General practitioner and registrar involvement in refugee health: exploring needs and perceptions.
Conclusions Issues such as time, costs, language and culture were recognised as challenges in providing services for refugees. GPs highlighted particular issues for rural and regional areas in addressing refugee health, such as finding jobs, problems with isolation and the effect of lack of anonymity in such communities. These social factors have implications for the health of the refugees, especially psychological health, which is also challenged by poor resources.What is known about the topic? Providing refugees equitable access to healthcare services presents considerable challenges, particularly in rural and regional a...
Source: Australian Health Review - September 4, 2017 Category: Hospital Management Authors: Harding C, Seal A, Duncan G, Gilmour A Tags: Aust Health Rev Source Type: research

Review and analysis of the Mental Health Nurse Incentive Program.
Conclusions The MHNIP greatly benefits the health of people with mental illness. Larger and more representative sampling of consumers is needed, as well as intensive case studies to provide a more comprehensive and effective understanding of the benefits and limitations of the program as it evolves with the establishment of primary health networks.What is known about the topic? The MHNIP is designed to increase access to mental health care in primary care settings such as general practice clinics. Studies have reported favourable views about the program. However, research is limited and further investigation is required to...
Source: Australian Health Review - September 4, 2017 Category: Hospital Management Authors: Happell B, Platania-Phung C Tags: Aust Health Rev Source Type: research

Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program.
Abstract Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health's Hospital Admission Risk Program (HARP).Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model.Results Th...
Source: Australian Health Review - August 24, 2017 Category: Hospital Management Authors: Lawn S, Zabeen S, Smith D, Wilson E, Miller C, Battersby M, Masman K Tags: Aust Health Rev Source Type: research

Changes in surgical team performance and safety climate attitudes following expansion of perioperative services: a repeated-measures study.
Conclusions The improvements seen in surgical teams' NTS performance and safety culture attitudes may be related to the move to a new state-of-the-art perioperative department.What is known about the topic? Patient safety in surgery relies on optimal team performance, underpinned by effective NTS.What does this paper add? The NTS of surgical teams may be improved through ergonomic innovations that promote teams' shared mental models.What are the implications for practitioners? Effective multidisciplinary teamwork relies on a combination of NTS and ergonomic factors, which inherently contribute to team performance and safet...
Source: Australian Health Review - August 10, 2017 Category: Hospital Management Authors: Gillespie BM, Harbeck E, Kang E, Steel C, Fairweather N, Chaboyer W Tags: Aust Health Rev Source Type: research

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners.
Abstract Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs.Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia...
Source: Australian Health Review - August 10, 2017 Category: Hospital Management Authors: Catzikiris N, Tapley A, Morgan S, Holliday EG, Ball J, Henderson K, Elliott T, Spike N, Regan C, Magin P Tags: Aust Health Rev Source Type: research

Exploration of an allied health workforce redesign model: quantifying the work of allied health assistants in a community workforce.
Abstract The Victorian Assistant Workforce Model (VAWM) enables a systematic approach for the identification and quantification of work that can be delegated from allied health professionals (AHPs) to allied health assistants (AHAs). The aim of the present study was to explore the effect of implementation of VAWM in the community and ambulatory health care setting. Data captured using mixed methods from allied health professionals working across the participating health services enabled the measurement of opportunity for workforce redesign in the community and ambulatory allied health workforce. A total of 1112 AH...
Source: Australian Health Review - July 25, 2017 Category: Hospital Management Authors: Somerville L, Davis A, Milne S, Terrill D, Philip K Tags: Aust Health Rev Source Type: research

Skill sharing and delegation practice in two Queensland regional allied health cancer care services: a comparison of tasks.
Conclusions Strong consistency was apparent for the clinical tasks undertaken by the two cancer care AH teams, with moderate agreement for the frequency of tasks performed. The proportion of tasks considered appropriate for skill sharing and/or delegation was similar, although variation at the task level was apparent. Further research is warranted to examine the range of factors that affect the decision to skill share or delegate.What is known about the topic? There is limited research evidence regarding the use of skill sharing and delegation service models for AH in cancer care services. In particular, the extent to whic...
Source: Australian Health Review - July 24, 2017 Category: Hospital Management Authors: Passfield J, Nielsen I, Brebner N, Johnstone C Tags: Aust Health Rev Source Type: research

