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

Comparison of specialist and generalist care.
Conclusions Compared with speciality care, general medicine units can safely and efficiently care for patients presenting to hospital with community-acquired pneumonia.What is known about the topic? Within the narrow range of any specific disease, generalist medical services are often cited as inferior in performance compared with a speciality service. This has implications for hospital resourcing, including both staffing and ward allocation.What does this paper add? This paper demonstrates that most patients admitted with a principal diagnosis of community-acquired pneumonia were admitted to a generalist unit and did not ...
Source: Australian Health Review - February 1, 2018 Category: Hospital Management Authors: Horwood CM, Hakendorf P, Thompson CH Tags: Aust Health Rev Source Type: research

Associations between clinical indicators of quality and aged-care residents.
Abstract Objectives To ascertain Australian multistate prevalence and incidence of five commonly collected clinical indicators of aged-care home quality and to measure associations between these clinical indicators and levels of care needs and consumer and staff satisfaction.Methods A retrospective analysis of national audit data collected from 426 facilities between 2015 and 2016 was performed. Regression models were used to examine associations between five clinical indicators (falls, pressure injury, physical restraint, unplanned weight loss and polypharmacy) and level of care needs measured by the Aged Care Fu...
Source: Australian Health Review - January 16, 2018 Category: Hospital Management Authors: Jeon YH, Casey AN, Vo K, Rogers K, Poole B, Fethney J Tags: Aust Health Rev Source Type: research

Improving the efficacy of healthcare services for Aboriginal Australians.
Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians.What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy.What does this pap...
Source: Australian Health Review - January 16, 2018 Category: Hospital Management Authors: Gwynne K, Jeffries T, Lincoln M Tags: Aust Health Rev Source Type: research

Repositioning interprofessional education from the margins to the centre of Australian health professional education ? what is required?
Conclusion This paper outlines the design of an innovative approach to national IPE governance and development. It explores how ideas drawn from sociocultural theories were used to guide the choice of methods and to enrich data analysis. Finally, the paper reflects on the implications of CRS findings for health professional education, workforce development and the future of Australian IPE.What is known about the topic? IPE to enable the achievement of interprofessional and collaborative practice capabilities is widely accepted and promoted. However, many problems exist in embedding and sustaining IPE as a system-wide eleme...
Source: Australian Health Review - January 16, 2018 Category: Hospital Management Authors: Dunston R, Forman D, Thistlethwaite J, Steketee C, Rogers GD, Moran M Tags: Aust Health Rev Source Type: research

A feasible model for early intervention for high-risk substance use in the emergency department setting.
Conclusion This study of a pilot program quantifies the relative contribution of AOD to ED presentations and demonstrates that hospital EDs can implement a feasible, proactive BI model with high participation rates for people presenting with AOD-related health consequences.What is known about the topic? Clinician-led BI for high-risk consumption of alcohol has been demonstrated to be effective in primary care and ED settings. However, hospital EDs are increasingly receiving people with high-risk AOD-related harms. The relative contribution of other drugs in relation to ED presentations has not been widely documented. In ad...
Source: Australian Health Review - January 4, 2018 Category: Hospital Management Authors: Howard R, Fry S, Chan A, Ryan B, Bonomo Y Tags: Aust Health Rev Source Type: research

Outpatient consultant physician service usage in Australia by specialty and state and territory.
Conclusion Significant per-capita variation in consultant physician utilisation is occurring across Australia. Future studies should explore the variation in greater detail to discern whether workforce issues, access or economic barriers to care, or the possibility of over- or under-servicing in certain geographic areas is leading to this variation.What is known about the topic? There are nearly 11million initial and subsequent consultant physician consultations billed to Medicare per year, incurring nearly A$850million in Medicare benefits. Little attention has been paid to per-capita variation in rates of consultant phys...
Source: Australian Health Review - December 21, 2017 Category: Hospital Management Authors: Freed GL, Allen AR Tags: Aust Health Rev Source Type: research

When is a medicine unwanted, how is it disposed, and how might safe disposal be promoted? Insights from the Australian population.
Conclusions Respondents were largely unaware of the RUM Project, yet were willing to use it once informed. Limited awareness could lead to environmental or public health risks, and targeted information campaigns are needed.What is known about the topic? There is a growing international evidence base on how people dispose of unwanted medicines and the negative consequences, particularly the environmental effects of inappropriate disposal. Although insight into variation in disposal methods is increasing, knowledge of how people perceive risks and awareness of inappropriate disposal methods is more limited.What does this pap...
Source: Australian Health Review - December 19, 2017 Category: Hospital Management Authors: Bettington E, Spinks J, Kelly F, Gallardo-Godoy A, Nghiem S, Wheeler AJ Tags: Aust Health Rev Source Type: research

