued relevance and importance. Conversely, canonical correlation analysis (CCA) is a technique for describing the relationship between two variable sets simultaneously to produce both structural and spatial meaning.What does this pap...
Source: Australian Health Review - August 10, 2015 Category: Hospital Management Authors: Enginyurt O, Cankaya S, Aksay K, Tunc T, Koc B, Bas O, Ozer E Tags: Aust Health Rev Source Type: research

Model of care for a changing healthcare system: are there foundational pillars for design?
Abstract Currently, healthcare organisations are being challenged to provide optimal clinical services within budget limitations while simultaneously being confronted by aging consumers and labour and skill shortages. Within this dynamic and changing environment, the ability to remain responsive to patient needs while managing these issues poses further challenges. Development or review of the model of care (MOC) may provide a possible solution to support efficiencies in service provision. Although MOC are not readily understood or appreciated as an efficiency strategy, they can be more easily explained by conside...
Source: Australian Health Review - August 3, 2015 Category: Hospital Management Authors: Booker C, Turbutt A, Fox R Tags: Aust Health Rev Source Type: research

An evaluation of current home enteral nutrition services at principal referral hospitals in New South Wales, Australia.
Conclusions HEN services among participating hospitals are inconsistent, demonstrating gaps in service provision. Baseline assessment scores varied, with an average of 61% of recommendations currently in use. Best practice guidelines are not firmly adhered to due to limited funding and allocated resources for HEN.What is known about the topic? HEN is recognised as a cost-effective and reliable way of treating patients requiring nutrition support post hospital discharge. There are best practice guidelines available to ensure quality care is provided to HEN patients in the community or home setting. As there is no national f...
Source: Australian Health Review - August 3, 2015 Category: Hospital Management Authors: Faruquie SS, Parker EK, Talbot P Tags: Aust Health Rev Source Type: research

?Newness?struggle?success.
Conclusion Family, friends, community and organisational structures (universities and public sector) play a vital role in the cultural learning process, affecting overseas-qualified dentist's ability to progress successfully through the cultural continuum.What is known about the topic? Australia is a popular host country for overseas-qualified dentists. Migrant dentists arrive from contrasting social and cultural backgrounds, and these contrasts can be somewhat more pronounced in dentists from developing countries. To date, there is no evidence available regarding the cultural adaptation process of overseas-qualified denti...
Source: Australian Health Review - August 3, 2015 Category: Hospital Management Authors: Balasubramanian M, Brennan DS, Spencer AJ, Short SD Tags: Aust Health Rev Source Type: research

Accuracy of rapid disposition by emergency clinicians.
Conclusion Rapid disposition by ED clinicians can predict patient destination accurately but was associated with a potential increase in admission rates. Any model of care using rapid disposition decision making should involve establishment of inpatient systems for further assessment, and a culture of timely inpatient team transfer of patients to the most appropriate treating team for ongoing patient management.What is known about the topic? In response to the National Emergency Access Targets, there has been widespread adoption of rapid-disposition-themed care models across Australia. Although there is emerging data that ...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Backay A, Bystrzycki A, Smit V, Keogh M, O'Reilly G, Mitra B Tags: Aust Health Rev Source Type: research

Use of a capacity audit tool in a mental health setting.
Conclusion The CAT was successfully applied to the mental health setting and identified a set of opportunities to improve processes and practices to reduce the identified delays or barriers in order to improve patient flow.What is known about the topic? Capacity management and, in particular, timely discharge are key components to optimise patient flow and improve access block for emergency departments. The CAT has been successfully applied in general health settings to identify key delays and barriers to discharge.What does this paper add? This article reports on the applicability of the CAT in a mental health setting and...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Zeitz K, Hester P Tags: Aust Health Rev Source Type: research

Stakeholder perspectives on the new sickness certificate in Victoria: results from a mixed-methods qualitative study.
Conclusions To ensure appropriate use of the new certificate, stakeholders must share a common understanding about its purpose and the certificate must be incorporated into existing medical software. Content on mental health assessment, an area of continued difficulty, needs additional refinement. The new certificate replaced the old certificate in March 2015; after it has been established in clinical practice, an impact evaluation should be completed to determine whether GPs are certifying capacity and earlier return to work.What is known about the topic? When it comes to sickness certification, GPs tend to focus on what ...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Brijnath B, Singh N, Mazza D Tags: Aust Health Rev Source Type: research

