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

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

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

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

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

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

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

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

Codesigned framework for organisational culture reform in South Australian older persons.
Abstract The Oakden Report documented failures in governance, clinical practice and organisational culture occurring at the Oakden Older Persons' Mental Health Service and drew national attention to the care of older people with complex clinical needs. Responding to the recommendations of the Report, a working group brought together stakeholders to engage in a codesign process involving literature review, gallery walks and focus groups, under the governance of the Oakden Response Oversight Committee. The working group developed a framework as a blueprint for organisational culture reform built around a central phi...
Source: Australian Health Review - March 1, 2019 Category: Hospital Management Authors: McKellar D, Hanson J Tags: Aust Health Rev Source Type: research

Making sense of paying for performance in health care: short-term targets versus patient-relevant outcomes.
Abstract Although there has been growing interest in pay-for-performance programs in health, the evidence of their success is weak. Reasons that have been posited for this are that they are misdirected (i.e. individual providers are not directly linked to incentives targeted at a practice level) or that they are too weak, either because of cost considerations or that they have been dominated by strong social or professional norms. In practice, a problem of pay-for-performance programs is that they are based on a transactional view of health care focused on short-term targets (such as vaccination rates, blood press...
Source: Australian Health Review - February 27, 2019 Category: Hospital Management Authors: Jan S Tags: Aust Health Rev Source Type: research

Taking the pulse of the health services research community: a cross-sectional survey of research impact, barriers and support.
This study reports on the characteristics of individuals conducting health service research (HSR) in Australia and New Zealand, the perceived accessibility of resources for HSR, the self-reported impact of HSR projects and perceived barriers to conducting HSR.MethodsA sampling frame was compiled from funding announcements, trial registers and HSR organisation membership. Listed researchers were invited to complete online surveys. Close-ended survey items were analysed using basic descriptive statistics. Goodness of fit tests determined potential associations between researcher affiliation and access to resources for HSR. O...
Source: Australian Health Review - February 20, 2019 Category: Hospital Management Authors: Fradgley EA, Karnon J, Roach D, Harding K, Wilkinson-Meyers L, Chojenta C, Campbell M, Harris ML, Cumming J, Dalziel K, McDonald J, Pain T, Smiler K, Paul CL Tags: Aust Health Rev Source Type: research

Readmissions following hospitalisations for cardiovascular disease: a scoping review of the Australian literature.
ConclusionsHigh rates of readmissions are reported for cardiovascular conditions, although substantial methodological heterogeneity exists among studies. Nationally standardised definitions are required to accurately measure readmissions and further studies are needed to address knowledge gaps and test interventions to lower readmissions in Australia.What is known about the topic?International studies suggest readmissions are common following cardiovascular hospitalisations and are costly to the health system, yet little is known about the burden of readmission in the Australian setting or the effectiveness of intervention...
Source: Australian Health Review - February 20, 2019 Category: Hospital Management Authors: Labrosciano C, Air T, Tavella R, Beltrame JF, Ranasinghe I Tags: Aust Health Rev Source Type: research

Costs and consequences of an intervention-based program to reduce hospital-acquired pressure injuries in one health district in Australia.
ConclusionsThe HAPI intervention-based program halved the incidence and substantially reduced the prevalence of HAPI, with a 23.1% cost saving compared with the previous approach to preventing HAPIs.What is known about the topic?HAPIs are costly to the individual, the organisation and health system. The prevention of HAPIs is a priority in Australia. There is limited research on the economic effect of HAPIs and the costs and consequences for hospitals of implementation strategies to reduce their incidence.What does this paper add?This paper informs health policy and decision makers about the costs and consequences for a lo...
Source: Australian Health Review - February 11, 2019 Category: Hospital Management Authors: Barakat-Johnson M, Lai M, Wand T, White K, De Abreu Lourenco R Tags: Aust Health Rev Source Type: research

Community-based case management does not reduce hospital admissions for older people: a systematic review and meta-analysis.
ConclusionCommunity-based case management intervention may be effective in reducing ED presentations for older people.What is known about the topic?Although community-based case management is common in Australia, little is known about its effectiveness in reducing healthcare utilisation for community-dwelling older people.What does this paper add?The results indicate that community-based case management may decrease the number of ED presentations among older people.What are the implications for practitioners?Patients with high ED presentation rates may benefit from community-based case management to reduce the number of un...
Source: Australian Health Review - February 7, 2019 Category: Hospital Management Authors: Poupard N, Tang CY, Shields N Tags: Aust Health Rev Source Type: research

