Journal articles on the topic 'Health service areas Victoria'
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1
Ansari, Z., MJ Ackland, NJ Carson, and BCK Choi. "Small Area Analysis of Diabetes Complications: Opportunities for Targeting Public Health and Health Services Interventions." Australian Journal of Primary Health 11, no. 3 (2005): 72. http://dx.doi.org/10.1071/py05045.
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The objective of this paper is to present small area analyses of diabetes complications in Victoria, Australia, and to illustrate their importance for targeting public health and health services interventions. Local government areas in Victoria were aggregated into 32 Primary Care Partnerships (PCP), which are voluntary alliances of primary care providers. The 32 PCP areas were used as the basic geographic units for small area analyses. Admission rates for diabetes complications were age and sex standardised using the direct method and the 1996 Victorian population as the reference. Admission rate ratios were calculated using the Victorian admission rates as the reference. The 95 per cent confidence intervals for the standardised admission rate ratios were based on the Poisson distribution. There was a wide variation (almost fivefold) in admission rates for diabetes complications across the PCP catchments, with the lowest standardised rate ratio of 0.37 and the highest of 1.75. There were 11 PCPs (seven metropolitan, four rural) with admission rate ratios significantly higher than the Victorian average. The seven metropolitan PCPs contributed more than 43% of all admissions and bed days for diabetes complications in Victoria. Small area analyses of diabetes complications are an exciting new development aimed at stimulating an evidence-based dialogue between local area health service providers, planners and policy-makers. The purpose is to provide opportunities to target public health and health services interventions at the local level to improve the management of diabetes complications in the community.
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McLennan, Fiona, Kate Vickers, Kylie Mason, Karen Bloomberg, Victoria Leadbetter, and Meg Engel. "Capacity Building and Complex Communication Needs: A New Approach to Specialist Speech Pathology Services in Rural Victoria." Australian Journal of Primary Health 12, no. 2 (2006): 66. http://dx.doi.org/10.1071/py06024.
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The aim of this article is to provide a description of the establishment of an innovative approach to improving speech pathology services and community inclusion of people with complex communication needs in rural Victoria. The East Hume Regional Communication Service was established by Ovens and King Community Health Service in partnership with Wodonga Regional Health Service in 2004 as part of a "hub and spoke" network of services across Victoria for people with complex communication needs. Unlike traditional speech pathology services that historically have focused on clinical one-to-one intervention, the Regional Communication Service has a strong focus on community capacity building, enhancing inclusion of people with complex communication needs through improved knowledge, skills and attitudes. This paper will review the relevant literature and outline the Victorian Government policy context within which the service was established. Service highlights and successful initiatives will be described and key factors contributing to the success of the East Hume Regional Communication Service will be explored. Areas for process improvement during the initial two years of operation will also be discussed. This article will provide an insight into establishment of a service delivery model addressing both individual needs and community inclusion that has the potential to be extended across multiple disciplines and areas of practice within rural Australia.
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Alford, Katrina. "Reforming Victoria's primary health and community service sector:rural implications." Australian Health Review 23, no. 3 (2000): 58. http://dx.doi.org/10.1071/ah000058.
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In 1999 the Victorian primary care and community support system began a process of substantial reform, involvingpurchasing reforms and a contested selection process between providers in large catchment areas across the State.The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questionsthe reforms from a rural perspective. They were based on a generic template that did not consider rural-urbandifferences in health needs or other differences including socio-economic status, and may have reinforced if notaggravated rural-urban differences in the quality of and access to primary health care in Victoria.
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Teshuva, Karen, Heather Russell, and Laura Varanelli. "The Victorian Aged Care Assessment Service quality improvement framework." Australian Journal of Primary Health 14, no. 2 (2008): 73. http://dx.doi.org/10.1071/py08026.
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The purpose of this paper is to describe the development and evaluation of the Victorian Aged Care Assessment Service (ACAS) quality improvement framework. The framework was developed in 2001 by a reference group consisting of ACAS managers and government officers, to enable ACAS to engage in a quality improvement process specific to its core areas of business. The framework comprises seven core business domains which are used by the ACAS for annual quality improvement planning and reporting. Using the qualitative methodology of thematic analysis, the ACAS Evaluation Unit has examined annual quality improvement reports submitted by the 18 Victorian ACAS teams from 2002-03 to 2006-07. The findings were used to revise the framework and the ACAS quality improvement reporting template. The number and range of ACAS-related quality improvement activities carried out in Victoria since the implementation of the framework demonstrates its effectiveness as a mechanism for capturing and centrally recording quality improvement activities in areas of core ACAS business. The paper concludes that the Victorian QI framework could be drawn on to develop a quality improvement framework for the Aged Care Assessment Program nationwide.
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Paxton, Georgia A., Pete C. G. Spink, Margaret H. Danchin, Lauren Tyrrell, Chelsea L. Taylor, Susan Casey, and Hamish R. Graham. "Catching up with catch-up: a policy analysis of immunisation for refugees and asylum seekers in Victoria." Australian Journal of Primary Health 24, no. 6 (2018): 480. http://dx.doi.org/10.1071/py17049.
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This study examines catch-up immunisation for people of refugee-like background in Victoria, exploring effective models of service delivery to complete catch-up vaccinations. The analysis is based on: (i) review of the medical literature, Commonwealth and Victorian government immunisation policy and immunisation patient information; (ii) review of vaccination coverage and service delivery data; and (iii) stakeholder interviews completed in 2014 with 45 people from 34 agencies, including 9 local government areas in Victoria. Although refugees and asylum seekers all need catch-up vaccinations on arrival, they face significant barriers to completing immunisation in Australia. Analysis suggests missed opportunities by service providers and perceptions that catch-up vaccination is time-consuming, difficult and resource-intensive. Service delivery is fragmented across primary care and local government, and pathways depend on age, location and healthcare access. There are strengths, but also limitations in all current service delivery models. Gaps in vaccine funding for refugee-like populations have now been addressed through Commonwealth initiatives, however migration is still not well considered in immunisation policy, and existing systems for notification payments do not capture catch-up vaccination for these groups. Providers identify areas for improvement in professional development and support, patient information, patient-held records and immunisation surveillance data.
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McDonald, Paul. "From Streets to Sidewalks: Developments in Primary Care Services for Injecting Drug Users." Australian Journal of Primary Health 8, no. 1 (2002): 65. http://dx.doi.org/10.1071/py02010.
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Primary Health Care for the Injecting Drug User (IDU) has been established in Victoria in recognition of the serious health needs of IDUs, which require a relevant and effective response. Research shows the medical consequences that flow from drug abuse, ranging from the onset of blood borne viruses to cardiovascular conditions, and the propensity of drug users to access health services only through accident and emergency areas of hospitals. In 1999, the Victorian government announced the funding of five Local Drug Strategies in five of Melbourne's 'hotspot' street drug areas to address both the needs of users and communities in relation to substance abuse. This funding was an impetus to establish and trial the concept of primary health services, combining both a fixed site and a mobile outreach service. These services are designed to meet the primary health needs of street-based injecting drug users who are at high risk of experiencing overdose or other forms of drug-related harm.
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J. Mayhew-Rankcom, Vanessa, Melissa A. Lindeman, Keith D. Hill, and Robyn A. Smith. "Who Should Get Personal Alarms? The Development of Instruments for the Assessment of Need." Australian Journal of Primary Health 7, no. 3 (2001): 54. http://dx.doi.org/10.1071/py01047.
