Analysis of uncertainty in the surgical department: durations, requests and cancellations.
Conclusions The analysis presented herein can be used to ensure that assumptions surrounding planning and scheduling in the surgical department are valid. Understanding the stochasticity in the surgical department may result in the implementation of more realistic decision models.What is known about the topic? Many surgical departments rely on crude estimates and general intuition to predict surgical duration, surgical requests (both elective and non-elective) and cancellations.What does this paper add? This paper describes how statistical analysis can be performed to validate common assumptions surrounding surgical uncert...
Source: Australian Health Review - September 6, 2018 Category: Hospital Management Authors: Spratt B, Kozan E, Sinnott M Tags: Aust Health Rev Source Type: research

Cost of vascular access devices in public hospitals in Queensland.
Conclusion Vascular access is an important component of healthcare expenditure. The present study is the first to characterise and cost vascular access devices in Queensland. Further research is needed on the costs of maintaining device function and of treating complications associated with vascular access.What is known about the topic? The cost of vascular access in Australia has previously been estimated from modelling, using various assumptions, or based on device utilisation in other countries.What does this paper add? For the first time, device utilisation for vascular access in Queensland has been quantified and cost...
Source: Australian Health Review - September 4, 2018 Category: Hospital Management Authors: Tuffaha HW, Marsh N, Byrnes J, Gavin N, Webster J, Cooke M, Rickard CM Tags: Aust Health Rev Source Type: research

Cost impact of high staff turnover on primary care in remote Australia.
Abstract Objectives The aim of this study was to estimate the costs of providing primary care and quantify the cost impact of high staff turnover in Northern Territory (NT) remote communities.Methods This cost impact assessment used administrative data from NT Department of Health datasets, including the government accounting system and personnel information and payroll systems between 2004 and 2015, and the primary care information system from 2007 to 2015. Data related to 54 government-managed clinics providing primary care for approximately 27200 Aboriginal and non-Aboriginal people. Main outcome measures were ...
Source: Australian Health Review - August 30, 2018 Category: Hospital Management Authors: Zhao Y, Russell DJ, Guthridge S, Ramjan M, Jones MP, Humphreys JS, Wakerman J Tags: Aust Health Rev Source Type: research

Realist evaluation of allied health management in Queensland: what works, in which contexts and why.
Conclusions The initial middle range theory of allied health organisational structures in Queensland was supported and extended to better understand which contexts were important and which key mechanisms were activated to achieve effective outcomes. Executive allied health leadership roles enable allied health leaders to use their influence in organisational planning and decision-making to ensure allied health professionals deliver successful patient care services. Professional governance systems embed the management and support of the clinical workforce most efficiently within professional disciplines. With consistent dat...
Source: Australian Health Review - August 30, 2018 Category: Hospital Management Authors: Mickan S, Dawber J, Hulcombe J Tags: Aust Health Rev Source Type: research

Analysing aggregate clinical data to support evaluation of the Tackling Indigenous Smoking program, 2014-16.
Abstract Objective The aim of this study was to assess the change in recording of client population smoking attributes (smoking status recorded and smoking status) in Tackling Indigenous Smoking (TIS)-funded services compared with non-funded services for Aboriginal and Torres Strait Islander people, 2014-16.Methods The study included a cohort of 152 Aboriginal-community controlled services with aggregate client smoking data from 2014 to 2016. Negative binomial regression was used to assess change in smoking status recorded and smoking status between TIS and non-TIS funded organisations. The models controlled for s...
Source: Australian Health Review - August 28, 2018 Category: Hospital Management Authors: Wright A, Cameron H, Roe Y, Lovett R Tags: Aust Health Rev Source Type: research

Therapeutic equivalence program: continued economic benefits in the context of rising costs and increased demand.
Conclusions This paper provides an update on the progress of the TEP at Monash Health and outlines additional learnings gained. The market dynamics for pharmaceuticals means ongoing maintenance and review of the therapeutic medicine classes targeted is important to enable continued economic benefits.What is known about the topic? There is continued and increasing focus on efficient, cost-effective and financially sustainable medication management. There is limited information available on strategies that can be implemented at a health service level.What does this paper add? The TEP has resulted in sustained savings. The ma...
Source: Australian Health Review - August 27, 2018 Category: Hospital Management Authors: Chynoweth T, Larmour I Tags: Aust Health Rev Source Type: research