A wake-up call for physical activity promotion in Australia: results from a survey of Australian nursing and allied health professionals.
Conclusions Australian nurses and AHPs perceive that PA promotion is part of their role, however few have specific knowledge of the PA guidelines. To increase PA promotion by nurses and AHPs awareness of the PA guidelines appears to be essential.What is known about the topic? Nurses and AHPs are in an ideal position to promote PA, although there is limited evidence of their PA promotion and knowledge.What does the paper add? Australian nurses and AHPs are confident and think it is feasible to promote PA to patients in several healthcare settings but many lack sufficient PA knowledge, limiting their PA promotion.What are th...
Source: Australian Health Review - December 11, 2017 Category: Hospital Management Authors: Freene N, Cools S, Hills D, Bissett B, Pumpa K, Cooper G Tags: Aust Health Rev Source Type: research

Comparative emergency department resource utilisation across age groups.
Conclusion With ED care of older people demonstrated to be more resource intensive than care for younger people, the projected increase in older person presentations anticipated with population aging will have a magnified effect on ED services. These predicted changes in demand for ED care will only be able to be optimally managed if Australian health policy, ED funding instruments and ED models of care are adjusted to take into account the specific care and resource needs of older people.What is known about the topic? Current Australian ED funding models do not adjust for patient age. Several regional studies have suggest...
Source: Australian Health Review - December 11, 2017 Category: Hospital Management Authors: Burkett E, Martin-Khan MG, Gray LC Tags: Aust Health Rev Source Type: research

Time to establish comprehensive long-term monitoring of Australian medical graduates?
This article presents a schema for building long-term monitoring in Australia, using linked and reliable data, that will enable these questions to be answered. Although the answers will be of interest to many, medical schools will then be well placed to alter their programs and processes based on these three domains of graduate well being, workplace performance and patient outcomes. PMID: 29212589 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - December 7, 2017 Category: Hospital Management Authors: Jorm C, Bleasel J, Haq I Tags: Aust Health Rev Source Type: research

Mental health consultations in the perinatal period: a cost-analysis of Medicare services provided to women during a period of intense mental health reform in Australia.
Conclusion Increased access to mental health consultations has coincided with the introduction of recent mental health initiatives, however disparities exist based on geographic location. This detailed cost analysis identifies inequities of access to perinatal mental health services in regional and remote areas and provides important data for economic and policy analysis of future mental health initiatives.What is known about the topic? The mental healthcare landscape in Australia has changed significantly over the last decade, with the introduction of numerous policies aimed at prevention, screening and improving access t...
Source: Australian Health Review - December 5, 2017 Category: Hospital Management Authors: Chambers GM, Randall S, Mihalopoulos C, Reilly N, Sullivan EA, Highet N, Morgan VA, Croft ML, Chatterton ML, Austin MP Tags: Aust Health Rev Source Type: research

Table of Contents and Advertisements.
Authors: PMID: 29190442 [PubMed - in process] (Source: Australian Health Review)
Source: Australian Health Review - December 1, 2017 Category: Hospital Management Tags: Aust Health Rev Source Type: research

Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.
Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists.What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists...
Source: Australian Health Review - December 1, 2017 Category: Hospital Management Authors: May J, Walker J, McGrail M, Rolley F Tags: Aust Health Rev Source Type: research

Factors that affect general practice as a choice of medical speciality: implications for policy development.
Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual.What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other.What does this paper add? The present study is the first intergenerational research on this topic in the Australian contex...
Source: Australian Health Review - November 28, 2017 Category: Hospital Management Authors: Vohra A, Ladyshewsky R, Trumble S Tags: Aust Health Rev Source Type: research

