Building allied health workforce capacity: a strategic approach to workforce innovation.
Conclusions The skills of AHAs are not being optimally utilised. Significant opportunity exists to reform the current allied health workforce. Such reform should result in increased capacity of the workforce to meet future demands. What is known about the topic? Increasing skill shortages across Australia's health workforce necessitates that the capabilities of all healthcare team members should be used optimally. AHA roles are an important and growing response to current health workforce needs. Increasing workforce capacity will ensure the right health workers are matched to the right task by skill, experience and experti...
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Somerville L, Davis A, Elliott AL, Terrill D, Austin N, Philip K Tags: Aust Health Rev Source Type: research

Roster process review: a case study on the implications of preliminary findings.
Abstract Rostering is an important process to enable efficient, effective and safe delivery of health care, and one which receives little attention. The work outlined in this case study demonstrates that the analysis of rostering processes from a range of perspectives including the organisation, staff and the roster manager can identify significant opportunities for improvement. Roster governance is not universally applied, nor understood, which can result in dissonant expectations between managers and staff and a lack of transparency in how and why decisions about rostering are made. Redesigning roster processes ...
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Eather B, Malica E, Walton C, Hollmann P, Kwong W Tags: Aust Health Rev Source Type: research

Implementation and impact of an extended-hours service in mental health care: lessons learned.
Conclusions A comprehensive needs analysis, enabling full description of target populations and their needs, should underpin establishment of any service. Such understanding is needed to ensure resources are appropriate. Importantly, because mental health clinicians are not interchangeable, matching philosophy of care and clinical skills to identified need is critical to quality and efficiency. What is known about the topic? Public mental health services are obliged to deliver services which meet the needs of the service community in a timely manner. This requires enabling access to care outside routine business hours. How...
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Erskine D, Baumgartner B, Patterson S Tags: Aust Health Rev Source Type: research

Back to basics: an audit of measurement of infant growth at presentation to hospital.
Conclusions Infant measurements were not recorded on many occasions. Assessment of growth as a marker of illness or nutritional deficit has been poorly assessed in this group. This is a missed opportunity to assess infant growth in this population, which has been found to be at risk of decreased nutritional status. Identification and treatment of growth deficits are a cost-effective method of optimising infant health worldwide. What is known about this topic? Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. What do...
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Williams LA, Ware RS, Davies PS Tags: Aust Health Rev Source Type: research

Concerns about the Australian Institute of Health and Welfare.
PMID: 25844879 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Kerr R Tags: Aust Health Rev Source Type: research

Factors that affect job satisfaction and intention to leave of allied health professionals in a metropolitan hospital.
Conclusion In relation to Herzberg's job satisfaction theory, both intrinsic and extrinsic work factors have been shown to have a significant correlation with intention to leave in this study group. This information can assist workforce planners to implement strategies to improve retention levels of allied health professionals in the work place. What is known about the topic? Job satisfaction is a significant predictor of retention in the workplace for allied health professionals in rural and remote areas; however, limited research has reviewed predictors of job satisfaction of allied health professionals in metropolitan h...
Source: Australian Health Review - April 7, 2015 Category: Hospital Management Authors: Wilson NA Tags: Aust Health Rev Source Type: research

Healthcare resource use in patients of the Australian Transition Care Program.
Conclusions Although the cost of the TCP is relatively high, it may have some impact on reducing hospital re-admissions and preventing or delaying residential care admissions. What is known about the topic? A majority of healthcare costs occur in older age. What does this paper add? Hospital costs, both initial and re-admissions, are the major contributor to healthcare costs in transition care recipients. Orthopaedic conditions are the most expensive to treat and neurological conditions are the most variable. What are the implications for practitioners? Reducing the length of hospitalisation and reducing re-admissions for ...
Source: Australian Health Review - March 30, 2015 Category: Hospital Management Authors: Comans TA, Peel NM, Cameron ID, Gray L, Scuffham PA Tags: Aust Health Rev Source Type: research

