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Purtell, Jade, and Philip Mendes. "Stand By Me – Flexible and Holistic Support for Young Care Leavers: Smoothing Transitions from Care." Children Australia 41, no. 3 (August 17, 2016): 208–13. http://dx.doi.org/10.1017/cha.2016.18.
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Young people placed in out-of-home care (OHC) through Child Protection in Victoria are formally discharged by the expiration of their care order at the age of 18 years or younger. In contrast, young people in Australia generally live in their family home with parents or carers well into their twenties. Whilst there are a range of leaving care and post-care services funded for care leavers, these supports tend to be temporary and discretionary in contrast to the ongoing support young people receive whilst in care or, in some cases, from family and social networks post care. Numerous studies have documented the developmental challenges experienced by young people leaving state care, and the often poor outcomes faced by this group. The Stand By Me (SBM) programme was developed in Victoria to replicate the ongoing support provided in the UK to care leavers by Personal Advisers who remain available to assist young people until 21 years of age. Evaluation of the SBM programme has shown that ongoing, holistic support, including housing support, has assisted 12 young people through the SBM pilot to access stable housing, address multiple and complex issues, and form trusting relationships with SBM workers that contribute to positive outcomes.
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Campbell, Lynda. "The Families First Pilot Program in Victoria: Cuckoo or contribution?" Children Australia 19, no. 2 (1994): 4–10. http://dx.doi.org/10.1017/s1035077200003898.
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The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.
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Bennett, N. J., J. M. Bradford, A. L. Bull, and L. J. Worth. "Infection prevention quality indicators in aged care: ready for a national approach." Australian Health Review 43, no. 4 (2019): 396. http://dx.doi.org/10.1071/ah18052.
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Accreditation standards for Australian aged care homes include the requirement for programs to ensure infections are controlled. Effective infection prevention programs are supported by surveillance data providing the impetus for quality improvement and facilitating evaluation of interventions at the facility level. In 2016, infection control professionals employed in Victorian public-sector residential aged care services were surveyed to examine the nature and resourcing of local infection prevention programs and monitoring activities. Overall, 164 services participated (90% response rate). A high proportion (84%) reported executive support for infection surveillance, with mean allocation of 12h per fortnight per facility for infection prevention activities. Current surveillance activities included monitoring of infections and antimicrobial use (90%), influenza vaccination compliance for staff (96%) and residents (76%) and monitoring of infection due to significant organisms (84%). A successful statewide program including eight quality indicators has subsequently been implemented in Victoria. We suggest that a national focus could strengthen this framework, ensuring a uniform strategy with enhanced benchmarking capacity. Stakeholder engagement and refinement of appropriate indicators for monitoring quality improvement in public, not-for-profit and private sectors within aged care is required.
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Morris, Heather, Melissa Savaglio, Nick Halfpenny, Renee O’Donnell, Alesia Pileggi, Andrea Dunbar, Robyn Miller, and Helen Skouteris. "MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study." International Journal of Environmental Research and Public Health 18, no. 19 (September 29, 2021): 10279. http://dx.doi.org/10.3390/ijerph181910279.
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International evidence supports the effect of intensive family preservation and reunification services in preventing children’s placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program’s fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families’ outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families.
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Nathoo, Tasnim, Nancy Poole, Margaret Bryans, Lynda Dechief, Samantha Hardeman, Lenora Marcellus, Elizabeth Poag, and Marliss Taylor. "Voices from the community: Developing effective community programs to support pregnant and early parenting women who use alcohol and other substances." First Peoples Child & Family Review 8, no. 1 (September 9, 2020): 93–106. http://dx.doi.org/10.7202/1071409ar.
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Since the 1990s, many communities in Canada have worked to develop specialized programs to meet the needs of pregnant and early parenting women who use alcohol and other substances. These programs provide a range of services under one roof (a “single-access” or “one-stop shop” model), address women’s needs from a holistic perspective, provide practical and emotional support, and strive to reduce barriers to accessing care and support. Over the years, these programs have trialed new approaches to working with indigenous and non-indigenous women, their families, and their communities. In this paper, we describe the development of single-access programs in four different communities in Canada, discuss some of the elements of what makes these programs successful, and share our "lessons learned" over the years. We use examples from four different programs, including the Maxxine Wright Place Project in Surrey, BC; the Healthy, Empowered, Resilient (H.E.R) Pregnancy Program in Edmonton, AB; HerWay Home in Victoria, BC; and Manito Ikwe Kagiikwe in Winnipeg, MB. All four programs are based upon the "best practices" elements of: (1) engagement and outreach, (2) harm reduction, (3) cultural safety (4) supporting mother and child, and (5) partnerships. In addition to serving First Nations, Métis, Inuit and other indigenous women and their families, these programs have drawn upon indigenous knowledge in their program design, values, and philosophy and have collaborated with indigenous women in evaluation and research to track the successes of these programs and to improve service delivery.
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Entwisle, George. "EVALUATION IN HOME CARE SERVICES*." Annals of the New York Academy of Sciences 107, no. 2 (December 15, 2006): 725–31. http://dx.doi.org/10.1111/j.1749-6632.1963.tb13315.x.
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Ashburn, Ann, Ruth Pickering, Emma McIntosh, Sophia Hulbert, Lynn Rochester, Helen C. Roberts, Alice Nieuwboer, et al. "Exercise- and strategy-based physiotherapy-delivered intervention for preventing repeat falls in people with Parkinson’s: the PDSAFE RCT." Health Technology Assessment 23, no. 36 (July 2019): 1–150. http://dx.doi.org/10.3310/hta23360.