Economic modelling of telehealth substitution of face-to-face specialist outpatient consultations for Queensland correctional facilities.
Conclusions Under the modelled conditions, telehealth may reduce the cost of providing specialist outpatient consultations to prisoners in Queensland correctional facilities. Telehealth may improve the timeliness of services to a traditionally underserved population.What is known about the topic? Specialist medical services are located in only a few metropolitan centres across Australia, which requires some populations to travel long distances to attend appointments. Some face-to-face specialist outpatient consultations can be substituted by telehealth.What does this paper add? Prisoners from correctional facilities repres...
Source: Australian Health Review - November 28, 2017 Category: Hospital Management Authors: Taylor M, Caffery LJ, Scuffham PA, Smith AC Tags: Aust Health Rev Source Type: research

Identification of vulnerability within a child and family health service.
Abstract Objective The aims of the present study were to describe the prevalence of vulnerability in a cohort of newborns, identify the factors that increase the risk of vulnerability and examine whether those who are most vulnerable are receiving home visits.Methods A prospective cross-sectional study was performed using data collected from questionnaires completed by child and family health nurses and obstetric discharge summaries for each mother-baby dyad. Descriptive frequencies and percentages are used to describe the proportions of children who were vulnerable, offered services and had risk factors for vulne...
Source: Australian Health Review - November 21, 2017 Category: Hospital Management Authors: Kimla K, Nathanson D, Woolfenden S, Zwi K Tags: Aust Health Rev Source Type: research

Implementing a 6-day physiotherapy service in rehabilitation: exploring staff perceptions.
Conclusion Staff perceived a large number of barriers before implementation of a 6-day rehabilitation service, but these did not eventuate following implementation. Staff perceived improved LOS and patient goal attainment after implementation of a 6-day rehabilitation service incorporating staff feedback.What is known about this topic? Rehabilitation weekend services improve patient quality of life and functional independence while reducing LOS.What does this study add? Staff feedback during implementation and modification of new services is important to address potential barriers and ensure staff satisfaction and support....
Source: Australian Health Review - November 20, 2017 Category: Hospital Management Authors: Caruana EL, Kuys SS, Clarke J, Brauer SG Tags: Aust Health Rev Source Type: research

Role of strategic human resource management in crisis management in Australian greenfield hospital sites: a crisis management theory perspective.
Conclusion This study provided an identification of how the use of CMT in a hospital's greenfield stage can increase the hospital's chances of 'success'.What is known about the topic? Journal and media articles illustrated a gap in greenfield human resource management (HRM) regarding successful consolidation, especially the healthcare context. Although manufacturing firms are addressed in academic literature in a greenfield context, there is a lack of knowledge concerning successful greenfield HRM in a healthcare context.What does this paper add? This study is among the first to identify the role of CMT in successful green...
Source: Australian Health Review - November 20, 2017 Category: Hospital Management Authors: Kendrick MI, Bartram T, Cavanagh J, Burgess J Tags: Aust Health Rev Source Type: research

Turning attention to clinician engagement in Victoria.
Abstract The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels - from the clinical microsystem to state health policy making. Multiple interventions are possible to enh...
Source: Australian Health Review - November 16, 2017 Category: Hospital Management Authors: Jorm C, Hudson R, Wallace E Tags: Aust Health Rev Source Type: research

Outcomes following changing from a two-tiered to a three-tiered hospital rapid response system.
Abstract Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change. The main outcome measures were changes in: (1) the incident ...
Source: Australian Health Review - November 16, 2017 Category: Hospital Management Authors: Cheung W Tags: Aust Health Rev Source Type: research

Perspectives from practice: complexities of personal care workers.
Abstract Personal care workers (PCWs) make up the bulk of the workforce in residential and community care services. The knowledge and skill set needed for safe and effective practice in care settings is extensive. A diverse range of registered training organisations (RTOs) offering Certificate III and IV in Individual Support (aging, home and community) are tasked with producing job-ready PCWs. However, the curricula of these programs vary. Additionally, a national code of conduct for healthcare workers became effective in October 2015 as a governance framework for PCWs. The language of the code statements is ambi...
Source: Australian Health Review - November 14, 2017 Category: Hospital Management Authors: Martyn JA, Zanella S, Wilkinson A Tags: Aust Health Rev Source Type: research

Use of medical emergency call data as a marker of quality of emergency department care in the post-National Emergency Access Target era.
Conclusions This is the first report to investigate the correlation between inpatient medical emergency call incidence and emergency department model of care. Medical emergency call data showed significant promise as a measure of morbidity and as a more direct, objective, simple, quantitative and meaningful measure of patient safety.What is known about the topic? It is well established that extended emergency department lengths of stay are associated with poorer patient outcomes. The corollary of this is not always true however; shorter emergency department length of stay does not automatically translate into better care. ...
Source: Australian Health Review - November 14, 2017 Category: Hospital Management Authors: Westacott L, Graves J, Khatun M, Burke J Tags: Aust Health Rev Source Type: research