Recent trends in the use of linked data in Australia.
Conclusions Investment in Australian data linkage infrastructure has seen an increase in the number of research publications involving the use of linked health and human services data. This study identified areas where linked data is commonly used and those where use could be improved.What is known about the topic? Data linkage is a method of bringing together information about individual people, places and events from different sources in a way that protects individual privacy. Individual jurisdictions have reported benefits from research conducted using linked data, including the generation of new knowledge and supportin...
Source: Australian Health Review - August 27, 2018 Category: Hospital Management Authors: Young A, Flack F Tags: Aust Health Rev Source Type: research

Is capital investment in Australian hospitals effectively funding patient access to efficient public hospital care?
Conclusion Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care.What is known about the topic? Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving eff...
Source: Australian Health Review - August 23, 2018 Category: Hospital Management Authors: Kerr R, Hendrie DV Tags: Aust Health Rev Source Type: research

Factors that contribute to high-quality clinical supervision of the rural allied health workforce: lessons from the coalface.
Conclusions High-quality clinical supervision is essential to achieve quality and safety of health care, as well as to support the health workforce. Information on high-quality clinical supervision identified in this study can be applied to clinical supervision practices in rural and remote settings, and to professional support policies and training to enhance the quality of supervision.What is known about the topic? There is mounting evidence on the benefits of clinical supervision to health professionals, organisations and patients. Clinical supervision enhances recruitment and retention of the health workforce. However,...
Source: Australian Health Review - August 23, 2018 Category: Hospital Management Authors: Martin P, Baldock K, Kumar S, Lizarondo L Tags: Aust Health Rev Source Type: research

Infection prevention quality indicators in aged care: ready for a national approach.
Abstract Accreditation standards for Australian aged care homes include the requirement for programs to ensure infections are controlled. Effective infection prevention programs are supported by surveillance data providing the impetus for quality improvement and facilitating evaluation of interventions at the facility level. In 2016, infection control professionals employed in Victorian public-sector residential aged care services were surveyed to examine the nature and resourcing of local infection prevention programs and monitoring activities. Overall, 164 services participated (90% response rate). A high propor...
Source: Australian Health Review - August 21, 2018 Category: Hospital Management Authors: Bennett NJ, Bradford JM, Bull AL, Worth LJ Tags: Aust Health Rev Source Type: research

Factors affecting the performance of public out-patient services.
Conclusion. Strategies to address the five core domains identified may provide a framework for sustainable improvement in the delivery of out-patient services.What is known about the topic? The provision of specialist out-patient services is an essential element of health service delivery. Access to specialist services in the public sector is challenging because of the escalating demand associated with an increasing and aging demographic. The factors that may affect the delivery of out-patient services need to be addressed for long-term sustainable improvement.What does this paper add? This paper provides a conceptual fram...
Source: Australian Health Review - August 20, 2018 Category: Hospital Management Authors: Naiker U, FitzGerald G, Dulhunty JM, Rosemann M Tags: Aust Health Rev Source Type: research

Participation in Hospital in the Home for patients in inner metropolitan Sydney: implications for access and equity.
Conclusion Data analysis through an equity lens can effectively identify who is accessing health services and who is missing out. Further analysis is required to understand patient and system barriers to accessing HITH.What is known about the topic? Advances in medical and surgical treatments and pharmaceuticals reduce the need for in-patient hospitalisation. For some conditions, home-based treatment is safer, cheaper and preferable to the patient and carers, particularly some older people who may experience deteriorating cognitive and physical functioning related to hospitalisation. It is well known that health and access...
Source: Australian Health Review - August 20, 2018 Category: Hospital Management Authors: Page J, Comino E, Burgess M, Cullen J, Harris E Tags: Aust Health Rev Source Type: research

