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

Effectiveness and efficiency of training in digital healthcare packages: training doctors to use digital medical record keeping software.
Conclusions Overall, the greatest improvements in task performance followed daily ward-based experience using BOSSnet rather than formalised training. The greatest benefits of training were noted when training was delivered in close proximity to the onset of employment.What is known about the topic? Formalised training in the use of information and communications technology (ICT) is widespread in the health service. However, there is limited evidence to support the modes of learning typically used. Formalised training is often costly and there is little other than anecdotal evidence that currently supports its efficacy in ...
Source: Australian Health Review - September 5, 2016 Category: Hospital Management Authors: Benwell N, Hird K, Thomas N, Furness E, Fear M, Sweetman G Tags: Aust Health Rev Source Type: research

Public or private care: where do specialists spend their time?
Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs.What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospita...
Source: Australian Health Review - September 5, 2016 Category: Hospital Management Authors: Freed GL, Turbitt E, Allen A Tags: Aust Health Rev Source Type: research

Experience of clinical supervisors of international medical graduates in an Australian district hospital.
Conclusions The additional work required to supervise IMGs in order to enable them to perform at a satisfactory level and successfully integrate into the Australian healthcare system needs to be recognised and resourced. Assistance with attaining proficiency in English and with communication skills over and above the standard required to pass the International English Language Testing System examination should be seriously considered as a means of improving performance.What is known about the topic? To date, there is little research available about the experience of supervisors of IMGs in Australia.What does this paper add...
Source: Australian Health Review - September 2, 2016 Category: Hospital Management Authors: Henderson D, McGrath PD, Patton MA Tags: Aust Health Rev Source Type: research

Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs?
Conclusions The data confirm that the PIR program, at least in the two regions evaluated, is mostly reaching its intended audience. Some data were being collected inconsistently, limiting the usefulness of the data and the ability to build on PIR findings to develop ongoing support for this population.What is known about the topic? PIR is a unique national program funded to engage with and address the needs of Australians living with severe and persistent mental illness by facilitating service access.What does this paper add? This paper reports on recruitment of people living with severe and persistent mental illness, thei...
Source: Australian Health Review - September 2, 2016 Category: Hospital Management Authors: Hancock N, Smith-Merry J, Gillespie JA, Yen I Tags: Aust Health Rev Source Type: research

Improving the accuracy of admitted subacute clinical costing: an action research approach.
Conclusions Engaging clinicians and cost centre managers was effective in facilitating the development of robust clinical costing data in an admitted subacute setting. Further investigation into the value of this approach across other care types and healthcare services is warranted.What is known about this topic? Accurate clinical costing data is essential for informing price models used in activity-based funding. In Australia, there is currently a lack of robust admitted subacute cost data to inform the price model for this care type.What does this paper add? The action research framework presented in this study was effec...
Source: Australian Health Review - August 29, 2016 Category: Hospital Management Authors: Hakkennes S, Arblaster R, Lim K Tags: Aust Health Rev Source Type: research

Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data.
Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia.What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people.What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including ...
Source: Australian Health Review - August 29, 2016 Category: Hospital Management Authors: de Silva AM, Martin-Kerry JM, McKee K, Cole D Tags: Aust Health Rev Source Type: research

Beyond clinical priority: what matters when making operational decisions about emergency surgical queues?
Conclusions Queue positions of patients waiting for unplanned surgery, or emergency surgery, are determined by medical clinicians according to clinicians' indication of clinical priority. However, operating theatre managers are important in facilitating smooth operations when planning for emergency surgeries. It is necessary for surgeons to understand the logistical challenges faced by managers when requesting logistical priorities for their operations.What is known about the topic? Tensions exist about the efficient use of operating theatres and negotiating individual surgeon's demands, especially between surgeons and man...
Source: Australian Health Review - August 29, 2016 Category: Hospital Management Authors: Fitzgerald A, Wu Y Tags: Aust Health Rev Source Type: research

What systems participants know about access and service entry and why managers should listen.
Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity.What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing.What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level.What are the implications for practitioners?...
Source: Australian Health Review - August 29, 2016 Category: Hospital Management Authors: Duncombe R Tags: Aust Health Rev Source Type: research