Shared decision making implementation: a case study analysis to increase uptake in New South Wales.
Abstract The aim of this study was to identify potential implementation interventions to increase the uptake of shared decision making (SDM) in clinical practice in New South Wales (NSW) Health. The Agency for Clinical Innovation hosted a full-day SDM masterclass in May 2017 and 53 attendees completed a survey to identify barriers to implementing SDM. The Theoretical Domains Framework, COM-B ('capability', 'opportunity', motivation' and 'behaviour') Model and Behaviour Change Wheel were used to conduct a theoretical analysis of the barriers and identify potential interventions to increase the uptake of SDM. This w...
Source: Australian Health Review - January 31, 2019 Category: Hospital Management Authors: Dimopoulos-Bick T, Osten R, Shipway C, Trevena L, Hoffmann T Tags: Aust Health Rev Source Type: research

Allied health professionals in Queensland Health returning to work after maternity leave: hours of work and duration of time on part-time hours.
ConclusionThe study showed that most AHPs who took maternity leave returned to work part-time and remained part-time for an extended period. The data suggest that managers could permanently backfill a proportion of hours released due to FWA after maternity leave without major budgetary risk due to the need to accommodate existing employees' entitlements. However, this would require a significant policy change.What is known about this topic?Current research on this topic has concentrated on the benefits of paid maternity leave, timing of return to work and use of FWA by employees on return to work after maternity leave.What...
Source: Australian Health Review - January 30, 2019 Category: Hospital Management Authors: Hulcombe J, Capra S, Whitehouse G Tags: Aust Health Rev Source Type: research

Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews.
ConclusionsBarriers to accessing health care include refugee characteristics, practice issues in health services, including the knowledge and skills of health professionals, and the resettlement context. Health services need to identify barriers to culturally sensitive care. Improvements in service delivery are needed that meet the needs of refugees. More research is needed to evaluate facilitators to improving health care accessibility for these vulnerable groups.What is known about the topic?Refugee health after resettlement is poor, yet health service use is low.What does this paper add?Barriers to accessing health serv...
Source: Australian Health Review - January 18, 2019 Category: Hospital Management Authors: Parajuli J, Horey D Tags: Aust Health Rev Source Type: research

Examination of the dependency and complexity of patients admitted to in-patient rehabilitation in Australia.
ConclusionThe dependency and complexity of patients admitted to in-patient rehabilitation in Australia has increased between 2007 and 2016.What is known about the topic?Anecdotal reports suggest that rehabilitation patients in Australia have become more complex, necessitating increased active management of their presenting health condition and comorbid health conditions. However, to date, no systematic investigation has been undertaken to examine trends in rehabilitation in-patient dependency and complexity over time.What does this paper add?This study provides measurable evidence of increased dependency and complexity in ...
Source: Australian Health Review - January 18, 2019 Category: Hospital Management Authors: McKechnie D, Pryor J, Fisher MJ, Alexander T Tags: Aust Health Rev Source Type: research

'Right fit, right job, right time.
ConclusionA behaviourally grounded recruitment approach to allied health improves overall staff attrition over traditional competency-based models. PMID: 30621851 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - January 9, 2019 Category: Hospital Management Authors: Withiel T, Marr L, Juj G Tags: Aust Health Rev Source Type: research

How Local Health Districts can prepare for the effects of climate change: an adaptation model applied to metropolitan Sydney.
Abstract Climate change adaptation can be defined as a form of risk management (i.e. assessing climate change-related risks and responding appropriately so that the risks can be pre-emptively minimised and managed as they arise). Adapting to climate change by hospital and community health services will entail responding to changing health needs of the local population, and to the likely effects of climate change on health service resources, workforce and infrastructure. In this paper we apply a model that health services can use to predict and respond to climate change risks and illustrate this with reference to S...
Source: Australian Health Review - December 21, 2018 Category: Hospital Management Authors: Rychetnik L, Sainsbury P, Stewart G Tags: Aust Health Rev Source Type: research