Reviewing public policy for promoting population oral health in Victoria, Australia (2007?12).
Conclusion There is a policy opportunity to address oral health at a community level, and to implement population approaches aligned with the Ottawa Charter that address the social determinants of health.What is known about the topic? Poor oral health is a significant global health concern and places a major burden on individuals and the healthcare system, affecting approximately 50% of all children and 75%-95% of adults in Australia. The Ottawa Charter acknowledges the key role of policy in improving the health of a population; however, little is known about the policy emphasis placed on oral health by local government, p...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Heilbrunn-Lang AY, Carpenter LM, Powell SM, Kearney SL, Cole D, de Silva AM Tags: Aust Health Rev Source Type: research

Training a system-literate care coordination workforce.
Abstract People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce - but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for t...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Naccarella L, Osborne RH, Brooks PM Tags: Aust Health Rev Source Type: research

Allied health: integral to transforming health.
Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the 'maximum value for spend' of the increasingly s...
Source: Australian Health Review - July 27, 2015 Category: Hospital Management Authors: Lizarondo L, Turnbull C, Kroon T, Grimmer K, Bell A, Kumar S, McEvoy M, Milanese S, Russell M, Sheppard L, Walters J, Wiles L Tags: Aust Health Rev Source Type: research

Transformational change in healthcare: an examination of four case studies.
Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare.What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society.What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies.What are the implications for practitioners? Collectively, these key factors can guid...
Source: Australian Health Review - July 20, 2015 Category: Hospital Management Authors: Charlesworth K, Jamieson M, Davey R, Butler CD Tags: Aust Health Rev Source Type: research

Comparing the reimbursement of new medicines between Australia and New Zealand.
PMID: 26189014 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - July 20, 2015 Category: Hospital Management Authors: Ragupathy R, Babar ZU Tags: Aust Health Rev Source Type: research

Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations.
Conclusions Although migrant groups are disproportionately affected by social and health inequalities, the findings of the present study show that migrant-related research is inadequately funded compared with mainstream-related research. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce these inequalities among migrants.What is known about the topic? Immigration is on the rise in most developing countries, including Australia, and most migrants come from low- and middle-income countries. In Australia, migrants constitute 26% of the...
Source: Australian Health Review - July 13, 2015 Category: Hospital Management Authors: Renzaho A, Polonsky M, Mellor D, Cyril S Tags: Aust Health Rev Source Type: research

Senior staff perspectives of a quality indicator program in public sector residential aged care services: a qualitative cross-sectional study in Victoria, Australia.
Conclusions The QIs and QI program acted as a foundation for improving standards of care when used at the front line or point of care. Senior executive engagement in the QI program was vital to successful implementation.What is known about this topic? QIs measure the structures, processes or outcomes of care and identify issues that need further investigation or improvement. QIs are increasingly being adopted throughout the world. In Australia, the public sector RACS QIs project was implemented in 2006. It is yet to be formally evaluated.What does this paper add? Perceived benefits and limitations of the QI program were id...
Source: Australian Health Review - July 13, 2015 Category: Hospital Management Authors: Chadwick LM, MacPhail A, Ibrahim JE, McAuliffe L, Koch S, Wells Y Tags: Aust Health Rev Source Type: research

Application and implications of Mental Health Act 2007 (NSW) certificate use in acute generalist settings.
Conclusion This study highlights inconsistencies in legislative knowledge and requirements between professional groups. Education and training opportunities have been identified to ensure greater consistency in application of the MHA, preservation of patient rights and avoidance of stigma. MHA use in this setting should be exercised with caution and by appropriately trained individuals.What is known about the topic? The MHA and its state and territory counterparts provide for the treatment, care and support of people who have a mental illness and the protection of a person's rights therein. Despite not being intended for a...
Source: Australian Health Review - July 13, 2015 Category: Hospital Management Authors: Lamont S, Brunero S, Sharma S Tags: Aust Health Rev Source Type: research

Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury.
Conclusion A significant number of patients admitted for in-patient rehabilitation following TBI require acute rehospitalisation due to preventable medical causes. Because the duration of acute rehospitalisation has a negative impact on rehabilitation functional gain, preventive measures and surveillance need to be further investigated and optimised.What is known about the topic? The incidence of acute rehospitalisation of patients in the community following brain injury rehabilitation is 20%-25%, with approximately half the re-admissions being for elective reasons, including orthopaedic and reconstructive surgery.What doe...
Source: Australian Health Review - July 13, 2015 Category: Hospital Management Authors: Andraweera N, Seemann R Tags: Aust Health Rev Source Type: research

Models of care choices in today.
Abstract This paper provides an overview of the developmental history of models of care (MOC) in nursing since Florence Nightingale introduced nurse training programs in a drive to make nursing a discipline-based career option. The four principal choices of models of nursing care delivery (primary nursing, individual patient allocation, team nursing and functional nursing) are outlined and discussed, and recent MOC literature reviewed. The paper suggests that, given the ways work is being rapidly reconfigured in healthcare services and the pressures on the nursing workforce projected into the future, team nursing ...
Source: Australian Health Review - July 6, 2015 Category: Hospital Management Authors: Fairbrother G, Chiarella M, Braithwaite J Tags: Aust Health Rev Source Type: research

Effects of a pilot multidisciplinary clinic for frequent attending elderly patients on deprescribing.
Abstract Objective Multimorbidity and associated polypharmacy are risk factors for hospital re-admission. The Targeting Hospitalization Risks in Vulnerable Elders (THRIVE) clinic is a novel multidisciplinary out-patient clinic to improve transitions of care and decrease re-admission risk for older medical patients with frequent hospital admissions. This pilot study examined the effect of the THRIVE model on medication count, tablet load and potentially inappropriate medicines (PIMs).Methods Participants with frequent medical admissions were referred within 2 weeks of discharge from hospital and assessed at baselin...
Source: Australian Health Review - July 6, 2015 Category: Hospital Management Authors: Mudge A, Radnedge K, Kasper K, Mullins R, Adsett J, Rofail S, Lloyd S, Barras M Tags: Aust Health Rev Source Type: research

Is health workforce planning recognising the dynamic interplay between health literacy at an individual, organisation and system level?
Abstract The growing demands on the health system to adapt to constant change has led to investment in health workforce planning agencies and approaches. Health workforce planning approaches focusing on identifying, predicting and modelling workforce supply and demand are criticised as being simplistic and not contributing to system-level resiliency. Alternative evidence- and needs-based health workforce planning approaches are being suggested. However, to contribute to system-level resiliency, workforce planning approaches need to also adopt system-based approaches. The increased complexity and fragmentation of t...
Source: Australian Health Review - June 30, 2015 Category: Hospital Management Authors: Naccarella L, Wraight B, Gorman D Tags: Aust Health Rev Source Type: research

South Asians and Anglo Australians with heart disease in Australia.
Conclusions The findings show that in those with established IHD, cardiovascular risk factors, such as age at onset and BMI, differ between SAs and AAs and these differences should be considered in the prevention and management of IHD.What is known about the topic? There is much evidence on CVD and SAs, it being a leading cause of mortality and morbidity for this population both in their home countries and in countries they have migrated to. Studies conducted in Western nations other than Australia have suggested a difference in the risk profiles and presentations of CVD among SA migrants compared with the host populations...
Source: Australian Health Review - June 30, 2015 Category: Hospital Management Authors: Gupta S, Aroni R, Lockwood S, Jayasuriya I, Teede H Tags: Aust Health Rev Source Type: research

Thrombolysis in acute stroke: ongoing challenges based on a tertiary hospital audit and comparisons with other Australian studies.
Conclusion The proportion of eligible stroke patients who receive tPA in a timely manner remains less than ideal at our centre. More accurate patient selection and reductions in treatment delays serve as targets for quality improvement efforts that have broad applicability.What is known about the topic? Stroke unit care and tPA thrombolysis are two proven strategies to improve outcome in patients with ischaemic stroke. Although the stroke unit is gaining momentum of growth in Australia (especially in Queensland), little improvement has been achieved in thrombolysis rate and timeliness of treatment delivery, and little is k...
Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Lau AH, Hall G, Scott IA, Williams M Tags: Aust Health Rev Source Type: research