Bridging the language gap: a co-designed quality improvement project to engage professional interpreters for women duing labour.
Conclusion Improving interpreter use in high-intensity hospital birth suites is possible with supportive leadership, multidisciplinary co-design and within a framework of quality improvement cycles of change.What is known about the topic? Despite Australian healthcare standards and policies stipulating the use of accredited interpreters where needed, studies indicate that services fall well short of meeting these during critical stages of childbirth.What does the paper add? Collaborative approaches to quality improvement in hospitals can significantly improve the engagement of interpreters to facilitate communication betwe...
Source: Australian Health Review - August 29, 2016 Category: Hospital Management Authors: Yelland J, Biro MA, Dawson W, Riggs E, Vanpraag D, Wigg K, Antonopoulos J, Morgans J, Szwarc J, East C, Brown S Tags: Aust Health Rev Source Type: research

Recurrent episodes of injury in children: an Australian cohort study.
Abstract Objective The aim of the present study was to compare sociodemographic characteristics of children with single versus recurrent episodes of injury and provide contemporary evidence for Australian injury prevention policy development.Methods Participants were identified from the Environments for Healthy Living: Griffith Birth Cohort Study 2006-11 (n=2692). Demographic data were linked to the child's hospital emergency and admissions data from birth to December 2013. Data were dichotomised in two ways: (1) injured or non-injured; and (2) single or recurrent episodes of injury. Multivariate logistic regressi...
Source: Australian Health Review - August 19, 2016 Category: Hospital Management Authors: Cameron CM, Spinks AB, Osborne JM, Davey TM, Sipe N, McClure RJ Tags: Aust Health Rev Source Type: research

Informed consent in a vulnerable population group: supporting individuals aging with intellectual disability to participate in developing their own health and support programs.
Conclusions Three critical factors for facilitating personal involvement in decision making for individuals with an intellectual disability were identified: (1) defining consent specifically for the target outcome; (2) outlining the criteria needed for consent to be obtained; and (3) using appropriately modified alternative communication mechanisms as necessary.What is known about the topic? Self-determination is one of the fundamental principles of human rights legislation around the world and, as such, it is considered desirable to have personal input by individuals into the development of their own health care plans. Ho...
Source: Australian Health Review - August 19, 2016 Category: Hospital Management Authors: Wark S, MacPhail C, McKay K, Müeller A Tags: Aust Health Rev Source Type: research

Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.
Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities.What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifica...
Source: Australian Health Review - August 19, 2016 Category: Hospital Management Authors: McGrail MR, Russell DJ, Humphreys JS Tags: Aust Health Rev Source Type: research

Patients.
Conclusion Tangible opportunities to enhance the patient experience are apparent. Small changes to the way that the health system operates and is resourced and the way that health professionals engage with patients could substantially improve care. Examples include inviting patients and carers to contribute to decision making and discussions about their treatment options and care preferences.What is known about the topic? Patient experience is identified as a key component of an optimal health system, along with improving the health of populations and reducing the per capita costs of care. The use of patient experience dat...
Source: Australian Health Review - August 19, 2016 Category: Hospital Management Authors: Harrison R, Walton M, Manias E, Mears S, Plumb J Tags: Aust Health Rev Source Type: research

Identifying areas of need relative to liver disease: geographic clustering within a health service district.
Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing.What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of t...
Source: Australian Health Review - August 11, 2016 Category: Hospital Management Authors: El-Atem N, Irvine KM, Valery PC, Wojcik K, Horsfall L, Johnson T, Janda M, McPhail SM, Powell EE Tags: Aust Health Rev Source Type: research

Diabetic patient adherence to pathology request completion in primary care.
Conclusion A high proportion of patients do not prioritise the monitoring of their diabetes, potentially because of a lack of understanding of the importance such management has on their health. Further research should be conducted to determine the effect of the implementation of point-of-care testing on patient outcomes in such areas of low non-adherence with disease management.What is known about the topic? Little quantitative information exists regarding the adherence rate of patients to pathology request completion. Without up-to-date pathology results, a barrier is created, preventing accurate medical treatment of the...
Source: Australian Health Review - August 11, 2016 Category: Hospital Management Authors: Ramsay N, Johnson T, Badrick T Tags: Aust Health Rev Source Type: research