Achieving self-sufficiency: training Australia's future medical workforce.
Abstract There is an oversupply of Australian junior doctors, but significant training bottlenecks are developing, and geographical maldistribution in rural and remote areas remains. Last year, the Federal Minister for Immigration rejected a Department of Health recommendation for the removal of 41 health roles from the Skilled Occupation List after concerns that rural and regional communities would be left without access to medical services in areas currently serviced by international medical graduates. In an effort to achieve workforce self-sufficiency, Australia must ensure access to high-quality vocational tra...
Source: Australian Health Review - July 17, 2017 Category: Hospital Management Authors: Fernandes B, Cliff ERS, Chowdhury A Tags: Aust Health Rev Source Type: research

Partners in Recovery program evaluation: changes in unmet needs and recovery.
Conclusions The results of the present study suggest that PIR services in these two geographical regions have achieved positive results. Individuals with severe and persistent mental illness engaged with PIR appear to have reduced their unmet needs and enhanced their mental health recovery.What is known about the topic? PIR services were established to support individuals with severe and persistent mental illness by creating service linkages to address unmet needs in order to facilitate recovery. Services were delivered through the new role of 'support facilitator'.What does this paper add? By examining routinely collected...
Source: Australian Health Review - July 11, 2017 Category: Hospital Management Authors: Hancock N, Scanlan JN, Gillespie JA, Smith-Merry J, Yen I Tags: Aust Health Rev Source Type: research

Evaluation of Australia.
Abstract The aim of the present case study was to evaluate the service-wide implementation of Australia's first older adult-specific early intervention called Older Wiser Lifestyles (OWL). OWL was designed to reduce alcohol consumption and alcohol-related harm among people identified as being at risk. OWL used the Australian Alcohol-Related Problems Survey (A-ARPS) to classify people's drinking patterns as non-hazardous, hazardous or harmful. Participants of the present study were aged ≥60 years and consumed alcohol in the past month, although they did not require treatment for dependence. The Alcohol Use Disor...
Source: Australian Health Review - July 6, 2017 Category: Hospital Management Authors: Bright SJ, Williams CM Tags: Aust Health Rev Source Type: research

Antimicrobial Use and Resistance in Australia (AURA) surveillance system: coordinating national data on antimicrobial use and resistance for Australia.
Conclusion The AURA surveillance system has established the framework and foundation systems for an integrated and comprehensive picture of both antimicrobial use and resistance in Australia over time. National coordination and support will improve data collection, standardisation and analysis, and will facilitate collaboration across the states and territories, the Australian Government and the private sector. AURA publications will inform policy development and clinical decision making and improve consumer awareness of antimicrobial use and resistance. The system will continue to develop as a comprehensive system, with a...
Source: Australian Health Review - June 22, 2017 Category: Hospital Management Authors: Turnidge JD, Meleady KT Tags: Aust Health Rev Source Type: research

Physiotherapists' perceptions of workplace competency: a mixed-methods observational study.
Conclusions The perceptions of physiotherapists working in a metropolitan acute public hospital are reflected in five themes. These themes elucidate how workplace competency is supported, maintained and developed among physiotherapists in this setting. These themes also highlight key challenges of workplace learning faced by this cohort of physiotherapists and allude to methods that may assist with improving feedback mechanisms and knowledge acquisition.What is known about this topic? Studies investigating employee perceptions around workplace competency, knowledge, skills and learning are found across a range of industrie...
Source: Australian Health Review - June 22, 2017 Category: Hospital Management Authors: Sturt R, Burge AT, Harding P, Sayer J Tags: Aust Health Rev Source Type: research

Clinical activity profile of preregistration physiotherapy students during clinical placements.
Abstract Objective The aim of the present study was to determine the clinical activity profile of preregistration physiotherapy students during clinical placements and their clinical activity contribution to health service delivery.Methods Clinical activity data for 2014 were obtained from five Queensland public sector hospitals providing preregistration physiotherapy students clinical education in three key clinical areas (cardiorespiratory, musculoskeletal and neurological) over four 5-week placement blocks. Data regarding the number of student occasions of service (OOS) and the length of the OOS (LOOS) were col...
Source: Australian Health Review - June 22, 2017 Category: Hospital Management Authors: Stoikov S, Shardlow K, Gooding M, Kuys S Tags: Aust Health Rev Source Type: research