A review of the economic impact of mental illness.
Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions.What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy.What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The...
Source: Australian Health Review - November 13, 2017 Category: Hospital Management Authors: Doran CM, Kinchin I Tags: Aust Health Rev Source Type: research

Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care.
Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers.What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation's pursuit of high quality care.What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps.What are the implications for prac...
Source: Australian Health Review - November 13, 2017 Category: Hospital Management Authors: Leggat SG, Balding C Tags: Aust Health Rev Source Type: research

Human dimension of health service management.
This article identifies three relevant and valid constructs that are associated with personal and organisational performance that can be used in the training of current and future health service managers: personal engagement at work, emotional intelligence and conflict resolution. A review was undertaken of the literature in human resources management to identify key concepts that bind and strengthen the management of organisations. A curriculum content analysis was then performed of postgraduate health management courses in Australia to assess the extent of inclusion in these areas. Three concepts and practices of relevan...
Source: Australian Health Review - November 13, 2017 Category: Hospital Management Authors: Martins JM, Isouard G, Freshman B Tags: Aust Health Rev Source Type: research

Examining the high users of hospital resources: implications of a profile developed from Australian health insurance claims data.
Conclusions The highest users of hospital resources have a distinct profile, accounting for a large proportion of total resource utilisation for a narrow range of health conditions. The age and hospital admission profile of this group suggest both policy and service considerations for the targeting of interventions to support this high-needs group.What is known about this topic? Statistics are regularly published on the uptake and use of private health insurance in Australia but there is little detailed information on resource utilisation in specific subgroups, particularly those with the highest levels of hospitalisation....
Source: Australian Health Review - November 13, 2017 Category: Hospital Management Authors: Khoo J, Hasan H, Eagar K Tags: Aust Health Rev Source Type: research

Financial costs associated with monopolies on biologic medicines in Australia.
Conclusions Biologic medicines represent a large proportion of government expenditure on pharmaceuticals. Reducing the length of monopoly protections on these medicines could generate savings of hundreds of millions of dollars per year.What is known about the topic? Biologics take up an increasing share of pharmaceutical expenditure, but no previous published studies have examined Australian Government expenditure on biologics or the potential savings from reducing the duration of monopoly protection.What does this paper add? This paper provides new evidence about Australian Government expenditure on biologics and potentia...
Source: Australian Health Review - November 9, 2017 Category: Hospital Management Authors: Gleeson D, Townsend B, Lopert R, Lexchin J, Moir H Tags: Aust Health Rev Source Type: research

Emergency department referral patterns of Australian general practitioner registrars: a cross-sectional analysis of prevalence, nature and associations.
Abstract Objective Limited international evidence suggests general practice registrars' emergency department (ED) referral rates exceed those of established general practitioners (GPs). The aim of the present study was to fill an evidence gap by establishing the prevalence, nature and associations of Australian GP registrar ED referrals.Methods A cross-sectional analysis was performed of the Registrar Clinical Encounters in Training (ReCEnT) cohort study of GP registrars' consultation experiences, between 2010 and 2015. The outcome factor in logistic regression analysis was referral to an ED. Independent variables...
Source: Australian Health Review - November 9, 2017 Category: Hospital Management Authors: Catzikiris N, Tapley A, Morgan S, van Driel M, Spike N, Holliday EG, Ball J, Henderson K, McArthur L, Magin P Tags: Aust Health Rev Source Type: research

What's in a name? An overview of organisational health literacy terminology.
Abstract Organisational health literacy (OHL) is a relatively new concept and its role in improving population health outcomes is gaining recognition. There are several terms being used in relation to OHL but there is no consensus about the definition of OHL nor agreement on a single approach to its application within health services. This contested space continues to create discussion and debate between health literacy researchers worldwide. Increasingly, health service accreditation standards are moving towards including OHL and so services need to clearly define their roles and responsibilities in this area. In...
Source: Australian Health Review - November 9, 2017 Category: Hospital Management Authors: Meggetto E, Ward B, Isaccs A Tags: Aust Health Rev Source Type: research