Shape of allied health: an environmental scan of 27 allied health professions in Victoria.
Conclusions Workforce planning for allied health is extremely complex because of the lack of data, fragmented funding and regulatory frameworks and diverse employment contexts.What is known about this topic? There is a lack of good-quality workforce data on the allied health professions generally. The allied health workforce is highly feminised and unevenly distributed geographically, but there is little analysis of these issues across professions.What does this paper add? The juxtaposition of the health workforce demographics and distribution of 27 allied health professions in Victoria illustrates some clear trends and id...
Source: Australian Health Review - August 11, 2016 Category: Hospital Management Authors: Nancarrow SA, Young G, O'Callaghan K, Jenkins M, Philip K, Barlow K Tags: Aust Health Rev Source Type: research

Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change.
Conclusion Growth in Australian ED presentations from 2006-07 to 2010-11 was greater than that expected from population growth alone. The 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? Rapid population aging is anticipated over coming decades. International studies and specific local-level Australian studies have demonstrated significant growth in ED presentations. There have been no prior national-l...
Source: Australian Health Review - July 29, 2016 Category: Hospital Management Authors: Burkett E, Martin-Khan MG, Scott J, Samanta M, Gray LC Tags: Aust Health Rev Source Type: research

Addressing cost of unwarranted medical care in the medical curriculum.
Abstract Within the past decade, there has been a significant increase in Australia's health expenditure, with a concurrent rise in overdiagnosis. Australia has introduced the Choosing Wisely campaign in a bid to identify and reduce commonly used investigations, treatments and procedures that add little benefit to patient care. By catalysing a discussion regarding evidence-based use of medications and medical testing, the Choosing Wisely campaign can minimise risk of harm to patients, as well as reduce expenditure. Internationally, several institutions are considering introducing training regarding cost-effective ...
Source: Australian Health Review - July 29, 2016 Category: Hospital Management Authors: Tran DM, Forbes MP Tags: Aust Health Rev Source Type: research

Supporting continuity of care between prison and the community for women in prison: a medical record review.
Conclusion Increased health information transfer to community HCPs is needed to improve continuity of care between prison and community.What is known about the topic? Many women in prison have high health needs. Health and well being are at further risk at the time of transition between prison and community.What does this paper add? This study provides evidence that outside formal programs, which are currently available only for a minority of women, continuity of care arrangements and transfer of health information do not usually occur when women leave prison. Pragmatic choices about continuity of care at the interface bet...
Source: Australian Health Review - July 29, 2016 Category: Hospital Management Authors: Abbott P, Magin P, Lujic S, Hu W Tags: Aust Health Rev Source Type: research

Practical applications of rapid review methods in the development of Australian health policy.
Abstract Rapid reviews (RRs) are a method of evidence synthesis that can provide robust evidence to support policy decisions in a timely manner. Herein we describe the methods used to conduct RRs and present an illustrative case study to describe how RRs can be used to inform contemporary Australian health policy. The aim of the present study was to explore several important aspects of how RRs can inform decision makers. RRs are conducted within limited time frames of as little as 4 weeks. Policy questions may focus on issues of efficacy, service delivery and service organisation rather than reimbursement of new s...
Source: Australian Health Review - July 29, 2016 Category: Hospital Management Authors: Lambert R, Vreugdenburg TD, Marlow N, Scott NA, McGahan L, Tivey D Tags: Aust Health Rev Source Type: research

Survey of parent and carer experiences and expectations of paediatric rheumatology care in New South Wales.
Conclusions Children with RD in NSW still experience significant delays from symptom onset to final diagnosis through consultations with multiple healthcare professionals. Multidisciplinary team care was not the norm for this patient group, despite established national and international management standards.What is known about the topic? Early diagnosis and management by a multidisciplinary team is the gold standard in PR management. Delays in diagnosis may significantly impair the outcomes of children diagnosed with RD, with reduced quality of life, increased pain level and worse long-term prognosis.What does this paper a...
Source: Australian Health Review - July 29, 2016 Category: Hospital Management Authors: Coda A, Jones J, Grech D, Grewal DS Tags: Aust Health Rev Source Type: research