Principles of capacity management, applied in the mental health context.
Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting.What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs.What does this paper add? This paper describes the application of a suite of patient flow improvement pr...
Source: Australian Health Review - June 22, 2017 Category: Hospital Management Authors: Zeitz K, Watson D Tags: Aust Health Rev Source Type: research

Population estimates and characteristics of Australians potentially eligible for bariatric surgery: findings from the 2011?13 Australian Health Survey.
Conclusion Even if only 5% of Australian adults estimated to be eligible for bariatric surgery sought this intervention, the demand, particularly in the public health system and outside major cities, would far outstrip current capacity. Better guidance on patient prioritisation and greater resourcing of public surgery are needed.What is known about this topic? In the period 2011-13, 4million Australian adults were estimated to be obese, with obesity disproportionately more prevalent in areas of socioeconomic disadvantage. Bariatric surgery is considered to be cost-effective and the most effective treatment for adults with ...
Source: Australian Health Review - June 8, 2017 Category: Hospital Management Authors: Sharman MJ, Breslin MC, Kuzminov A, Palmer AJ, Blizzard L, Hensher M, Venn AJ Tags: Aust Health Rev Source Type: research

Internet images of the speech pathology profession.
Conclusion Current images of speech pathology continue to portray narrow professional demographics and client groups (e.g. paediatrics). Promoting images of wider scope to fully represent the depth and breadth of speech pathology professional practice may assist in attracting a more diverse group of people into the profession in the future.What is known about the topic? To date, research has not considered the promotional profile of allied health professionals on the Internet. There has been a lack of consideration of whether the way in which the professions are promoted may affect clients accessing allied health services ...
Source: Australian Health Review - June 5, 2017 Category: Hospital Management Authors: Byrne N Tags: Aust Health Rev Source Type: research

Enhancing national data to align with policy objectives: Aboriginal and Torres Strait Islander smoking prevalence at finer geographic levels.
Conclusion There are significant limitations with analysing national survey data at finer geographical scales. Given the national program for Indigenous tobacco control is a regional model, evaluation requires finer geographical analysis of smoking prevalence to inform public health progress, policy and program effects. Options to improve the data currently collected include increasing national survey sample sizes, implementing a smoking status question in census surveys, investing in current cohort studies focused on this population or implementing localised surveys.What is known about the topic? The last geospatial analy...
Source: Australian Health Review - June 5, 2017 Category: Hospital Management Authors: Wright A, Lovett R, Roe Y, Richardson A Tags: Aust Health Rev Source Type: research

Decision-making under pressure: medical errors in uncertain and dynamic environments.
Conclusions The challenge for researchers is to build the body of knowledge concerning the safe management of patients, particularly where clinicians are working under pressure. This understanding is important for developing pathways that optimise clinical decision making in uncertain and dynamic environments.What is known about the topic? Emergency departments (EDs) are characterised by high complexity, high throughput and greater uncertainty compared with routine hospital wards or out-patient situations, and the ED is therefore prone to unpredictable workflows and non-replicable conditions when presented with unique and ...
Source: Australian Health Review - June 5, 2017 Category: Hospital Management Authors: Zavala AM, Day GE, Plummer D, Bamford-Wade A Tags: Aust Health Rev Source Type: research

Cost savings from a teledentistry model for school dental screening: an Australian health system perspective.
Conclusions The present study shows that the teledentistry model of dental screening can minimise costs. The estimated savings were due primarily to the low salaries of dental therapists and the avoidance of travel and accommodation costs. Such savings could be redistributed to improve infrastructure and oral health services in rural or other underserved areas.What is known about the topic? Caries is a preventable disease, which, if it remains untreated, can cause significant morbidity requiring costly treatment. Regular dental screening and oral health education have the great potential to improve oral health and save sig...
Source: Australian Health Review - June 5, 2017 Category: Hospital Management Authors: Estai M, Bunt S, Kanagasingam Y, Tennant M Tags: Aust Health Rev Source Type: research