Can the simple clinical score usefully predict the mortality risk and length of stay for a recently admitted patient?
Conclusion There was no useful prospective role for the SCS in predicting LOS and mortality of in-patients newly admitted to a General Medicine service. What is known about the topic? After their presentation to the emergency department, care efficiency is improved by the 'streaming' of patients according to their risk of imminent deterioration and their likelihood of being a long-stay patient. Although streaming is currently effected by bedside assessment of the patient, an accepted aggregate assessment score may assist disposition decisions. What does this paper add? Bedside assessment of each patient still offers the mo...
Source: Australian Health Review - March 30, 2015 Category: Hospital Management Authors: Nguyen MT, Woodman RJ, Hakendorf P, Thompson CH, Faunt J Tags: Aust Health Rev Source Type: research

Pre-entry student clinical placement demand: can it be met?
Conclusions The Initiative enabled a co-ordinated response to meeting placement demand and enhanced collaborations between the health and education sectors. Sustaining pre-entry student placement provision remains a challenge for the future. What is known about the topic? The literature clearly identifies factors impacting on increasing demand for clinical placements and a range of strategies to increase clinical placement capacity. However, reported initiatives have mostly been ad hoc or reactive responses, often isolated within services or professions. What does this paper add? This paper describes implementation of a cl...
Source: Australian Health Review - March 30, 2015 Category: Hospital Management Authors: McBride LJ, Fitzgerald C, Morrison L, Hulcombe J Tags: Aust Health Rev Source Type: research

The future healthcare?
Conclusions Six key trends were identified. Collectively, they suggest that future systems are likely to be characterised by increasingly sophisticated technology, but at the same time greater personal and community responsibility for health and well being, innovative use of social capital, and a new approach to ageing and end-of-life care. What is known about the topic? Health care systems in Australia and around the world are failing to address the key health challenges of modern society. There are calls for radical, transformational change of our health care systems; however it is unclear what a future, sustainable syst...
Source: Australian Health Review - March 30, 2015 Category: Hospital Management Authors: Charlesworth K, Jamieson M, Butler CD, Davey R Tags: Aust Health Rev Source Type: research

Changing roles of population-based cancer registries in Australia.
Abstract Registries have key roles in cancer incidence, mortality and survival monitoring and in showing disparities across the population. Incidence monitoring began in New South Wales in 1972 and other jurisdictions soon followed. Registry data are used to evaluate outcomes of preventive, screening, treatment and support services. They have shown decreases in cancer incidence following interventions and have been used for workforce and other infrastructure planning. Crude markers of optimal radiotherapy and chemotherapy exist and registry data are used to show shortfalls against these markers. The data are also ...
Source: Australian Health Review - March 23, 2015 Category: Hospital Management Authors: Roder D, Creighton N, Baker D, Walton R, Aranda S, Currow D Tags: Aust Health Rev Source Type: research

Improvements in patient care: videoconferencing to improve access to interpreters during clinical consultations for refugee and immigrant patients.
Conclusions The present study has demonstrated that accessing an interpreter via videoconference is well accepted and preferred to telephone interpreting by both doctors and patients. What is known about the topic? Many immigrants and refugees settle in rural Australia. Access to professional on-site interpreters is difficult, particularly in rural Australia. What does this study add? Interpreters can be successfully accessed by videoconference. Patients and doctors prefer an interpreter accessed by videoconference rather than a telephone interpreter. What are the implications for practitioners? Doctors can utilise videoco...
Source: Australian Health Review - March 23, 2015 Category: Hospital Management Authors: Schulz TR, Leder K, Akinci I, Biggs BA Tags: Aust Health Rev Source Type: research

A step towards evidence-based regulation of health practitioners.
Abstract In 2010 Australia established a national registration and accreditation scheme, covering more than 620000 health practitioners. The data held by the Australian Health Practitioner Regulation Agency is a remarkable platform for research aimed at improving health practitioner regulation, health care quality and workforce planning. PMID: 25796534 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - March 23, 2015 Category: Hospital Management Authors: Bismark MM, Fletcher M, Spittal MJ, Studdert DM Tags: Aust Health Rev Source Type: research

Embedding research culture and productivity in hospital physiotherapy departments: challenges and opportunities.
Abstract Few studies have investigated research culture in the Australian hospital system. Although physiotherapists working in tertiary hospital departments conduct and publish research, a conflict between service delivery and research productivity remains. Few departments record research achievements, which limits the accuracy of investigating factors associated with research productivity within allied health. The conduct and translation of research within acute physiotherapy and allied health departments is imperative to improve patient health outcomes, optimise health service efficiency and cost-effectiveness ...
Source: Australian Health Review - March 17, 2015 Category: Hospital Management Authors: Skinner EH, Williams CM, Haines TP Tags: Aust Health Rev Source Type: research