Costs associated with hereditary haemochromatosis in Australia: a cost-of-illness study.
Conclusion The present cost-of-illness study, the first to be published for haemochromatosis, found that although costs were substantial, they could be decreased by reducing clinical penetrance. Development of cost-effective strategies to increase early diagnosis is likely to result in better health outcomes for patients and lower total costs.What is known about the topic? To date, no cost-of-illness study has been conducted for haemochromatosis. Previous economic work in this area has relied on cost estimates based on expert opinion.What does the paper add? This paper provides the first cost estimates for haemochromatosis...
Source: Australian Health Review - July 22, 2016 Category: Hospital Management Authors: de Graaff B, Neil A, Sanderson K, Yee KC, Palmer AJ Tags: Aust Health Rev Source Type: research

Growth of linked hospital data use in Australia: a systematic review.
Conclusion More than 80% of publications were from WA and NSW, whereas other states significantly lag behind. The observable growth in these two states clearly demonstrates the underutilised opportunities for data linkage to add value in health services research in the other states.What is known about the topic? Linking administrative hospital data to other data has the potential to be a cost-effective method to significantly improve health policy. Over the past two decades, Australia has made significant investments in improving its data linkage capabilities. However, several articles have highlighted the many barriers in...
Source: Australian Health Review - July 22, 2016 Category: Hospital Management Authors: Tew M, Dalziel KM, Petrie DJ, Clarke PM Tags: Aust Health Rev Source Type: research

Parental preferences for paediatric specialty follow-up care.
Conclusion Most parents attending paediatric out-patient appointments prefer to return for follow-up care; however, a paediatrician's advice may have an important role in return of paediatric patients to primary care.What is known about the topic? In Australia, there has been a growing concern regarding long waiting times for specialist consultations in out-patient clinics and difficulties with access for new patients. This has occurred when the ratio of review attendees to new patients has tipped towards the review attendees.What does this paper add? Most parents of children attending paediatric out-patient clinics value ...
Source: Australian Health Review - July 22, 2016 Category: Hospital Management Authors: Kunin M, Turbitt E, Gafforini SA, Sanci LA, Spike NA, Freed GL Tags: Aust Health Rev Source Type: research

Effects of social integration on depressive symptoms in Korea: analysis from the Korean Longitudinal Study of Aging (2006?12).
Conclusions The results of the present study provide a scientific basis for the specific association between the level of social integration and changes in social integration pattern with the risk of depressive symptoms in current practice. Therefore, interventions to provide emotional support for older adults via social integration may be important to protect against depressive symptoms.What is known about the topic? Although there has been considerable discussion about social integration among old adults, few studies related to effect of social integration on depression have been conducted.What does this paper add? The f...
Source: Australian Health Review - July 15, 2016 Category: Hospital Management Authors: Kim JH, Park EC, Lee SG, Lee Y, Jang SI Tags: Aust Health Rev Source Type: research

The prevalence of pre-existing mental health, drug and alcohol conditions in major trauma patients.
Conclusions Under-reporting of mental health conditions in hospital discharge data appears likely, reducing the capacity to characterise the injury population. Further validation is needed.What is known about the topic? Medical record review, routine hospital discharge data and self-report have been used by studies previously to characterise mental health, drug and alcohol conditions in injured populations, with medical record review considered the most accurate and reliance on self-report measures being considered at risk of recall bias. The use of routinely collected data sources provides an efficient and standardised me...
Source: Australian Health Review - July 15, 2016 Category: Hospital Management Authors: Nguyen TQ, Simpson PM, Gabbe BJ Tags: Aust Health Rev Source Type: research

Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia.
Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia.What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exis...
Source: Australian Health Review - July 15, 2016 Category: Hospital Management Authors: Cyril S, Polonsky M, Green J, Agho K, Renzaho A Tags: Aust Health Rev Source Type: research

How shortcomings in the mental health system affect the use of involuntary community treatment orders.
Conclusion The findings of the present study indicate that deficiencies in health service structures and resourcing are a significant factor in CTO use. This raises questions about policy accountability for mental health services (both voluntary and involuntary), as well as about the usefulness of CTOs, justifications for CTO use and the legal criteria regulating CTO implementation.What is known about this topic? Following the deinstitutionalisation of psychiatric services over recent decades, community settings are increasingly the focus for the delivery of mental health services to people living with severe and persisten...
Source: Australian Health Review - July 15, 2016 Category: Hospital Management Authors: Light EM, Robertson MD, Boyce P, Carney T, Rosen A, Cleary M, Hunt GE, O'Connor N, Ryan CJ, Kerridge IH Tags: Aust Health Rev Source Type: research