Detecting change in patient outcomes in a rural ambulatory rehabilitation service: the responsiveness of Goal Attainment Scaling and the Lawton Scale.
This study examined the performance of the Goal Attainment Scaling (GAS) concomitantly with the Lawton Scale in ambulatory rehabilitation patients.Methods Consecutive patients (n = 83) of WWARS were evaluated pre and post treatment with the Lawton Scale and GAS. The statistical properties, particularly responsiveness, of the scales were compared.Results Statistically significant change (P
Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Baggio L, Buckley DJ Tags: Aust Health Rev Source Type: research

Prevalence and associations of general practice nurses.
Conclusions Associations with Aboriginal or Torres Strait Islander status and NESB status suggest GPNs are addressing healthcare needs of these under-serviced groups. But GPNs may be underutilised in chronic disease care.What is known about this topic? GPNs are increasingly involved in team-based care in Australian general practice. The potential positive contribution of GPNs to general practice teams is acknowledged, but the role of the GPN is still being refined.What does this paper add? GPNs contribute to the care of a modest proportion of patients seen by GP registrars. Aboriginal or Torres Strait Islander status and N...
Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Turnock A, Morgan S, Henderson K, Tapley A, van Driel M, Oldmeadow C, Ball J, Presser J, Davey A, Scott J, Magin P Tags: Aust Health Rev Source Type: research

Successful linking of patient records between hospital services and general practice to facilitate integrated care in a hospital and health service in south-east Queensland.
Abstract This brief paper describes a recent exercise undertaken within a hospital and health service in south-east Queensland to attempt to link patient records between general practice and hospital services. It describes the technical and governance processes undertaken to achieve this link and the challenges experienced to date in linking the two data sources. PMID: 26117559 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Connor M, Day GE, Meston D Tags: Aust Health Rev Source Type: research

Potential economic impact on hospitalisations of the Palliative Care Clinical Studies Collaborative (PaCCSC) ketamine randomised controlled trial.
Conclusions The findings from the modelled impact analysis suggest that dissemination of the PaCCSC ketamine RCT results may have saved the Australian healthcare system approximately A$663 000 in annual hospitalisation costs and freed up 443 in-patient bed-days, although there was high uncertainty within the study. Wider dissemination over time and targeted, local de-adoption strategies could result in further savings. PMID: 26093387 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - June 22, 2015 Category: Hospital Management Authors: McCaffrey N, Hardy J, Fazekas B, Agar M, Devilee L, Rowett D, Currow D Tags: Aust Health Rev Source Type: research

Retirement patterns of Australian doctors aged 65 years and older.
Conclusions Strategies to support doctors at the late career stage to provide their valued contributions to the medical workforce for as long as possible may include increasing job satisfaction and addressing barriers to reducing work hours.What is known about the topic? Much of the available literature provides measures of retirement intentions.What does this paper add? The present study examined actual retirements and the factors associated with them.What are the implications for practitioners? Consideration should be given by policy makers to ensure that doctors are retained for as long as possible as active contributor...
Source: Australian Health Review - June 22, 2015 Category: Hospital Management Authors: Joyce CM, Wang WC, McDonald HM Tags: Aust Health Rev Source Type: research

What a great idea! Someone should evaluate that...
Abstract How often, as clinicians, do we see a really clever idea implemented in the workplace? In rural health in particular, creative work-around solutions are relatively commonplace. However, the evaluation and promotion of these ideas is less so, and this leads to lost opportunities for perpetuating these clever ideas. This paper explores one rural clinician's experience of what can happen if, instead of appreciating and complementing a great idea, that step of evaluating the great idea is taken. A reflective narrative was created, beginning with a corridor conversation ('What a great idea! Someone should eval...
Source: Australian Health Review - June 22, 2015 Category: Hospital Management Authors: Schmidt DD Tags: Aust Health Rev Source Type: research

Chronic wounds should be one of Australia's National Health Priority Areas.
Abstract Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A$2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Area...
Source: Australian Health Review - June 15, 2015 Category: Hospital Management Authors: Kapp S, Santamaria N Tags: Aust Health Rev Source Type: research