Future of specialised roles in allied health practice: who is responsible?
Abstract Allied health professions have developed specialised advanced and extended scope roles over the past decade, for the benefit of patient outcomes, allied health professionals' satisfaction and to meet labour and workforce demands. There is an essential need for formalised, widely recognised training to support these roles, and significant challenges to the delivery of such training exist. Many of these roles function in the absence of specifically defined standards of clinical practice and it is unclear where the responsibility for training provision lies. In a case example of physiotherapy practice in the...
Source: Australian Health Review - March 17, 2015 Category: Hospital Management Authors: Skinner EH, Haines KJ, Hayes K, Seller D, Toohey JC, Reeve JC, Holdsworth C, Haines TP Tags: Aust Health Rev Source Type: research

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia.
Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised. What is known about the topic? People with mental illness have a lower life expectancy and poorer physical health than people who do not have a mental illness. Government policy is critical to reducing inequalities in physical health and increasing longevity. What does this paper add? Evaluating policy developments against the World Health Organization's Mental Health Action Plan 2013-202...
Source: Australian Health Review - March 10, 2015 Category: Hospital Management Authors: Happell B, Platania-Phung C, Webster S, McKenna B, Millar F, Stanton R, Galletly C, Castle D, Furness T, Liu D, Scott D Tags: Aust Health Rev Source Type: research

Multisite analysis of the timing and outcomes of unplanned transfers from subacute to acute care.
Abstract Objective The aim of the present study was to examine the timing and outcomes of patients requiring an unplanned transfer from subacute to acute care. Methods Subacute care in-patients requiring unplanned transfer to an acute care facility within four Victorian health services from 1 January to 31 December 2010 were included in the study. Data were collected using retrospective audit. The primary outcome was transfer within 24h of subacute care admission. Results In all, 431 patients (median age 81 years) had unplanned transfers; of these, 37.8% had a limitation of medical treatment (LOMT) order. The medi...
Source: Australian Health Review - March 10, 2015 Category: Hospital Management Authors: Considine J, Street M, Botti M, O'Connell B, Kent B, Dunning Am T Tags: Aust Health Rev Source Type: research

Exploring the implications of a fixed budget for new medicines: a study of reimbursement of new medicines in Australia and New Zealand.
Conclusion The discrepancy in the number of new medicines listed in New Zealand compared with Australia raises questions regarding the consequences of implementing a capped budget for new medicines. However, further research is needed to understand the relationship between listing outcomes, access to medicines and health benefits for the community. What is known about this topic? Due to factors such as an aging population and longer life expectancy, total government health expenditure as a proportion of gross domestic product (GDP) is expected to rise. Consequently, many commentators have suggested current expenditure patt...
Source: Australian Health Review - March 10, 2015 Category: Hospital Management Authors: Taylor C, Wonder M Tags: Aust Health Rev Source Type: research

Knowledge and motivation: two elements of health literacy that remain low with regard to nurse practitioners in Australia.
Conclusion The low levels of health literacy raise questions of how to meaningfully include health consumers in innovative health-related policy work. What is known about the topic? Health literacy includes individual attributes and those of the system in which the context of care is placed. Individual attributes include not only knowledge and confidence but also motivation. It is known that consumer knowledge related to the nursing workforce is low. What does this paper add? This paper adds the finding that along with knowledge that consumer motivation is low to find out more about the nursing workforce in general. This f...
Source: Australian Health Review - March 10, 2015 Category: Hospital Management Authors: Cashin A, Heartfield M, Cox D, Dunn S, Stasa H Tags: Aust Health Rev Source Type: research

Outdoor areas of Australian residential aged care facilities do not facilitate appropriate sun exposure.
Conclusions The physical environment of the outdoor areas of residential aged care facilities was associated with their use for sunlight exposure. Suitably designed or modified spaces have the potential to encourage their greater use, and residential aged care facilities should also plan regular activities in those areas. These measures can facilitate safe sun exposure, as well as physical activity and social interaction in older people. What is known about the topic? Older people living in aged care facilities have inadequate outdoor sun exposure and vitamin D deficiency. The outdoor spaces of aged care facilities are not...
Source: Australian Health Review - March 2, 2015 Category: Hospital Management Authors: Durvasula S, Mason RS, Kok C, Macara M, Parmenter TR, Cameron ID Tags: Aust Health Rev Source Type: research