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Background People with Parkinson’s disease are twice as likely to experience a fall as a healthy older person, often leading to debilitating effects on confidence, activity levels and quality of life. Objective To estimate the effect of a physiotherapy programme for fall prevention among people with Parkinson’s disease. Design A multicentre, pragmatic, investigator-masked, individually randomised controlled trial (RCT) with prespecified subgroup analyses. Setting Recruitment from NHS hospitals and clinics and community and social services in eight English regions with home-based interventions. Participants A total of 474 people with Parkinson’s disease (i.e. Hoehn and Yahr scale stages 1–4) were recruited: 238 were assigned to a physiotherapy programme and 236 were assigned to usual care. Random allocation was 50 : 50. Interventions All participants received routine care; the usual-care group received an information digital versatile disc (DVD) and a single advice session at trial completion. The intervention group had an individually tailored, progressive, home-based fall avoidance strategy training programme with balance and strengthening exercises: PDSAFE. Main outcome measures The primary outcome was the risk of repeat falling, collected by self-report monthly diaries between 0 and 6 months after randomisation. Secondary outcomes included near-falls, falls efficacy, freezing of gait (FoG), health-related quality of life, and measurements taken using the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Chair Stand Test (CST), the Geriatric Depression Scale, the Physical Activity Scale for the Elderly and the Parkinson’s Disease Questionnaire. Results PDSAFE is the largest RCT of falls management among people with Parkinson’s disease: 541 patients were screened for eligibility. The average age was 72 years, and 266 out of 474 (56%) participants were men. Of the 474 randomised participants, 238 were randomised to the intervention group and 236 were randomised to the control group. No difference in repeat falling within 6 months of randomisation was found [PDSAFE group to control group odds ratio (OR) 1.21, 95% confidence interval (CI) 0.74 to 1.98; p = 0.447]. An analysis of secondary outcomes demonstrated better balance (Mini-BESTest: mean difference 0.95, 95% CI 0.24 to 1.67; p = 0.009), functional strength (CST: p = 0.041) and falls efficacy (Falls Efficacy Scale – International: mean difference 1.6, 95% CI –3.0 to –0.19; p = 0.026) with near-falling significantly reduced with PDSAFE (OR 0.67, 95% CI 0.53 to 0.86; p = 0.001) at 6 months. Prespecified subgroup analysis (i.e. disease severity and FoG) revealed a PDSAFE differing effect; the intervention may be of benefit for people with moderate disease but may increase falling for those in the more severe category, especially those with FoG. Limitations All participants were assessed at primary outcome; only 73% were assessed at 12 months owing to restricted funding. Conclusions PDSAFE was not effective in reducing repeat falling across the range of people with Parkinson’s disease in the trial. Secondary analysis demonstrated that other functional tasks and self-efficacy improved and demonstrated differential patterns of intervention impact in accordance with disease severity and FoG, which supports previous secondary research findings and merits further primary evaluation. Future work Further trials of falls prevention on targeted groups of people with Parkinson’s disease are recommended. Trial registration Current Controlled Trials ISRCTN48152791. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 36. See the NIHR Journals Library website for further project information. Sarah E Lamb is funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) at Oxford Health NHS Foundation Trust, the NIHR Oxford Biomedical Research Centre at the Oxford University Hospitals NHS Foundation Trust and CLAHRC Oxford. Victoria A Goodwin is supported by the NIHR Collaborations for Leadership in Applied Health Research and Care in the South West Peninsula (PenCLAHRC). Lynn Rochester is supported by the NIHR Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. The research was also supported by the NIHR Newcastle Clinical Research Facility Infrastructure funding. Helen C Roberts is supported by CLAHRC Wessex and the NIHR Southampton Biomedical Research Centre.
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O'Connor, Margaret, and Janet Philips. "Challenges of implementing voluntary assisted dying in Victoria, Australia." International Journal of Palliative Nursing 26, no. 8 (December 2, 2020): 425–30. http://dx.doi.org/10.12968/ijpn.2020.26.8.425.
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Background: Staff working in community palliative care services are accustomed to the intimate conversations that a patient being at home can engender. Being at home can provide a safe space for a patient to express difficulties, including expressing a desire for hastened death. With the implementation of voluntary assisted dying in Victoria in mid-2019, palliative care services have needed to review and adapt policies and practices to incorporate this new procedure. While it was anticipated that a small percentage of people would request access to voluntary assisted dying, in the wake of such significant change, there were numerous implications for palliative care services to consider. This paper describes both the organisational and individual changes undertaken by one community-based palliative care service, in anticipation of legalised assistance in dying. The range of responses to the issues raised are discussed, in preparation for, and in the early days of, voluntary assisted dying.
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Ayar, G., S. Sahin, M. Uysal Yazici, R. Gunduz, H. Yakut, and F. Demirel. "O-199 Evaluation Of Home Health Care Services." Archives of Disease in Childhood 99, Suppl 2 (October 2014): A99.3—A100. http://dx.doi.org/10.1136/archdischild-2014-307384.267.
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Mola, Giorgio Di. "Role and Evaluation of Palliative Home Care Services." Progress in Palliative Care 3, no. 1 (January 1995): 6–11. http://dx.doi.org/10.1080/09699260.1995.11746687.
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Uchida, Yoko, Setsu Shimanouchi, and Ayumi Kouno. "Outcome Evaluation and Cost-Effectiveness of Home Care Services." Journal of Japan Academy of Nursing Science 21, no. 1 (2001): 9–17. http://dx.doi.org/10.5630/jans1981.21.1_9.
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Allison, S. P., A. Micklewright, J. Rawlings, and M. Hull. "Organisation and evaluation of home enteral nutrition services." Clinical Nutrition 12 (January 1993): S38—S43. http://dx.doi.org/10.1016/s0261-5614(09)90007-3.
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Williams, Allison M., Michelle V. Caron, Maria McMillan, Anne Litkowich, Noreen Rutter, Arlete Hartman, and John Yardley. "An evaluation of contracted palliative care home care services in Ontario, Canada." Evaluation and Program Planning 24, no. 1 (February 2001): 23–31. http://dx.doi.org/10.1016/s0149-7189(00)00044-6.
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Cadilhac, Dominique A., Tara Purvis, Monique F. Kilkenny, Mark Longworth, Katherine Mohr, Michael Pollack, and Christopher R. Levi. "Evaluation of Rural Stroke Services." Stroke 44, no. 10 (October 2013): 2848–53. http://dx.doi.org/10.1161/strokeaha.113.001258.
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Background and Purpose— The quality of hospital care for stroke varies, particularly in rural areas. In 2007, funding to improve stroke care became available as part of the Rural Stroke Project (RSP) in New South Wales (Australia). The RSP included the employment of clinical coordinators to establish stroke units or pathways and protocols, and more clinical staff. We aimed to describe the effectiveness of RSP in improving stroke care and patient outcomes. Methods— A historical control cohort design was used. Clinical practice and outcomes at 8 hospitals were compared using 2 medical record reviews of 100 consecutive ischemic or intracerebral hemorrhage patients ≥12 months before RSP and 3 to 6 months after RSP was implemented. Descriptive statistics and multivariable analyses of patient outcomes are presented. Results— Sample: pre-RSP n=750; mean age 74 (SD, 13) years; women 50% and post-RSP n=730; mean age 74 (SD, 13) years; women 46%. Many improvements in stroke care were found after RSP: access to stroke units (pre 0%; post 58%, P <0.001); use of aspirin within 24 hours of ischemic stroke (pre 59%; post 71%, P <0.001); use of care plans (pre 15%; post 63%, P <0.001); and allied health assessments within 48 hours (pre 65%; post 82% P <0.001). After implementation of the RSP, patients directly admitted to an RSP hospital were 89% more likely to be discharged home (adjusted odds ratio, 1.89; 95% confidence interval, 1.34–2.66). Conclusions— Investment in clinical coordinators who implemented organizational change, together with increased clinician resources, effectively improved stroke care in rural hospitals, resulting in more patients being discharged home.
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Haswira, Ma'mur, Wahidin Wahidin, and Syarif Ahmad. "EVALUATION OF HOME CARE PROGRAM IMPLEMENTATION IN THE BARA-BARAYA PUSKESMAS MAKASSAR CITY." Jurnal Administrasi Negara 25, no. 3 (December 30, 2019): 212–28. http://dx.doi.org/10.33509/jan.v25i3.889.