Mapping regulatory models for medicinal cannabis: a matrix of options.
Conclusions The regulatory options, as used internationally, involve different forms of cannabis (synthetic and plant-based pharmaceutical preparations or herbal cannabis) and the varying extent to which patient authorisation policies and procedures are stringently or more loosely defined. The optimal combination of supply and patient authorisation options in any jurisdiction that chooses to make medicinal cannabis accessible will depend on policy goals.What is known about the topic? Internationally, regulation of medicinal cannabis has developed idiosyncratically, depending on formulations that were made available and loc...
Source: Australian Health Review - May 30, 2017 Category: Hospital Management Authors: Belackova V, Shanahan M, Ritter A Tags: Aust Health Rev Source Type: research

Projecting demands for renal replacement therapy in the Northern Territory: a stochastic Markov model.
Conclusions The present study demonstrates the effects of changing service patterns to increase Tx, self-care and prevention, all of which will substantially attenuate the growth in FHD requirements in the NT.What is known about the topic? The burden of ESKD is projected to increase in the NT, with demand for FHD doubling every 15 years. Little is known about the potential effect of changes in health policy and clinical practice on demand.What does this paper add? This study assessed the usefulness of a stochastic Markov model to evaluate the effects of potential policy changes on FHD demand.What are the implications for p...
Source: Australian Health Review - May 30, 2017 Category: Hospital Management Authors: You J, Zhao Y, Lawton P, Guthridge S, McDonald SP, Cass A Tags: Aust Health Rev Source Type: research

Health professionals.
Conclusion This review provides an international understanding of health professionals' views of patient safety. From an Australian context, the review highlights the need for further investigation, because there is a lack of recent Australian literature in the acute hospital setting relating to patient safety culture.What is known about the topic? Globally, many research papers have reported upon the correlation between a positive patient safety culture and a reduction in healthcare errors.What does this paper add? The present integrative review highlights that regardless of the country of origin, there are differences in...
Source: Australian Health Review - May 30, 2017 Category: Hospital Management Authors: Willmott J, Mould J Tags: Aust Health Rev Source Type: research

Factors leading to overutilisation of hospital pathology testing: the junior doctor.
Conclusions Overutilisation of hospital pathology testing occurs when there are high social costs to JMOs for underordering, with little cost for overordering. Interventions should restore this balance through reframing overutilisation as both a costly and potentially harmful activity, promoting a supportive culture with regular senior guidance, and addressing clinical systems in which missed tests create an excessive workload.What is known about the topic? Mean overutilisation rates of pathology testing are reported to be as high as 44%. Although numerous studies have reported successful efforts to decrease hospital patho...
Source: Australian Health Review - May 25, 2017 Category: Hospital Management Authors: Ericksson W, Bothe J, Cheung H, Zhang K, Kelly S Tags: Aust Health Rev Source Type: research

Advanced musculoskeletal physiotherapists are effective and safe in managing patients with acute low back pain presenting to emergency departments.
Abstract Objective The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners).Methods A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED.Results One thousand...
Source: Australian Health Review - May 25, 2017 Category: Hospital Management Authors: Sayer JM, Kinsella RM, Cary BA, Burge AT, Kimmel LA, Harding P Tags: Aust Health Rev Source Type: research

Comparison of policies for recognising and responding to clinical deterioration across five Victorian health services.
Conclusions Current guidance documents related to the frequency of observations and escalation of care omit the vital role of nurses in these processes. Inconsistencies between health services may lead to confusion in a mobile workforce and may reduce system dependability.What is known about the topic? Recognising and responding to clinical deterioration is a major patient safety priority. To comply with national standards, health services must have systems in place for recognising and responding to clinical deterioration.What does this paper add? There is some variability in terminology, definitions and specifications of ...
Source: Australian Health Review - May 25, 2017 Category: Hospital Management Authors: Considine J, Hutchison AF, Rawson H, Hutchinson AM, Bucknall T, Dunning T, Botti M, Duke MM, Street M Tags: Aust Health Rev Source Type: research

