Journal articles on the topic 'Medical care Research Australia'
To see the other types of publications on this topic, follow the link: Medical care Research Australia.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Medical care Research Australia.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Swenson, Wade T., Emily Westergard, and Abigail Paige Swenson. "Rural health cancer care: A literature review." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18500-e18500. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18500.
Full textAbstract:
e18500 Background: A recent review of the medical literature of rural health cancer care delivery has not been published. We conducted a preliminary review of the last twenty years of rural health cancer care delivery literature utilizing medical subject headings (MeSH) within the PubMed NCBI) database. Methods: Using PubMed MeSH Major Topic terms “rural population” and “cancer” we identified publications published from 2000 to 2020. We searched PubMed for publications that included the major topic MeSH terms “rural population” and “cancer”. We individually reviewed articles, confirmed the focus of the article, and subcategorized the articles. Results: We identified 580 publications which met the search criteria, the majority were focused on the United States (266), followed by China (56), Australia (54), and India (27). Among the publications focusing on the United States, 76 involved Appalachian States. Kentucky (18) and Georgia (10) were the states most frequently represented. Malignancies most commonly represented were: breast cancer (148), uterine/cervical (84), and colorectal cancers (68). The journals which published the most rural health cancer care delivery were The Journal of Rural Health (42), Asian Pacific Journal of Cancer Prevention (20), Cancer (14), Rural and Remote Health (13), Journal of Cancer Education (13), Australian Journal of Rural Health (12). Conclusions: The rural health cancer care literature in the last two decades focuses primarily on the United States, China, Australia, and India. Within the United States, the research focus is Appalachia. The majority of articles focus on breast cancer, uterine/cervical, and colorectal cancers. The journal which published the majority of rural health cancer care articles was the Journal of Rural Health.
2
Macdonald, John. "Primary Health Care or Primary Medical Care: In Reality." Australian Journal of Primary Health 13, no. 2 (2007): 18. http://dx.doi.org/10.1071/py07019.
Full textAbstract:
Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.
3
Huang, Beatrice, and Stefan Priebe. "Media coverage of mental health care in the UK, USA and Australia." Psychiatric Bulletin 27, no. 09 (September 2003): 331–33. http://dx.doi.org/10.1017/s0955603600002968.
Full textAbstract:
Aims and Method We aimed to assess the contents and tone of articles on mental health care in the UK print media by comparing them with reporting in the USA and Australia. Two broadsheets from each country were analysed using the Internet for a random 4 months over a 1-year period. The number of articles, their content and the views expressed in them were identified and compared. Results A total of 118 articles on mental health care issues were found. The predominant tone of the articles in all three countries was negative, though there were slightly more positive articles in the USA and Australian media. Positive articles highlighted in the UK media covered mostly medical conferences and research findings. Clinical Implications Efforts to achieve a more positive attitude towards people with mental illnesses in the public, such as anti-stigma campaigns, operate against a background of predominantly negative coverage of mental health care issues in broadsheets. The coverage in the UK may tend to be even less positive than in the USA and Australia. Medical conferences and research findings can, however, be used to promote positive views of mental health care in the media.
4
Huang, Beatrice, and Stefan Priebe. "Media coverage of mental health care in the UK, USA and Australia." Psychiatric Bulletin 27, no. 9 (September 2003): 331–33. http://dx.doi.org/10.1192/pb.27.9.331.
Full textAbstract:
Aims and MethodWe aimed to assess the contents and tone of articles on mental health care in the UK print media by comparing them with reporting in the USA and Australia. Two broadsheets from each country were analysed using the Internet for a random 4 months over a 1-year period. The number of articles, their content and the views expressed in them were identified and compared.ResultsA total of 118 articles on mental health care issues were found. The predominant tone of the articles in all three countries was negative, though there were slightly more positive articles in the USA and Australian media. Positive articles highlighted in the UK media covered mostly medical conferences and research findings.Clinical ImplicationsEfforts to achieve a more positive attitude towards people with mental illnesses in the public, such as anti-stigma campaigns, operate against a background of predominantly negative coverage of mental health care issues in broadsheets. The coverage in the UK may tend to be even less positive than in the USA and Australia. Medical conferences and research findings can, however, be used to promote positive views of mental health care in the media.