New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.
Abstract Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the pro...
Source: Australian Health Review - March 2, 2015 Category: Hospital Management Authors: Hanning B, Predl N Tags: Aust Health Rev Source Type: research

Pressure injury in Australian public hospitals: a cost-of-illness study.
Conclusions The costs estimated in the present study highlight the economic waste for the Australian health system associated with a largely avoidable injury. Wastage can also be reduced by preventing moderate injuries (Stage I and II) from developing into severe cases (Stage III and IV), because the severe cases, accounting for 12% of cases, mounted to 30% of the total cost. PMID: 25725696 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - March 2, 2015 Category: Hospital Management Authors: Nguyen KH, Chaboyer W, Whitty JA Tags: Aust Health Rev Source Type: research

Can clinical supervision sustain our workforce in the current healthcare landscape? Findings from a Queensland study of allied health professionals.
Abstract Objective Clinical supervision is widely recognised as a mechanism for providing professional support, professional development and clinical governance for healthcare workers. There have been limited studies about the effectiveness of clinical supervision for allied health and minimal studies conducted within the Australian health context. The aim of the present study was to identify whether clinical supervision was perceived to be effective by allied health professionals and to identify components that contributed to effectiveness. Participants completed an anonymous online questionnaire, administered th...
Source: Australian Health Review - March 2, 2015 Category: Hospital Management Authors: Saxby C, Wilson J, Newcombe P Tags: Aust Health Rev Source Type: research

Assessing improvements in survival for stroke patients in the Northern Territory 1992?2013: a marginal structural analysis.
Abstract Objective The aim of the present study was to investigate changes in stroke survival among Indigenous and non-Indigenous patients in the Northern Territory (NT). Methods A longitudinal study was undertaken of stroke patients admitted to NT public hospitals between 1992 and 2013. The Kaplan-Meier method and proportional hazards regression were used for survival analysis. A marginal structural model was applied to adjust for time-dependent confounders and informative censoring. Results There were 4754 stroke in-patients over the period, with 3540 new cases and 837 stroke deaths. Mean age of onset for Indige...
Source: Australian Health Review - February 23, 2015 Category: Hospital Management Authors: Zhao Y, Condon J, You J, Guthridge S, He V Tags: Aust Health Rev Source Type: research

Allied health: leaders in health care reform.
PMID: 25701889 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - February 23, 2015 Category: Hospital Management Authors: Markham D Tags: Aust Health Rev Source Type: research

Inter-hospital lateral transfer does not increase length of stay.
Abstract Objective The aim of the present study was to assess the effect of an inter-hospital transfer on efficiency and quality of in-patient care. Methods A retrospective cohort study from 2010 to 2012 inclusive was conducted in two tertiary-referral urban hospitals within a single area healthcare network. The study included 14571 acutely unwell patients admitted to a general medical service. The main outcome measures were length of in-patient stay, relative stay index, readmission rate within 7 and 28 days of discharge and in-hospital mortality rate. Results Compared with patients who were transferred to a long...
Source: Australian Health Review - February 23, 2015 Category: Hospital Management Authors: Russell P, Hakendorf P, Thompson C Tags: Aust Health Rev Source Type: research

Costly chronic diseases: a retrospective analysis of Chronic Disease Dental Scheme expenditure.
Conclusions Rebate claims increased in each of the last 3 full years of the CDDS across all areas. The majority of Medicare rebate claims were from major city areas and for crown and bridge, removable prostheses and restorative services. The service mix varied between regions. What is known about the topic? The CDDS was described as 'unsustainable' from the governmental budgetary perspective, being controversial around the value of the program, 'poorly targeted' and having implementation and administrative requirement shortfalls. What does this paper add? The CDDS rebates for the period 2008-13 totalled A$2.8 billion, with...
Source: Australian Health Review - February 23, 2015 Category: Hospital Management Authors: Crocombe LA, Kraatz J, Hoang H, Qin D, Godwin D Tags: Aust Health Rev Source Type: research