Digital disruption ?syndromes.
Abstract The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR). We observed this transformation and propose several digital disruption "syndromes&q...
Source: Australian Health Review - May 18, 2017 Category: Hospital Management Authors: Sullivan C, Staib A Tags: Aust Health Rev Source Type: research

Mapping workforce configuration and operational models in Australian emergency departments: a national survey.
Conclusions The present study has established a baseline measure of the staffing configuration and organisational characteristics of Australian EDs.What is known about the topic? EDs are overcrowded due, in part, to the combined effect of increased service demand and access block. Innovative service and workforce models have been implemented by health departments aiming to improve service and performance. National uptake of these service and workforce innovations is unknown.What does this paper add? The present study is the most comprehensive to date profiling Australian EDs covering hospital characteristics, workforce con...
Source: Australian Health Review - May 18, 2017 Category: Hospital Management Authors: Gardner G, Gardner A, Middleton S, Considine J, Fitzgerald G, Christofis L, Doubrovsky A, Adams M, O'Connell J Tags: Aust Health Rev Source Type: research

Realising the potential of health needs assessments.
Abstract Population-level assessment and planning has traditionally been the role of public health departments but in establishing Primary Health Networks (PHNs), the Australian Government has instituted a new mechanism for identifying community needs and commissioning services to meet those needs. If PHNs are to achieve the vision of nimble organisations capable of identifying and addressing local health needs via integrated health and social services, several things need to occur. First, PHN funding schedules must become more flexible. Second, the Federal health department must maintain an open dialogue with PHN...
Source: Australian Health Review - May 15, 2017 Category: Hospital Management Authors: Anstey M, Burgess P, Angus L Tags: Aust Health Rev Source Type: research

Systematic review of evidence underpinning non-pharmacological therapies in dementia.
Conclusion Although all the therapies identified could be used as part of the treatment of behavioural symptoms, there is insufficient evidence relating to the indications, appropriate use and effectiveness of these therapies to apply in each behavioural treatment. Thus, the present study has demonstrated a significant research gap.What is known about the topic? Despite the widespread use of many different types of therapies, there is limited evidence regarding the efficacy of non-pharmaceutical therapies deployed in the management of behaviours of concern manifested by some people who suffer with dementia in all its forms...
Source: Australian Health Review - May 15, 2017 Category: Hospital Management Authors: Olley R, Morales A Tags: Aust Health Rev Source Type: research

Distrusting doctors.
Conclusion Doctors, providing evidence to support applications, play an important role in determining disability. However, policy makers perceive doctors' evidence about mental illnesses as less trustworthy than evidence about somatic illnesses. This affects decisions by government adjudicators.What is known about the topic? Doctors (GPs and psychiatrists) are often asked to provide evidence to substantiate a DIS application for those with mental illnesses. We know little about the perception of this evidence by the policy makers who consider these applications.What does this paper add? Policy makers distrust doctors' evid...
Source: Australian Health Review - May 15, 2017 Category: Hospital Management Authors: McAllister A, Leeder SR Tags: Aust Health Rev Source Type: research

Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?
Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services.What is known about the topic? Advanced practice physiotherapy-led services ha...
Source: Australian Health Review - May 15, 2017 Category: Hospital Management Authors: Chang AT, Gavaghan B, O'Leary S, McBride LJ, Raymer M Tags: Aust Health Rev Source Type: research

Process to establish 11 primary contact allied health pathways in a public health service.
Conclusion This paper describes key features of the allied health primary contact models of care and presents preliminary data including new case throughput, effect on wait times and enablers and challenges for clinic establishment.What is known about the topic? Allied health clinics have been demonstrated to result in high patient, referrer and consultant satisfaction, and are a cost-effective management strategy for wait list demand. In Queensland, physiotherapy-led orthopaedic clinics have been operating since 2005.What does this paper add? This paper describes the establishment of 11 allied health primary contact model...
Source: Australian Health Review - May 9, 2017 Category: Hospital Management Authors: Stute M, Moretto N, Raymer M, Banks M, Buttrum P, Sam S, Bhagwat M, Comans T Tags: Aust Health Rev Source Type: research

