Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review.
Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples.What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health.What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Abor...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Campbell MA, Hunt J, Scrimgeour DJ, Davey M, Jones V Tags: Aust Health Rev Source Type: research

Effect of health insurance on direct hospitalisation costs for in-patients with ischaemic stroke in China.
Conclusions Costs per hospitalisation, costs per hospital day and the reimbursement rate were higher for BMISE- than BMISUR-insured in-patients, but BMISE-insured patients had lower out-of-pocket costs. The financial burden was higher for BMISUR- than BMISE-insured in-patients. For BMISUR-insured in-patients, the out-of-pocket payment was 43.54% of total expenses, which means the government should increase the financial investment, raise reimbursement rates and set up differential reimbursements to meet the health needs of in-patients with different income levels.What is known about the topic? Cardiovascular and cerebrovas...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Yong M, Xianjun X, Jinghu L, Yunyun F Tags: Aust Health Rev Source Type: research

Health and well being of lesbian, gay, bisexual, transgender and intersex people aged 50 years and over.
Conclusions Although many older LGBTI people are well, both physically and mentally, they do appear to face increased risk of certain health issues compared with the general population.What is known about the topic? Overseas research indicates that older LGBTI people may be at greater risk of certain physical and mental health conditions than the general population.What does this paper add? This paper provides Australian data, using well-validated instruments, on the health and well being of older LGBTI people. It provides evidence of the health issues that older LGBTI people are most concerned about and the barriers they ...
Source: Australian Health Review - March 7, 2017 Category: Hospital Management Authors: Hughes M Tags: Aust Health Rev Source Type: research

Working Together to Connect Care: a metropolitan tertiary emergency department and community care program.
Conclusion It is expected that data regarding the number of ED presentations, potential fiscal savings and client outcomes will be available in 2017.What is known about the topic? Frequent attendance at EDs is a global issue and although the number of 'super users' is small compared with non-frequent users, the presentations are high. People in the frequent attendee group will often seek care from multiple EDs for, in the main, mental health issues and substance abuse. Furthermore, frequent ED users are vulnerable and experience higher mortality, hospital admissions and out-patient visits than non-frequent users. Aggressiv...
Source: Australian Health Review - March 2, 2017 Category: Hospital Management Authors: Harcourt D, McDonald C, Cartlidge-Gann L, Burke J Tags: Aust Health Rev Source Type: research

Faecal occult blood testing (FOBT)-based colorectal cancer screening trends and predictors of non-use: findings from the South Australian setting and implications for increasing FOBT uptake.
Conclusions FOBT screening trends are indicative of the positive effect of the continued expansion of the national screening program. FOBT uptake may be increased by addressing salient barriers, as indicated by persisting reasons for non-use of FOBT.What is known about the topic? Australia has one of the highest age-standardised incidence rates of CRC (or bowel cancer) in the world. Population screening using non-invasive stool-based FOBT was implemented in Australia in 2006 with the introduction of the National Bowel Cancer Screening Program (NBCSP). To date, the NBCSP has been extended to only a small proportion of the t...
Source: Australian Health Review - March 2, 2017 Category: Hospital Management Authors: Todorov K, Wilson C, Sharplin G, Corsini N Tags: Aust Health Rev Source Type: research

Health service planning and sustainable development: considering what, where and how care is delivered through a pro-environmental lens.
Abstract The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed.What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not...
Source: Australian Health Review - March 2, 2017 Category: Hospital Management Authors: Desmond S Tags: Aust Health Rev Source Type: research

Do acute hospitalised patients in Australia have a different body mass index to the general Australian population: a point prevalence study?
Conclusions Despite health warnings about the direct relationship between illness and being overweight or obese, the results of the present study reveal fewer hospitalised patients in these BMI categories and more underweight patients than in the non-hospitalised general Australian population. Being overweight or obese may offer some protection against hospitalisation, but there is a point where the deleterious effect of obesity results in more extremely obese individuals being hospitalised than the proportion represented in the general population.What is known about the topic? Although there is significant current publish...
Source: Australian Health Review - February 23, 2017 Category: Hospital Management Authors: Dennis DM, Carter V, Trevenen M, Tyler J, Perrella L, Lori E, Cooper I Tags: Aust Health Rev Source Type: research