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Home care services at midnight many residents complained and there is no distribution of home care officers at the Bara-Baraya Public Health Center in Makassar. The focus of research in this study is the evaluation of the implementation of home care programs at the Bara-Baraya Public Health Center in Makassar City. This study aims to evaluate the implementation of home care programs at the Makassar City of Bara Baraya Health Center. The approach used in this study is a qualitative approach that describes and observes deeply the evaluation of the implementation of home care programs at the Makassar City of Bara Baraya Health Center. This research also uses applied research design. The data source in this study was taken from four home care officers at the Bara-Baraya Public Health Center in Makassar City and four people who use home care services. The results showed that the input sub-variables can be quite good. Medical devices such as thermometers, tensimeters, and stethoscopes function properly and are suitable for use in home care health services. Then operational funds such as staff salaries are paid according to the number of visits to the community. The doctor for Rp. 100,000 / visit and nurses 75,000 / visit. But in the aspect of home care officers is still inadequate. Home care workers have a dual role between serving the community at the puskesmas, as well as serving the community at the residence. In the process sub-variables, it can be quite good. In the call center aspect, people can easily call the call center because this service is toll free. Home visits and observations have been carried out carefully. But the division of duties of home care officers is not optimal. In the output sub-variable, it can be said to be good because the public can directly benefit from home care services.
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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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Tilbury, Clare, and June Thoburn. "Children in out-of-home care in Australia: International comparisons." Children Australia 33, no. 3 (2008): 5–12. http://dx.doi.org/10.1017/s1035077200000262.
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As governments increasingly search globally for strategies to improve child welfare outcomes, it is vital to consider how policies and programs developed in other countries are likely to suit local conditions. Routinely collected child welfare administrative data can provide contextual information for cross-national comparisons. This article examines out-of-home care in Australia compared to other developed countries, and explores possible explanations for differences in patterns and trends. In doing so, it also examines the similarities and differences between NSW, Victoria and Queensland. It is argued that a sound understanding of how out-of-home care is used, the profile of children in care and the influences on data can assist policy makers to match proposed solutions to clearly understood current problems. The imperative is to plan and implement policies and programs that locate out-of-home care within a range of child welfare services that meet the diverse needs of children and families within local contexts.
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Butler, Claire, Patricia Wilson, Vanessa Abrahamson, Rasa Mikelyte, Heather Gage, Peter Williams, Charlotte Brigden, et al. "Optimum models of hospice at home services for end-of-life care in England: a realist-informed mixed-methods evaluation." Health and Social Care Delivery Research 10, no. 24 (August 2022): 1–304. http://dx.doi.org/10.3310/msay4464.
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Background Many people prefer to die at home when the time comes. Hospice at home services aim to support patients to achieve this. A range of hospice at home services exist; some services have been evaluated, but there has been limited evidence synthesis. Objectives The main objective was to find out what models of hospice at home services work best, for whom and in what circumstances. Other objectives supported this aim, including an analysis of the health economic costs of hospice at home models. Design The study was an overarching, non-interventional, realist evaluation comprising three phases. Phase 1 was a survey of hospice at home services. Phase 2 involved 12 case studies, grouped into four models on the basis of size and 24 hours per day, 7 days per week (24/7), operations, from which quantitative and health economics data were gathered. Qualitative interview data from bereaved carers, commissioners and providers were analysed to generate context–mechanism–outcome configurations. Phase 3 comprised stakeholder consensus meetings. Setting Hospice at home services across England. Participants A total of 70 hospice at home managers responded to the survey. A total of 339 patient and family/informal carer dyads were recruited; 85 hospice at home providers and commissioners were interviewed. A total of 88 stakeholders participated in consensus meetings. Main outcome measures The quality of dying and death of patients was assessed by bereaved carers (using the Quality of Dying and Death questionnaire). A patient’s use of services was collected using the Ambulatory and Home Care Record. Results Hospice at home services varied; two-thirds were mainly charitably funded, and not all operated 24/7. Most patients (77%) had cancer. Hospice at home services overall provided care that was likely to deliver ‘a good death’, and 73% of patients died in their preferred place. Six context–mechanism–outcome configurations captured factors relevant to providing optimum hospice at home services: (1) sustainability (of the hospice at home service); (2) volunteers (use of, in the hospice at home service); (3) integration and co-ordination (with the wider health and social care system); (4) marketing and referral (of the hospice at home service); (5) knowledge, skills and ethos (of hospice at home staff); and (6) support directed at the carer at home. Key markers of a good service included staff who had time to care, providing hands-on care; staff whose knowledge and behaviour promoted supportive relationships and confidence through the process of dying; and services attending to the needs of the informal carer. Areas of potential improvement for most hospice at home services were the use of volunteers in hospice at home, and bereavement care. Limitations The study had the following limitations – heterogeneity of hospice at home services, variations in numbers and patient clinical statuses at recruitment, a low Quality of Dying and Death questionnaire response rate, and missing data. Only patients with an informal carer involved on a daily basis were eligible for the study. Conclusions Hospice at home services delivered high-quality care and a ‘good death’, with the majority of patients dying in their stated preferred place. Hospice at home providers can improve their impact by focusing on the features identified that deliver the best patient outcomes. Commissioners can facilitate patient preference and reduce the number of hospital deaths by working with hospice at home services to secure their financial sustainability and increase the numbers and range of patients admitted to hospice at home services. Future research Future research should explore the use of volunteers in the hospice at home setting and evaluate approaches to bereavement support. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 24. See the NIHR Journals Library website for further project information.
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Mendes, Philip, and Badal Moslehuddin. "Moving out from the state parental home: A comparison of leaving care policies in Victoria and New South Wales." Children Australia 29, no. 2 (2004): 20–29. http://dx.doi.org/10.1017/s1035077200005976.
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Young people leaving care are arguably one of the most vulnerable and disadvantaged groups in society. Compared to most young people, they face numerous barriers to accessing educational, employment and other developmental and transitional opportunities.Using information from interviews and a range of documents, this study compares the leaving care supports currently available in two Australian states, Victoria and New South Wales. Attention is drawn to the history of the leaving care debate in both states, the nature of the existing legislative and program supports for care leavers in each state, the key political and policy actors that have either helped or hindered the development of leaving care policies and services in each state, and the principal unmet needs of care leavers in each state.The findings suggest that NSW leads the way in terms of providing effective legislative and program supports to care leavers. The differences between Victoria and NSW are attributed to a number of factors including particularly the different relationships between the respective government bureaucracies and non-government child welfare sectors.
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J. Black, Kirsten, and Patricia L. Buckley. "Developing a Consistent Approach to Determining Priority for HACC Services." Australian Journal of Primary Health 9, no. 1 (2003): 78. http://dx.doi.org/10.1071/py03010.
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This paper reports on the development of a Priority of Access tool for Home and Community Care services provided by local governments in the Western Metropolitan Region of Victoria. Managing the demand for these services requires an equitable approach to service allocation decisions. The Priority of Access tool was developed with input from Western Metropolitan Region local government HACC representatives and the Department of Human Services. A literature review identified indicators of need that predicted use of community services; however, no substantial contributions were identified relating to prioritising access to health services in the home. The tool developed relies on cross-referencing responses from the Service Coordination tools developed through the Victorian Primary Care Partnership initiative. A pilot was conducted with assessment staff and their feedback led to modification of the tool. Staff found the tool a useful method of increasing objectivity in assessments and providing a framework to consistently determine priority. The importance of training in the use of the tool was reinforced during piloting of the tool. The Priority of Access tool provides a simple and consistent, yet comprehensive, approach for Western Metropolitan Region local government HACC services to equitably determine priority of access for clients.