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Personal alarms or Personal Response Systems (PRSs) are electronic systems designed to enable frail older people and people with disabilities living at home to summon help in an emergency. The demand for government subsidised PRSs in Victoria (called Personal Alert Victoria) currently exceeds supply (Department of Human Services, 1998) but until now there has been no consistently applied method to ensure that those at highest risk had access to the service. Instruments to aid assessment and determining relative priority for receiving a PRS were developed for the Victorian Department of Human Services (DHS). The development of the instruments was largely informed by the published literature on PRSs and falls risk factors. Three major areas were identified as important in assessing for relative priority to receive a PRS: the client?s assessed risk of being involved in a critical incident requiring immediate assistance, such as a fall; the availability of alternative means of accessing immediate assistance; and the expected impact that a PRS would have on the client?s and/or carer?s wellbeing and their ability to engage in important activities. The process for selecting the items used to determine need in each of these key areas is described, as is the recommended method for determining relative priority. The process for assessing clients to receive a PRS is outlined, emphasising that a PRS is one potential service outcome of an assessment of need.
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Keeves, Jemma, Belinda Gabbe, Sarah Arnup, Christina Ekegren, and Ben Beck. "Serious Injury in Metropolitan and Regional Victoria: Exploring Travel to Treatment and Utilisation of Post-Discharge Health Services by Injury Type." International Journal of Environmental Research and Public Health 19, no. 21 (October 28, 2022): 14063. http://dx.doi.org/10.3390/ijerph192114063.
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This study aimed to describe regional variations in service use and distance travelled to post-discharge health services in the first three years following hospital discharge for people with transport-related orthopaedic, brain, and spinal cord injuries. Using linked data from the Victorian State Trauma Registry (VSTR) and Transport Accident Commission (TAC), we identified 1597 people who had sustained transport-related orthopaedic, brain, or spinal cord injuries between 2006 and 2016 that met the study inclusion criteria. The adjusted odds of GP service use for regional participants were 76% higher than for metropolitan participants in the orthopaedic and traumatic brain injury (TBI) groups. People with spinal cord injury (SCI) living in regional areas had 72% lower adjusted odds of accessing mental health, 76% lower adjusted odds of accessing OT services, and 82% lower adjusted odds of accessing physical therapies compared with people living in major cities. People with a TBI living in regional areas on average travelled significantly further to access all post-discharge health services compared with people with TBI in major cities. For visits to medical services, the median trip distance for regional participants was 76.61 km (95%CI: 16.01–132.21) for orthopaedic injuries, 104.05 km (95% CI: 51.55–182.78) for TBI, and 68.70 km (95%CI: 8.34–139.84) for SCI. Disparities in service use and distance travelled to health services exist between metropolitan Melbourne and regional Victoria following serious injury.
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Savage, Sally, Susan Bailey, David Wellman, and Sharon Brady. "Service Provision Factors that Affect the Health and Wellbeing of People Living in a Lower SES Environment: The Perspective of Service Providers." Australian Journal of Primary Health 11, no. 3 (2005): 11. http://dx.doi.org/10.1071/py05037.
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Inequalities in health and wellbeing within low socioeconomic (SES) environments are well documented. Factors inherent to the health care system itself, such as inaccessible, inflexible or inappropriate service provision, contribute to the poorer health status of residents of low SES areas. This paper explores the issues of service provision in low SES areas, documenting the perceptions of service providers about the service needs of residents, in order to understand the systemic factors that negatively impact on health and wellbeing. A total of 54 health and welfare service providers from two adjacent low SES suburbs within regional Victoria were interviewed using qualitative research methods. Key findings indicate that successful navigation of health care services by residents within these low SES environments is being impeded by issues of access, a lack of appropriate early intervention options or measures, and general resident disempowerment. Central to the improvement of service provision is the need for services to become economically, geographically and culturally accessible. In particular, the importance of community involvement in health planning and health promoting services must be reflected in the ethos of service provision.
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Fabb, Linda. "Community Health and the Environment." Australian Journal of Primary Health 2, no. 3 (1996): 85. http://dx.doi.org/10.1071/py96045.
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Case Study One: The Lead Project: Public Health On The Ground: Doutta Galla Community Health Service (DGCHS) is located in Victoria, in Melbourne's inner West. It aims to provide health care services, and health education and promotion to a culturally diverse and changing community. It currently services two local council areas and a population of 146,000 people, with a further 249,000 coming into the area daily for work, study or shopping. It covers four of Melbourne's largest public housing estates and large groups of people from Non-English Speaking Background including South America, the Horn of Africa, Turkey, Vietnam and China.
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Adams, Catina, Leesa Hooker, and Angela Taft. "The Enhanced Maternal and Child Health nursing program in Victoria: a cross-sectional study of clinical practice." Australian Journal of Primary Health 25, no. 3 (2019): 281. http://dx.doi.org/10.1071/py18156.
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The Maternal and Child Health (MCH) service in Victoria comprises a universal service, an enhanced program providing additional support for vulnerable families (EMCH) and a 24-h MCH telephone line. There is anecdotal evidence of variation in EMCH programs between Local Government Areas, and this study aims to explore the variation in EMCH programs to inform future EMCH policy and practice. An online survey was sent to MCH coordinators in Victoria in December 2016 (n = 79), with a response rate of 70% (55/79). Quantitative data have been analysed using descriptive statistics, with open-ended questions examined using content analysis. The data confirms that EMCH programs vary significantly across the state. Differences include a variation in referral and intake criteria, different models of service and modes of delivery, differences in EMCH nurse working conditions, issues with data collection and a lack of systematic clinical tools. Variation in the EMCH program is greatest between urban and rural services and between advantaged and disadvantaged urban councils. Lack of consistent service delivery and data collection impairs program evaluation, including outcome measurement and evidence of program effectiveness.
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Bagot, Kathleen L., Christopher F. Bladin, Michelle Vu, Joosup Kim, Peter J. Hand, Bruce Campbell, Alison Walker, Geoffrey A. Donnan, Helen M. Dewey, and Dominique A. Cadilhac. "Exploring the benefits of a stroke telemedicine programme: An organisational and societal perspective." Journal of Telemedicine and Telecare 22, no. 8 (October 30, 2016): 489–94. http://dx.doi.org/10.1177/1357633x16673695.
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We undertook a qualitative analysis to identify the broader benefits of a state-wide acute stroke telemedicine service beyond the patient-clinician consultation. Since 2010, the Victorian Stroke Telemedicine (VST) programme has provided a clinical service for regional hospitals in Victoria, Australia. The benefits of the Victorian Stroke Telemedicine programme were identified through document analysis of governance activities, including communications logs and reports from hospital co-ordinators of the programme. Discussions with the Victorian Stroke Telemedicine management were undertaken and field notes were also reviewed. Several benefits of telemedicine were identified within and across participating hospitals, as well as for the state government and community. For hospitals, standardisation of clinical processes was reported, including improved stroke care co-ordination. Capacity building occurred through professional development and educational workshops. Enhanced networking, and resource sharing across hospitals was achieved between hospitals and organisations. Governments leveraged the Victorian Stroke Telemedicine programme infrastructure to provide immediate access to new treatments for acute stroke care in regional areas. Standardised data collection allowed routine quality of care monitoring. Community awareness of stroke symptoms occurred with media reports on the novel technology and improved patient outcomes. The value of telemedicine services extends beyond those involved in the clinical consultation to healthcare funders and the community.