Pacific island health inequities forecast to grow unless profound changes are made to health systems in the region.
Conclusions The current trajectory for health in the Pacific will lead to increasing health inequity with the rest of the world. The challenges to health in the region include persisting communicable disease and maternal and child health threats, unprecedented levels of NCDs, climate change and instability, as well as low economic growth. In order to change the fortunes of this region in the age of the SDGs, a substantial investment in health is required, including in the health workforce, by countries and donors alike. That investment requires a nuanced response that takes into account the contextual differences between a...
Source: Australian Health Review - February 20, 2017 Category: Hospital Management Authors: Matheson D, Park K, Soakai TS Tags: Aust Health Rev Source Type: research

Emergency department utilisation by older people in metropolitan Melbourne, 2008?12: findings from the Reducing Older Patient.
Conclusion Older people made a significant number of PAGP-type presentations to the ED during the period 2008-12. A low rate of referral back to the primary care setting implies a potential lost opportunity to redirect older patients from ED services back to their GPs for ongoing care.What is known about the topic? Older patients are increasingly attending EDs, with a proportion attending for problems that could potentially be managed in the general practice setting (termed PAGP-type presentations).What does this paper add? This study found that PAGP-type presentations, although declining, remain an important component of ...
Source: Australian Health Review - February 20, 2017 Category: Hospital Management Authors: Mazza D, Pearce C, Joe A, Turner LR, Brijnath B, Browning C, Shearer M, Lowthian J Tags: Aust Health Rev Source Type: research

Hunter and New England HealthPathways: a 4-year journey of integrated care.
Conclusions HealthPathways is a vehicle for building strong foundations to support system change and integrated care. The critical elements for acceptability, growth and sustainability are the strong relationships between primary care and specialist clinicians, as well as formal partnerships that are built from the processes used to develop HealthPathways.What is known about the topic? HealthPathways and similar web-based evidence-informed guidelines aimed at improving system integration are increasing in Australia. There are few published papers that describe approaches to inform the ongoing implementation of such program...
Source: Australian Health Review - February 20, 2017 Category: Hospital Management Authors: Gray JS, Swan JR, Lynch MA, Tay TM, Mackenzie MJ, Wiggers JH, Harrison KA, McDonald RC, O'Dea IP, Harrigan LM, Fitzgerald SM Tags: Aust Health Rev Source Type: research

Assistive technology pricing in Australia: is it efficient and equitable?
Conclusions The results indicate that AT prices in Australia are efficient and equitable, with no significant indicators of market failure which would require government intervention. Efforts to reduce prices through the excessive use of large-scale government procurement programs are likely to reduce diversity and innovation in AT and raise AT prices over time. Open markets and competition with centralised tracking of purchases and providers to minimise possible over-servicing/over-charging align well with the original intention of the NDIS, and are likely to yield the best outcomes for consumers at the lowest costs.What ...
Source: Australian Health Review - February 6, 2017 Category: Hospital Management Authors: Summers MP, Verikios G Tags: Aust Health Rev Source Type: research

Legislation, policies and guidelines related to breastfeeding and the Baby Friendly Health Initiative in Australia: a document analysis.
Conclusions National and state guidelines are supportive of breastfeeding and the BFHI. However, the BFHI and Code of Marketing of Breast-milk Substitutes are not legislated in Australia and information related to breastfeeding rates is not up to date. A legislative establishment supporting the Code and establishing plans to monitor the MAIF Agreement and breastfeeding outcomes may influence uptake and implementation of the BFHI.What is known about the topic? Extensive evidence supports the health and economic benefits of breastfeeding. Despite a high initiation rate of breastfeeding in Australia (96%) most recently report...
Source: Australian Health Review - February 6, 2017 Category: Hospital Management Authors: Esbati A, Barnes M, Henderson A, Taylor J Tags: Aust Health Rev Source Type: research

Advance care directive documentation: issues for clinicians in New South Wales.
Conclusions Documents identified as ACDs may carry doubt about their validity. Clinicians require education about differences in template formats, the application of content to clinical decisions and associated legal responsibilities.What is known about this topic? Advance Care Directives in NSW exist without a specific legislative framework or prescriptive format. Clinicians are presented with a wide variety of documents with broad variance in content.What does this paper add? This paper describes the variance found within ACDs in detail, and identifies concerns about validity that healthcare systems need to consider.What...
Source: Australian Health Review - February 2, 2017 Category: Hospital Management Authors: Friedewald MI, Cleasby PA Tags: Aust Health Rev Source Type: research