Developing key performance indicators for a tertiary children's hospital network.
Conclusion Developing a KPI suite requires substantial time, effort and organisational courage. A structured approach to performance measurement and improvement is needed to ensure a balanced suite of KPIs that can be expected to drive an organisation to improve child health outcomes. Future directions for SCHN include a systematic approach to implementation beyond the mandated KPIs, including KPIs that reflect equity and improved outcomes for priority populations, development of meaningful measures for the aspirational KPIs, adding structure KPIs and measurement of changes in child health outcomes related to the developme...
Source: Australian Health Review - August 20, 2018 Category: Hospital Management Authors: Elliot C, Mcullagh C, Brydon M, Zwi K Tags: Aust Health Rev Source Type: research

Framework for better care: reconciling approaches to patient safety and quality.
Abstract In September 2017, the Royal Australasian College of Medical Administrators adopted a new clinical governance framework that recognised healthcare as a complex adaptive system, and embraced the need for resilient thinking and understanding the differences between work-as-imagined by managers and work-as-done at the front line of patient care. Directors of medical services may soon be implementing the framework in health services across Australia. This perspective describes a new conceptual model that underpins the Royal Australasian College of Medical Administrators framework, and characterises the challe...
Source: Australian Health Review - August 16, 2018 Category: Hospital Management Authors: Johnson A, Clay-Williams R, Lane P Tags: Aust Health Rev Source Type: research

Resuscitation status in psychogeriatric and general medical inpatients aged 65 years and older: a retrospective comparison study.
Conclusions Resuscitation orders were more frequently documented on the psychogeriatric unit. Further prospective analysis is needed of how resuscitation orders are made before depression is discounted as a predictor of end-of-life decision-making.What is known about the topic? Despite increased community, media and research attention to end-of-life decision-making, resuscitation preferences of older patients are often poorly documented. Existing research into patient clinical and demographic factors that influence end-of-life decision-making have largely focused on general medical rather than psychogeriatric settings. The...
Source: Australian Health Review - August 14, 2018 Category: Hospital Management Authors: Hill J, Gerace A, Oster C, Ullah S Tags: Aust Health Rev Source Type: research

Should endometriosis be managed within a chronic disease framework? An analysis of national policy documents.
Conclusion In Australia, long-term and complex conditions are managed within a chronic disease framework and include mechanisms such as chronic disease management plans (CDMPs) to assist with coordination and management of these conditions. Because endometriosis has most of the characteristics of chronic disease, it could potentially be reframed as a chronic disease in endometriosis clinical practice guidelines and consensus statements. Further, the use of CDMPs may provide a mechanism to promote individualised care and multidisciplinary management of this chronic, enigmatic and debilitating disease.What is known about the...
Source: Australian Health Review - August 10, 2018 Category: Hospital Management Authors: O'Hara R, Rowe H, Roufeil L, Fisher J Tags: Aust Health Rev Source Type: research

Review of methods and study designs of evaluations related to clinical pathways.
Conclusions Clinical pathways evaluations commonly use pragmatic study designs, straightforward statistical tests and cost-consequence analyses. More HealthPathways program evaluations focused on patient and economic outcomes, clinical pathway evaluations in a primary care setting and cost-effectiveness analyses of clinical pathways are needed.What is known about the topic? HealthPathways is a web-based program that originated from Canterbury, New Zealand, and has seen uptake elsewhere in New Zealand, Australia and the UK. The HealthPathways program aims to assist the provision of consistent and integrated health services ...
Source: Australian Health Review - August 9, 2018 Category: Hospital Management Authors: Lee XJ, Blythe R, Choudhury AAK, Simmons T, Graves N, Kularatna S Tags: Aust Health Rev Source Type: research

Preventable hospitalisations in regional Queensland: potential for primary health?
Conclusions High hospitalisation rates and costs for common preventable chronic conditions represent opportunities for primary healthcare interventions. In particular, community-level health services need to be more responsive to the needs of local Indigenous families.What is known about the topic? PPH rates are used as a measure of timely access to quality primary health care, and are incrementally higher in regional and remote areas than in major cities. Investment in primary healthcare services has been shown to significantly reduce costs associated with avoidable hospitalisations.What does this paper add? This study us...
Source: Australian Health Review - August 3, 2018 Category: Hospital Management Authors: Harriss LR, Thompson F, Lawson K, Loughlin MO, McDermott R Tags: Aust Health Rev Source Type: research