Accuracy of national key performance indicator reporting from two Aboriginal medical services: potential to underestimate the performance of primary health care.
Conclusions CAT accurately extracts a subset of nKPI data from Communicare. However, given the widespread use of Communicare in ACCHSs, the inclusion of deceased clients and past patients in the OCHREStreams nKPI data program is likely to have resulted in systematic under-reporting of health service performance nationally.What is known about the topic? There has been limited validation of health data exported via data-extraction tools in Australia. More specifically, there are no current published data describing the accuracy of the CAT in mapping health data extracted from Communicare or the accuracy of internal nKPI repo...
Source: Australian Health Review - May 9, 2017 Category: Hospital Management Tags: Aust Health Rev Source Type: research

Management of patients brought in by ambulance to the emergency department: role of the Advanced Musculoskeletal Physiotherapist.
Conclusions Patients aged ≤65 years with musculoskeletal complaints brought in by ambulance to the ED and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by an AMP. This study has added to the evidence that AMPs improve patient flow in the ED, freeing up time for other ED staff to see higher-acuity, more complex patients.What is known about the topic? There is a growing body of evidence establishing that AMPs improve the flow of patients presenting with musculoskeletal conditions to the ED through reduced wait times and LOS and, at the same time, provid...
Source: Australian Health Review - May 9, 2017 Category: Hospital Management Authors: Kinsella R, Collins T, Shaw B, Sayer J, Cary B, Walby A, Cowan S Tags: Aust Health Rev Source Type: research

Establishing a new model of integrated primary and secondary care based around general practice: a case study of lessons learned and challenges.
Abstract This case study describes the development and implementation of an innovative integrated primary-secondary model of care for people with complex diabetes. The aim of the paper is to present the experiences of clinicians and researchers involved in implementing the 'Beacon' model by providing a discussion of the contextual factors, including lessons learned, challenges and solutions. Beacon-type models of community care for people with chronic disease are well placed to deliver on Australia's health care reform agenda, and this commentary provides rich contextual information relevant to the translation of ...
Source: Australian Health Review - May 9, 2017 Category: Hospital Management Authors: Jackson CL, Donald M, Russell AW, McIntyre HD Tags: Aust Health Rev Source Type: research

Effect of the 4-h target on ?time-to-ECG.
Conclusion There is likely to be a relationship between NEAT and TTE that is reflective of overall hospital and not just ED functioning; however the exact relationship remains uncertain. Further study in a multisite study is warranted to further explore the relationship between NEAT, TTE and other important clinical metrics of ED performance.What is known about the topic? The 4-h time target or National Emergency Access Target (NEAT) is implemented in Australia to ease crowding and access block. However, little is known of its effect on important clinical endpoints, particularly 'time-to-ECG' (TTE).What does this paper add...
Source: Australian Health Review - May 9, 2017 Category: Hospital Management Authors: Hughes JA, Cabilan CJ, Young C, Staib A Tags: Aust Health Rev Source Type: research

Advance care planning, culture and religion: an environmental scan of Australian-based online resources.
Conclusions There is no comprehensive Australian-based ACP website or informational booklet supporting ACP across several cultural and religious contexts. Considering Australia's multicultural and multifaith population, such a resource may be beneficial in increasing awareness and uptake of ACP.What is known about the topic? Health professionals and consumers frequently use the Internet to find information. Non-regulation has resulted in the proliferation of ACP online resources (i.e. ACP websites and online informational booklets). Although this has contributed to raising awareness of ACP, the availability of Australian-b...
Source: Australian Health Review - April 20, 2017 Category: Hospital Management Authors: Pereira-Salgado A, Mader P, Boyd LM Tags: Aust Health Rev Source Type: research

Expertise and infrastructure capacity impacts acute coronary syndrome outcomes.
Abstract Objective Effective translation of evidence to practice may depend on systems of care characteristics within the health service. The present study evaluated associations between hospital expertise and infrastructure capacity and acute coronary syndrome (ACS) care as part of the SNAPSHOT ACS registry.Methods A survey collected hospital systems and process data and our analysis developed a score to assess hospital infrastructure and expertise capacity. Patient-level data from a registry of 4387 suspected ACS patients enrolled over a 2-week period were used and associations with guideline care and in-hospita...
Source: Australian Health Review - April 20, 2017 Category: Hospital Management Authors: Astley CM, Ranasinghe I, Brieger D, Ellis CJ, Redfern J, Briffa T, Aliprandi-Costa B, Howell T, Bloomer SG, Gamble G, Driscoll A, Hyun KK, Hammett CJ, Chew DP Tags: Aust Health Rev Source Type: research