Improving the ascertainment of refugee-background people in health datasets and health services.
Abstract Ascertainment of vulnerable populations in health datasets is critical to monitoring disparities in health outcomes, enables service planning and guides the delivery of health care. There is emerging evidence that people of refugee backgrounds in Australia experience poor health outcomes and barriers to accessing services, yet a clear picture of these disparities is limited by what is routinely collected in health datasets. There are challenges to improving the accuracy of ascertainment of refugee background, with sensitivities for both consumers and providers about the way questions are asked. Initial te...
Source: Australian Health Review - February 2, 2017 Category: Hospital Management Authors: Yelland J, Riggs E, Szwarc J, Vanpraag D, Dawson W, Brown S Tags: Aust Health Rev Source Type: research

Rural health services and the task of community participation at the local community level: a case study.
Abstract Community participation in health service decision making is entrenched in health policy, with a strong directive to develop sustainable, effective, locally responsive services. However, it is recognised that community participation is challenging to achieve. The aim of the present study was to explore how a rural health service in Victoria enacts community participation at the local level. Using case study methodology, the findings indicate that enactment of community participation is desired by the health service, but a lack of understanding of the concept and how to enact associated policy are barriers...
Source: Australian Health Review - January 30, 2017 Category: Hospital Management Authors: Wilson E, Kenny A, Dickson-Swift V Tags: Aust Health Rev Source Type: research

Are wait lists inevitable in subacute ambulatory and community health services? A qualitative analysis.
Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow.What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to g...
Source: Australian Health Review - January 30, 2017 Category: Hospital Management Authors: Harding KE, Robertson N, Snowdon DA, Watts JJ, Karimi L, O'Reilly M, Kotis M, Taylor NF Tags: Aust Health Rev Source Type: research

Challenges in implementing individual placement and support in the Australian mental health service and policy context.
Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs.What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain...
Source: Australian Health Review - January 20, 2017 Category: Hospital Management Authors: Stirling Y, Higgins K, Petrakis M Tags: Aust Health Rev Source Type: research

What is the role of health systems in responding to domestic violence? An evidence review.
Conclusions There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence.What is known about the topic? Domestic violence is a significant problem globally with enormous human, social and economic costs. Although women who have experienced abuse make extensive use of healthcare services, health services have lagged behind the policing, criminal justice and other human service domains in responding to domestic violence.What does this paper add? The present comprehensive review identifies best-practice health system responses to domestic violence.Wha...
Source: Australian Health Review - January 20, 2017 Category: Hospital Management Authors: Spangaro J Tags: Aust Health Rev Source Type: research

Electronic health records and online medical records: an asset or a liability under current conditions?
Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services.What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but ha...
Source: Australian Health Review - January 20, 2017 Category: Hospital Management Authors: Allen-Graham J, Mitchell L, Heriot N, Armani R, Langton D, Levinson M, Young A, Smith JA, Kotsimbos T, Wilson JW Tags: Aust Health Rev Source Type: research

Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice.
Conclusion eHealth technologies in hospital settings appear to improve efficiency and appropriateness of care, prescribing safety and disease control. Effects on mortality, readmissions, total costs and patient and provider experience remain uncertain.What is known about the topic? Healthcare systems internationally are undertaking large-scale digitisation programs with hospitals being a major focus. Although predictive analyses suggest that eHealth technologies have the potential to markedly transform health care delivery, contemporary peer-reviewed research evidence detailing their benefits and harms is limited.What does...
Source: Australian Health Review - January 9, 2017 Category: Hospital Management Authors: Keasberry J, Scott IA, Sullivan C, Staib A, Ashby R Tags: Aust Health Rev Source Type: research

It.
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 16, 2016 Category: Hospital Management Authors: May J, Walker J, McGrail M, Rolley F Tags: Aust Health Rev Source Type: research

General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial.
Conclusion These findings suggest that the ACTIVATE program aimed at training GPs to screen and better manage chronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changes in medical management practices by GPs in the intervention area during that time.What is known about the topic? People with an SMI have higher mortality and poorer physical health than the general population.What does this paper add? The community intervention had a significant and sustained effect, with demonstrated desired changes in screening and medical management by GPs for adults with SM...
Source: Australian Health Review - December 16, 2016 Category: Hospital Management Authors: Cameron CM, Cameron CM, Cumsille Nazar J, Cumsille Nazar J, Ehrlich C, Ehrlich C, Kendall E, Kendall E, Crompton D, Crompton D, Liddy AM, Liddy AM, Kisely S, Kisely S Tags: Aust Health Rev Source Type: research