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Thornton, Katherine, Susan Webster, and Meredith Temple-Smith. "Is immunisation for children and young people in statutory care in Victoria 'all too hard'? A qualitative study with health professionals." Australian Journal of Primary Health 25, no. 2 (2019): 131. http://dx.doi.org/10.1071/py18096.
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This formative study aimed to identify health professionals’ perspectives on vaccination issues among children in statutory out-of-home care in Victoria. Eight health professionals, drawn from a purposive Victorian sample known to be proactive in addressing the vaccination needs of children in out-of-home care, took part in semi-structured interviews. Questions addressed participants’ views about roles and responsibilities, barriers and enabling factors affecting vaccination, and ideas about systems improvements. Interview transcripts were analysed thematically. The main themes that emerged were health professionals’ observations about vaccine hesitancy among significant adults in the out-of-home care sector, the paucity of child medical history information available and diffuse responsibility for the provision of legal consent to vaccination. More accurate immunisation status monitoring appears warranted for children in out-of-home care. Unless the collection and maintenance of child medical records improves and vaccination consent processes are streamlined, health professionals will be limited in their capacity to provide efficient vaccination services to these children. Research on vaccine hesitancy among staff and carers in the statutory care sector may be of value. This study supports other Australian research that indicates these children may require more targeted, inter-sectoral immunisation approaches.
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Fikar, Christian, and Patrick Hirsch. "Evaluation of trip and car sharing concepts for home health care services." Flexible Services and Manufacturing Journal 30, no. 1-2 (August 26, 2016): 78–97. http://dx.doi.org/10.1007/s10696-016-9252-8.
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Stragliotto, Silvia, Antonella Brunello, Sara Galuppo, Sabina Murgioni, Vincenzo Dadduzio, Evelina Lamberti, Irene Guglieri, et al. "Simultaneous Care clinic (SCC): A three-year monoinstituional experience." Journal of Clinical Oncology 35, no. 31_suppl (November 1, 2017): 169. http://dx.doi.org/10.1200/jco.2017.35.31_suppl.169.
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169 Background: Early palliative care has been shown to improve outcomes in pts with advanced cancer. In accordance with ASCO and AIOM recommendations of implementing palliative care early for pts with metastatic cancer along with active cancer treatment a SCC was set up at Istituto Oncologico Veneto (IOV) in Padova since 2014; Methods: Data of pts referred to the SCC from Mar 2014 to Nov 2016 were retrieved from a prospectively maintained database. Data collected included cancer type, status of disease, PS, ongoing oncological treatment, psychological evaluation, social evaluation, nutritional evaluation, activation of home territorial services and/or Palliative Care services, use of other health services after a first visit and place of death; Results: 533 pts were evaluated by a multidisciplinary team. Overall symptom burden was low with baseline symptom scores highest for fatigue, lack of appetite and depression. Nutritional evaluation revealed 224 pts (42%) with nutritional problems, the most frequent being weight loss (n = 121). Psychological distress was present in 185 pts (35%). Social issues were present in 26 pts (5%) and were dealt with activation of social services (n = 9) or volunteer territorial services (n = 8). Patients deemed in need of home care services after the first access to the SCC were 177 (33%) and for these a formal request for Home Care services activation was sent to the Local Health Territorial Unit. After the first visit 141 patients referred to Emergency Room for intervening problems with median time of 41 days. Globally 290 pts (54%) died with 53% of deaths occurring at home. For pts who were receiving active oncological treatment median time from first-visit in the SCC and death was 126 days. We are also evaluating a score for priority for access to SCC; Conclusions: Early integrated SC may be most effective if targeted to the specific needs of each patient population
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Konstantinovic, Dejan, Vesna Lazarevic, Valentina Milovanovic, Mirjana Lapcevic, Vladan Konstantinovic, and Mira Vukovic. "Financial sustainability of home care in the health system of the Republic of Serbia." Srpski arhiv za celokupno lekarstvo 141, no. 3-4 (2013): 214–18. http://dx.doi.org/10.2298/sarh1304214k.
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Introduction. Over the last several years, during the economic crisis, the Ministry of Health and the Republican Health Insurance Fund (RHIF) have been faced with new challenges in the sphere of healthcare services financing both in the primary as well as other types of health insurance in the Republic of Serbia (RS). Objective. Analysis of cost?effectiveness of two models of organization of home treatment and healthcare in the primary insurance, with evaluation of the cost sustainability of a single visit by the in?home therapy team. Methods. Economic evaluation of the cost of home treatment and healthcare provision in 2011 was performed. In statistical analysis, the methods of descriptive statistics were employed. The structure of fixed costs of home healthcare was developed according to the RS official norms, as well as fixed costs of providing services of home therapy by the Healthcare Centre "New Belgrade". The statement of account for provided home therapy services was made utilizing the RHIF price list. Results. The results showed that the cost of home healthcare and therapy of the heterogeneous population of patients in the Healthcare Centre "New Belgrade" was more cost?effective in relation to the cost of providing home therapy services according to the RS official norms. Conclusion. Approved costs utilized when making a contract for services of home therapy and healthcare with the RHIF are not financially sustainable. It was shown that the price of 10 EUR for each home visit by the in?home therapy team enables sustainability of this form of providing healthcare services in RS.
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Rodrigo, J., Hanny Calache, and Martin Whelan. "Socio-demographic profile of child and adolescent users of oral health services in Victoria, Australia." Cadernos de Saúde Pública 30, no. 9 (September 2014): 1903–11. http://dx.doi.org/10.1590/0102-311x00083613.
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The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
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Hu, Jinrong, Yuyuan Zhang, Le Wang, and Victor Shi. "An Evaluation Index System of Basic Elderly Care Services Based on the Perspective of Accessibility." International Journal of Environmental Research and Public Health 19, no. 7 (April 2, 2022): 4256. http://dx.doi.org/10.3390/ijerph19074256.
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Population aging has become more and more severe in many countries. As a result, the demand for basic elderly care services has risen. The establishment of an evaluation index system for basic elderly care services can provide guidelines for governments to improve the quality of such services. Based on the “5A” theoretical analysis framework of Penchansky and Thomas, this paper introduces the concept of “accessibility” into evaluation. The “accessibility” model of services, through a literature review, field research, and three rounds of expert correspondence, consists of three first-level indicators, including the accessibility of home-based community elderly care services, the accessibility of institutional elderly care services, and the accessibility of administrative services. The evaluation index system of 15 s-level indicators and 70 third-level indicators, using AHP to determine the weight value of each indicator, provides a quantitative basis for the quality evaluation and improvement of basic elderly care services. Based on our quantitative results, policy recommendations are put forward: strengthen the support for the human and financial resources of community home-based elderly care services; improve the affordability of basic elderly care services; increase the types and numbers of institutional elderly care service projects; improve the availability and adaptability of institutional elderly care services; improve the accessibility of administrative services so that elderly care service institutions and elderly care administrative agencies can establish an effective communication and feedback mechanism.