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Adam, Jenny, and Rae Walker. "Trust in Relationships Between Primary Health Care Organisations." Australian Journal of Primary Health 7, no. 1 (2001): 56. http://dx.doi.org/10.1071/py01008.
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In Victoria the primary health care sector is in a period of change intended to strengthen the integration of a complex service system through a process of partnership development based on collaboration. The partnerships are voluntary alliances of the primary care service providers, usually within a locality of two to three local government areas. Their purpose is to improve the health and wellbeing of the local population by strengthening inter-agency coordination in the areas of needs identification, planning and service delivery. Trust is a key issue in this process. This paper is a report of the first stage of a study to explore trust in the context of relationships between organisations in the primary care sector.
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Yaping nad Pauline Stanton, Dong. "Evaluation of the health services management training course of Jiangsu, China." Australian Health Review 25, no. 3 (2002): 161. http://dx.doi.org/10.1071/ah020161.
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Health service management education programs emerged in the early 1980s in China as a result of changing demands on health service managers created by new directions in health policy. This paper reports on an evaluation of the Jiangsu-Victoria Health Management Training Program and discusses five of the main findings. Participants in the study believed that the Program has impacted positively on the health management practice of Jiangsu Province, and has made a significant contribution to health services management education in China. However, certain areas in teaching practice need to be improved and participants in the study provided suggestions to achieve this. The study also found that there were limitations to the impact of managerial education due to administrative and environmental factors.
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Kenny, Amanda, Susan Kidd, Jenni Tuena, Melanie Jarvis, and Angela Roberston. "Falling Through the Cracks: Supporting Young People with Dual Diagnosis in Rural and Regional Victoria." Australian Journal of Primary Health 12, no. 3 (2006): 12. http://dx.doi.org/10.1071/py06040.
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Research has indicated that people with a dual diagnosis of mental illness and substance abuse are more difficult to manage than any other group of mentally ill clients. For young people with a dual diagnosis, particularly in rural and regional areas, there are significant barriers to the provision of optimal care. Currently, a lack of communication between mental health, drug and alcohol services and consumers results in the inadequate provision of treatment for young people, with a resultant significant service gap. Dual diagnosis programs that focus on both substance abuse and mental health issues demonstrate greatly improved client outcomes. Developing a peer education program provides one constructive way of involving dual diagnosis consumers in developing more responsive health services. It provides a highly structured and supported way of involving consumers who ordinarily find mental health services bewildering and inaccessible. By drawing on the knowledge and skills of young people with dual diagnosis, and involving them as peer educators, the notion of expertise in lived experience is captured and harnessed to provide the establishment of a consumer-focused service that better meets the needs of this complex, often neglected, client group.
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Galbally, Rhonda. "Mental Health Promotion in Victoria: A Strategic Approach." Australasian Psychiatry 5, no. 1 (February 1997): 14–18. http://dx.doi.org/10.3109/10398569709082086.
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Health promotion has proved to be crucial in most areas of health, for example, cardiovascular health, cancer control and injury prevention. However, mental health promotion has hitherto been a very poor cousin by comparison with funds spent on other health promotion areas, and also by comparison with funds spent on mental health services. This situation is understandable. First, there has been a need to shake mental health services out of antiquity to ensure that they not only meet fundamental standards of human rights, but also begin to develop a focus on rehabilitation. Second, the amorphous, unspecific and often haphazard nature of the few existing mental health promotion programs has, to a degree, given mental health promotion a bad name. As mental health promotion initiatives must inevitably relate to social and structural issues, the health content of mental health promotion has sometimes been hard to identify.
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Ansari, M. Z., D. Simmon s, W. G. Hart, F. Cicuttin i, N. J. Carson, N. I. A. G. Brand, M. J. Ackland, and D. J. Lang. "Preventable Hospitalisations for Diabetic Complications in Rural and Urban Victoria." Australian Journal of Primary Health 6, no. 4 (2000): 261. http://dx.doi.org/10.1071/py00060.
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The objective of the study was to describe and explain variations in rates of hospital admissions for long-term complications of diabetes mellitus in rural and urban Victoria as an indicator of the adequacy of ambulatory care services. The Victorian Inpatient Minimum Database (VIMD), Health Insurance Commission data for 1998, Medical Labour Force Annual Survey 1998, Socioeconomic Indexes for Areas 1996 (SEIFA) and Accessibility/Remoteness Index of Australia (ARIA) were merged to determine the extent to which hospitalisation for complications of diabetes can be predicted from accessibility and utilisation of general practitioner services. The rural and urban differentials for long-term diabetic complications and their strong relationship with GP services, the degree of remoteness, lack of insurance, and Aboriginality reflect issues related to equity and access, patient and GP education, and inclination to seek care, all of which have implications for planning of primary health services in rural areas. This study describes a model for the analysis of ambulatory care sensitive conditions, and illustrates the important use of routine databases combined with other sources of information in quantifying the impact of factors related to primary care services.
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Smith, Erin C., Frederick M. Burkle, Paul F. Holman, Justin M. Dunlop, and Frank L. Archer. "Lessons from the Front Lines: The Prehospital Experience of the 2009 Novel H1N1 Outbreak in Victoria, Australia." Disaster Medicine and Public Health Preparedness 3, S2 (December 2009): S154—S159. http://dx.doi.org/10.1097/dmp.0b013e3181be8250.
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ABSTRACTThe H1N1 (swine influenza) 2009 outbreak in Victoria, Australia, provided a unique opportunity to review the prehospital response to a public health emergency. As part of Ambulance Victoria’s response to the outbreak, relevant emergency response plans and pandemic plans were instigated, focused efforts were aimed at encouraging the use of personal protective equipment (PPE), and additional questions were included in the call-taking script for telephone triage of emergency calls to identify potential cases of H1N1 from the point of call. As a result, paramedics were alerted to all potential cases of H1N1 influenza or any patient who met the current case definition before their arrival on the scene and were advised to use appropriate PPE. During the period of May 1 to July 2, Ambulance Victoria telephone triaged 1598 calls relating to H1N1 (1228 in metropolitan areas and 243 in rural areas) and managed 127 calls via a referral service that provides specific telephone triage for potential H1N1 influenza cases based on the national call-taking script. The referral service determines whether a patient requires an emergency ambulance or can be diverted to other resources such as flu clinics. Key lessons learned during the H1N1 outbreak include a focused need for continued education and communication regarding infection control and the appropriate use of PPE. Current guidelines regarding PPE use are adequate for use during an outbreak of infectious disease. Compliance with PPE needs to be addressed through the use of intra-agency communications and regular information updates early in the progress of the outbreak. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S154–S159)
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Liang, Zhanming, Peter F. Howard, Lee C. Koh, and Sandra Leggat. "Competency requirements for middle and senior managers in community health services." Australian Journal of Primary Health 19, no. 3 (2013): 256. http://dx.doi.org/10.1071/py12041.
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The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development.
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Ruth, Denise, Rosalind Hurworth, and Nabil Sulaiman. "Moving towards meaningful local population health data: The service provider perspective." Australian Journal of Primary Health 11, no. 2 (2005): 113. http://dx.doi.org/10.1071/py05029.