Diagnosis of dementia in Australia: a narrative review of services and models of care.
Conclusion Memory clinics are most effective for formal dementia diagnosis, but healthcare professionals in other settings play vital roles in recognising patients with dementia and initiating investigations and referrals to appropriate services.What is known about this topic? Delays in dementia diagnosis are common, and it is unclear where majority of patients receive a diagnosis of dementia in Australia. While the Australian Clinical Practice Guidelines and Principles of Care for People with Dementia advocate referrals to services such as memory clinics for comprehensive assessment and diagnosis of dementia, such service...
Source: Australian Health Review - July 27, 2018 Category: Hospital Management Authors: Ng NSQ, Ward SA Tags: Aust Health Rev Source Type: research

Scoping review of claimants' experiences within Australian workers' compensation systems.
Conclusions There are common difficulties that injured workers experience within Australian workers' compensation systems that are reported to impede rehabilitation and return to work. A less harmful, more cooperative approach to worker rehabilitation and compensation is needed.What is known about the topic? Different workers' compensation systems exist throughout Australia. Little is known about injured workers' perceptions of their experiences within these systems in Australia and whether these experiences are similar or different across systems.What does this paper add? This scoping review synthesises available evidence...
Source: Australian Health Review - July 23, 2018 Category: Hospital Management Authors: Dean AM, Matthewson M, Buultjens M, Murphy G Tags: Aust Health Rev Source Type: research

Assessing concordance between patient preferences in advance care plans and in-hospital care.
Abstract Objective The aims of this study were to assess: (1) concordance between patient preferences stated in advance care plans (ACPs) and hospital care over the subsequent 12 months; (2) change in preferences over time; (3) justifications for discordant care; and (4) effects of ACP completion on hospital utilisation.Methods A retrospective study was conducted of 198 patients with an ACP form registered with an ACP registry and tagged with a hospital unique record number. Data collected from ACP forms and hospital records comprised ACP completion and revisions, care preferences, patient characteristics and hosp...
Source: Australian Health Review - July 23, 2018 Category: Hospital Management Authors: Oo NM, Scott IA, Maggacis R, Rajakaruna N Tags: Aust Health Rev Source Type: research

Health literacy education for rural health professionals: shifting perspectives.
Abstract Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants' change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy...
Source: Australian Health Review - July 23, 2018 Category: Hospital Management Authors: Finlay S, Meggetto E, Robinson A, Davis C Tags: Aust Health Rev Source Type: research

Clinical engagement: a new concept or common sense all round?
Abstract Clinical engagement has supplemented clinical governance in healthcare to strengthen the contribution of medical professionals to the assessment of clinical outcomes for patients. Assessments of clinical engagement have, until now, been qualitative; this case study introduces the concept of quantitative assessment of clinical engagement by measuring the number of patients managed according to specialist society guidelines. Such an assessment engages all staff (medical, nursing, allied health and pharmacy) involved in patients receiving treatment according to such guidelines and provides an assessment of i...
Source: Australian Health Review - July 19, 2018 Category: Hospital Management Authors: Bolsin S, Carter J, Kitson A, Walter D, Roberts S Tags: Aust Health Rev Source Type: research

How do health consumer organisations in Australia manage pharmaceutical industry sponsorship? A cross-sectional study.
Conclusion Industry-funded health consumer organisations in Australia have low transparency when reporting industry funding and few have policies governing corporate sponsorship. Relationships between health consumer organisations and the industry require effective actions to minimise the risks of undue influence.What is known about this topic? Pharmaceutical industry funding of health consumer organisations is common in the US and Europe, yet only a minority of such organisations publicly disclose this funding and have policies regulating their relationships with industry.What does this paper add? Industry-funded health c...
Source: Australian Health Review - July 19, 2018 Category: Hospital Management Authors: Lau E, Fabbri A, Mintzes B Tags: Aust Health Rev Source Type: research