Revenue of consultant physicians for private out-patient consultations.
Conclusions The effect of the multiyear Medicare freeze on consultant physician revenue has been partially offset by changes in billing practices.What is known about the topic? There was a 'freeze' on Medicare schedule fees for consultations from November 2012 to July 2018. Concerns were expressed that the schedule has not kept pace with inflation and does not represent appropriate payments to physicians.What does this paper add? Accounting for bulk-billing, changes in gap fees and inflation, revenue from standard initial and subsequent consultations decreased from 2011 to 2015. Use of item codes for complex consultations ...
Source: Australian Health Review - December 18, 2018 Category: Hospital Management Authors: Freed GL, Allen AR Tags: Aust Health Rev Source Type: research

Investment in Australian mental health carer services: how much and does it reflect evidence of effectiveness?
Conclusions These findings suggest a mismatch between what is known about the extent to which different service types deliver positive carer outcomes and the current allocation of funds across Australia's mental health system. This study also highlights the fragmentation of the mental health carer services system, supporting the need to streamline access.What is known about this topic? Informal carers of people with mental disorders provide a critical role to the significant number of individuals with mental illness in Australia, and provide an unpaid workforce to the Australian mental health system. This role comes with s...
Source: Australian Health Review - December 18, 2018 Category: Hospital Management Authors: Schess J, Diminic S, Hielscher E, Harris MG, Lee YY, Kealton J, Whiteford HA Tags: Aust Health Rev Source Type: research

Prevalence and characteristics associated with concurrent smoking and alcohol misuse within Australian general practice patients.
This study sought to determine, among a large sample of Australian general practice patients: (1) the prevalence of smoking among different levels of alcohol misuse; and (2) whether the associations between demographic characteristics and alcohol use differ according to smoking status.Methods A cross-sectional survey was administered from 2010 to 2011 to 3559 patients from 12 Australian urban general practices. Patients reported their demographic details, smoking status and their alcohol intake.Results The overall prevalence of reported concurrent smoking and alcohol misuse was 7.8%. Smokers were 3.81-fold more likely to h...
Source: Australian Health Review - December 14, 2018 Category: Hospital Management Authors: Hobden B, Bryant J, Forshaw K, Oldmeadow C, Evans TJ, Sanson-Fisher R Tags: Aust Health Rev Source Type: research

Are the benefits of new health services greater than their opportunity costs?
Abstract The Australian health system performs well compared with other developed countries, but there is potential for improved health outcomes through the consideration of the opportunity costs of funding new health services. The opportunity costs of funding a new health service are the benefits forgone from the activities that would be funded if the new health service was not funded. When the forgone activity cannot be observed directly, the expected opportunity costs have been estimated as the expected gain in quality-adjusted life years (QALYs) associated with marginal increases in government expenditure on h...
Source: Australian Health Review - December 10, 2018 Category: Hospital Management Authors: Edney L, Haji Ali Afzali H, Karnon J Tags: Aust Health Rev Source Type: research

Road deaths relating to the attendance of medical appointments in Queensland.
Conclusion Fatal risk is present in any road journey regardless of distance, duration or the purpose of travel. Individuals living in regional and remote Queensland are exposed to a larger risk than those living in the major cities of Queensland when travelling to obtain public health care.What is already known on this subject? Road safety remains one of Australia's most serious public health issues, with 1295 road-related fatalities recorded throughout Australia in 2016. Although the potential dangers of road travel are well understood, extended journeys by road to attend hospital appointments are often undertaken despite...
Source: Australian Health Review - December 10, 2018 Category: Hospital Management Authors: Greenup EP, Potts BA Tags: Aust Health Rev Source Type: research

Work-related injury and illness in the Victorian healthcare sector: a retrospective analysis of workers.
Conclusions Although the greatest volume of claims was observed in nurses, ambulance officers and paramedics were at higher risk for injury, followed by social workers. The differential patterns of injury and illness among occupation groups suggests a need for primary and secondary prevention responses tailored by occupation.What is known about the topic? The health and social care industry is a large and diverse industry. Health and social care workers encounter unique occupational health risks, with exposure varying by occupation.What does this paper add? This study provides evidence of a high rate of work-related injury...
Source: Australian Health Review - December 5, 2018 Category: Hospital Management Authors: Xia T, Collie A Tags: Aust Health Rev Source Type: research