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Markiewicz, Anne. "The child welfare system in Victoria: Changing context and perspectives 1945-1995." Children Australia 21, no. 3 (1996): 32–41. http://dx.doi.org/10.1017/s1035077200007185.
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This paper traces the history of child welfare in Victoria, from the formation of the Children's Welfare Department to the present time. It draws principally upon the Annual Reports of the responsible state government department, to illustrate trends in out-of-home placement for children and young people admitted to care. It describes substantial shifts in direction to the institutions in the 1960s, deinstitutionalisation of the 1980s, and the re-emergence of home-based care as a favoured, economical option.The paper traces the ebbs and flows in numbers, periods of overcrowding and the current reduced number of children and young people in care. It notes events impacting on evolving child welfare history in Victoria, the child migration program, building projects, the establishment of family group homes, regionalisation, external review, the Children and Young Persons Act (1989), and mandatory reporting legislation. Themes emerging include: early child welfare as a period of rescue and reform; the monitoring of standards and re-entry of the department to residential care; the building of institutions and rising numbers in care; redevelopment and the emergence of a community focus; the expansion of child protection; and the phasing out of old models and the search for cost efficient alternatives.A challenge for the 1990s is the need for deliberate and planned monitoring and evaluation as institutional and residential care give way to home-based care, and numbers of admissions decrease. The paper aims to provide useful, historical material for readers with an interest in child welfare work which would benefit from a descriptive review of the past.
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Miller, Elizabeth M., Joanne E. Porter, and Rebecca Peel. "Palliative and End-of-Life Care in the Home in Regional/Rural Victoria, Australia: The Role and Lived Experience of Primary Carers." SAGE Open Nursing 7 (January 2021): 237796082110362. http://dx.doi.org/10.1177/23779608211036284.
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Introduction Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results Two themes emerged: “ Negotiating healthcare systems” which described the needs for multidisciplinary supports and “ The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system.
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Chang, Shuchih Ernest, YiChian Chen, MingFang Lu, and Hueimin Louis Luo. "Development and Evaluation of a Smart Contract–Enabled Blockchain System for Home Care Service Innovation: Mixed Methods Study." JMIR Medical Informatics 8, no. 7 (July 28, 2020): e15472. http://dx.doi.org/10.2196/15472.
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Background In the home care industry, the assignment and tracking of care services are controlled by care centers that are centralized in nature and prone to inefficient information transmission. A lack of trust among the involved parties, information opaqueness, and large manual manipulation result in lower process efficiency. Objective This study aimed to explore and demonstrate the application of blockchain and smart contract technologies to innovate/renovate home care services for harvesting the desired blockchain benefits of process transparency, traceability, and interoperability. Methods An object-oriented analysis/design combined with a unified modeling language tool was used to construct the architecture of the proposed home care service system. System feasibility was evaluated via an implementation test, and a questionnaire survey was performed to collect opinions from home care service respondents knowledgeable about blockchain and smart contracts. Results According to the comparative analysis results, the proposed design outperformed the existing system in terms of traceability, system efficiency, and process automation. Moreover, for the questionnaire survey, the quantitative analysis results showed that the proposed blockchain-based system had significantly (P<.001) higher mean scores (when compared with the existing system) in terms of important factors, including timeliness, workflow efficiency, automatic notifications, insurance functionality, and auditable traceability. In summary, blockchain-based home care service participants will be able to enjoy improved efficiency, better transparency, and higher levels of process automation. Conclusions Blockchain and smart contracts can provide valuable benefits to the home care service industry via distributed data management and process automation. The proposed system enhances user experiences by mitigating human intervention and improving service interoperability, transparency/traceability, and real-time response to home care service events. Efforts in exploring and integrating blockchain-based home care services with emerging technologies, such as the internet of things and artificial intelligence, are expected to provide further benefits and therefore are subject to future research.
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Porter, Eileen J. "An Older Rural Widow’s Transition From Home Care to Assisted Living." Care Management Journals 3, no. 1 (January 2001): 25–32. http://dx.doi.org/10.1891/1521-0987.3.1.25.
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Designed to foster appreciation of comprehensive evaluation of home care outcomes, this case study of an older rural widow is part of a longitudinal phenomenological study of home care. Over 14 months, while her home care agency reacted to the Balanced Budget Act, nine interviews were done with a 95-year-old woman who lived alone until she moved to an assisted living facility. Data analysis yielded structures of her changing experience of home care. Although primarily supportive services may have been inconsistent with Medicare regulations, such services may have influenced the favorable outcomes of sustaining elders at home and undergirding the rural economy
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Kerber, Nalú Pereira da Costa, Ana Lúcia Cardoso Kirchhof, Marta Regina Cezar-Vaz, and Rosemary Silva da Silveira. "Right of the Citizen and Evaluation of Health Services: theoretical-Practical Approaches." Revista Latino-Americana de Enfermagem 18, no. 5 (October 2010): 1013–19. http://dx.doi.org/10.1590/s0104-11692010000500024.
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This study was carried out at a Family Medical Unit in a city in the south of Brazil, aiming at analyzing how the evaluation process takes place in a Brazilian public health unit, specifically considering a home care service. Data were collected through observation of the work process and interviews with workers, managers and users, between March and June 2006. The subjects were asked about the means applied to evaluate the home care service. No work is done to identify problems and reorient actions taken, evaluating the practices and measuring the impact of service and program actions on the population’s health status.
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COLAK, Muhteber, Ozden GOKDEMIR, Seval YAPRAK, and Mehtap KARTAL. "Evaluation of home care services at a training and research hospital in Izmir." Marmara Medical Journal 29, no. 3 (October 15, 2016): 170. http://dx.doi.org/10.5472/marumj.281397.
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COLAK, Muhteber, Ozden GOKDEMIR, Seval YAPRAK, and Mehtap KARTAL. "Evaluation of home care services at a training and research hospital in Izmir." Marmara Medical Journal 29, no. 3 (January 3, 2017): 170. http://dx.doi.org/10.5472/mmjoa.2903.06.
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Gilmartin, Julia Fiona-Maree, Jennifer Lillian Marriott, and Safeera Yasmeen Hussainy. "Improving Australian care home medicine supply services: Evaluation of a quality improvement intervention." Australasian Journal on Ageing 35, no. 2 (October 21, 2015): E1—E6. http://dx.doi.org/10.1111/ajag.12236.
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Lee, Sue-Hyang, Soo-Myoung Bae, Bo-Mi Shin, and Sun-Jung Shin. "Types of Perception of Home Visiting Oral Health Care Services for Korean Older Persons: A Q Methodology Study." International Journal of Environmental Research and Public Health 18, no. 1 (December 30, 2020): 214. http://dx.doi.org/10.3390/ijerph18010214.