Effect of post-hospital discharge telephonic intervention on hospital readmissions in a privately insured population in Australia.
Conclusions The HODI program post-discharge telephonic support to patients recently discharged from a hospital effectively reduced the incidence and odds of hospital 28-day readmission in a diseased population.What is known about the topic? High readmission rates are a recognised problem in Australia and contribute to the over 600000 potentially preventable hospitalisations per year.What does this paper add? The present study is the first study of a scalable intervention delivered to an Australian population with a wide variety of conditions for the purpose of reducing readmissions. The intervention reduced 28-day readmiss...
Source: Australian Health Review - April 10, 2017 Category: Hospital Management Authors: Hamar GB, Coberley C, Pope JE, Cottrill A, Verrall S, Larkin S, Rula EY Tags: Aust Health Rev Source Type: research

Self-management of health care: multimethod study of using integrated health care and supportive housing to address systematic barriers for people experiencing homelessness.
Conclusions Extending the evidence about housing as a social determinant of health, the present study shows that integrated health care and supportive housing enabled tenants to take control to self-manage their health care. In addition to homelessness directly contributing to ill health, the present study provides evidence of how the experience of homelessness contributes to exclusions from mainstream healthcare.What is known about the topic? People who are homeless experience poor physical and mental health, have unmet health care needs and use disproportionate rates of emergency health services.What does the paper add? ...
Source: Australian Health Review - April 7, 2017 Category: Hospital Management Authors: Parsell C, Ten Have C, Denton M, Walter Z Tags: Aust Health Rev Source Type: research

Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting.
We present a real case example of the experience of setting up one such best-practice, community-engaged and informed partnership model of maternity and child healthcare in south-east Queensland. We share our experience using a World Café to facilitate community engagement, service delivery and workforce planning.What are the implications for practitioners? Health professionals providing maternity care for Aboriginal and Torres Strait Islander families are encouraged to incorporate Birthing on Country principles into their model of care to address the specific needs and demands of the local Indigenous community and ...
Source: Australian Health Review - April 7, 2017 Category: Hospital Management Authors: Kildea S, Hickey S, Nelson C, Currie J, Carson A, Reynolds M, Wilson K, Kruske S, Passey M, Roe Y, West R, Clifford A, Kosiak M, Watego S, Tracy S Tags: Aust Health Rev Source Type: research

Time to wait: a systematic review of strategies that affect out-patient waiting times.
Conclusions Strategies to align resources, increase operational efficiency and improve processes provide a comprehensive approach that may reduce out-patient waiting times.What is known about the topic? Out-patient waiting times are a challenge in most countries that seek to provide universal access to health care for all citizens. Although there has been extensive research in this area, many patients still experience extensive delays accessing specialist care, particularly in the public health sector. The multiple factors that contribute to bottlenecks and inefficiencies in the referral process and affect patient waiting ...
Source: Australian Health Review - March 30, 2017 Category: Hospital Management Authors: Naiker U, FitzGerald G, Dulhunty JM, Rosemann M Tags: Aust Health Rev Source Type: research

Community knowledge of law at the end of life: availability and accessibility of web-based resources.
Conclusions Although numerous resources on end-of-life law are available online, community members may not be able to identify relevant resources or find resource content accessible.What is known about the topic? Research on participation by patients in decision making about their treatment has focused primarily on medical rather than legal knowledge.What does this paper add? The present study investigated which online resources community members may access to inform themselves about the law on end-of-life decision making. The resources identified were analysed for ease of location and content accessibility.What are the im...
Source: Australian Health Review - March 30, 2017 Category: Hospital Management Authors: White B, Willmott L, Tilse C, Wilson J, Lawson D, Pearce A, Dunn J, Aitken JF, Feeney R, Jowett S Tags: Aust Health Rev Source Type: research