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Increasingly, primary care services are required to use data to assess their local population's health needs and plan services. This paper reports focus group discussions of service providers' perceived current practice, issues and needs related to obtaining and using data for planning services in two local government areas of Melbourne. Six groups were conducted with nominees from two municipal councils, four divisions of general practice, three community health services, three hospital networks and eight community organizations. Two groups were conducted with planners and data providers from the Department of Human Services, Victoria. The 66 participants had a broad range of experience in using data to assess local population health needs. Participants reported that issues limiting the use of data related to: access to data (lack of awareness, contacting the right person, poor communication between data providers and users, resource constraints, lack of central access); gaps in data; quality of data (inconsistent definitions and collection, currency, ties to funding); applicability of data (unfriendly format, problems with aggregated versus small area data, non-matching data sets, lack of contextual information); and support for data use in local population health planning. If local population needs assessment is to lead to better health outcomes, service providers need access to high quality data presented in formats that are applicable to their communities. They also need practicable planning methods, skills training and support in using data for local population needs assessment and service planning.
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Mercier, Eric, Peter A. Cameron, Karen Smith, and Ben Beck. "Prehospital trauma death review in the State of Victoria, Australia: a study protocol." BMJ Open 8, no. 7 (July 2018): e022070. http://dx.doi.org/10.1136/bmjopen-2018-022070.
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IntroductionRegionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.Methods and analysisThe planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.Ethics and disseminationThe present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.
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Keeves, Jemma, Sandra C. Braaf, Christina L. Ekegren, Ben Beck, and Belinda J. Gabbe. "Access to Healthcare Following Serious Injury: Perspectives of Allied Health Professionals in Urban and Regional Settings." International Journal of Environmental Research and Public Health 18, no. 3 (January 29, 2021): 1230. http://dx.doi.org/10.3390/ijerph18031230.
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Barriers to accessing healthcare exist following serious injury. These issues are not well understood and may have dire consequences for healthcare utilisation and patients’ long-term recovery. The aim of this qualitative study was to explore factors perceived by allied health professionals to affect access to healthcare beyond hospital discharge for people with serious injuries in urban and regional Victoria, Australia. Twenty-five semi-structured interviews were conducted with community-based allied health professionals involved in post-discharge care for people following serious injury across different urban and regional areas. Interview transcripts were analysed using thematic analysis. Many allied health professionals perceived that complex funding systems and health services restrict access in both urban and regional areas. Limited availability of necessary health professionals was consistently reported, which particularly restricted access to mental healthcare. Access to healthcare was also felt to be hindered by a reliance on others for transportation, costs, emotional stress and often lengthy time of travel. Across urban and regional areas, a number of factors limit access to healthcare. Better understanding of health service delivery models and areas for change, including the use of technology and telehealth, may improve equitable access to healthcare.
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Ugalde, A., S. Aranda, C. Paul, L. Orellana, I. Plueckhahn, C. Segan, D. Baird, et al. "Improving Health Outcomes for People With Cancer in Rural and Regional Areas by Embedding Evidence-Based Smoking-Cessation Strategies Into Usual Care: A Study Protocol." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 95s. http://dx.doi.org/10.1200/jgo.18.10100.
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Background: Smoking following a diagnosis of cancer is a powerful clinical risk indicator, with known poorer health outcomes and associated health care costs. In Australia, smoking rates are higher in rural and regional areas. There are established and effective interventions to promote smoking cessation after a diagnosis of cancer yet these are not in routine practice. Aim: This protocol paper reports on a study that aims to embed evidence-based smoking cessation strategies for people with cancer who are current smokers into routine care, resulting in in system wide improvements, an implemented program and model for further dissemination. Methods: Across three rural/regional sites, and with partners Quit Victoria and Western Alliance, this study employs a variety of methodologies to embed smoking cessation support to improve outcomes for people with cancer who currently smoke. Specifically, the project will embed a system of responsibilities and training in rural and regional health services to routinely engage people with cancer who smoke in support services. The program will: · Promote routine delivery of smoking cessation care by trained oncology staff (oncologists/nurses/ allied health) · Establish referral pathways to Quitline · Correspond with general practitioners, to: i) outline the benefits of quitting in this context, ii) promote access to nicotine replacement therapy and iii) support quitting in the community. · Improve routine recording of smoking status and documentation of provision of brief intervention (personalised advice given, resources provided) and outcomes. Participants: are oncology staff and general practitioners across three health services: Ballarat Health Service, East Grampians Health Service (Ararat), Wimmera Health Care Group (Horsham), all located in Victoria, Australia. Data collection will occur across four sources: 1) Oncology staff: qualitative and quantitative data collection understanding confidence and views on provision on cessation advice; 2) Monitoring Quitline calls, 3) Interview with local general practitioners and 4) Medical record reviews to explore frequency of recording of smoking status. Data will be collected pre/postintervention. Results: The project is underway with the intervention manuals in development. The project is due for completion in 2020. Conclusion: This project takes a health services approach to integration of smoking cessation support in routine care for people with cancer in rural and regional areas. This program of work has capacity to determine best approaches to integrate smoking cessation into routine care, resulting in reduced mortality and morbidity, improved effectiveness of anticancer treatments, and reduced health care costs; by establishing internationally relevant, embedded health care interventions.
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Willcox, Jane, and Marie Gill. "Integrated Disease Management Programs: Reflections and Learnings from Implementation." Australian Journal of Primary Health 13, no. 2 (2007): 113. http://dx.doi.org/10.1071/py07029.
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Integrated Chronic Disease Management (ICDM) is a key focus of recent Victorian Government primary care partnership (PCP) and community health policy direction documents. Planning for a more ICDM approach has been informed by earlier integrated disease management (IDM) projects funded through the PCP Strategy. In 2001, five IDM pilot projects were funded, for three years, under the Department of Human Services (Victoria) IDM Initiative. The IDM projects aimed to inform future planning for chronic disease care by developing models of care that sought a better quality of life, fewer complications for individuals, and reduced overall use of health care resources. The projects trialled different processes and components of IDM to accommodate local priorities, resources and existing care practice with more than 1000 consumers collectively involved. The experience of building community programs targeting consumers with chronic disease resulted in key learnings about IDM and effecting change. Enablers and barriers were identified, and the relationship between best practice and key learnings explored in the areas of partnerships, service coordination and consumer engagement, to further understand the best approaches to improve care for people with chronic disease.
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Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.
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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.
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Ollerenshaw, Alison, and John McDonald. "Dimensions of Pastoral Care: Student Wellbeing in Rural Catholic Schools." Australian Journal of Primary Health 12, no. 2 (2006): 137. http://dx.doi.org/10.1071/py06033.
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This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students? primary health care needs? The research methods involved analysis of (1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model - as it is currently configured - is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
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Mullen, P., and J. Ogloff. "Providing mental health services to adult offenders in Victoria, Australia: Overcoming barriers." European Psychiatry 24, no. 6 (September 2009): 395–400. http://dx.doi.org/10.1016/j.eurpsy.2009.07.003.
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AbstractPurposeTo illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.MethodDeveloping effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.ConclusionsActive engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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Cheng, Melanie S., Angela Clarke, Timothy D. Moore, and Phyllis M. Lau. "Making the connection: a qualitative study of brokerage in Aboriginal health in a metropolitan area of Victoria and a regional area of New South Wales." Australian Health Review 35, no. 1 (2011): 18. http://dx.doi.org/10.1071/ah09809.