Community representation in hospital decision making: a literature review.
Conclusions The analysis indicates that: quality subcommittees set up to assist boards are a key structure for involving community representation in decision making around quality of care. There are clearly a number of challenges to effectively developing the process of community representation in hospital governance, associated with ambiguity, organisational and consumer issues. For an inclusive agenda to real life, work must be done on understanding the representatives' role and the decision making process, adequately supporting the representational process, and developing organisational cooperation and culture regarding...
Source: Australian Health Review - February 9, 2015 Category: Hospital Management Authors: Murray Z Tags: Aust Health Rev Source Type: research

Strategic information for hospital service planning: a linked data study to inform an urban Aboriginal Health Liaison Officer program in Western Australia.
Conclusions Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes. What is known about the topic? The health gap between Aboriginal and non-Aboriginal Australians is well documented. Aboriginal people have significantly higher hospital utilisation rates, as well as higher rates of complications, comorbidities and discharges against medical advice (DAMA). Aboriginal patients receive most of their specialist...
Source: Australian Health Review - February 2, 2015 Category: Hospital Management Authors: Katzenellenbogen JM, Miller LJ, Somerford P, McEvoy S, Bessarab D Tags: Aust Health Rev Source Type: research

Australian midwives.
Conclusions Professional bodies need to support staff in this transition by providing clearer guidance that exemplifies the Nursing and Midwifery Board of Australia expectations. What is known about the topic? Impact subsequent to Australian legislative and regulatory changes affecting midwifery and nursing registration has not been examined. What does this paper add? The findings of this study provide an insight into midwives' responses to the changed re-registration standard in Australia. What are the implications for practitioners? There appears to be a problem in the way tensions and challenges are being met; misinterp...
Source: Australian Health Review - January 27, 2015 Category: Hospital Management Authors: Gray M, Rowe J, Barnes M Tags: Aust Health Rev Source Type: research

Organisational development in a rural hospital in Australia.
Conclusions The existence of at least four different organisational 'worlds' and identities, according to different professional groupings with different goals, languages and values, was evident. The relationship between the researcher and subjects was key in terms of whether the researcher is seen as an 'expert' or as a 'facilitator'. In bringing about change, we need to work with the Chief Executive Officer in empowering others. Hence, the researchers need to engage in continual dialogue across boundaries and within groups as well as at individual levels to provide support for organisational change. What is known about t...
Source: Australian Health Review - January 22, 2015 Category: Hospital Management Authors: Young S, Leggat S, Stanton P, Bartram T Tags: Aust Health Rev Source Type: research

Thinking differently: working together for better care.
Abstract This paper describes the development and outcomes from 'joint working' between Prince of Wales Hospital and BD (Becton, Dickinson and Company) in Australia. 'Joint working' is a term used within the English National Health Service to describe health system and industry partners working together to create novel service models which benefit patients. The joint working process broadened the perspective of both parties through learning from each other and so enhanced the range of tools they each bring to their work. What is known about the topic? Collaboration between industry - specifically the pharmaceutica...
Source: Australian Health Review - January 22, 2015 Category: Hospital Management Authors: Bolton P, Crilly H, Rivas K Tags: Aust Health Rev Source Type: research

Advance care planning in palliative care: a national survey of health professionals and service managers.
Conclusions This first national survey examining ACP in palliative care services demonstrates there is a need to improve systems to support ACP and to understand circumstances in which ACP wishes are not followed. What is known about the topic? ACP is increasingly recognised as an important part of care of people in hospital and community settings. However, currently there is no empirical evidence about the national uptake and quality of ACP in palliative care settings specifically. What does this paper add? This nationwide survey shows improvements on past small-scale research showing that ACP is supported by palliative c...
Source: Australian Health Review - January 22, 2015 Category: Hospital Management Authors: Sellars M, Silvester W, Masso M, Johnson CE Tags: Aust Health Rev Source Type: research

Palliative care health professionals.
Conclusions Advance care planning benefits HPs, patients and their family. To maximise these benefits, ACDs need to be clear, comprehensive, medically relevant and transportable documents. What is known about the topic? Ideally, advance care planning encompasses the identification and documentation of a person's preferences for future medical treatments and care in preparation for an occasion when the person cannot express their values and wishes. The uptake and practice of advance care planning is inconsistent, and the extent to which it is used by health professionals and patients is variable. Many people are cared for a...
Source: Australian Health Review - January 22, 2015 Category: Hospital Management Authors: Johnson CE, Singer R, Masso M, Sellars M, Silvester W Tags: Aust Health Rev Source Type: research