Factors associated with unplanned readmissions in a major Australian health service.
Conclusions There were specific patient and index admission characteristics associated with increased risk of unplanned readmission in ≤28 days; however, these characteristics varied between patient groups, highlighting the need for tailored interventions.What is known about the topic? Unplanned hospital readmissions within 28 days of hospital discharge are considered an indicator of quality and safety of health care.What does this paper add? The factors associated with increased risk of unplanned readmission in ≤28 days varied between patient groups, so a 'one size fits all approach' to reducing unplanned readmissio...
Source: Australian Health Review - November 2, 2017 Category: Hospital Management Authors: Considine J, Fox K, Plunkett D, Mecner M, O'Reilly M, Darzins P Tags: Aust Health Rev Source Type: research

Key lessons for designing health literacy professional development courses.
This study presents key learnings from evaluation data from three health literacy courses using Wenger's professional educational learning design framework. The framework has three educational learning architecture components (engagement, imagination and alignment) and four educational learning architecture dimensions (participation, emergent, local/global, identification). Participatory realist evaluation approaches and qualitative methods were used. The evaluations revealed that the health literacy courses are developing leadership in health literacy, building partnerships among course participants, developing health lit...
Source: Australian Health Review - November 2, 2017 Category: Hospital Management Authors: Naccarella L, Murphy B Tags: Aust Health Rev Source Type: research

Health professionals' views on health literacy issues for culturally and linguistically diverse women in maternity care: barriers, enablers and the need for an integrated approach.
Conclusions There are significant health literacy and systemic issues affecting the hospital's provision of maternity care for CALD women. These findings, mapped onto the four domains of cultural competence education interventions will inform a technology-delivered health literacy intervention for CALD maternity patients. This approach may be applied to other culturally diverse healthcare settings to foster patient health literacy.What is known about the topic? There are health inequities for pregnant women of culturally and linguistically diverse (CALD) backgrounds. Low health literacy compounded by language and cultural ...
Source: Australian Health Review - October 30, 2017 Category: Hospital Management Authors: Hughson JA, Marshall F, Daly JO, Woodward-Kron R, Hajek J, Story D Tags: Aust Health Rev Source Type: research

Person-centred care in a digital hospital: observations and perspectives from a specialist rehabilitation setting.
Conclusions Technological change closely aligned with frontline practice brought expected and unexpected challenges that may resolve over time. Practitioners' persistence and adaptability demonstrated their commitment to person-centred care in the digital environment. The impact of this less visible work of professional discretion seemed to vary, primarily by discipline-specific roles, with nurses experiencing the greatest pressure.What is known about this topic? Integrated electronic medical records (eMRs) bring benefits but challenge person-centred care.What does this paper add? These first insights regarding frontline i...
Source: Australian Health Review - October 30, 2017 Category: Hospital Management Authors: Burridge L, Foster M, Jones R, Geraghty T, Atresh S Tags: Aust Health Rev Source Type: research

Effects and mechanisms of an allied health research position in a Queensland regional and rural health service: a descriptive case study.
In conclusion, the case study highlights the potential value of an AH research position in building research capacity within a large non-metropolitan health service. Factors to facilitate ongoing success could include additional research and administrative funding, as well as increased use of technology and team-based research.What is known about the topic? Dedicated research positions embedded within health care settings are a well cited strategy to increase research capacity building of allied health professionals (AHPs). However the majority of these positions are within metropolitan health settings and unique challenge...
Source: Australian Health Review - October 30, 2017 Category: Hospital Management Authors: Wenke RJ, Tynan A, Scott A, Mickan S Tags: Aust Health Rev Source Type: research

Building health literacy responsiveness in Melbourne's west: a systems approach.
Abstract With high health inequities among some population groups, health professionals and organisations are increasingly taking action on health literacy. This case study demonstrates how a systems approach to health literacy responsiveness created change across a region. From 2013 to 2017 the Health Literacy Development Project incorporating a training course and community of practice (the Project) targeted the health and community services system in Melbourne's west. The Project created a ripple effect that built health literacy responsiveness at the individual and organisational level. This contributed to inc...
Source: Australian Health Review - October 24, 2017 Category: Hospital Management Authors: Allott ML, Sofra T, O'Donnell G, Hearne JL, Naccarella L Tags: Aust Health Rev Source Type: research