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Objective. Health brokerage is one method being employed by government health agencies in an attempt to improve Aboriginal and Torres Strait Islander people’s access to primary healthcare. This qualitative study explores key stakeholders’ understanding and acceptance of the health brokerage model, prior to the implementation of brokerage services. Methods. Semistructured interviews and focus groups were conducted with key stakeholders. The resulting data was analysed using a grounded theory approach. Results. Qualitative analysis of the interviews and focus groups revealed five major themes. These were: (1) the perceived limitations of brokerage as a service delivery model; (2) the benefits of health brokerage such as increased flexibility; (3) issues relating to patient independence; (4) the necessity for broker independence; and (5) a mistrust of health brokerage and the authority handling the brokerage funds. Conclusions. Since this study was conducted in 2008, ongoing funding for urban brokerage services has been suspended. Although the reasons for this are unclear, our study suggests that barriers to the acceptance of brokerage services by the community may have existed even before such services were implemented, thus highlighting the need for transparency when launching new health initiatives that hope to engage the Aboriginal community. What is known about the topic? Brokerage models have previously been described in the areas of mental health and aged care. In these examples, brokerage agencies have provided patients with a key entry point into the healthcare system. Benefits of the brokerage model, such as flexibility, have been contrasted with its limitations, such as a heavy reliance upon existing services. What does this paper add? This paper provides insight into the acceptability of health brokerage, as a service delivery model, to the Aboriginal community. Although findings from the study reinforce many of the benefits and limitations already described in the literature, they also introduce the new and important themes of patient empowerment and mistrust. What are the implications for practitioners? This study provides vital information about community perceptions of health brokerage. It is important that policy makers take heed of such insights when planning attempts to close the gap in Aboriginal health.
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Jablensky, Assen, John McGrath, Helen Herrman, David Castle, Oye Gureje, Mandy Evans, Vaughan Carr, Vera Morgan, Ailsa Korten, and Carol Harvey. "Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders." Australian & New Zealand Journal of Psychiatry 34, no. 2 (April 2000): 221–36. http://dx.doi.org/10.1080/j.1440-1614.2000.00728.x.
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Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.
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Perrin, Byron M., Marcus J. Gardner, Susan R. Kennett, Jodie L. Cornelius, and Michael J. Fanning. "An organised approach to the podiatric care of people with diabetes in regional Australia." Australian Health Review 36, no. 1 (2012): 16. http://dx.doi.org/10.1071/ah11010.
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Objective. To ensure an efficient publicly funded podiatric service for people with diabetes in regional Victoria, a Podiatry Diabetes Model (PDM) of care was developed. The aim of this study was to determine if people with diabetes attended the most appropriate podiatric service as depicted by the model. Methods. A 3-month prospective clinical audit of the PDM was undertaken. Primary variables of interest were the podiatric service where the patients were seen and the patients’ risk of future foot morbidity. Chi-square analyses for each service category were undertaken to compare the expected number of patients seen according to foot-health risk as predicted by the model, with what was observed. Results. Five hundred and seventy-six people with diabetes were seen in the 3-month period. There was no statistically significant difference between the proportion of patients seen by each podiatric service according to risk status, with what was expected (community: χ2 = 3.3, P = 0.4; subacute: χ2 = 8.0, P = 0.05; acute: χ2 = 6.6, P = 0.09). Conclusions. The Podiatry Diabetes Model is a sound podiatric model of care and is an example of cross-organisational collaboration that could be implemented in other areas of Australia. What is known about the topic? Diabetes-related foot complications are a significant burden on health systems and individuals with diabetes. Podiatric services are important in the prevention and management of complications such as peripheral neuropathy, ulceration and lower limb amputation. It is important to organise healthcare systems to ensure appropriate and efficient services are provided for people with diabetes. What does this paper add? This paper describes and tests a novel collaborative, multi-organisation podiatric model of care for people with diabetes in a large regional Australian setting. What are the implications for practitioners? This paper demonstrates that it is possible to collaborate across multiple organisations to provide a comprehensive publicly funded podiatric service to people with diabetes that encompasses the entire risk spectrum for future diabetes-related foot complications.
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Heilbrunn-Lang, Adina Y., Lauren M. Carpenter, Andrea M. de Silva, Lisa K. Meyenn, Gillian Lang, Allison Ridge, Amanda Perry, Deborah Cole, and Shalika Hegde. "Family-centred oral health promotion through Victorian child-health services: a pilot." Health Promotion International 35, no. 2 (April 21, 2019): 279–89. http://dx.doi.org/10.1093/heapro/daz025.
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Abstract Maternal and Child Health Services (MCHS) provide ideal settings for oral disease prevention. In Victoria (Australia), child mouth-checks (Lift-the-Lip) and oral health promotion (OHP) occur during MCHS child visits. This study trialled Tooth-Packs (OHP resources, toothbrushes, toothpastes) distribution within MCHS to (i) assess the impacts of Tooth-Packs distribution on child and family oral health (OH) behaviours and knowledge, including Maternal and Child Health Nurses (MCHN) child referral practices to dental services, and (ii) determine the feasibility and acceptability of incorporating Tooth-Packs distribution into MCHN OHP practices. A mixed-methods evaluation design was employed. MCHN from four high-needs Victorian Local Government Areas distributed Tooth-Packs to families of children attending 18-month and/or 24-month MCHS visits (baseline). Families completed a questionnaire on OH and dietary practices at baseline and 30-month follow-up. Tooth-Packs distribution, Lift-the-lip mouth-checks and child OH referrals were conducted. Guided discussions with MCHN examined intervention feasibility. Overall, 1585 families received Tooth-Packs. Lift-the-lip was conducted on 1493 children (94.1%). Early childhood caries were identified in 142 children (9.5%) and these children were referred to dental services. Baseline to follow-up behavioural improvements (n = 230) included: increased odds of children having ever seen an OH professional (OR 28.0; 95% CI 7.40–236.88; p < 0.001), parent assisted toothbrushing twice/day (OR 1.76; 95% CI 1.05–3.00; p = 0.030) and toothpaste use >once/day (OR 2.82; 95% CI 1.59–5.24; p < 0.001). MCHN recommendations included distribution of Tooth-Packs to at-risk children <12-months of age. MCHS provide an ideal setting to enable timely family-centred OHP intervention and adoption of good OH behaviours at an early age.
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Ridgewell, Emily, Michael Dillon, Jackie O'Connor, Sarah Anderson, and Leigh Clarke. "Demographics of the Australian orthotic and prosthetic workforce 2007–12." Australian Health Review 40, no. 5 (2016): 555. http://dx.doi.org/10.1071/ah15147.
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Objective Health workforce data are vital to inform initiatives to meet the future healthcare needs of our society, but there are currently no data describing the Australian orthotic and prosthetic workforce. The aim of the present study was to describe demographic changes in the Australian orthotic and prosthetic workforce from 2007 to 2012. Methods In the present retrospective time series study, data from the Australian Orthotic Prosthetic Association member database were analysed for trends from 2007 to 2012. Data describing the absolute number of practitioners, the number of practitioners per 100 000 population, age, gender, state or territory of residence and service location (i.e. metropolitan, regional and remote) were analysed for significant changes over time using linear regression models. Results Although the number of orthotist/prosthetists in Australia increased (P = 0.013), the number of orthotist/prosthetists per 100 000 population remained unchanged (P = 0.054). The workforce became younger (P = 0.004) and more female (P = 0.005). Only Victoria saw an increase in the proportion of orthotist/prosthetists in regional and remote areas. There was considerable state-to-state variation. Only Victoria (P = 0.01) and Tasmania (P = 0.003) saw an increase in the number of orthotist/prosthetists per 100 000 population. Conclusions The orthotic and prosthetic workforce has increased proportionately to Australia’s population growth, become younger and more female. The proportion of practitioners in regional and remote areas has remained unchanged. These data can help inform workforce initiatives to increase the number of orthotist/prosthetists relative to the Australian population and make the services of orthotist/prosthetists more accessible to Australians in regional and remote areas. What is known about the topic? Currently, there are no demographic data describing changes in the Australian orthotic and prosthetic workforce over time. These data are vital to inform initiatives to increase the size of the workforce, locate practitioners where health services are most needed and thereby plan to meet the future health care needs of our society. What does this paper add? This paper describes changes in the Australian orthotic and prosthetic workforce, where previously these data have not been available as part of federal initiatives to plan for future workforce needs. What are the implications for practitioners? Demographic data describing changes in the orthotic and prosthetic workforce are needed to inform workforce initiatives that improve access in regional and remote Australia, and retain a younger and more female workforce.