Supporting Northern Territory Top End allied health graduates and early career staff by means of an interprofessional graduate program.
Conclusions The pilot program provided a sustainable model of learning and development for early career allied health professionals. Supporting the Top End graduate allied health workforce proved to be an important factor in facilitating interprofessional practice from an early stage, as integrated care and interprofessional practice are crucial to patient treatment.What is known about the topic? Research from within Australia and internationally has demonstrated that preparing allied health professionals for interprofessional practice helped facilitate collaboration and partnerships among different professions. This, in t...
Source: Australian Health Review - November 30, 2018 Category: Hospital Management Authors: Sooful P, Williams J, Moore R Tags: Aust Health Rev Source Type: research

Documenting the process of developing the Victorian voluntary assisted dying legislation.
Abstract Many countries across the world have legislated for their constituents to have control over their death. Commonalities and differences can be found in the regulations surrounding the shape and practices of voluntary assisted dying (VAD) and euthanasia, including an individual's eligibility and access, role of health professions and the reporting. In Australia there have been perennial debates across the country to attempt legislative change in assisting a terminally ill person to control the ending of their life. In 2017, Victoria became the first state to successfully legislate for VAD. In describing the...
Source: Australian Health Review - November 30, 2018 Category: Hospital Management Authors: O'Connor MM, Hunt RW, Gardner J, Draper M, Maddocks I, Malowney T, Owler BK Tags: Aust Health Rev Source Type: research

'We get so task orientated at times that we forget the people': staff communication experiences when caring for Aboriginal cardiac patients.
Conclusions Providing effective communication that is both clinically and culturally appropriate is often challenging within a busy and non-adaptive hospital environment. Moving beyond clinical tasks, increased Aboriginal and Torres Strat Islander health workforce and cultural competency, supporting coordinated care and improved skills are required to meet the communication needs of Aboriginal and Torres Strait Islander patients.What is known about this topic? Communication between patients, their families and hospital staff is crucial for health care quality and safety. There is little understanding of the challenges and ...
Source: Australian Health Review - November 23, 2018 Category: Hospital Management Authors: Kelly J, Dowling A, McBride K, Keech W, Brown A Tags: Aust Health Rev Source Type: research

Future of assisted dying reform in Australia.
Abstract The Voluntary Assisted Dying Act 2017 (Vic) will come into force in June 2019, becoming the first law in Australia in 20 years to permit voluntary assisted dying (VAD). This paper considers how other Australian states and territories are likely to respond to this development. It analyses three key factors that suggest that law reform is likely to occur in other parts of Australia: (1) the growing international trend to permit VAD; (2) social science evidence about how VAD regimes operate; and (3) changes to the local political environment. The paper argues that these three factors, coupled with the effect...
Source: Australian Health Review - November 23, 2018 Category: Hospital Management Authors: White B, Willmott L Tags: Aust Health Rev Source Type: research

Improving the utility of multisource feedback for medical consultants in a tertiary hospital: a study of the psychometric properties of a survey tool.
Conclusions Overall, the 20-item multisource review survey tool showed good internal consistency reliability for both self and peer ratings; however, further investigation using a larger dataset is needed to analyse the robustness of the model and to clarify the role that a single global question may play in future multisource review processes.What is known about the topic? Defining and measuring skills and behaviours that reflect competence in the health setting have proven to be complex, and this has resulted in the development of specific multisource feedback surveys for individual medical specialities. Because little l...
Source: Australian Health Review - November 22, 2018 Category: Hospital Management Authors: Corbett H, Pearson K, Karimi L, Lim WK Tags: Aust Health Rev Source Type: research

Allied health pre-entry student clinical placement capacity: can it be sustained?
Conclusion Sustaining pre-entry student placements requires stakeholder flexibility and responsiveness and is underpinned by collaboration, information and resource sharing. Dedicated clinical education positions were highly valued and seen as a key contributor to placement sustainability.What is known about the topic? The increasing demand for student placements and strategies used to enhance placement capacity are well known. To date, there have been limited studies investigating cross-sectoral trends and health service enablers and barriers to sustaining responses to placement demand.What does this paper add? This paper...
Source: Australian Health Review - November 22, 2018 Category: Hospital Management Authors: McBride LJ, Fitzgerald C, Costello C, Perkins K Tags: Aust Health Rev Source Type: research