What is access to radiation therapy? A conceptual framework and review of influencing factors.
Conclusion 'Access' is a term that is widely used in the context of health service related research, planning and political discussions. It is a multi-faceted concept with many descriptions. We propose a conceptual framework for the consideration of 'RT access' so that factors affecting RT access and utilisation may be identified and examined. Understanding these factors, and quantifying them where possible, will allow objective evaluation of their impact on RT utilisation and guide implementation of strategies to modify their effects.What is known about the topic? It is well documented that the use of RT in Australia is w...
Source: Australian Health Review - June 15, 2015 Category: Hospital Management Authors: Sundaresan P, Stockler MR, Milross CG Tags: Aust Health Rev Source Type: research

Evaluation of a mobile X-ray service for elderly residents of residential aged care facilities.
Conclusion The present study suggests a reduction in hospital ED attendances for high users of the MXS. This has benefits for hospitals, patients and nursing homes. It also allows the extension of other programs designed to treat patients in their RACFs. Special rebates for home-based radiology service provision should be considered.What is already known about this subject? Digital processing has changed the way radiology delivers services. The Australian community is in the middle of a shift towards an aging population, with a greater numbers of residents in RACFs. It has been suggested in previous studies that mobile X-r...
Source: Australian Health Review - June 15, 2015 Category: Hospital Management Authors: Montalto M, Shay S, Le A Tags: Aust Health Rev Source Type: research

Advanced allied health assistants: an emerging workforce.
Conclusion AHAs make a positive contribution to the delivery of effective, responsive, consumer-focused healthcare. The advanced AHA role provides further opportunities to enhance the flexibility of allied health services while also providing a career structure for this growing workforce. PMID: 26053482 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - June 9, 2015 Category: Hospital Management Authors: Pearce C, Pearce C, Pagett L, Pagett L Tags: Aust Health Rev Source Type: research

The Australian 75+ Health Assessment: could it detect early functional decline better?
Conclusion Reassessment of the 75+HA with a view to including current evidence-based assessments for early FD is recommended. Updating the 75+HA items with ways to detect FD earlier may increase its relevance to Australia's ageing population.What is known about the topic? There are consistent predictions of increasing lifespan of Australians, increasing numbers of older Australians wanting to live independently in the community and the increasing burden on already scarce hospital resources associated with managing the ramifications of declining function in older Australians. The 75+HA is now 15 years old and has not been u...
Source: Australian Health Review - June 9, 2015 Category: Hospital Management Authors: Grimmer K, Kennedy K, Milanese S, Price K, Kay D Tags: Aust Health Rev Source Type: research

Relinquishing or taking control? Community perspectives on barriers and opportunities in advance care planning.
Conclusions There is unnecessary fear, avoidance and mistrust around ACP activities, largely resulting from misinformation. There is an undoubted need for greater education and support to be offered to individuals and their families regarding ACP, its benefits and its limitations.What is known about the topic? There is a lack of awareness about ACP in Australia, which is compounded by issues in the accessibility of ACP information, forms and support in completing the often complex documentation. Further, studies have indicated health practitioners tend to avoid assisting patients with ACP decision making and formalisation ...
Source: Australian Health Review - June 1, 2015 Category: Hospital Management Authors: McLennan VE, Boddy JH, Daly MG, Chenoweth LM Tags: Aust Health Rev Source Type: research

Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria.
Conclusions More research is needed to understand how online resources can optimally elicit and record consumers' individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement.What is known about the topic? Online availability of ACD templates provides consumers with an opportunity for advance care planning outside of formal healthcare settings. While online availability has advantages, there is a risk that templates may be biased either for or against medical treatment and may not elicit direct...
Source: Australian Health Review - June 1, 2015 Category: Hospital Management Authors: Luckett T, Bhattarai P, Phillips J, Agar M, Currow D, Krastev Y, Davidson PM Tags: Aust Health Rev Source Type: research

Associations between Australian clinical medical practitioner exposure to workplace aggression and workforce participation intentions.
Conclusions Exposure to workplace aggression presents a risk to the retention of medical practitioners in clinical practice and a potential risk to community access to quality medical care. More concerted efforts in preventing and minimising workplace aggression in clinical medical practice are required.What is known about the topic? Very few studies have addressed the impact of workplace aggression on workforce participation intentions of medical practitioners.What does this paper add? This paper provides evidence that exposure to workplace aggression from any source is associated with intentions to reduce clinical worklo...
Source: Australian Health Review - June 1, 2015 Category: Hospital Management Authors: Hills DJ Tags: Aust Health Rev Source Type: research