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Hall, Teresa, Sharon Goldfeld, Hayley Loftus, Suzy Honisett, Hueiming Liu, Denise De Souza, Cate Bailey, et al. "Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites." BMJ Open 12, no. 5 (May 2022): e055431. http://dx.doi.org/10.1136/bmjopen-2021-055431.
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IntroductionIntegrated community healthcare Hubs may offer a ‘one stop shop’ for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales.Methods and analysisThis multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100–200 per site) and Hub practitioners (n=20–30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data.Ethics and disseminationRoyal Children’s Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications.Trial registration numberISRCTN55495932.
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Lee, Vivian Wing Woon, and Louise Kathryn Newman. "A model for the provision of integrated perinatal and infant mental health services in regional settings." Australasian Psychiatry 26, no. 5 (July 16, 2018): 531–33. http://dx.doi.org/10.1177/1039856218783856.
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Objective: This paper aims to describe current approaches in Victoria to the development of perinatal and infant mental health services in regional areas. Method: The paper outlines the significance of perinatal mental disorder for maternal wellbeing and impact on infant development, and describes the model of care at the Agnes Unit. Results: The Agnes Unit has been established as a residential therapeutic unit offering short-term treatment that focusses on promoting parental mental health, parenting sensitivity and the parent-infant relationship. Conclusions: A coordinated and integrated approach with focus on early intervention is needed to deliver perinatal and infant mental health services. Services need to focus on the infant and parent-infant relationship in addition to parental mental health.
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Siegloff, Shari, and Rosalie Aroni. "Mental illness and "self"-management in rural Australia: caregivers' perspectives." Australian Journal of Primary Health 9, no. 3 (2003): 90. http://dx.doi.org/10.1071/py03029.
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Current models of chronic disease self-management incorporate an understanding that people with chronic illnesses, their carers and clinicians need to work together in addressing illness management issues (Von Korff, Gruman, Schaefer, Curry, & Wagner, 1997) and that this process enhances personal control of health (Lorig, Ritter et al., 2000). The question we ask is whether the understandings in these models, both implicit and explicit, apply to those people living with mental illness in rural areas in Australia. In-depth interviews were used to explore and examine the way in which carers of people living with mental illness in rural Victoria experienced and perceived the nature of chronic disease self-management. Our findings indicate that illness management in rural areas occurs predominantly as a partnership between the person with mental illness and the family members who act as caregivers, rather than a partnership with health professionals. This confirms that the lack of resources in the rural mental health care system results in a crisis-oriented service rather than a service that is able to respond to preventative and ongoing mental health care. This is recognised as a considerable burden for many families and requires further examination. In addition, a finding of considerable clinical and policy importance in this arena is the experience of family caregivers as partners in not only the support of the ?management? aspects of self-management of mental illness, but also in supporting the person living with mental illness in the maintenance of the ?self? aspect of self-management.
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Dwyer, Alison, and John McNeil. "Are Clinical Registries Actually Used? The Level of Medical Staff Participation in Clinical Registries, and Reporting within a Major Tertiary Teaching Hospital." Asia Pacific Journal of Health Management 11, no. 1 (March 16, 2016): 56–64. http://dx.doi.org/10.24083/apjhm.v11i1.245.
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Clinical Registries are established to provide a clinically credible means for monitoring and benchmarking healthcare processes and outcomes, to identify areas for improvement, and drive strategies for improving patient care. Clinical Registries are used to assess changes in clinical practice, appropriateness of care and health outcomes over time. The American Heart Association Policy Statement in April 2011 called for expanding the application for existing and future Clinical Registries, with well-designed Clinical Registry programs. Concurrently, in Australia, and similarly within the United States and United Kingdom, there has been an increased focus on performance measurement for quality and patient safety. Within Victoria, the Victorian Clinical Governance Policy Framework outlines clinical effectiveness as one of the four domains of Clinical Governance
As Clinical Registries evaluate effectiveness and safety of patient care by measuring patient outcomes compared with peers, the use of Clinical Registries data to improve a health service’s quality of care seems intuitive. A mixed methods approach was utilised, involving (1) semi-structured interviews and (2) documentation audit in this study conducted at Austin Health, a major tertiary teaching hospital in North-Eastern metropolitan Melbourne, affiliated with the University of Melbourne and various research institutes within Austin LifeSciences.
Although many studies have highlighted the benefits of data collected via individual Clinical Registries, [5,6] the level of voluntary medical staff participation in Clinical Registries at a health service level is yet to be established. The aim of this study was to document the level of medical staff involvement for Clinical Registries within a major tertiary teaching hospital, and the level of reporting into Quality Committees within the organisation.
This study demonstrates that along with a very high level of medical staff participation in Clinical Registries, there is a lack of systematic reporting of Registries data into quality committees beyond unit level, and utilisation of such data to reflect upon practice and drive quality improvement.
Abbreviations: CREPS – Centre for Excellence in Patient Safety; CSU – Clinical Services Unit; HOU – Heads of Unit; VASM – Victorian Audit of Surgical Mortality.
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Callister, Valerie, and Julie Geilman. "Getting it Together: A Rural Health Promotion Program." Australian Journal of Primary Health 6, no. 4 (2000): 194. http://dx.doi.org/10.1071/py00053.
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The Getting It Together Rural Health Promotion project was established by a group of community health providers in Gippsland, Victoria. The overall aim of Getting It Together was to extend and improve health promotion practice amongst participating organisations. This was achieved through collaboration around health promotion training and planning. Complementary strategies addressing Cardio-Vascular Disease (CVD) were developed across four Local Government Areas (LGAs). Central resourcing was provided for coordination of the project, and for marketing and network support tasks. The project was based on an integrated and coordinated health promotion model, which contained overlapping strategies combining to create a broadly based partnership of action. At the commencement of the project, health promotion workers from each LGA were provided with a three-day training course conducted by the Royal Melbourne Institute of Technology University (RMIT). Participants developed Action Plans based around the three driving strategies of community wide-strategies, targeted strategies and marketing. A special feature of Getting It Together was a common media strategy, to support and reinforce action at the local level. An overall slogan was adopted, 'Slicker Ticker - A Gippsland Healthy Heart Project'. Uniting themes included 'Stress Less Week' and 'Gippsland Get Up and Go'. Latrobe Community Health Service facilitated the project and senior managers from the partnering agencies formed a Steering Committee, which met at key intervals to monitor the project.
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Gamage, Deepa G., Candice A. Fuller, Rosey Cummings, Jane E. Tomnay, Mark Chung, Marcus Chen, Cameryn C. Garrett, Jane S. Hocking, Catriona S. Bradshaw, and Christopher K. Fairley. "Advertising sexual health services that provide sexually transmissible infection screening for rural young people - what works and what doesn't." Sexual Health 8, no. 3 (2011): 407. http://dx.doi.org/10.1071/sh10144.