Transforming institutional racism at an Australian hospital.
Conclusions The health outcomes of some racial groups can be damaged by institutional racism. An external assessment tool can help hospitals and health services to change.What is known about the topic? Institutional racism theory is still developing. An external assessment tool to measure, monitor and report on institutional racism has been developed in Australia.What does this paper add? This study on institutional racism has useful propositions for healthcare organisations experiencing disparities in outcomes between racial groups.What are the implications for practitioners? The deleterious effects of institutional racis...
Source: Australian Health Review - November 21, 2018 Category: Hospital Management Authors: Bourke CJ, Marrie H, Marrie A Tags: Aust Health Rev Source Type: research

Paramedic involvement in health education within metropolitan, rural and remote Australia: a narrative review of the literature.
Conclusion This review highlights a broadening of paramedicine's traditional scope of practice, and an indication of how vital paramedics could be to local communities, particularly in rural and remote areas. An expanded role may help address health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers.What is known about the topic? A broadening of paramedicine's traditional scope of practice has been linked to improvements in health workforce sustainability problems in areas where health care provision is challenged by geographical constr...
Source: Australian Health Review - November 15, 2018 Category: Hospital Management Authors: McManamny T, Jennings PA, Boyd L, Sheen J, Lowthian JA Tags: Aust Health Rev Source Type: research

Reductions in quality of life and increased economic burden associated with mental disorders in an Australian adult sample.
Abstract Objective The aim of this study was to determine the effect of a broad range of common mental disorders and their comorbidity on health-related quality of life and functional disability.Methods In all, 2734 Australians aged ≥18 years, recruited from the general community via Facebook during August-December 2014, completed an online survey assessing demographic characteristics, nine mental disorders, suicidal ideation and attempt. Outcome measures were health-related quality of life (assessed using the Assessment of Quality of Life (AQoL)-4D measure and functional disability (days out of role).Results O...
Source: Australian Health Review - November 14, 2018 Category: Hospital Management Authors: McCallum SM, Batterham PJ, Calear AL, Sunderland M, Carragher N Tags: Aust Health Rev Source Type: research

Going digital: a narrative overview of the effects, quality and utility of mobile apps in chronic disease self-management.
Conclusion Evidence of clinical benefit of most available apps is very limited. Design features that enhance usability and maximise efficacy were identified. A provisional 'first-pass' evaluation framework is proposed that can help decide which apps should be endorsed by government agencies following more detailed technical assessments and which could then be recommended with confidence by clinicians to their patients.What is known about the topic? Smartphone health apps have attracted considerable interest from patients and health managers as a means of promoting more effective self-management of chronic diseases, which l...
Source: Australian Health Review - November 13, 2018 Category: Hospital Management Authors: Scott IA, Scuffham P, Gupta D, Harch TM, Borchi J, Richards B Tags: Aust Health Rev Source Type: research

Testimonials within health advertising in Australia: an analysis of current policy.
This article considers policy implications relating to advertising with a focus on the use of testimonials, particularly those that are online. Although there would seem to be appetite for amending the current legislative framework, there is uncertainty as to the form change may take and the effect this could have.What is known about the topic? Testimonials relating to health care are a prohibited form of advertising, but a form still used by non-regulated health providers and those who are regulated but who are either ignorant of the law or defiant of its requirements. Views are split as to whether the restriction on cons...
Source: Australian Health Review - November 2, 2018 Category: Hospital Management Authors: Holden ACL Tags: Aust Health Rev Source Type: research

Digital transformation of hospital quality and safety: real-time data for real-time action.
Abstract The Australian Commission for Safety and Quality in Health Care has created the National Safety and Quality Health Service standards that all hospitals must address in order to remain accredited. This case study details the first known digitisation of the 10 national quality and safety standards mandated in a quaternary integrated digital hospital. A team of clinical informaticians, information technology experts and clinicians was assembled. Data were chosen and the data were then extracted and validated and presented (often in near real time) in an easily consumable dashboard format with appropriate gov...
Source: Australian Health Review - November 2, 2018 Category: Hospital Management Authors: Barnett A, Winning M, Canaris S, Cleary M, Staib A, Sullivan C Tags: Aust Health Rev Source Type: research