Disparities in access to health care in Australia for people with mental health conditions.
Abstract Objective One aim of Australia's Equally Well National Consensus Statement is to improve monitoring of the physical health of people with mental health conditions, which includes measures of accessibility and people's experiences of physical health care services. The present analysis contributes to this aim by using population survey data to evaluate whether, and in what domains, Australians with a mental health condition experience barriers in accessing care when compared with Australians without a mental health condition.Methods The 2016 Commonwealth Fund International Health Policy Survey includes a sa...
Source: Australian Health Review - July 17, 2018 Category: Hospital Management Authors: Corscadden L, Callander EJ, Topp SM Tags: Aust Health Rev Source Type: research

Effects of eHealth on hospital practice: synthesis of the current literature.
Conclusion This overview can help inform other hospitals in Australia and elsewhere of the likely effects resulting from eHealth technologies. The findings suggest that the effects of these systems are largely mixed, but there are positive findings, which encourage ongoing digital transformation of hospital practice.What is known about the topic? Governments are increasingly devoting substantial resources towards implementing eHealth technologies in hospital practice with the goals of improving clinical and financial outcomes. Yet, these outcomes are yet to be fully realised in practice and conflicting findings are often r...
Source: Australian Health Review - July 10, 2018 Category: Hospital Management Authors: Eden R, Burton-Jones A, Scott I, Staib A, Sullivan C Tags: Aust Health Rev Source Type: research

Sharing the pain: lessons from missed opportunities for healthcare improvement from patient complaints and litigation in the Australian health system.
Abstract Learning from medical errors to prevent their recurrence is an important component of any healthcare system's quality and safety improvement functions. Traditionally, this been achieved principally from review of adverse clinical outcomes. The opportunity to learn systematically and in a system manner from patient complaints and litigation has been less well harnessed. Herein we describe the pathways and processes for both patient complaints and medicolegal claims in Victoria, and Australia more broadly, and assess the potential for these to be used for system improvement. We conclude that both patient co...
Source: Australian Health Review - June 19, 2018 Category: Hospital Management Authors: Nowotny BM, Loh E, Lorenz K, Wallace EM Tags: Aust Health Rev Source Type: research

Health status of people who have provided informal care or support to an adult with chronic disease in the last 5 years: results from a population-based cross-sectional survey in South Australia.
Conclusions Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers.What is known about the topic? Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers.What does this paper add? Including recent as well as current carers in a ...
Source: Australian Health Review - June 14, 2018 Category: Hospital Management Authors: Luckett T, Agar M, DiGiacomo M, Ferguson C, Lam L, Phillips J Tags: Aust Health Rev Source Type: research

Combining participatory action research and appreciative inquiry to design, deliver and evaluate an interdisciplinary continuing education program for a regional health workforce.
Conclusion. ICE programs enhance interdisciplinary collaboration. However, attendance constraints for regional healthcare workforce include location, cost, workplace and personal factors. Through community engagement, resource sharing and cooperation, a local university and the interdisciplinary focus group members successfully designed and delivered the local education and research nexus program to address a CE problem for a regional healthcare workforce.What is known about the topic? Participation in CE is mandatory for most health professionals. However, various barriers exist for regional health workers to attending CE...
Source: Australian Health Review - June 12, 2018 Category: Hospital Management Authors: Martyn JA, Scott J, van der Westhuyzen JH, Spanhake D, Zanella S, Martin A, Newby R Tags: Aust Health Rev Source Type: research

Datasets collected in general practice: an international comparison using the example of obesity.
The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data so...
Source: Australian Health Review - June 4, 2018 Category: Hospital Management Authors: Sturgiss E, van Boven K Tags: Aust Health Rev Source Type: research

Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.
Abstract Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this,
Source: Australian Health Review - May 29, 2018 Category: Hospital Management Authors: Naccarella L, Biuso C, Jennings A, Patsamanis H Tags: Aust Health Rev Source Type: research