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Background ‘TESTme’ is a sexually transmissible infection (STI) screening service for Victorian young people living in rural areas. We evaluated the effectiveness of advertising for this service over an 11-month pilot period. Methods: The advertising that was used included websites, a Facebook page, posters, flyers, business cards, wrist bands and professional development sessions for health nurses that occurred throughout the pilot period. We also used once-off methods including advertisements in newspapers, student diaries and short messages to mobile phones. Results: Twenty-eight clients had a consultation through TESTme. Twenty found the service through health professionals, six through the Melbourne Sexual Health Centre (MSHC) web page, one through the Facebook page and one through the student diary. The total direct costs incurred by the centre for advertising were $20 850. The advertising cost per client reached for each advertising method was $26 for health professionals, $80 for the MSHC web advertisement, $1408 for Facebook and $790 for the student diary. Other advertising methods cost $12 248 and did not attract any clients. Conclusion: Advertising STI health services for rural young people would be best to focus on referrals from other health services or health care websites.
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Paton, Kate, Lynn Gillam, Hayley Warren, Melissa Mulraney, David Coghill, Daryl Efron, Michael Sawyer, and Harriet Hiscock. "Clinicians’ perceptions of the Australian Paediatric Mental Health Service System: Problems and solutions." Australian & New Zealand Journal of Psychiatry 55, no. 5 (January 18, 2021): 494–505. http://dx.doi.org/10.1177/0004867420984242.
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Objectives: Despite substantial investment by governments, the prevalence of mental health disorders in developed countries remains unchanged over the past 20 years. As 50% of mental health conditions present before 14 years of age, access to high-quality mental health care for children is crucial. Barriers to access identified by parents include high costs and long wait times, difficulty navigating the health system, and a lack of recognition of the existence and/or severity of the child’s mental health disorder. Often neglected, but equally important, are clinician views about the barriers to and enablers of access to high-quality mental health care. We aimed to determine perspectives of Australian clinicians including child and adolescent psychiatrists, paediatricians, psychologists and general practitioners, on barriers and enablers within the current system and components of an optimal system. Methods: A total of 143 clinicians (approximately 35 each of child and adolescent psychiatrists, paediatricians, child psychologists and general practitioners) from Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings: Clinician-identified barriers included multi-dimensional family factors, service fragmentation, long wait times and inadequate training for paediatricians and general practitioners. Rural and regional locations provided additional challenges but a greater sense of collaboration resulting from the proximity of clinicians in rural areas, creating an opportunity to develop support networks. Suggestions for an optimal system included novel ways to improve access to child psychiatry expertise, training for paediatricians and general practitioners, and co-located multidisciplinary services. Conclusion: Within the current mental health system for children, structural, training and workforce barriers prevent optimal access to care. Clinicians identified many practical and systemic ideas to improve the system. Implementation and evaluation of effectiveness and cost effectiveness of these ideas is the next challenge for Australia’s children’s mental health.
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Leggat, Sandra G., Timothy Bartram, and Pauline Stanton. "Performance monitoring in the Victorian health care system: an exploratory study." Australian Health Review 29, no. 1 (2005): 17. http://dx.doi.org/10.1071/ah050017.
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This paper reports on an exploratory study which aims to improve our understanding of how the Chief Executive Officers of Victorian health services monitor strategic and operational performance in their organisations. As a component of a large scale human resource management study, we surveyed 130 Chief Executive Officers (CEOs) of Victorian health sector agencies. Our findings suggest that performance monitoring was more advanced among the larger Victorian health sector organisations, and that there were areas for improvement throughout the system. Overall, the CEOs reported limited use of performance indicators related to service and clinical perspectives, with financial and volume indicators most widely used. There was little evidence that these organisations had processes in place (such as benchmarking and linking required outcomes to staff performance management) to understand the implications of the performance information and translate them into management action. The findings suggest that the sector requires technical expertise and support in data reporting, benchmarking and quality improvement in order to improve performance monitoring and ensure its relevance to strategic control, but further study is required.
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Kelaher, Margaret, Judith Gray, and David Dunt. "Understanding the effectiveness of partnership-based early childhood interventions." Australian Journal of Primary Health 15, no. 3 (2009): 218. http://dx.doi.org/10.1071/py08070.
Full textAbstract:
In this paper, we seek to understand the relationship between partnership effectiveness and preschool enrolment in Best Start, an early childhood intervention for children living in disadvantaged areas in Victoria, an Australian State. We will examine the application of theories of partnership effectiveness at a whole of intervention level and in the context of local evaluation initiatives at the Broadmeadows Early Years Partnership. For the statewide intervention, partnership effectiveness was measured using the VicHealth Partnership Analysis Tool at 11 Best Start Sites. The dependent variable was preschool enrolment in Best Start local government area. For the Broadmeadows Early Years Partnership case study, partnership is conceptualised in terms of the Lasker and Weiss (2003) model of collaborative decision making. Scores rose significantly between the two applications of the VicHealth Partnership Analysis Tool at the beginning and end of the Best Start funding period on almost all of the dimensions of the VicHealth Tool. Support for ‘making partnerships work’, ‘minimising barriers to partnerships’ and the ‘total’ partnership scores were associated with increased preschool enrolments. The results of the case study supported the model for collaborative decision making with particular emphasis on the role of shared leadership, synergy and bridging social ties as crucial processes in improving service integration. The results of the statewide intervention and the case study both provide evidence of the value of partnership approaches in improving service uptake and integration for children living in disadvantaged areas. The study also supports current conceptualisations of partnership value and effectiveness.
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Almado, Haidar, Estie Kruger, and Marc Tennant. "Application of spatial analysis technology to the planning of access to oral health care for at-risk populations in Australian capital cities." Australian Journal of Primary Health 21, no. 2 (2015): 221. http://dx.doi.org/10.1071/py13141.
Full textAbstract:
Australians are one of the healthiest populations in the world but there is strong evidence that health inequalities exist. Australia has 23.1 million people spread very unevenly over ~20 million square kilometres. This study aimed to apply spatial analysis tools to measure the spatial distribution of fixed adult public dental clinics in the eight metropolitan capital cities of Australia. All population data for metropolitan areas of the eight capital cities were integrated with socioeconomic data and health-service locations, using Geographic Information Systems, and then analysed. The adult population was divided into three subgroups according to age, consisting of 15-year-olds and over (n = 7.2 million), retirees 65 years and over (n = 1.2 million), and the elderly, who were 85 years and over (n = 0.15 million). It was evident that the States fell into two groups; Tasmania, Northern Territory, Australian Capital Territory and Western Australia in one cluster, and Victoria, New South Wales, Queensland and South Australia in the other. In the first group, the average proportion of the population of low socioeconomic status living in metropolitan areas within 2.5 km of a government dental clinic is 13%, while for the other cluster, it is 42%. The clustering remains true at 5 km from the clinics. The first cluster finds that almost half (46%) of the poorest 30% of the population live within 5 km of a government dental clinic. The other cluster of States finds nearly double that proportion (86%). The results from this study indicated that access distances to government dental services differ substantially in metropolitan areas of the major Australian capital cities.
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Hegarty, Kelsey, Rhian Parker, Danielle Newton, Laura Forrest, Janelle Seymour, and Lena Sanci. "Feasibility and acceptability of nurse-led youth clinics in Australian general practice." Australian Journal of Primary Health 19, no. 2 (2013): 159. http://dx.doi.org/10.1071/py12025.