A 5-year retrospective cohort study of unplanned readmissions in an Australian tertiary paediatric hospital.
Conclusion This study highlights the variability in the distribution of time intervals from discharge to readmission among diagnoses, suggesting the commonly used 28- or 30-day readmission measurement requires review. It is crucial to establish an appropriate measurement for specific paediatric conditions related to readmissions for the accurate determination of the prevalence and actual costs associated with readmissions.What is known about this topic? Unplanned hospital readmissions result in inefficient use of health resources. Australia has used 28 days to measure unplanned readmissions. However, the 30-day measurement...
Source: Australian Health Review - October 29, 2018 Category: Hospital Management Authors: Zhou H, Della P, Roberts P, Porter P, Dhaliwal S Tags: Aust Health Rev Source Type: research

'We can work together, talk together': an Aboriginal Health Care Home.
Conclusions For HCH to be successful, service providers need to engage with service users to identify and implement patient-centred strategies to improve access, acceptability and patient activation.What is known about the topic? Success of the Commonwealth's HCH reform is contingent on improving care access and patient activation to better manage chronic conditionsWhat does this paper add? This is the first opportunity that this Aboriginal community has had to articulate their aspirations for high quality healthcare. Beyond the strong alignment with the HCH building blocks, their care preferences posit practical and achie...
Source: Australian Health Review - October 25, 2018 Category: Hospital Management Authors: Smith G, Kirkham R, Gunabarra C, Bokmakarray V, Burgess CP Tags: Aust Health Rev Source Type: research

Shoulder pain cost-of-illness in patients referred for public orthopaedic care in Australia.
Conclusions Public orthopaedic shoulder waiting lists create a large economic burden for society; few referrals require surgery and just over half the hospital care costs are for out-patient services. New models of care that better manage shoulder pain and identify surgical candidates before orthopaedic referral could reduce this burden.What is known about the topic? Little is known about the cost of shoulder pain in Australia, or the cost of patients referred for public orthopaedic care.What does this paper add? This article quantifies the costs of shoulder pain and the value of lost production from shoulder pain. The tim...
Source: Australian Health Review - October 15, 2018 Category: Hospital Management Authors: Marks D, Comans T, Bisset L, Thomas M, Scuffham PA Tags: Aust Health Rev Source Type: research

Understanding the role of the public transport network in the greater Sydney area in providing access to dental care.
Conclusion Metropolitan Sydney has a transport system that is substantial and robust, and appears to offer relatively similar spatial accessibility for all socioeconomic groups. This system is an example of great urban planning, where the distribution of bus stops is evenly positioned in both high-density areas and areas of low socioeconomic status.What is known about the topic? Older adults and disadvantaged people suffer from higher levels of dental disease compared with the rest of the population. Older adults and disadvantaged people are more likely to rely on public transport to access healthcare services, including d...
Source: Australian Health Review - October 11, 2018 Category: Hospital Management Authors: Patel R, Tennant M, Kruger E Tags: Aust Health Rev Source Type: research

Improving health information to address low health literacy for patients with multimorbidity.
Abstract A letter to the editor in response to the recently published article by Hill and Sofra (AHR, vol. 42, no. 2, pp. 134-9) on improving health information. PMID: 30248279 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - September 25, 2018 Category: Hospital Management Authors: Jessup RL, Putrik P, Beauchamp A Tags: Aust Health Rev Source Type: research

Socioeconomic differences in access to care in Australia for women fearful of birth.
Conclusions Given the known positive outcomes of continuity of midwifery care for women fearful of birth, health policy makers need to provide equity in access to evidence-based models of midwifery care.What is known about this topic? Caseload midwifery care is considered the gold standard care due to the known positive outcomes it has for the mother and baby during the perinatal period. Pregnant women who receive caseload midwifery care are more likely to experience a normal vaginal birth.What does this paper add? There is unequal access to midwifery caseload care for women fearful of birth across socioeconomic boundaries...
Source: Australian Health Review - September 25, 2018 Category: Hospital Management Authors: Toohill J, Callander E, Fox H, Lindsay D, Gamble J, Creedy D, Fenwick J Tags: Aust Health Rev Source Type: research