?Why didn.
Conclusions It is likely that futile CPR is provided contrary to policy and legal documents relating to end-of-life care, with the potential for harms relating to both patient and family, and members of resuscitation teams. The failure appears to relate to process rather than recognition of poor patient outcome.What is known about the topic? Mandatory CPR has been established in Australian hospitals on the premise that it will save lives. The outcome from in-hospital cardiac arrest has not improved despite significant training and resources. The outcome for those acutely hospitalised patients aged over 80 years has been re...
Source: Australian Health Review - December 16, 2016 Category: Hospital Management Authors: Levinson M, Mills A, Barrett J, Sritharan G, Gellie A Tags: Aust Health Rev Source Type: research

Can a clinical senate enhance state-wide clinician engagement? A survey study.
Conclusion A clinical senate model can facilitate state-wide clinician engagement.What is known about the topic? High levels of clinical engagement foster a culture within healthcare organisations that is associated with the delivery of sustained high-quality, safe and efficient services. This has led to a focus on strategies to optimise clinical engagement in healthcare planning and reform. However, there is limited data exploring how to achieve clinical engagement at a state, rather than local, level within the healthcare system.What does this paper add? This survey study evaluates the effectiveness of the Western Austra...
Source: Australian Health Review - December 16, 2016 Category: Hospital Management Authors: Quinlivan JA, Miller M, Hutton M Tags: Aust Health Rev Source Type: research

Reply to ?Evidence-based review, not change in usage patterns, should drive Medicare Benefit Schedule (MBS) disinvestment decisions.
PMID: 27914485 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - December 5, 2016 Category: Hospital Management Authors: Mundy L Tags: Aust Health Rev Source Type: research

Are organisational factors affecting the emotional withdrawal of community nurses?
Conclusion Emotional dissonance can be a potential stressor for community nurses that can trigger withdrawal behaviours. Improving work organisational factors may help reduce emotional conflict and its effect on withdrawal behaviours.What is known about the topic? Although emotional labour has been broadly investigated in the literature, very few studies have addressed the effect of the quality of work organisation on nurses' withdrawal behaviours in a nursing setting.What does this paper add? This paper provides evidence that work organisation affects levels of emotional dissonance and has an effect on job neglect through...
Source: Australian Health Review - December 5, 2016 Category: Hospital Management Authors: Karimi L, Leggat SG, Cheng C, Donohue L, Bartram T, Oakman J Tags: Aust Health Rev Source Type: research

Investigation of training and support needs in rural and remote disability and mainstream service providers: implications for an online training model.
Conclusion Overall, service providers in rural and remote areas are generally not currently meeting their needs in terms of frequency of supervision and professional development. The present needs analysis identifies key areas for learning, the ideal frequency of support and the acceptability of using technology to deliver this support. This information will guide future researchers in the development of an evidence-based model that will be accessible and meaningful to its participants.What is known about the topic? It is known that there are difficulties in recruiting and retaining practitioners in rural and remote commun...
Source: Australian Health Review - November 28, 2016 Category: Hospital Management Authors: Johnsson G, Kerslake R, Crook S, Cribb C Tags: Aust Health Rev Source Type: research

Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory.
Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services.What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available ...
Source: Australian Health Review - November 28, 2016 Category: Hospital Management Authors: Borotkanics R, Rowe C, Georgiou A, Douglas H, Makeham M, Westbrook J Tags: Aust Health Rev Source Type: research

Evidence-based review, not change in usage patterns, should drive Medicare Benefit Schedule (MBS) disinvestment decisions.
PMID: 27883872 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - November 25, 2016 Category: Hospital Management Authors: Orchard JW, Orchard JJ, Samra DJ Tags: Aust Health Rev Source Type: research