Improving outcomes for Aboriginal and Torres Strait Islander people with cancer requires a systematic approach to understanding patients.
Abstract Indigenous Australians experience a greater burden of cancer than other Australians, but there is little systematic information about their experiences of cancer care. Patient-centred care is increasingly recognised as one of the core domains of quality care, alongside clinical effectiveness and patient safety. Qualitative studies have identified significant issues relating to Indigenous patients' experiences of cancer care, but these data are often insufficient to inform and evaluate health service improvement. We need to establish appropriate methods that will lead to systematic, routinely collected, ac...
Source: Australian Health Review - July 7, 2016 Category: Hospital Management Authors: Green M, Cunningham J, O'Connell D, Garvey G Tags: Aust Health Rev Source Type: research

The Rosen?Cunningham debate: another, alternative view.
PMID: 27385562 [PubMed - as supplied by publisher] (Source: Australian Health Review)
Source: Australian Health Review - July 7, 2016 Category: Hospital Management Authors: Brown P Tags: Aust Health Rev Source Type: research

New graduate transition to practice: how can the literature inform support strategies?
Conclusions The interactions emerging from the literature will serve to inform the delivery and focus of supervision, support and education for new graduate occupational therapists as they transition to practice. The results may have application for other health professions.What is known about the topic? The transition to practice for new graduate occupational therapists has been reported as challenging with health services implementing various actions to support and assist this transition. A previous literature review of recommended support strategies could not be found providing an impetus for this enquiry.What does this...
Source: Australian Health Review - July 4, 2016 Category: Hospital Management Authors: Moores A, Fitzgerald C Tags: Aust Health Rev Source Type: research

Clinical care ratios: quantifying clinical versus non-clinical care for allied health professionals.
Abstract Objective Clinical care ratios (CCRs) are a useful tool that can be used to quantify and benchmark the clinical and non-clinical workloads of allied health professionals. The purpose of this study was to determine if CCRs are influenced by level of seniority, type of role or profession. This will provide meaningful information for allied health service managers to better manage service demand and capacity.Method Data was collected from 2036 allied health professionals from five professions across 11 Australian tertiary hospitals. Mean (95% confidence intervals) CCRs were calculated according to profession...
Source: Australian Health Review - July 4, 2016 Category: Hospital Management Authors: Hearn C, Govier A, Semciw AI Tags: Aust Health Rev Source Type: research

Embedding continuous quality improvement processes in multidisciplinary teams in cancer care: exploring the boundaries between quality and implementation science.
Conclusions The identification of enabling factors for and barriers to translational research and QI provides evidence for how multidisciplinary cancer care teams may best be engaged in research and QI that aims to improve service and care outcomes.What is known about the topic? MDTs are key to the delivery of cancer care in Australia, but there is scant research into how teams can best be engaged in translating research from basic science through to implementation science and QI.What does this paper add? This paper provides new evidence from an immersive study of cancer care MDTs in two large metropolitan hospitals in Syd...
Source: Australian Health Review - July 4, 2016 Category: Hospital Management Authors: Robinson TE, Janssen A, Harnett P, Museth KE, Provan PJ, Hills DJ, Shaw T Tags: Aust Health Rev Source Type: research

Differences in risk and protective factors for workplace aggression between male and female clinical medical practitioners in Australia.
Abstract Objectives The aim of the present study was to investigate differences in prevalence, as well as risk and protective factors, for exposure to workplace aggression between male and female clinicians in Australian medical practice settings.Methods In a cross-sectional, self-report study in the third wave of the Medicine in Australia: Balancing Employment and Life survey (2010-11), 16 327 medical practitioners were sampled, with 9449 (57.9%) respondents working in clinical practice. Using backward stepwise elimination, parsimonious logistic regression models were developed for exposure to aggression from ext...
Source: Australian Health Review - June 23, 2016 Category: Hospital Management Authors: Hills DJ Tags: Aust Health Rev Source Type: research

Clinical pathways for suicidality in emergency settings: a public health priority.
Abstract Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency department. Herein we outline the difference between clinical practice guidelines and clinical pathways, discuss pathways we have identified on self-harm in Australia and overseas and discuss their applicability to the Australian context and the next steps forward in...
Source: Australian Health Review - June 23, 2016 Category: Hospital Management Authors: Wilhelm K, Korczak V, Tietze T, Reddy P Tags: Aust Health Rev Source Type: research