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This study was conducted using the Q methodology to categorize Korean older persons’ subjective perceptions of home visiting oral health care services. Various opinions regarding home visiting oral health care services were collected based on related literature, and by conducting in-depth interviews with 12 people. Thirty-two statements were finally selected, and Q classification was applied. Based on data analysis with the PC-QUANL program, six factors (seven types) were derived, which accounted for 49.6% of the total variance. By comprehensive analysis of the types of subjective perceptions of home visiting oral health care services, the following two characteristics were identified. Korean older persons were expected to promote their own oral health activities, or improved access to expert health care services, through the home visiting oral health care services. Additionally, they had a need for social, economic, emotional, and informational support. Therefore, home visiting dental personnel should be able to provide customized visiting oral health care services based on evaluation of the need and type of perception of older persons. Thus, it is essential for visiting dental personnel to be trained in the knowledge of social welfare, and to develop diverse competencies.
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Meriç, Meltem, Gül Ergün, Ganna Pola, Meral Dölek, Burcu Totur Dikmen, and Ümran Dal Yılmaz. "Relationship Between Nursing Students’ Attitudes Toward Elderly Discrimination and Opinions About Home Care Services." Home Health Care Management & Practice 31, no. 4 (March 26, 2019): 219–23. http://dx.doi.org/10.1177/1084822319839365.
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The determination of nursing students’ attitudes toward elderly discrimination and their opinions about home care is important in that it will affect the quality of care provided to elderly individuals in their homes by the students in the future. For this reason, the aim of this study was to determine relationship between nursing students’ attitudes toward elderly discrimination and their opinions about home care services. This descriptive study was conducted with a total of 318 students from a university nursing faculty during the fall semester of the 2016-2017 academic year. Data for the study were collected using the Home Care Services Evaluation Questionnaire and the Ageism Attitude Scale. It was found that there was a positively significant but weak relationship between the students’ age discrimination scale total score and the positive discrimination subdimension score, and their opinions about home care services ( p < .001). Students’ attitudes toward elderly discrimination were found to make a statistically significant contribution to their opinions about home care services. It was ascertained that students’ attitudes toward elderly discrimination affected their opinions about home care services. It is recommended that geriatric nursing and home care nursing lectures be included in the nursing education curriculum, awareness of the importance of the concept of old age and elderly care be increased by establishing internship fields for students in institutions that provide home care for the elderly, and positive attitudes toward the elderly be promoted.
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Biro, Mary Anne, Jane S. Yelland, Stephanie J. Brown, and Georgina A. Sutherland. "Women’s experience of domiciliary postnatal care in Victoria and South Australia: a population-based survey." Australian Health Review 36, no. 4 (2012): 448. http://dx.doi.org/10.1071/ah11128.
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Objective. Despite the expansion of postnatal domiciliary services, we know little about the women receiving visits and how they regard their care. The aim of this study is to examine the provision of postnatal domiciliary care from a consumer perspective. Methods. All women who gave birth in September–October 2007 in South Australia and Victoria were mailed questionnaires 6 months after the birth. Women were asked if they had received a midwifery home visit, and to rate the care they received. Results. More women in South Australia reported receiving a domiciliary visit than in Victoria (88.0% v. 76.0%) and they were more likely to rate their care as ‘very good’ (69.1% v. 63.4%). Younger women, women on a lower income, who were holding a healthcare concession card or who had not completed secondary education were less likely to receive a visit. Conclusion. Although the majority of women in public maternity care in Victoria and South Australia receive domiciliary care and rate it positively, there are significant state-based differences. Those more likely to benefit from domiciliary care are less likely to receive a visit. There is a need to further explore the purpose, aims and content of domiciliary care at individual and state-wide levels. What is known about the topic? Postnatal domiciliary services have expanded dramatically over the past decade as the postpartum hospital stay has shortened. Despite its widespread introduction, there are no mechanisms in place to monitor or evaluate whether these services are meeting women’s expectations. We know little about the women who receive domiciliary postnatal visits in the first week after discharge from hospital, and how they regard their experience of care. What does the paper add? This is the first Australian population-based survey that describes the experience of domiciliary care according to the state in which women reside and to examine the sociodemographic, obstetric and organisational factors associated with the provision of services. What are the implications for practitioners? There were state-based differences in the provision of domiciliary care and whilst the majority of women received domiciliary care and rated it positively, an inverse care law seems to apply: women who were more likely to need and derive benefit from domiciliary care were less likely to receive it. There is a need to further explore the purpose, aims and content of domiciliary care at individual and state-wide levels.
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Haydon, Helen M., Liam J. Caffery, Centaine L. Snoswell, Emma E. Thomas, Monica Taylor, Marc Budge, Jacinta Probert, and Anthony C. Smith. "Optimising specialist geriatric medicine services by telehealth." Journal of Telemedicine and Telecare 27, no. 10 (November 2, 2021): 674–79. http://dx.doi.org/10.1177/1357633x211041859.
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Telehealth can effectively increase access to specialist care and reduce the need for travel. The Geri-Connect service was established in 2017 to support people living in residential aged care facilities in regional Victoria, Australia. Using the Model for the Assessment of Telemedicine, an evaluation of the Geri-Connect service identified service activity patterns and factors associated with uptake. Service activity from 2017 to 2020 and 10 semi-structured, key stakeholder interviews were captured and analysed. Between 2017 and 2020, video consultations were provided to 53 residential aged care facilities. Sustained growth (over 178%) and strong stakeholder acceptance highlight the effectiveness of this telegeriatric service. Four recommendations provide opportunities to further enhance service delivery including: implementation of an integrated health information system; systematic evaluation of service impact on stakeholders and residents, auditing and subsequent provision of targeted training; and regular auditing of software and hardware. Additionally, the need to augment fixed room hardware with mobile telehealth systems would increase access for residents with mobility problems. Dedicated personnel of the centralised team are best suited to implementing the recommendations. Whilst the provision of routine telehealth services into residential aged care facilities is challenging, the Geri-Connect service demonstrates that telehealth can be effectively provided to residential aged care facility residents needing specialist geriatric care.
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Volard, Jill, Christine Baxter, and Cliff da Costa. "Recruiting Out-of-Home Caregivers for Children with an Intellectual Disability in the Shared Family Care Program." Children Australia 18, no. 4 (1993): 23–27. http://dx.doi.org/10.1017/s1035077200003692.
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Recruiting caregivers for children with an intellectual disability who require out-of-home respite or longer-term care is a problem which has challenged service providers for many years. This paper summarises findings of a recent evaluation of Shared Family Care, a foster care program in Victoria for children with intellectual disabilities/developmental delay. Current recruiting is not succeeding in meeting the demand for either respite, short term or long term care. Findings of the evaluation suggest that factors such as use of appropriate media, and running effective recruitment campaigns is only part of the answer. It is also important at every stage to address caregiver satisfaction with the job and employ strategies to find potential caregivers in the community.
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Rizk, Sabrin, Emmanuel Ngui, Teal Benevides, Victoria A. Moerchen, Mary Alunkal Khetani, and Kris Barnekow. "Adequacy of Medical Home Primary Care and Factors Associated With Educational Services Use Among Children and Youth With Autism Spectrum Disorder." American Journal of Occupational Therapy 76, Supplement_1 (July 1, 2022): 7610510157p1. http://dx.doi.org/10.5014/ajot.2022.76s1-po157.