Doctors.
Conclusion There are complex barriers to the writing and implementation of NFR orders, including doctors' knowledge around the need for consent when cardiopulmonary resuscitation is likely to be futile or excessively burdensome. Doctors also believed that NFR orders result in changes to goals-of-care, suggesting a confounding of NFR orders with palliative care. Furthermore, doctors are willing to write NFR orders where there is clear medical indication and the patient is imminently dying, but are otherwise reliant on patients and family to initiate discussion.What is known about the topic? Hospitalised elderly patients, in...
Source: Australian Health Review - November 25, 2016 Category: Hospital Management Authors: Sritharan G, Mills AC, Levinson MR, Gellie AL Tags: Aust Health Rev Source Type: research

Structured interdisciplinary bedside rounds do not reduce length of hospital stay and 28-day re-admission rate among older people hospitalised with acute illness: an Australian study.
Conclusions Although ineffective interdisciplinary communication is associated with negative outcomes for patients and healthcare services, models of care that aim to improve communication are not necessarily effective in reducing LOS or early re-admission. Clinical services implementing SIBR are encouraged to independently evaluate their effects.What is known about the topic? Ineffective interdisciplinary communication may harm patients and increase LOS. Only two publications have evaluated the implementation of SIBR, a new model of care that aims to improve interdisciplinary communication and collaboration. One paper rep...
Source: Australian Health Review - November 25, 2016 Category: Hospital Management Authors: Huynh E, Basic D, Gonzales R, Shanley C Tags: Aust Health Rev Source Type: research

Is the Australian 75+ Health Assessment person-centred? A qualitative descriptive study of older people.
Conclusion To enable older people to make informed decisions about and successfully manage their own health and well being, and to choose when to invite others to act on their behalf, primary health professionals need to ask questions in the 75+HA within a person-centred mindset. The 75+HA is an opportunity to ensure older people know why they need support, which ones, and agree to, supports and services they require.What is known about the topic? The Australian Medicare Benefits Schedule includes the 75+HA, developed as a proactive primary care opportunity for general practitioners and practice nurses to identify issues a...
Source: Australian Health Review - November 18, 2016 Category: Hospital Management Authors: Price K, Grimmer K, Foot J Tags: Aust Health Rev Source Type: research

Profile of 1 year of fieldwork experiences for undergraduate occupational therapy students from a large regional Australian university.
Conclusions The placement profile of undergraduate occupational therapy students appeared to be consistent with workforce reports on occupational therapy professional practice.What is known about the topic? Fieldwork experienced by health professional students is critical to preparing new graduates for practice. Although the World Federation of Occupational Therapy provides guidance on what is required for occupational therapy fieldwork experience, little is known about what students actually experience during their fieldwork placements.What does this paper add? The present study is the first to document the range of field...
Source: Australian Health Review - November 4, 2016 Category: Hospital Management Authors: Mackenzie L, O'Toole G Tags: Aust Health Rev Source Type: research

Exploring interhospital transfers and partnerships in the hospital sector in New South Wales, Australia.
Conclusion NSW IHTs were often to hospitals with greater speciality services. The patterns of interhospital interactions could be affected by organisational and regional preferences.What is known about the topic? IHTs aim to provide efficient and effective care. Nonetheless, information on transfers and the sharing of care among hospitals in an Australian setting is lacking. Studies of transfers and hospital partnership patterns will inform efforts to improve patient-centred transfers and hospital accountability in terms of end outcomes for patients.What does this paper add? Transfer-in patients accounted for 3.9% of all N...
Source: Australian Health Review - November 4, 2016 Category: Hospital Management Authors: Assareh H, Achat HM, Levesque JF, Leeder SR Tags: Aust Health Rev Source Type: research

Home enteral nutrition: are we providing a quality service?
PMID: 27809959 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - November 4, 2016 Category: Hospital Management Authors: Qvist A Tags: Aust Health Rev Source Type: research

Inconsistencies in authoritative national paediatric workforce data sources.
Conclusions The national datasets currently available from federal and speciality sources do not provide consistent or reliable counts of the number of medical practitioners. The lack of an adequate baseline for the workforce prevents accurate predictions of future needs to provide the best possible care of children in Australia.What is known about the topic? Various national data sources contain counts of the number of medical practitioners in Australia. These data are used in health workforce projections, policy and planning.What does this paper add? The present study found that the current data sources do not provide co...
Source: Australian Health Review - October 28, 2016 Category: Hospital Management Authors: Allen AR, Doherty R, Hilton AM, Freed GL Tags: Aust Health Rev Source Type: research