Going digital: a checklist in preparing for hospital-wide electronic medical record implementation and digital transformation.
Conclusion This evidence-based, field-tested checklist provides guidance to hospitals planning EMR implementation and separates readiness for EMR from readiness for digital transformation.What is known about the topic? Many hospitals throughout Australia have implemented, or are planning to implement, hospital wide electronic medical records (EMRs) with varying degrees of functionality. Few hospitals have implemented a complete end-to-end digital system with the ability to bring about major transformation in clinical care. Although the many challenges in implementing EMRs have been well documented, they have not been incor...
Source: Australian Health Review - May 24, 2018 Category: Hospital Management Authors: Scott IA, Sullivan C, Staib A Tags: Aust Health Rev Source Type: research

Widening participation of M āori and Pasifika students in health careers: evaluation of two health science academies.
Conclusions Health science academies show promise as an innovative approach to supporting Māori and Pasifika students prepare for a career in the health professions. Evaluating the long-term outcomes of the academies is required to determine their contribution to addressing inequities in the local health workforce.What is known about the topic? Despite progress in health workforce participation for underrepresented indigenous and ethnic minority groups in New Zealand, significant disparities persist. Within this context, a workforce development pipeline that targets preparation of secondary school students is recommended ...
Source: Australian Health Review - May 24, 2018 Category: Hospital Management Authors: Middleton L, Tanuvasa AF, Pledger M, Grace N, Smiler K, Loto-Su'a TT, Cumming J Tags: Aust Health Rev Source Type: research

Building capacity for change: evaluation of an organisation-wide leadership development program.
Conclusion. Although conducted during a period of intense internal and external pressure, Leading 4 Change led to demonstrable effects. It effectively engaged middle managers across a health system. However, there was no evidence that the effect of the program extended beyond individual participants to their perceptions of their work environment as a learning organisation.What is known about the topic? Although much has been written about change management and change leadership within healthcare, the failure to manage the 'people' element and engage employees hampers the success of that change. However, how to engage emplo...
Source: Australian Health Review - May 23, 2018 Category: Hospital Management Authors: Schultz T, Shoobridge J, Harvey G, Carter L, Kitson A Tags: Aust Health Rev Source Type: research

General practitioners' views on the influence of cost on the prescribing of asthma preventer medicines: a qualitative study.
Conclusion The results suggest that financial incentives, such as lower patient copayments, would be unlikely to encourage GPs to preferentially prescribe ICS alone, unless accompanied by other strategies, including evidence for clinical effectiveness. GPs should be encouraged to discuss cost barriers to treatment with patients when considering treatment choices.What is known about the topic? Australian guidelines recommend that most patients with asthma should be treated with low-dose ICS alone to minimise symptom burden and risk of flare ups. However, most patients in Australian general practice are instead prescribed co...
Source: Australian Health Review - May 14, 2018 Category: Hospital Management Authors: Tudball J, Reddel HK, Laba TL, Jan S, Flynn A, Goldman M, Lembke K, Roughead E, Marks GB, Zwar N Tags: Aust Health Rev Source Type: research

Comparison of health literacy in privately insured and public hospital orthopaedic patients.
Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review.What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including increased ...
Source: Australian Health Review - May 14, 2018 Category: Hospital Management Authors: Cosic F, Porter T, Norsworthy C, Price R, Bedi H Tags: Aust Health Rev Source Type: research

Review of medication errors that are new or likely to occur more frequently with electronic medication management systems.
Conclusions. Although the results suggest that the errors reported were of low severity, organisations must remain vigilant to the risk of new errors and avoid the assumption that eMMS is the panacea to all medication error issues.What is known about the topic? eMMS have been shown to reduce some types of medication errors, but it has been reported that some new medication errors have been identified and some are likely to occur more frequently with eMMS. There are few published Australian studies that have reported on medication error types that are likely to occur more frequently with eMMS in more than one organisation a...
Source: Australian Health Review - May 14, 2018 Category: Hospital Management Authors: Van de Vreede M, McGrath A, de Clifford J Tags: Aust Health Rev Source Type: research