The Queensland Health Ministerial Taskforce on health practitioners.
Conclusions The Ministerial Taskforce was an effective and efficient process for capturing broad-based engagement for workforce change while ensuring high-level support and involving potential adversaries in the decision-making processes.What is known about the topic? Anecdotal evidence exists to suggest that allied health professionals do not work to their full scope of practice and there is potential to enhance health service efficiencies by ensuring practitioners are supported to work to their full scope of practice.What does this paper add? This paper presents the findings from a large-scale consultation, endorsed by t...
Source: Australian Health Review - May 25, 2015 Category: Hospital Management Authors: Young G, Hulcombe J, Hurwood A, Nancarrow S Tags: Aust Health Rev Source Type: research

National Emergency Access Targets metrics of the emergency department-inpatient interface: measures of patient flow and mortality for emergency admissions to hospital.
Abstract Background Movement of emergency patients across the emergency department (ED)-inpatient ward interface influences compliance with National Emergency Access Targets (NEAT). Uncertainty exists as to how best measure patient flow, NEAT compliance and patient mortality across this interface.Objective To compare the association of NEAT with new and traditional markers of patient flow across the ED-inpatient interface and to investigate new markers of mortality and NEAT compliance across this interface.Methods Retrospective study of consecutive emergency admissions to a tertiary hospital (January 2012 to June ...
Source: Australian Health Review - May 18, 2015 Category: Hospital Management Authors: Sullivan C, Staib A, Eley R, Scanlon A, Flores J, Scott I Tags: Aust Health Rev Source Type: research

Research capacity and culture of the Victorian public health allied health workforce is influenced by key research support staff and location.
Abstract Objective The aim of the present study was to identify and understand the self-rated research capacity and culture of the allied health workforce.Methods The present study was a cross-sectional survey. The Research Capacity and Culture tool was disseminated to all Victorian public health allied health departments. General demographic data were also collected, including the presence of an organisational allied health research lead.Results Five hundred and twenty fully completed surveys were returned by participants; all allied health disciplines and all grades were represented. One hundred and eighty-six p...
Source: Australian Health Review - May 18, 2015 Category: Hospital Management Authors: Williams C, Miyazaki K, Borkowski D, McKinstry C, Cotchet M, Haines T Tags: Aust Health Rev Source Type: research

Sudden cardiac death rates in an Australian population: a data linkage study.
Conclusions Administrative morbidity and mortality data can be used to estimate rates of SCD and therefore provide a suitable methodology for monitoring SCD over time. The findings highlight the magnitude of SCD and its potential for public health prevention.What is known about the topic? There is considerable variability in rates of SCD worldwide. Different data sources and varied methods of case ascertainment likely contribute to this variation.What does this paper add? The rate of SCD in Australia is low compared with international estimates from USA, Ireland, Netherlands and China. Two in every three cases of SCD aged ...
Source: Australian Health Review - May 18, 2015 Category: Hospital Management Authors: Feng JL, Hickling S, Nedkoff L, Knuiman M, Semsarian C, Ingles J, Briffa TG Tags: Aust Health Rev Source Type: research

A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities.
Abstract This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to th...
Source: Australian Health Review - May 18, 2015 Category: Hospital Management Authors: Conway J, Dilworth S, Hullick C, Hewitt J, Turner C, Higgins I Tags: Aust Health Rev Source Type: research

Mapping allied health evidence-based practice: providing a basis for organisational realignment.
Conclusions The results underscore the need to provide organisational supports to AH staff for EBP implementation. Strategies other than training are required to maximally enhance EBP attitudes. The new organisational structure provides an opportunity for this cultural shift to occur.What is known about the topic? Factors affecting the EBP capabilities of AH professionals are complex and are associated with institutional culture and barriers, personal self-belief and individual experience and ability, and can exist at clinician, team and organisational levels.What does this paper add? The data from the present study confir...
Source: Australian Health Review - May 4, 2015 Category: Hospital Management Authors: Ziviani J, Wilkinson SA, Hinchliffe F, Feeney R Tags: Aust Health Rev Source Type: research