Motivating the workforce: beyond the 'two-factor' model.
Conclusions Contrary to most previous research, the present study found that some factors - like communication or resources - could be a source of satisfaction and dissatisfaction, depending on whether they supported the individual and the team. The research method chosen in the present study differed from most using the two-factor model in that it did not use closed survey questions. The breadth of these results reflects the ability to provide a more nuanced response.What is known about the topic? Professionals working in health and human services have a high degree of authority and autonomy. Increasing staff motivation h...
Source: Australian Health Review - October 19, 2017 Category: Hospital Management Authors: Shannon EA Tags: Aust Health Rev Source Type: research

Privately practising nurse practitioners' provision of care subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme in Australia: results from a national survey.
Conclusion The findings of the present study suggest that PPNPs are providing subsidised care through the MBS and PBS. The PPNPs in the present study reported challenges with the current structure and breadth of the NP MBS and PBS items, which restrict them from providing complete episodes of patient care.What is known about the topic? Since the introduction of legislative changes in 2010, services provided by PPNPs in Australia have been eligible for subsidisation through the MBS and PBS.What does this paper add? This paper provides data on PPNPs' provision of care subsidised through the MBS and PBS.What are the implicati...
Source: Australian Health Review - October 16, 2017 Category: Hospital Management Authors: Currie J, Chiarella M, Buckley T Tags: Aust Health Rev Source Type: research

Deconstructing the 4-h rule for access to emergency care and putting patients first.
Abstract Evidence suggests improved outcomes for patients requiring emergency admission to hospital are associated with improved emergency department (ED) efficiency and lower transit times. Factors preventing timely transfers of emergency patients to in-patient beds across the ED-in-patient interface are major causes for ED crowding, for which several remedial strategies are possible, including parallel processing of probable admissions, direct-to-ward admissions and single-point medical registrars for receiving and processing all referrals directed at specific speciality units. Dynamic measures of ED overcrowdin...
Source: Australian Health Review - October 16, 2017 Category: Hospital Management Authors: Scott I, Sullivan C, Staib A, Bell A Tags: Aust Health Rev Source Type: research

Centralisation of oesophagectomy in Australia: is only caseload critical?
Conclusions The data suggest that under specific conditions, oesophagectomies can be safely performed even in smaller- or low-volume centres in Australia. The policy of centralisation for these procedures in Australia needs to be carefully tailored to the needs of the population, clinical outcomes, cost-effectiveness and optimal utilisation of existing facilities rather than on caseload alone.What is known about the topic? High caseload is considered one of the most important factors for good outcomes after oesophagectomy and a driving force behind centralisation of this procedure. However, other factors may also affect ou...
Source: Australian Health Review - October 16, 2017 Category: Hospital Management Authors: Hummel R, Ha NH, Lord A, Trochsler MI, Maddern G, Kanhere H Tags: Aust Health Rev Source Type: research

Does the accreditation of private dental practices work? Time to rethink how accreditation can improve patient safety.
This article considers whether accreditation has a proven track record of improving quality of service and offers opinions about how a more appropriate safety management program for PDPs may look.What is known about the topic? There has been minimal research about the impact of accreditation schemes in improving patient safety in PDP.What does this paper add? This paper proposes a redesign of the Scheme to make it more relevant to PDPs. The paper offers strategies to minimise duplication of purpose between accreditation and existing legislation; and to strengthen critical elements of accreditation to improve effects on pat...
Source: Australian Health Review - October 9, 2017 Category: Hospital Management Authors: Jean G Tags: Aust Health Rev Source Type: research

Public reporting of hospital performance data: views of senior medical directors in Victoria, Australia.
Conclusions The next steps needed to advance public reporting of hospital performance data in Australia include engaging clinicians and patients in selection and development of metrics, improving timeliness of reporting, and improving communication of information so that it is accessible and meaningful for different audiences.What is known about the topic? Public reporting of hospital performance data is a mechanism increasingly used in the Australian health system, but it has attracted little research.What does this paper add? This paper reveals a lack of shared understanding among medical directors in Victoria, Australia...
Source: Australian Health Review - October 9, 2017 Category: Hospital Management Authors: Canaway R, Bismark M, Dunt D, Kelaher M Tags: Aust Health Rev Source Type: research