Embedding health literacy into health systems: a case study of a regional health service.
Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems.What is known about the topic? Poor health literacy is a signif...
Source: Australian Health Review - October 28, 2016 Category: Hospital Management Authors: Vellar L, Mastroianni F, Lambert K Tags: Aust Health Rev Source Type: research

Responses by hospital complaints managers to recommendations for systemic reforms by health complaints commissions.
Conclusions Hospital complaints managers mostly responded as virtuous or rational actors to the symbolic power of complaints commissions. This may be context dependent because Australian health commissions operate within a pro-reform context as a result of recent publicity around health system failures.What is known about the topic? Little is known about regulatory relationships between complaints commissions and hospitals. There has been no Australian research considering how complaints managers respond to commission recommendations for quality improvements and reforms to hospital services.What does the paper add? The pap...
Source: Australian Health Review - October 21, 2016 Category: Hospital Management Authors: Smith-Merry J, Walton M, Healy J, Hobbs C Tags: Aust Health Rev Source Type: research

Capturing religious identity during hospital admission: a valid practice in our increasingly secular society?
Conclusions This study illustrates that religious identity is important for a majority of Royal Melbourne's culturally diverse inpatients. This data would seem to give the practice of collecting religious identity data on admission new credence, especially as our culturally and linguistically diverse populations increase. In order to understand these nuances and provide appropriate care, skilled spiritual screening and assessment would appear to be not optional, but rather necessary in our increasingly complex healthcare future.What is known about the topic? A search of the literature using related terms (religious, religi...
Source: Australian Health Review - October 21, 2016 Category: Hospital Management Authors: Glenister D, Prewer M Tags: Aust Health Rev Source Type: research

Completion of Limitation of Medical Treatment forms by junior doctors for patients with dementia: clinical, medicolegal and education perspectives.
Conclusions LMT forms should be designed for clarity and consistency across HCOs. Enhancing patient care requires appropriate and sensitive completion of LMT. Relevant HCO policy and clinical practice changes are discussed herein, and recommendations are made for junior doctors in this arena, specifically in the context of patients with dementia.What is known about the topic? Junior doctors continue to play a central role in LMT orders, a highly complex decision-making task that they are poorly prepared to complete. LMT decision making in Australia's aging population and for people with dementia is especially challenging.W...
Source: Australian Health Review - October 14, 2016 Category: Hospital Management Authors: Yoong J, MacPhail A, Trytel G, Rajendram PY, Winbolt M, Ibrahim JE Tags: Aust Health Rev Source Type: research

Creating a new investment pool for innovative health systems research.
Abstract Recent trends in health research funding towards 'safe bets' is discouraging investment into the development of health systems interventions and choking off a vital area of policy-relevant research. This paper argues that to encourage investment into innovative and perceivably riskier health systems research, researchers need to create more attractive business cases by exploring alternative approaches to the design and evaluation of health system interventions. At the same time, the creation of dedicated funding opportunities to support this work, as well as for relevant early career researchers, is neede...
Source: Australian Health Review - October 14, 2016 Category: Hospital Management Authors: Laba TL, Patel A, Jan S Tags: Aust Health Rev Source Type: research

Social participation as an indicator of successful aging: an overview of concepts and their associations with health.
Conclusion A model of social participation on health is presented, showing the evidence that all three concepts contribute to the association between social participation and health through their shared mechanisms of social support and social cohesion with the wider community. Using an instrument that can be separated into these three distinct concepts will assist health services researchers to determine the relative effect of each form of participation on the health of older adults.What is known about the topic? Social participation has generated a wealth of research in gerontology. The scope of the literature on social p...
Source: Australian Health Review - October 7, 2016 Category: Hospital Management Authors: Douglas H, Georgiou A, Westbrook J Tags: Aust Health Rev Source Type: research

Integration of nurse practitioners using a change management framework: the way forward.
Conclusions Healthcare reform is a complex organisational change. Alignment of several key elements is required for the process to be successful. A change management proposal for reframing organisations provides an apt framework for use in the Australian context of reforming workforce to integrate NPs into healthcare teams. The theoretical framework proposes that multiple lenses be applied to change processes, to integrate NPs into the workforce and highlights the need for exceptional leadership throughout such endeavours.What is known about the topic? NPs provide safe and efficient care to patients, often in settings wher...
Source: Australian Health Review - October 7, 2016 Category: Hospital Management Authors: Lowe G, Plummer V, Boyd L Tags: Aust Health Rev Source Type: research