Should fee-for-service be for all guideline-advocated acute coronary syndrome (ACS) care? Observations from the Snapshot ACS study.
Conclusion Fee-for-service reimbursement may explain differences in the provision of selected guideline-advocated components of ACS care between privately insured and public patients. What is known about this topic? There is variation in the pattern of acute coronary syndrome care across Australia. What does this paper add? Clear differences in the provision of selected proven therapies for acute coronary syndrome apply independent of whether a fee is charged or not. What are the implications for practitioners? Consideration should be given to the remuneration for proven therapies for acute coronary syndrome care in prefer...
Source: Australian Health Review - April 27, 2015 Category: Hospital Management Authors: Briffa TG, Hammett CJ, Cross DB, Macisaac AI, Rankin JM, Board N, Carr B, Hyun KK, French J, Brieger DB, Chew DP Tags: Aust Health Rev Source Type: research

The ?unnecessary.
Conclusions For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this. What is known about the topic? Increasing demands are being placed on hospital emergency departments and there are concerns that a growing number of presentations are 'inappropriate presentations'. Older people are considered to be one group that overuse eme...
Source: Australian Health Review - April 27, 2015 Category: Hospital Management Authors: Faulkner D, Law J Tags: Aust Health Rev Source Type: research

Patient experience of expanded-scope-of-practice musculoskeletal physiotherapy in the emergency department: a qualitative study.
Conclusions Participants from both settings described their experience in positive terms, reflecting satisfaction with their management by an expanded scope of practice musculoskeletal physiotherapist. What is known about the topic? To date, the literature evaluating expanded scope of practice by physiotherapists (or advanced musculoskeletal physiotherapy services) has consistently reported positive participant satisfaction. Participant satisfaction has been typically restricted to the use of standardised questionnaires. What does this paper add? To our knowledge, this is the first study to describe the participant experie...
Source: Australian Health Review - April 27, 2015 Category: Hospital Management Authors: Harding P, Prescott J, Block L, O'Flynn AM, Burge AT Tags: Aust Health Rev Source Type: research

Australian doctors.
Conclusions Further work is required to better understand the full range of non-clinical activities doctors are involved in and how this may impact future workforce projections. What is known about the topic? Doctors usually engage in a range of non-clinical activities, such as research, education and administration. Policy documents suggest these activities are expected to comprise 20%-30% of a doctor's time in public settings. Understanding how engagement in non-clinical activities affects doctors' time in direct patient care, their career progression and job and life satisfaction is highly important and poorly understoo...
Source: Australian Health Review - April 27, 2015 Category: Hospital Management Authors: Joyce C, Eyre H, Wang WC, Laurence C Tags: Aust Health Rev Source Type: research

Health professionals as politicians.
PMID: 25913737 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - April 27, 2015 Category: Hospital Management Authors: Forbes M, Eyre H, Mitchell R, Di Natale R Tags: Aust Health Rev Source Type: research

Becoming environmentally sustainable in healthcare: an overview.
Abstract This paper provides an overview of environmental sustainability in healthcare and highlights the need for a policy framework for action. Examples from overseas demonstrate what has effectively enabled mitigation of and adaptation to the threat of climate change. The need to overcome perceived limits and barriers to health professionals' engagement in sustainable practice is noted. The scientific evidence recommends immediate action. What is known about the topic? Climate change has negative impacts on human health. There are co-benefits in mitigating and adapting to climate change that will benefit both h...
Source: Australian Health Review - April 20, 2015 Category: Hospital Management Authors: Jamieson M, Wicks A, Boulding T Tags: Aust Health Rev Source Type: research

Underutilisation of Victorian in-patient palliative care consultation services? Results of an exploratory study.
PMID: 25863696 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - April 13, 2015 Category: Hospital Management Authors: Eastman P, Le B Tags: Aust Health Rev Source Type: research

Development, implementation and evaluation of an interprofessional graduate program for nursing?paramedicine double-degree graduates.
Abstract Over the past decade, several Australian universities have offered a double degree in nursing and paramedicine. Mainstream employment models that facilitate integrated graduate practice in both nursing and paramedicine are currently lacking. The aim of the present study was to detail the development of the Interprofessional Graduate Program (IPG), the industrial and professional issues that required solutions, outcomes from the first pilot IPG group and future directions. The IPG was an 18-month program during which participants rotated between graduate nursing experience in emergency nursing at Northern ...
Source: Australian Health Review - April 13, 2015 Category: Hospital Management Authors: Considine J, Walker T, Berry D Tags: Aust Health Rev Source Type: research