Effect of an ageing population on services for the elderly in the Northern Territory.
Conclusions The NT has a relatively small but growing elderly population with increasing needs. This population is markedly different compared with its counterparts in other Australian states and territories, but receives aged care services based on national policies. Recent changes to community-based services and increases in residential beds should improve services and care, although remaining challenges and gaps need to be addressed.What is known about the topic? Increasing health and care needs of elderly people will place significant stress across the health and aged care system. In Australia, most aged care services ...
Source: Australian Health Review - October 2, 2017 Category: Hospital Management Authors: Lowe M, Coffey P Tags: Aust Health Rev Source Type: research

Strengthening the primary care workforce to deliver community case management for child health in rural Indonesia.
Conclusions CCM is viewed as a useful model of care in terms of enhancing the capacity of rural PHCWs to provide child health care and improve the uptake of life-saving interventions. However, work is needed to strengthen the workforce and to fully integrate CCM into maternal and child health service delivery across Indonesia.What is known about the topic? Indonesia has successfully reduced infant mortality in the past 10 years. However, concerns remain regarding issues related to disparities between districts. The number of infant deaths in rural areas tends to be staggeringly high compared with that in the cities. One of...
Source: Australian Health Review - October 2, 2017 Category: Hospital Management Authors: Setiawan A, Dawson A Tags: Aust Health Rev Source Type: research

Health service use in the older person with complex health needs.
Discussion The greater rates of hospitalisation and specialist service use, the absence of a similar finding for GP services and the prominence of the role of primary care in service integration literature, policy and strategy underscore the importance of careful planning, consultation and inclusiveness in the development and implementation of integrated care policy.What is known about the topic? Older people with complex health needs are significant consumers of primary and secondary health services and benefit from well-planned and coordinated care.What does this paper add? The findings presented here indicate that altho...
Source: Australian Health Review - September 28, 2017 Category: Hospital Management Authors: Bartlett M, Wang J, Hay L, Pang G Tags: Aust Health Rev Source Type: research

A two-way street: reciprocal teaching and learning in refugee health.
Abstract The Water Well Project is a health promotion charity that aims to improve the health literacy of individuals of refugee, asylum seeker and migrant backgrounds. Health literacy is an important predictor of health status, but many Australians cannot demonstrate functional health literacy, and individuals from culturally and linguistically diverse (CALD) backgrounds are at higher risk of poor health literacy. The primary participants of The Water Well Project's health education sessions are individuals of refugee, asylum seeker and migrant background, who are at risk of increased morbidity and mortality due ...
Source: Australian Health Review - September 28, 2017 Category: Hospital Management Authors: Martin TJ, Butters C, Phuong L Tags: Aust Health Rev Source Type: research

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews.
Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes.What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australia's First Peoples.What does this paper add? This narrative ove...
Source: Australian Health Review - September 19, 2017 Category: Hospital Management Authors: Browne J, Adams K, Atkinson P, Gleeson D, Hayes R Tags: Aust Health Rev Source Type: research

Cross-sectional study of area-level disadvantage and glycaemic-related risk in community health service users in the Southern.IML Research (SIMLR) cohort.
Abstract Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia.Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categori...
Source: Australian Health Review - September 19, 2017 Category: Hospital Management Authors: Cross R, Bonney A, Mayne DJ, Weston KM Tags: Aust Health Rev Source Type: research

Improving health literacy about dementia among older Chinese and Vietnamese Australians.
This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration.What is known about the topic? We know there is limited health literacy among older people and among older people from culturally and linguistically diverse (CALD) backgrounds. We also know that the older CALD population is increasing rapidly and with that comes increased chronic illness and chronic diseases, including mental health issues and dementia.What does this p...
Source: Australian Health Review - September 7, 2017 Category: Hospital Management Authors: Haralambous B, Mackell P, Lin X, Fearn M, Dow B Tags: Aust Health Rev Source Type: research

Workplace injuries in the Australian allied health workforce.
Conclusions Mechanism of injury, both physical and psychosocial, were identified. Prosthetists/orthotists are at the highest risk of workplace injury of all allied health professions. This suggests the need for further investigation and development of appropriately targeted injury prevention programs for each allied health profession.What is known about this topic? Retention of allied health professionals is a significant issue, with workplace injuries identified as one contributing factor to this problem. Healthcare workers are potentially at high risk of injury as they are exposed to a range of physical and psychosocial ...
Source: Australian Health Review - September 5, 2017 Category: Hospital Management Authors: Anderson S, Stuckey R, Fortington LV, Oakman J Tags: Aust Health Rev Source Type: research