Comment on ?Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice?
PMID: 25607634 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - January 22, 2015 Category: Hospital Management Authors: Dimmock T Tags: Aust Health Rev Source Type: research

Effectiveness of clinical supervision of physiotherapists: a survey.
Abstract Objectives Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. Methods CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total sco...
Source: Australian Health Review - January 5, 2015 Category: Hospital Management Authors: Snowdon DA, Millard G, Taylor NF Tags: Aust Health Rev Source Type: research

Demographics and discharge outcomes of dysvascular and non-vascular lower limb amputees at a subacute rehabilitation unit: a 7-year series.
Abstract Objective To examine personal and social demographics, and rehabilitation discharge outcomes of dysvascular and non-vascular lower limb amputees. Methods In total, 425 lower limb amputation inpatient rehabilitation admissions (335 individuals) from 2005 to 2011 were examined. Admission and discharge descriptive statistics (frequency, percentages) were calculated and compared by aetiology. Results Participants were male (74%), aged 65 years (s.d. 14), born in Australia (72%), had predominantly dysvascular aetiology (80%) and a median length of stay 48 days (interquartile range (IQR): 25-76). Following ampu...
Source: Australian Health Review - January 5, 2015 Category: Hospital Management Authors: Batten HR, Kuys SS, McPhail SM, Varghese PN, Nitz JC Tags: Aust Health Rev Source Type: research

Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia.
Conclusion Participants were unaware of each other's models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models. What is known about the topic? Many rural hospitals lack an optimal workforce to provide comprehensive health services, including pharmaceutical services. One solution to address medication management shortfalls is employment of a local communit...
Source: Australian Health Review - January 5, 2015 Category: Hospital Management Authors: Tan AC, Emmerton LM, Hattingh HL, La Caze A Tags: Aust Health Rev Source Type: research

Implementing antimicrobial stewardship in the Australian private hospital system: a qualitative study.
Conclusions Provision of advice from experts, championing by clinical leaders, marketing by hospital executives and involving nurses, pharmacists and patients should be considered during implementation of AMS in private hospitals. What is known about the topic? Hospital-wide AMS programs have been shown to be an effective means to address the problem of accelerating antimicrobial resistance. However, current literature predominantly focuses on evaluation of AMS activities rather than on improving implementation success. In addition, most research on hospital AMS programs is from the public hospital sector. AMS is now part ...
Source: Australian Health Review - January 5, 2015 Category: Hospital Management Authors: Cotta MO, Robertson MS, Marshall C, Thursky KA, Liew D, Buising KL Tags: Aust Health Rev Source Type: research

Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study.
Conclusions Children from lower SES families may have a greater need for health services due to higher rates of illness and injury. Bulk billing and low-cost access to GP services, regardless of length of consultation, improve equity of access; however, indirect costs may prevent low-income mothers from accessing care for their child when needed. What is known about the topic? The relationship between health and SES, and the influence that health service use can have on this relationship, are well recognised. Previous studies on adult populations in Australia suggest that people of lower SES have more frequent GP consultat...
Source: Australian Health Review - December 22, 2014 Category: Hospital Management Authors: Golenko XA, Shibl R, Scuffham PA, Cameron CM Tags: Aust Health Rev Source Type: research

Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study.
Conclusions Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed. What is known about the topic? A recent paper found that most women from the public sector in Victoria and South Australia receive an early post partum home visit from a midwife or nurse. Queensland only recently implemented a program to increase post partum home visiting but who receives visits is still unknown. What does this paper add? No previous study has investigated which wo...
Source: Australian Health Review - December 22, 2014 Category: Hospital Management Authors: Brodribb W, Miller Y Tags: Aust Health Rev Source Type: research