Improving care coordination for community-dwelling older Australians: a longitudinal qualitative study.
Conclusion Further policy and practice attention, including embedding early intervention and prevention, strengthening links between levels of care by building on existing programs and educative and self-help initiatives for patients and carers is recommended to improve care transition experiences and optimise the impact of the GEM model of care.What is known about the topic? Older people with complex care needs experience frequent care transitions because of fluctuating health and fragmentation of aged care services in Australia. The GEM model of care promotes multidisciplinary, coordinated care to improve care transition...
Source: Australian Health Review - June 23, 2016 Category: Hospital Management Authors: Harvey D, Foster M, Strivens E, Quigley R Tags: Aust Health Rev Source Type: research

Evolution of a multilevel framework for health program evaluation.
Abstract A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to s...
Source: Australian Health Review - June 16, 2016 Category: Hospital Management Authors: Masso M, Quinsey K, Fildes D Tags: Aust Health Rev Source Type: research

What will it take to improve prevention of chronic diseases in Australia? A case study of two national approaches.
Conclusions Both the NCDS and NPAPH were seen to have overlapping strengths and weaknesses. A key need identified was for future approaches to focus on generating more sustainable, system-wide change.What is known about the topic? Despite some important advances, chronic diseases remain Australia's greatest health challenge. In efforts to tackle this increasing burden from chronic diseases, several large-scale, national initiatives have been released in Australia over recent years, including the 2005 NCDS and the 2008 NPAPH.What does this paper add? From the viewpoint of practitioners, policy makers, advocates, researchers...
Source: Australian Health Review - June 16, 2016 Category: Hospital Management Authors: Wutzke S, Morrice E, Benton M, Wilson A Tags: Aust Health Rev Source Type: research

Comparison of cost determination of both resource consumption accounting and time-driven activity-based costing systems in a healthcare setting.
Conclusion Unlike TDABC, RCA calculates lower costs for unused capacities but higher costs for products or services in a healthcare setting in which fixed costs make up a high proportion of total costs.What is known about the topic? TDABC is a revision of the activity-based costing (ABC) system. RCA is also a new costing system that includes both the theoretical advantages of ABC and the practical advantages of German costing. However, little is known about the differences arising from application of TDABC and RCA.What does this paper add? There is no study comparing both TDABC and RCA in a single case study based on a rea...
Source: Australian Health Review - June 2, 2016 Category: Hospital Management Authors: Özyapıcı H, Tanış VN Tags: Aust Health Rev Source Type: research

Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, Australia.
Conclusions The review finds that the ROM appears to provide a wide coverage of aspects of planning and integrates into a single model some of the distinctive elements of the other models scoped.What is known about the topic? Various jurisdictions are moving towards a population-based approach to manage public services with regard to the provision of individual medical and social care. Various models have been proposed to guide the planning of services from a population health perspective.What does this paper add? This paper assesses the coverage of attributes of operating models supporting a population health planning app...
Source: Australian Health Review - June 2, 2016 Category: Hospital Management Authors: Levesque JF, O'Dowd JJ, Ní Shé ÉM, Weenink JW, Gunn J Tags: Aust Health Rev Source Type: research

Effect of the 4-h target on time-to-analgesia in an Australian emergency department: a pilot retrospective observational study.
Conclusion NEAT is a significant health policy initiative with little clinical evidence supporting its implementation. However, as the Admitted NEAT compliance increases, the probability of receiving analgesia increases, demonstrating a possible link between hospital function and clinical care provision that needs to be explored further.What is known about the topic? The 4-h target or NEAT is a widely used initiative in EDs to allay crowding and access block. However, little is known of its impact on clinical endpoints, such as TTA.What does this paper add? TTA was not significantly reduced as NEAT compliance increased. Ho...
Source: Australian Health Review - June 2, 2016 Category: Hospital Management Authors: Hughes JA, Cabilan CJ, Staib A Tags: Aust Health Rev Source Type: research

How do we capture the emergency nurse practitioners.
Abstract The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid ...
Source: Australian Health Review - May 26, 2016 Category: Hospital Management Authors: Jennings N, Lutze M, Clifford S, Maw M Tags: Aust Health Rev Source Type: research