Full textAbstract:
Internationally, youth access to primary health care is problematic due to documented barriers such as cost, concerns about confidentiality, and knowledge about when to attend and available services. The treatment of health problems earlier in life together with engagement in prevention and health education can optimise youth health and maximise the potential of future wellbeing. This study investigated the feasibility, acceptability and cost of establishing nurse-led youth clinics in Victoria, Australia. Three general practices in rural and regional areas of Victoria implemented the nurse-led youth health clinics. The clinics were poorly attended by young people. Practice nurses identified several barriers to the clinic attendance including the short timeframe of the study, set times of the clinics and a lack of support for the clinics by some GPs and external youth health clinics, resulting in few referrals. The clinics cost from $5912 to $8557 to establish, which included training the practice nurses. Benefits of the clinics included increased staff knowledge about youth health issues and improved relationships within the general practice staff teams. The implementation of youth health clinics is not feasible in a short timeframe and to maximise use of the clinics, all members of the general practice team need to find the clinics acceptable.
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Poljski, Carolyn, Regina Quiazon, and Chau Tran. "Ensuring Rights: Improving Access to Sexual and Reproductive Health Services for Female International Students in Australia." Journal of International Students 4, no. 2 (April 1, 2014): 150–63. http://dx.doi.org/10.32674/jis.v4i2.475.
Full textAbstract:
Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women’s Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students’ experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and reproductive health services is one of a number of areas identified by MCWH in which international students experience unequal treatment. The limitations of international students’ mandatory health insurance is of particular concern because it appears to conflict with Australia’s human rights obligations to take all appropriate measures to eliminate discrimination and to ensure appropriate services in connection with pregnancy. Given the social, cultural and economic benefits international students bring to the country in which they choose to study, state action on equitable health access for international students is urgently called for.
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Cramer, Rhian L., Helen L. McLachlan, Touran Shafiei, Lisa H. Amir, Meabh Cullinane, Rhonda Small, and Della A. Forster. "Maternal and child health nurses’ experiences of implementing two community-based breastfeeding interventions in Victoria, Australia: A mixed methods process evaluation." Australian Journal of Child and Family Health Nursing 16, no. 1 (July 2019): 4–14. http://dx.doi.org/10.33235/ajcfhn.16.1.4-14.
Full textAbstract:
Despite high rates of breastfeeding initiation in Australia, there is a significant drop in breastfeeding rates in the early postpartum period, and Australian government breastfeeding targets are not being met. The Supporting breastfeeding In Local Communities (SILC) trial was a three-arm cluster randomised trial implemented in 10 Victorian local government areas (LGAs). It aimed to determine whether early home-based breastfeeding support by a maternal and child health nurse (MCH nurse) with or without access to a community-based breastfeeding drop-in centre increased the proportion of infants receiving ‘any’ breast milk at four months. Focus groups, a written questionnaire and semi-structured interviews were undertaken to explore the interventions from the perspective of the SILC-MCH nurses (n=13) and coordinators (n=6), who established and implemented the interventions. Inductive thematic analysis was used to identify themes, then findings further examined using Diffusion of Innovations Theory as a framework. SILC-MCH nurses and coordinators reported high levels of satisfaction, valuing the opportunity to improve breastfeeding in our community; and having focused breastfeeding time with women in their own homes. They felt the SILC interventions offered benefits to women, nurses and the MCH service. Implementing new interventions into existing, complex community health services presented unforeseen challenges, which were different in each LGA and were in part due to the complexity of the individual LGAs and not the interventions themselves. These findings will help inform the planning and development of future programs aimed at improving breastfeeding and other interventions in MCH.
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Jan Forbes, Rouve, and Julie Williams. "The role of acknowledgment in the psychosocial recovery of young adults in disaster events." April 2021 10.47389/36, No 2 (April 2021): 42–47. http://dx.doi.org/10.47389/36.2.42.
Full textAbstract:
In 2009, 4 major bushfires destroyed vast areas of Gippsland in eastern Victoria including the areas around Delburn, Bunyip, Churchill and Wilsons Promontory. These are collectively known as the 2009 Gippsland bushfires. Research was conducted to investigate the psychosocial recovery of young adults in these areas. Twenty young adults participated in the study and, while these young adults are not an homogenous group, commonalities were identified across their stories. Asked what would have helped their recovery, the participants all said that acknowledgment of their personal and age-specific needs was the single most important factor that enabled or impeded recovery. This paper describes some of their stories. The paper looks at how participants viewed acknowledgment and the effects of its absence on their psychosocial recovery and how they felt unacknowledged in local recovery supports. The paper reports on the findings of this research and suggests an approach for management and longer-term recovery support that is inclusive of the specific needs of young adults.
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Parkinson, Sharon. "Victorian Health Policy Reform: Impact on Community-based Health Promotion." Australian Journal of Primary Health 3, no. 4 (1997): 7. http://dx.doi.org/10.1071/py97035.
Full textAbstract:
Since the Victorian Coalition Government was elected to office in 1992, community health policy has undergone considerable change as part of broader initiatives within the public sector. In the context of changing policy, concerns have been raised in the field of community health regarding the direction of community-based health promotion. The purpose of this study is to investigate the impact of policy reform on the conceptualisation, priority setting and practice of community-based health promotion. A series of interviews was conducted with a small sample of community health centre managers and staff within metropolitan Melbourne. Findings suggest that there has been a significant shift in the profile of community-based health promotion, with increasing emphasis on health promotion in clinical encounters and in groups, and less project work and community development. In terms of the principles of the Ottawa Charter, health promotion has moved away from the areas of community action and building healthy public policy as the centres focus increasingly on direct service provision. This study discusses the influences on and implications for the changing profile of community-based health promotion and considers directions for the future.
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Brusco, Natasha, Andrea Voogt, Melissa Nott, Libby Callaway, Mae Mansoubi, and Natasha Layton. "Meeting Unmet Needs for Stroke Rehabilitation in Rural Public Health: Explorative Economic Evaluation of Upper Limb Robotics-Based Technologies through a Capabilities Lens." Societies 12, no. 5 (October 10, 2022): 143. http://dx.doi.org/10.3390/soc12050143.
Full textAbstract:
Rehabilitation technologies are rapidly evolving, presenting promising interventions for people with neurological impairments. Access to technology, however, is greater in metropolitan than rural areas. Applying a capabilities approach to this access issue foregrounds healthcare recipients’ rights and personhood within the discourse on resource allocation. Within this context, this study aimed to investigate the economic viability of robotics-based therapy (RBT) in rural Victoria, Australia. A regional health network developed a model of care to provide equitable access to RBT following stroke. This explorative economic evaluation examined both the clinical and economic impact of RBT program implementation across six program iterations compared to 1:1 out-patient rehabilitation. While clinical outcomes were equivalent, the per patient RBT cost ranged from AUD 2681 (Program 1) to AUD 1957 (Program 6), while the per patient cost of usual care 1:1 out-patient rehabilitation, was AUD 2584. Excluding Program 1, the health service cost of usual care 1:1 out-patient rehabilitation was consistently higher, indicating that an established RBT program may be cost-effective, specifically providing less cost for the same effect. This research demonstrates the economic feasibility of delivering RBT in a regional public health stroke service. More broadly, it provided a reduction in the capability gap between rural and metropolitan stroke survivors by tackling an access disadvantage.