?Right.
This article reports on a project focused on increasing the rate of published work by implementing some of the strategies discussed in the literature. What does this paper add? This paper describes the development, delivery and outcomes of a project focused on implementing strategies discussed in the literature to increase the confidence and competence of clinical and academic health professionals to publish their scholarly, project-based and research work. What are the implications for practitioners? With many health professionals combining clinical and teaching roles, there is an expectation that as they progress through...
Source: Australian Health Review - December 22, 2014 Category: Hospital Management Authors: Paliadelis P, Parker V, Parmenter G, Maple M Tags: Aust Health Rev Source Type: research

Financial viability, benefits and challenges of employing a nurse practitioner in general practice.
Abstract This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The succe...
Source: Australian Health Review - December 22, 2014 Category: Hospital Management Authors: Helms C, Crookes J, Bailey D Tags: Aust Health Rev Source Type: research

Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?
Conclusions Understanding how different dimensions of access influence the utilisation of PHC services is critical in planning the provision of PHC services. This study reports how consumers 'trade-off' the different dimensions of access when accessing GP care in rural Australia. The results show that ensuring 'good' access requires that policymakers and planners should consider other dimensions of access to services besides geography. What is known about the topic? Research indicates that poorer 'access' to GPs, an impediment to seeking primary care at times of need, is the most important factor distinguishing rural from ...
Source: Australian Health Review - December 22, 2014 Category: Hospital Management Authors: Ward B, Humphreys J, McGrail M, Wakerman J, Chisholm M Tags: Aust Health Rev Source Type: research

A systems life cycle approach to managing the radiology profession: an Australian perspective.
Conclusion We posit that Australia may need to design a new system of radiology provision to meet future demands for high-quality medical radiation services. We also suggest some strategies, such as greater development of radiographers' role, are critical for enabling sustainable change over time. What is known about the topic? Long-term workforce planning for medical services at the national level has been very challenging for policy makers of the 21st century. The current demographic imbalance in the supply and demand of the Australian radiologist workforce makes it difficult to plan the effects of extra inflow of radiol...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: Taba ST, Atkinson SR, Lewis S, Chung KS, Hossain L Tags: Aust Health Rev Source Type: research

Whiteboards and discharge traffic lights: visual management in acute care.
Abstract Flinders Medical Centre was experiencing issues with timely discharge and knowing the potential discharges and in-patient bed capacity for the next day. This case study describes the application of 'visual management' theory to discharge processes. The solutions developed were 'patient journey boards' and 'discharge traffic lights'. The implementation of these visual management systems has enabled the hospital to improve its discharge processes. What is known about the topic? Communication is critical to the delivery of safe patient care. There is little in the literature on the use of visual management p...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: O'Brien L, Bassham J, Lewis M Tags: Aust Health Rev Source Type: research

A theoretical frameworks to support research of health service innovation.
Conclusion If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted. What is known about the topic? Providers of health services are rapidly implementing innovations in an effort to provide effective health care. Little research has been conducted to evaluate the sustainability of these health service innovations. What does this paper add? This paper ...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: Fox A, Gardner G, Osborne S Tags: Aust Health Rev Source Type: research

Dying in Australian hospitals: will a separate national clinical standard improve the delivery of quality care?
Abstract While it is commonly stated that for most people the preferred place of death is their own homes, the actual reality is that most people will die in hospitals. This is both by choice and necessity. However, for many, the care that they receive would not necessarily align with their expectations. The need to improve the quality of health care at the end of life has been acknowledged by the Australian Commission for Safety and Quality in Healthcare with the release of a recent discussion paper. It is presumed this is a prelude to the release of another quality standard specifically for end of life care. The...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: Clark K, Collier A, Currow DC Tags: Aust Health Rev Source Type: research

Diversity and consistency: a case study of regionalised clinical placements for medical students.
Abstract Objective A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods A retrospective analysis of academic records for UQ medical students (n=1514) completing clinical rotations (2009-2012) was performed using analysis of covariance (ANCOVA) for comparisons between clini...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: Casey MG, David M, Eley D Tags: Aust Health Rev Source Type: research

Managing ethical issues in patient care and the need for clinical ethics support.
Conclusion Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. Although this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, most respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. What is known about the topic? Clinicians working in hospitals in the US, Canada and UK have access to ethics expertise to help them manage ethical issues that ...
Source: Australian Health Review - December 17, 2014 Category: Hospital Management Authors: Doran E, Fleming J, Jordens C, Stewart CL, Letts J, Kerridge IH Tags: Aust Health Rev Source Type: research