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Abstract Date Presented 04/02/2022 Children and youth with autism spectrum disorder (ASD) use educational services for their complex needs. We analyzed the 2016/2017 National Survey of Children’s Health to examine the association between inadequate medical home primary care (MHPC) and educational service use in children with ASD. Inadequate MHPC was significantly associated with higher odds of educational service use. After adjustment, inadequate MHPC was significantly associated with lower odds of educational service use. Primary Author and Speaker: Sabrin Rizk Contributing Authors: Emmanuel Ngui, Teal Benevides, Victoria A. Moerchen, Mary Alunkal Khetani, Kris Barnekow
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Russell, Siân, Rachel Stocker, Robert Oliver Barker, Jennifer Liddle, Joy Adamson, and Barbara Hanratty. "Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation." British Journal of General Practice 70, no. 700 (October 5, 2020): e793-e800. http://dx.doi.org/10.3399/bjgp20x713069.
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BackgroundThe National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents’ vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England.AimTo identify challenges to implementation of NEWS in care homes.Design and settingQualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee.MethodInterviews were intended to capture people’s attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes.ResultsCare home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication.ConclusionThis evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.
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Cuthbert, Denise, and Marian Quartly. "Adoption, fostering, permanent care and beyond Re-thinking policy and practice on out-of-home care for children in Australia." Children Australia 35, no. 2 (2010): 2–5. http://dx.doi.org/10.1017/s1035077200000985.
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The papers published in this special issue of Children Australia were originally presented at a two day symposium held in Melbourne on 26 and 27 November 2009. The symposium, Adoption, fostering, permanent care and beyond: Re-thinking policy and practice on out-of-home care for children in Australia, was jointly convened by the Department of Human Services (DHS), Victoria and the School of Political and Social Inquiry at Monash University in conjunction with the History of Adoption in Australia project (Monash University 2009).The event was a partnership between professionals working in this area and university researchers. Each group brought different perspectives and imperatives to the table. For DHS and the sector, the immediate frame of the symposium was the major policy statement Directions for out-of-home care, announced in May 2009 by the Victorian Minister for Community Services after consultation with community service organisations and young people living in care (DHS 2009a). It announces a framework for change which incorporates action on seven fronts or ‘reform directions’. These are to support children to remain at home with their families; to provide a better choice of care placement; to promote wellbeing; to prepare young people who are leaving care to make the transition into adult life; to improve the education of children in care; to develop effective and culturally appropriate responses to the high numbers of Aboriginal children in our care; and to create a child-focused system and processes (DHS 2009a). The driving principle informing the reforms is to ensure that policy and service provision are centred on the needs and interests of children and young people, and to ensure that young people are consulted as to what their needs are (rather than assumptions being made by adults as to their needs).
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Aoyama, Maho, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, and Mitsunori Miyashita. "The Japan HOspice and Palliative Care Evaluation Study 3: Study Design, Characteristics of Participants and Participating Institutions, and Response Rates." American Journal of Hospice and Palliative Medicine® 34, no. 7 (May 2, 2016): 654–64. http://dx.doi.org/10.1177/1049909116646336.
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This article describes the whole picture of Japan HOspice and Palliative Care Evaluation Study 3 (J-HOPE3 Study) including study design and demographic data. The aims of the J-HOPE3 study were to (1) evaluate the process, structure, and outcome of palliative care in the following care settings: acute hospitals, inpatient hospice/palliative care units (PCUs), and home hospice services; (2) examine bereaved family members’ self-reported psychosocial conditions, such as grief and depression, as bereavement outcomes; (3) provide data to ensure and improve the quality of care provided by participating institutions through feedback concerning results for each institution; and (4) perform additional studies to explore specific clinical research questions. We conducted a cross-sectional, anonymous, self-report questionnaire survey involving patients’ bereaved family members in 20 acute hospitals, 133 PCUs, and 22 home hospice services between May and July 2014. Two types of questionnaires were used: main and specific studies questionnaires. The questionnaire was sent to totally 13 584, and 10 157 returned the questionnaire. The analysis included 9126 family members’ questionnaires from acute hospitals, PCUs, and home hospice services. Respondents’ average age was 61.6 years, 55% were women, and 40% had been married to the deceased. With respect to the characteristics of participating institutions, most institutions did not have religious affiliations, and most PCUs and home hospice services provided bereavement care. These results of the analysis of common and additional questionnaires could play an important role in clinical settings, quality improvement, research, and public accountability.
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Toal, Deborah, and DrPatricia McCaffrey. "266 Patient and Carers Experience of an Acute Care at Home Team: A Service Evaluation." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.166.
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Abstract Background The Aim of the Acute Care at Home Team is to provide acute care to over 65's in the patient's own home, providing assessment and treatment of acute conditions such as pneumonia, urinary sepsis and heart failure. It is a multidisciplinary team that works together to streamline services to enable a patient to stay safely in their own home. A full comprehensive geriatric assessment is carried out in all patients to help improve patient outcomes. The patients have full access to in patient services such as scans, and x-rays. All blood tests are treated as urgent to ensure the patient is in no way disadvantaged by being treated by acute care at home compared with hospital care. The aims and objectives are to explore patient and family experiences and identify any areas for improvement. Methods A service users and carers experience Questionnaire (N=31) was used to gain insight into how satisfied the patient or family were with the service and what the experience was like having the team come into their home. Results Patient satisfaction with this Acute Care at Home Team was reported at 100%. Patients were happy with the care they received, 100% of patients were happy with staff's knowledge of their condition and treatment plan. All of the respondents stated they would both recommend the service and use it again. The qualitative responses were in keeping with 100% satisfaction in that they were positive in nature. Conclusion This service evaluation has shown that patient and carer experience of this Acute Care at Home Team is a positive one, with 100% satisfaction levels. There are some small areas to be improved upon, however the results show this service is providing the over 65 population with a good experience of being treated at home as an alternative to hospital care when acutely unwell.
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Danilovich, Margaret, Laura Diaz, Jody Ciolino, William Healey, Gail Huber, and Daniel Corcos. "HOME CARE AIDE-LED RESISTANCE EXERCISE FOR MEDICAID HOME AND COMMUNITY-BASED SERVICES CLIENTS." Innovation in Aging 3, Supplement_1 (November 2019): S796. http://dx.doi.org/10.1093/geroni/igz038.2929.