Moving beyond the rhetoric of patient input in health technology assessment deliberations.
Abstract At a health system level, the importance of patient and public input into healthcare decision making is well recognised. Patient and public involvement not only provides a mechanism to legitimise decisions, but also contributes to improved translation of these decisions into practice, ultimately leading to better patient outcomes. Recent reviews in the health technology assessment space have identified the need for, and increased use of, patient input through systematic methodologies. Yet, what does this mean in practical terms? This paper outlines both short- and longer-term options for strengthening pat...
Source: Australian Health Review - May 26, 2016 Category: Hospital Management Authors: Wortley S, Wale J, Grainger D, Murphy P Tags: Aust Health Rev Source Type: research

Should the healthcare compass in Australia point towards value-based primary healthcare?
Abstract This paper provides an overview of quality improvement in healthcare in an Australian context. Specifically, the paper considers issues around defining, quantifying, recording and incentivising quality improvement and accountability in primary healthcare. The role of newly emerging Primary Health Networks provides a context for the discussion. The paper draws on international learnings that provide a framework for examining the important elements of quality improvement among reforming primary healthcare organisations in order to support healthcare providers and offer an evidence base for policy makers and...
Source: Australian Health Review - May 23, 2016 Category: Hospital Management Authors: Oliver-Baxter J, Brown L, Dawda P Tags: Aust Health Rev Source Type: research

The dynamic of non-communicable disease control policy in Indonesia.
Conclusion Indonesia's success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries.What is known about the topic? The burden of NCD in Indonesia has increased gradually. Nationally, NCD-related mortality accounted for 65% of deaths in 2010. Indonesia is also a country with the highest burden of tobacco smoking in the world. However, the government has not instituted sufficient policy action to tackle NCDs, including tobacco control.What does this paper add? This paper deepens our under...
Source: Australian Health Review - May 23, 2016 Category: Hospital Management Authors: Christiani Y, Dugdale P, Tavener M, Byles JE Tags: Aust Health Rev Source Type: research

Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review.
Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers.What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce.What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides ...
Source: Australian Health Review - May 23, 2016 Category: Hospital Management Authors: Gwynne K, Lincoln M Tags: Aust Health Rev Source Type: research

Clinicians.
Conclusions The information gained in the present study highlights the large variation in discharge practises between and within clinical groups. Further consultation with stakeholders involved in the care of trauma patients, as well as government bodies involved in hospital funding, is needed to derive a more consistent approach to discharge destination decision making.What is known about the topic? Little is known about the drivers for referral to, or acceptance at, in-patient rehabilitation following acute hospital care for traumatic injury in Victoria, Australia, including who makes these decisions of behalf of patient...
Source: Australian Health Review - May 5, 2016 Category: Hospital Management Authors: Kimmel LA, Holland AE, Lannin N, Edwards ER, Page RS, Bucknill A, Hau R, Gabbe BJ Tags: Aust Health Rev Source Type: research

Comparing clinical and demographic characteristics of people with mental illness in hospital- and community-based residential rehabilitation units in Queensland.
Conclusions Consumers in residential rehabilitation units have high levels of disability, poor physical health and high levels of vulnerability. Nonetheless, it is likely that a sizeable proportion of consumers occupying rehabilitation beds in Queensland could be discharged if more 'step-down' options to move patients on were available.What is known about the topic? A small subgroup of people with severe and complex mental health problems is likely to require time in a residential rehabilitation program. This group is characterised by failure to respond to treatment, severe negative symptoms and some degree of cognitive im...
Source: Australian Health Review - April 28, 2016 Category: Hospital Management Authors: Meehan T, Stedman T, Parker S, Curtis B, Jones D Tags: Aust Health Rev Source Type: research

Factors affecting turnover intentions among public hospital doctors in a middle-level city in central China.
Conclusion Research into turnover intentions indicates that public hospital doctors surveyed in urban China give greater weight to their professional environment and career development rather than salary in their employment decisions.What is known about the topic? Turnover of medical staff is a concern to hospital administrators because it is costly and detrimental to organisational performance and quality of care. Most studies have focused on the effects of individual and organisational factors on nurses' intentions to leave their employment. Income dissatisfaction was one of the determining factors of turnover intentions...
Source: Australian Health Review - April 28, 2016 Category: Hospital Management Authors: Zhang F, Luo Z, Chen T, Min R, Fang P Tags: Aust Health Rev Source Type: research