Healthcare in a carbon-constrained world.
Conclusions These ideas represent potentially low-carbon models of care. The next step would be to pilot and measure the outcomes (health, environmental, financial) of these models.What is known about the topic? The health sector needs to reduce its large carbon footprint. Traditional 'green' initiatives, such as recycling and improving energy efficiency, are insufficient to achieve the scale of decarbonisation required.What does this paper add? Healthcare thought leaders surveyed in the present study suggested that we also consider other, non-traditional ways to achieve environmental sustainability. In this paper we discu...
Source: Australian Health Review - May 7, 2018 Category: Hospital Management Authors: Charlesworth KE, Jamieson M Tags: Aust Health Rev Source Type: research

Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥ 45 years.
Conclusions Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. A review of the open disclosure guidelines in relation to the types of adverse events that require formal open disclosure and those more suitable to informal bedside disclosure is indicated. Guidelines for bedside disclosure should be drafted to assist medical practitioners and other health professionals facilitate and improve their communications about adverse even...
Source: Australian Health Review - April 26, 2018 Category: Hospital Management Authors: Walton M, Harrison R, Smith-Merry J, Kelly P, Manias E, Jorm C, Iedema R Tags: Aust Health Rev Source Type: research

Community views on factors affecting medicines resource allocation: cross-sectional survey of 3080 adults in Australia.
Conclusions These results provide useful information about public preferences for government spending on prescribed medicines. Understanding of public preferences on the funding of new medicines will help the Pharmaceutical Benefits Advisory Committee and government determine circumstances where greater emphasis on equity is required and help inform medicines funding policy that best meets the needs of the Australian population.What is known about this topic? There is increased recognition of the importance of taking into account public preferences in the heath technology assessment (HTA) decision-making process.What does ...
Source: Australian Health Review - April 19, 2018 Category: Hospital Management Authors: Chim L, Salkeld G, Kelly PJ, Lipworth W, Hughes DA, Stockler MR Tags: Aust Health Rev Source Type: research

Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals.
Conclusions There is a need to develop an evidence-based nurse-sensitive outcomes measure upon which staffing for safety, quality and workplace equity, as well as an instrument that reliability and validly projects nurse staffing requirements in a variety of clinical settings. Nurse-sensitive indicators reflect elements of patient care that are directly affected by nursing practice In addition, these measures must take into account patient satisfaction, workload and staffing, clinical risks and other measures of the quality and safety of care and nurses' work satisfaction. i.What is known about the topic? Nurse staffing is...
Source: Australian Health Review - April 17, 2018 Category: Hospital Management Authors: Olley R, Edwards I, Avery M, Cooper H Tags: Aust Health Rev Source Type: research

Partnering with consumers in the public reporting of quality of care: review of the Victorian quality of care reports.
Conclusion Overall, the present study demonstrated mixed findings and, in some cases, lower scores for the 2014 reports, which was after the introduction of the Partnering with Consumers NSQHS standard, compared with the 2011 reports. Overall, there is future scope to enhance the degree of consumer participation evident within the quality of care reports.What is known about the topic? Partnering with consumers has been associated with improved clinical outcomes, decreased readmission rates and rates of hospital-acquired infections, and improved adherence to treatment recommendations and health literacy. Engaging consumers ...
Source: Australian Health Review - March 23, 2018 Category: Hospital Management Authors: Zaga C, Leggat S, Hill S Tags: Aust Health Rev Source Type: research

Does the professional attitude of physicians always affect their professional behaviour? A survey in tertiary hospitals in Nanchang City, China.
Conclusions Professional attitude affects professional behaviour, but such an effect varies with different professional norms. These findings imply that improving the professional attitude is useful but insufficient to promote medical professionalism. A management system conducive to the conversion of professional attitude to professional behaviour should be established.What is known about the topic? Several studies have affirmed that Chinese physicians accept most areas of medical professionalism embodied in the Charter on Medical Professionalism. However, only a few published studies have examined the effect of professio...
Source: Australian Health Review - March 23, 2018 Category: Hospital Management Authors: Wang X, Wang X, Du X, Du X, Liu C, Liu C, Zhang X, Zhang X Tags: Aust Health Rev Source Type: research

Medicare needs to consider banning harmful knee osteoarthritis treatments, not effective ones.
PMID: 29555016 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - March 20, 2018 Category: Hospital Management Authors: Orchard JW, Orchard JJ Tags: Aust Health Rev Source Type: research

Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service.
Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered.What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver c...
Source: Australian Health Review - March 2, 2018 Category: Hospital Management Authors: Wotherspoon C, Williams CM Tags: Aust Health Rev Source Type: research

Relative contribution of overweight and obesity to rising public hospital in-patient expenditure in South Australia.
Conclusions The relatively minor contribution of overweight and obesity to expenditure growth over the time period examined invites reflection on arguments to boost preventive spending that centre upon reducing hospital costs. These arguments may inadvertently detract attention from the considerable health and social burdens of overweight and obesity and from unrelated sources of expenditure growth that reduce opportunities for state governments to fund obesity prevention programs despite their comparative benefits to population health.What is known about the topic? Stand-alone estimates suggest that overweight and obesity...
Source: Australian Health Review - February 22, 2018 Category: Hospital Management Authors: Larg A, Moss JR, Spurrier N Tags: Aust Health Rev Source Type: research

Bullying and sexual harassment of junior doctors in New South Wales, Australia: rate and reporting outcomes.
Conclusions The findings suggest that interventions targeted at the level of junior doctors to improve the culture of bullying and harassment in medicine are unlikely to be helpful. Different approaches that address the problem in a more systemic way are needed, as is further research about the effectiveness of such interventions.What is known about the topic? Bullying and sexual harassment are common workplace experiences in the medical profession.What does this paper add? Over half the junior doctors in the present study experienced bullying and nearly one-fifth experienced sexual harassment. Junior doctors are reluctant...
Source: Australian Health Review - February 16, 2018 Category: Hospital Management Authors: Llewellyn A, Karageorge A, Nash L, Li W, Neuen D Tags: Aust Health Rev Source Type: research

Towards a strategy for clinical quality registries in Australia.
Abstract The healthcare value of Australian clinical quality registries (CQRs) has recently been highlighted by the Australian Commission of Safety and Quality in Health Care (ACSQHC) as being similar to the benefits of CQRs reported internationally. However, the development of CQRs in Australia is currently limited by a lack of coordination and strategic planning, leading to governance and funding processes that are varied and non-sustainable. Despite this, Australia has achieved recognised success with exemplar clinical registries where funding has been sustained at least partly by public funds. To this end, Aus...
Source: Australian Health Review - February 8, 2018 Category: Hospital Management Authors: Ahern S, Evans S, Hopper I, Zalcberg J Tags: Aust Health Rev Source Type: research

HealthPathways improving access to care.
Conclusions HPW has the potential to improve patient management and health outcomes, and use of HPW is increasing over time.What is known about the topic? Initiatives such as HPW are viewed positively by clinicians and have the potential to address challenges at the primary-secondary care interface, specifically, referral to secondary specialists.What does this paper add? Proof of concept that the ongoing availability of localised HPW for common clinical conditions improves GP usage of HPW and has increased access to HPW as the first source of clinical information. Benefits and barriers to use have been identified.What are...
Source: Australian Health Review - February 8, 2018 Category: Hospital Management Authors: Gill SD, Mansfield S, McLeod M, von Treuer K, Dunn M, Quirk F Tags: Aust Health Rev Source Type: research

Cost analysis of an integrated aged care program for residential aged care facilities.
Conclusions The ACE service supported a reduction in avoidable ED presentations and ambulance transfers among RACF residents. It generated a cost saving to health service providers, allowing reallocation of healthcare resources.What is known about the topic? Residents from RACFs are at risk of further deterioration when admitted to hospital, with high rates of delirium, falls, and medication errors. For this cohort, some conditions can be managed in the RACF without hospital transfer. By addressing avoidable presentations to EDs there is an opportunity to improve ED efficiency as well as providing care that is consistent w...
Source: Australian Health Review - February 1, 2018 Category: Hospital Management Authors: Ling R, Searles A, Hewitt J, Considine R, Turner C, Thomas S, Thomas K, Drinkwater K, Higgins I, Best K, Conway J, Hullick C Tags: Aust Health Rev Source Type: research