Making every Australian count: challenges for the National Disability Insurance Scheme (NDIS) and the equal inclusion of homeless Aboriginal and Torres Strait Islander Peoples with neurocognitive disability.
This article highlights the dearth of accurate evidence available to inform the National Disability Insurance Scheme (NDIS) regarding the extent and nature of neurocognitive disability amongst homeless Aboriginal and Torres Strait Islander people. Without accurate prevalence rates of neurocognitive disability, homeless Aboriginal and Torres Strait Islander people are in danger of not being counted by the NDIS and not receiving supports to which they are entitled. Addressing this knowledge gap is challenged by a range of factors, including: (1) the long-term effect of profound intergenerational disenfranchisement of Aborigi...
Source: Australian Health Review - March 30, 2017 Category: Hospital Management Authors: Townsend C, White P, Cullen J, Wright CJ, Zeeman H Tags: Aust Health Rev Source Type: research

Allied health leadership in New South Wales: a study of perceptions and priorities of allied health leaders.
Conclusion The results provide new information about Australian AH leadership, governance, culture and organisation, and highlight potential priorities for future leadership activities.What is known about this topic? Although leadership is considered an essential element in the provision of high-quality health care, leadership across AH remains underexamined.What does this paper add? There is a paucity of literature pertaining to AH leadership nationally and internationally. This paper describes the issues affecting AH leaders and leadership in NSW, as reported by senior AH leaders.What are the implications for practitione...
Source: Australian Health Review - March 30, 2017 Category: Hospital Management Authors: Bradd P, Travaglia J, Hayen A Tags: Aust Health Rev Source Type: research

An examination of suicide research and funding in New Zealand 2006?16: implications for new research and policies.
Conclusions In the past decade, a substantial number of articles has been published and significant funding was invested in New Zealand's suicide research. The present review suggests that future research investments should focus on effective translation of research findings into suicide prevention programs. Several pragmatic recommendations are proposed to help improve the evidence base and reduce New Zealand's suicide rates.What is known about the topic? Suicide prevention continues to be a national public health priority for New Zealand. Although much is known about the prevalence of suicidal behaviours in New Zealand, ...
Source: Australian Health Review - March 16, 2017 Category: Hospital Management Authors: Coppersmith DD, Nada-Raja S, Beautrais AL Tags: Aust Health Rev Source Type: research

Nurse perceptions of safety climate in Australian acute hospitals: a cross-sectional survey.
Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations.What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in ...
Source: Australian Health Review - March 16, 2017 Category: Hospital Management Authors: Soh SE, Morello R, Rifat S, Brand C, Barker A Tags: Aust Health Rev Source Type: research

Healthcare-associated infections in Australia: tackling the ?known unknowns.
Abstract Australia does not have a national healthcare-associated infection (HAI) surveillance program. Without national surveillance, we do not understand the burden of HAIs, nor can we accurately assess the effects of national infection prevention initiatives. Recent research has demonstrated disparity between existing jurisdictional-based HAI surveillance activity while also identifying broad key stakeholder support for the establishment of a national program. A uniform surveillance program will also address growing concerns about hospital performance measurements and enable public reporting of hospital data. ...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Russo PL, Cheng AC, Mitchell BG, Hall L Tags: Aust Health Rev Source Type: research

Supporting return to work through appropriate certification: a systematic approach for Australian primary care.
Abstract Primary care practitioners play a critical role in supporting return to work (RTW) and minimising the detrimental physical and psychosocial sequelae of unnecessary and prolonged work absence in injured and ill workers. Accurate and consistent certification of capacity is an essential component of this role that has been scrutinised recently given the identified variation in certification practices between and within professions. This Perspective outlines the importance of correct certification of capacity for injured workers and provides a RTW flowchart to support systematised and appropriate certificatio...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Papagoras H, Pizzari T, Coburn P, Sleigh K, Briggs AM Tags: Aust Health Rev Source Type: research

How could health information be improved? Recommended actions from the Victorian Consultation on Health Literacy.
Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management.What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent ...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Hill SJ, Sofra TA Tags: Aust Health Rev Source Type: research