Paediatrician perceptions of patient referral and discharge.
Conclusions Understanding the factors involved in the referral process and the decision to discharge patients from speciality care clinics to primary care is essential to develop strategies to address long waiting times. Ensuring appropriate referral of children involves the participation of GPs, parents and specialists.What is known about the topic? Most paediatric subspecialists practice in paediatric hospitals, where there is a sufficient volume of patients requiring their services. There have been reports across Australia of increased referrals to general and subspecialist paediatricians, with subsequent increases in w...
Source: Australian Health Review - September 26, 2016 Category: Hospital Management Authors: Freed GL, Turbitt E, Gafforini S, Kunin M Tags: Aust Health Rev Source Type: research

Right care, right place, right time: improving the timeliness of health care in New South Wales through a public?private hospital partnership.
Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care.What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships.What does this pa...
Source: Australian Health Review - September 23, 2016 Category: Hospital Management Authors: Saunders C, Carter DJ Tags: Aust Health Rev Source Type: research

How do consumer leaders co-create value in mental health organisations?
Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings.What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consume...
Source: Australian Health Review - September 23, 2016 Category: Hospital Management Authors: Scholz B, Bocking J, Happell B Tags: Aust Health Rev Source Type: research

Implementation of a new model of clinical education for regional occupational therapy student clinical placements.
Abstract Expansion of occupational therapy education programs has resulted in increased student numbers and demand on clinicians to host clinical placements while also maintaining the delivery of high-quality, safe clinical services to patients. Much of the research about innovative placement models, including student contributions to service delivery, has been conducted in metropolitan areas. Therefore, there is a need to develop models that are suited to regional settings that face diversity of caseload, more generalised occupational therapy roles and variations in patient flow. The aim of the present study was ...
Source: Australian Health Review - September 16, 2016 Category: Hospital Management Authors: Furness L, Pighills AC, Ducat W, Tynan A Tags: Aust Health Rev Source Type: research

Identification of major factors in Australian primary care pharmacists.
Conclusions The three dominant groups of factors in each of the five STEEP environmental domains, which have a bearing on pharmacists' capacity to implement patient-focused models of practice, correlate well with the enabling factors identified in the profession's vision statement, with the addition of three factors in the Environmental domain of stakeholder attitudes, health system reform and external competition.What is known about the topic? The extensive range of patient-focused professional programs developed for application by pharmacists in primary care in Australia has yet to be widely implemented.What does this pa...
Source: Australian Health Review - September 16, 2016 Category: Hospital Management Authors: Jackson JK, Hussainy SY, Kirkpatrick CM Tags: Aust Health Rev Source Type: research

Empirical exploration of brilliance in health care: perceptions of health professionals.
Conclusions The research presents empirical material to support the emergence of an evidence-based health professional perspective of brilliance in health management. The findings support other studies that have drawn on both quantitative and qualitative materials to explore brilliance in health care. Pockets of brilliance have been previously identified as catalysts for changing health care systems. Both quality, seen as driven from the outside, and excellence, driven from within individuals, are necessary to produce brilliance.What is known about the topic? The quest for brilliance in health care is not easy but essentia...
Source: Australian Health Review - September 9, 2016 Category: Hospital Management Authors: Karimi L, Dadich A, Fulop L, Leggat SG, Rada J, Hayes KJ, Kippist L, Eljiz K, Smyth A, Fitzgerald JA Tags: Aust Health Rev Source Type: research

Collaborative arrangements and privately practising nurse practitioners in Australia: results from a national survey.
Conclusion Although there are benefits to collaborative arrangements, there is also concern from PPNPs that mandating such arrangements through legislation presents a barrier to establishing PPNP services and potentially reduces patient access to care. Collaboration with medical practitioners is intrinsic to nursing practice. Thus, legislating for collaborative arrangements is unnecessary, because it makes the normal abnormal.What is known about the topic? To access the MBS and PBS, PPNPs are required by law to have a collaborative arrangement with a medical practitioner or entity that employs medical practitioners. To dat...
Source: Australian Health Review - September 9, 2016 Category: Hospital Management Authors: Currie J, Chiarella M, Buckley T Tags: Aust Health Rev Source Type: research