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Abstract Home Care Aides (HCAs) assistance is the most common care provision to help clients with activities of daily living, but exercise is not currently provided, despite well-established health benefits. We developed a resistance exercise intervention using a stakeholder panel of physical therapists, HCAs, and clients. Stakeholders suggested a mobile application that played exercise videos. We then enrolled 128 HCA-client dyads (93% african american & 79% female) and randomized home care aides to lead the intervention with their clients in addition to usual care for 6 months or continue usual care. Our aims were to 1) evaluate the feasibility of the intervention and 2) determine the effects of the intervention on client physical performance, frailty classification, self-reported health, and strength. 96% of HCAs reported the training session successfully prepared them to lead exercise and we had no adverse events. There was high attrition rates among dyads (28.13%) at 6 months which was worse among HCAs (55%). We found no statistically significant differences between study arms. However, the range of completed sessions was 1-34 out of 52 possible sessions. Program evaluation indicated high satisfaction among clients and HCAs (8.9 & 8.6/10). HCA attrition limited client participation, technology did not facilitate exercise completion, and client motivation was a barrier to adherence. Results show it is feasible to train HCAs to lead exercise, however, given high turnover in the HCA profession, alternative implementation models should be studied. While the app use was an innovative way to engage older adults in exercise, technology challenged HCAs.
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Anderson, Ian, Harriet Young, Milica Markovic, and Lenore Manderson. "Koori Primary Health Care in Victoria: Developments in Service Planning." Australian Journal of Primary Health 6, no. 4 (2000): 24. http://dx.doi.org/10.1071/py00031.
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The Alma Ata 1978 Declaration on primary health care has conventionally been applied in developing countries, where medically trained personnel and other highly skilled health professionals and medical infrastructure are limited. Although such concepts have salience in relatively resource rich countries such as Australia, it is in Aboriginal and Torres Strait Islander health policy that they have become pivotal. A growing national focus on the development of Aboriginal primary health care capacity followed the release of the National Aboriginal Health Strategy (NAHS) in 1989 (Anderson, 1997). This focus consolidated further, following the evaluation of the National Aboriginal Health Strategy implementation in 1994 which preceded the transfer of administrative responsibility for the Commonwealth Aboriginal health program from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Commonwealth Health portfolio (DHFS, 1994). Within the strategic framework provided by federal state agreements, the development of primary health care services is a priority. In the current national policy framework domains of policy and strategy development have been identified as key developmental themes.
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J Black, Kristen, Deborah N Osborne, and Melissa A Lindeman. "Access to Local Government HACC services for people speaking a language other than English at home." Australian Journal of Primary Health 10, no. 1 (2004): 9. http://dx.doi.org/10.1071/py04002.
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Home and Community Care (HACC) services are provided to frail older people, other people with disabilities, and their carers, to assist independent living. HACC policy acknowledges that certain groups within the population have greater difficulty accessing HACC services than others. This paper considers the equity of access issue for one of the groups that have difficulty - people from culturally and linguistically diverse (CALD) backgrounds. Language spoken at home is used as an indicator of CALD status. The 2001 Census data and HACC-user data from the Western Metropolitan Region (WMR) of Victoria was analysed. The proportion of the HACC user population that speaks a language other than English (LOTE) was compared with the proportion of the general population that speaks a language other than English for two age groups ?the total population and those 65 years and over. Chi square analyses were conducted to determine odds ratios to give an indication of the magnitude and direction of the association between CALD status and access to HACC services. Analyses indicated that people who spoke a LOTE at home were approximately a third as likely to access Local Government HACC services than those who spoke English (OR=0.35). The findings suggest that policy and service development initiatives to improve access to HACC services for people of CALD backgrounds have not yet effectively reached their targets.
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Kubota, Rie, Junichi Mukai, Michiko Yamada, Yurika Yoshino, and Nakaba Okamura. "Evaluation of a New Home Patient Services Practicum for Community Pharmacy Students in Japan." Pharmacy 9, no. 3 (June 29, 2021): 120. http://dx.doi.org/10.3390/pharmacy9030120.
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This study aimed to evaluate the usefulness of the practicum as well as assess the knowledge, skills, and various specific realizations that the students gained from it. A total of 244 students role-played a scenario in which a pharmacist visited a patient at home and provided pharmaceutical management services. After completing the practicum, the students completed (i) a questionnaire survey consisting of six questions that assessed their level of understanding of the role of pharmacists in home medical care and (ii) a rubric survey that evaluated their learning achievement. In addition, they submitted practicum portfolios describing the patients’ living conditions, physical conditions, and background as well as the services that required consideration of said variables. Their responses to the portfolio item “What were noticed through the practicum” were analyzed using the grounded theory approach. After the practicum, 45% and 53% of the students reported having a full and partial understanding of a pharmacists’ role in home medical care. The students’ mean ± standard deviation rubric score was 3.0 ± 0.4. They classified monitoring drug use, support for improving medication adherence, and observation to identify side effects early as major service categories in home medical care. The practicum led the students to perceive the need for communication with patients and various healthcare professionals to improve their readiness for practical training.
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Wang, Yi-Luo, Ying Duan, and Ying Zhang. "A Summary of Researches on the Quality of Home-based Care Services in China." Public Administration Research 10, no. 1 (March 20, 2021): 41. http://dx.doi.org/10.5539/par.v10n1p41.
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With the increase of the aging of the population in china, the demand of the elderly continues to increase, which has brought great challenges to the elderly care service industry. As a new type of elderly care service, home-based care services directly affect the quality of the elderly’s health and daily life in their later years. Therefore, improving the product and quality of elderly care services has become the goal and purpose of the development of home-based care service for aged. This article uses Cite Space software to perform visual analysis of keyword clustering on existing literature, and concludes that scholars focus on the integration of medical care, social elderly care service system, service quality, and influencing factors, but the impact of service quality models and indicator systems is low. Then through the integration and induction of scholars’ research progress on home care services, existing problems in service quality, and service quality evaluation index systems, in order to continue to innovate on the basis of existing knowledge, improve the service quality index system, and focus on combing process indicators with outcome indicators effectively, thereby improving the quality of community home care services.
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Besier, T., J. M. Fegert, and L. Goldbeck. "Evaluation of psychiatric liaison-services for adolescents in residential group homes." European Psychiatry 24, no. 7 (October 2009): 483–89. http://dx.doi.org/10.1016/j.eurpsy.2009.02.006.
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AbstractObjectiveAdolescents in residential care are a high-risk population for psychiatric disorders. Due to limited access to outpatient treatment, crises often result in psychiatric hospitalizations. These crises are often accompanied by termination of supportive relationships, which increases the risk for further problems. To minimize hospitalizations and to stabilize the psychological state of these adolescents, we developed and evaluated a home-treatment intervention program based on psychiatric liaison-services and compared it to standard medical care (SMC).MethodsThe intervention was applied in 11 German residential group homes (N = 288, M = 14.1 years, SD = 2.7), while adolescents from 15 institutions (N = 336, M = 13.6 years, SD = 3.0) served as a comparison group (CG) (SMC). The frequency and duration of psychiatric inpatient treatment episodes were documented and caregiver-reported behavioural symptoms were assessed at baseline and at 6 and 12 months postintervention.ResultsIn both groups, less than 10% of the adolescents were admitted to psychiatric wards. Compared to SMC, hospitalizations were of shorter duration in the intervention group (IG) (1.30 vs 2.47 days per head within 12 months, p < .001). In both groups, behavioural problems decreased overtime.ConclusionsApplying a home-treatment intervention program to children in residential care helps to stabilize the developmental course of this high-risk population by shortening psychiatric inpatient treatment.