Simulation of health care and related costs in people with dementia in Australia.
Conclusions This simulation provides useful estimates of the potential future costs that will be borne for people with dementia and allows the exploration of the effects of capacity constraints on these costs. The model demonstrates that the level of real annual per capita growth in health and social expenditure has significant implications for the future sustainability of dementia care in Australia.What is known about the topic? With the aging of the Australian population, the number of people living with dementia is predicted to rise markedly in the next four decades. As the number of people living with dementia increase...
Source: Australian Health Review - September 24, 2018 Category: Hospital Management Authors: Standfield L, Comans T, Scuffham PA Tags: Aust Health Rev Source Type: research

Physiotherapy clinical education in Australia: an exploration of clinical educator characteristics, confidence and training requirements.
Abstract Objectives The aim of this study was to describe physiotherapists' involvement, confidence and training needs in the provision of student clinical education (CE) in Australia.Methods A valid and reliable cross-sectional online survey instrument was used to collect data from physiotherapists employed in public and private healthcare facilities in Australia. Survey questions included participant personal and professional characteristics, participation in CE-related continuing professional development (CPD) and confidence in components of CE.Results In all, 170 (34%) physiotherapists (mean age 37 years; mean...
Source: Australian Health Review - September 18, 2018 Category: Hospital Management Authors: Newstead C, Johnston CL, Nisbet G, McAllister L Tags: Aust Health Rev Source Type: research

Multicriteria decision analysis (MCDA) for health technology assessment: the Queensland Health experience.
Conclusions This pilot application of an MCDA framework, as a complement to committee deliberation, conferred greater transparency and objectivity on HTA assessment of technologies. The framework converted an implicit, unweighted review process to one that is more explicit, flexible in weighting importance and pragmatic.What is known about the topic? HTA programs involve complex decision-making processes requiring the consideration of multiple criteria. Explicit methods of analysis that use weighted criteria according to their relative importance enhance transparency and consistency of decision making by HTA committees, an...
Source: Australian Health Review - September 12, 2018 Category: Hospital Management Authors: Howard S, Scott IA, Ju H, McQueen L, Scuffham PA Tags: Aust Health Rev Source Type: research

Health justice partnerships: a promising model for increasing access to justice in health services.
Abstract Many people experience legal issues that affect their health, but do not seek legal help, particularly if they are disadvantaged in some way. This may be because they do not recognise they have a legal problem, they are unwilling or unable to address it, or they do not know how to go about dealing with it. Most people seek health care at some point, so linking health and legal services may help promote access to justice. There have been ongoing efforts in Australia to link health and law services, such as through co-locating health and legal services or through running legal 'clinics' in health services, ...
Source: Australian Health Review - September 10, 2018 Category: Hospital Management Authors: Lewis V, Adamson L, Hawthorne F Tags: Aust Health Rev Source Type: research

Emergency department models of care in Queensland: a multisite cross-sectional study.
Conclusion There is considerable variability in the MOC used throughout EDs in Queensland. A more complete analysis of the relative effectiveness of different MOC either in isolation or as part of a comprehensive approach would help inform more consistent MOC in Queensland EDs.What is known about the topic? MOC in any given ED are implemented in response to factors such as the geographical location of the hospital, hospital-specific characteristics and service profile, staffing profile and patient demographic profile. In the era of time-based targets, they may also serve to address a particular aspect of flow in the face o...
Source: Australian Health Review - September 7, 2018 Category: Hospital Management Authors: Bell A, Toloo GS, Crilly J, Burke J, Williams G, McCann B, FitzGerald G Tags: Aust Health Rev Source Type: research

Stakeholder perceptions on resident-to-resident aggression: implications for prevention.
Conclusion The research demonstrates that understanding perceptions of RRA among key stakeholders is critical to identifying the nature and scope of the problem and to developing and implementing appropriate prevention strategies.What is known about the topic? RRA is common in nursing homes, with potentially fatal consequences for residents involved, and has serious implications for nursing home staff, managers, providers, and regulators. Despite this, the prevalence, impact, and prevention of RRA remains under-recognised and under-researched in Australia.What does this paper add? This is the first Australian study to prod...
Source: Australian Health Review - September 6, 2018 Category: Hospital Management Authors: Jain B, Willoughby M, Winbolt M, Lo Giudice D, Ibrahim J Tags: Aust Health Rev Source Type: research