5
Kurti, Linda, Susan Rudland, Rebecca Wilkinson, Dawn DeWitt, and Catherine Zhang. "Physician's assistants: a workforce solution for Australia?" Australian Journal of Primary Health 17, no. 1 (2011): 23. http://dx.doi.org/10.1071/py10055.
Full textAbstract:
Significant medical workforce shortages, particularly in rural and remote locations, have prompted a range of responses in Australia at both state and Commonwealth levels. One such response was a pilot project to test the suitability of the Physician Assistant (PA) role in the Australian context. Five US-trained and accredited PAs were employed by Queensland Health and deployed in urban, rural and remote settings across Queensland. A concurrent mixed-method evaluation was conducted by Urbis, an independent research firm. The evaluation found that the PAs provided quality, safe clinical care under the supervision of local medical officers. The majority of nurses and doctors who worked with the PAs believed that the PAs made a positive contribution to the health care team by increasing capacity to meet patient needs; reducing on-call requirements for doctors; liaising with other clinical team members; streamlining procedures for efficient patient throughput; and providing continuity during periods of doctor changeover. The Pilot demonstrated that a delegated PA role can provide safe, quality health care by augmenting an established healthcare team. The PA role has the potential to benefit the community by increasing the capacity of the health care system, and to improve recruitment and retention by providing an additional professional pathway. The small size of the Pilot limits the ability to generalise regarding the future efficacy of the PA role in Australia. Further research is required to test training and deployment of PAs in a wider range of Australian clinical settings, including general practice and rural health clinics.
6
*Raman, Sainath, Georgia *Brown, *Equal first authors, Debbie Long, Ben Gelbart, Carmel Delzoppo, Johnny Millar, Simon Erickson, Marino Festa, and Luregn J. Schlapbach. "Priorities for paediatric critical care research: a modified Delphi study by the Australian and New Zealand Intensive Care Society Paediatric Study Group." Critical Care and Resuscitation 23, no. 2 (June 7, 2021): 194–201. http://dx.doi.org/10.51893/2021.2.oa6.
Full textAbstract:
OBJECTIVE: Most interventions in paediatric critical care lack high grade evidence. We aimed to identify the key research priorities and key clinical outcome measures pertinent to research in paediatric intensive care patients. DESIGN: Modified three-stage Delphi study combining staged online surveys, followed by a face-to-face discussion and final voting. SETTING: Paediatric intensive care units in Australia and New Zealand. PARTICIPANTS: Medical and nursing staff working in intensive care. MAIN OUTCOME MEASUREMENTS: Self-reported priorities for research. RESULTS: 193 respondents provided a total of 267 research questions and 234 outcomes. In Stage 3, the top 56 research questions and 50 outcomes were discussed face to face, which allowed the identification of the top 20 research questions with the Hanlon prioritisation score and the top 20 outcomes. Topics centred on the use of intravenous fluids (restrictive v liberal fluids, use of fluid resuscitation bolus, early inotrope use, type of intravenous fluid, and assessment of fluid responsiveness), and patient- and family-centred outcomes (health-related quality of life, liberation) emerged as priorities. While mortality, length of stay, and organ support/organ dysfunction were considered important and the most feasible outcomes, long term quality of life and neurodevelopmental measures were rated highly in terms of their importance. CONCLUSIONS: Using a modified Delphi method, this study provides guidance towards prioritisation of research topics in paediatric critical care in Australia and New Zealand, and identifies study outcomes of key relevance to clinicians and experts in the field.
7
Benrimoj, Shalom I., and Alison S. Roberts. "Providing Patient Care in Community Pharmacies in Australia." Annals of Pharmacotherapy 39, no. 11 (November 2005): 1911–17. http://dx.doi.org/10.1345/aph.1g165.
Full textAbstract:
OBJECTIVE To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. DATA SYNTHESIS The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. CONCLUSIONS Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.
8
Karapetis, Christos S. "Medical oncology group of Australia: taking a leading role in medical oncology education, patient care & research." Annals of Oncology 29 (October 2018): vii5. http://dx.doi.org/10.1093/annonc/mdy364.002.
Full text
9
Barreto, Savio George. "Pancreatic cancer in Australia: is not it time we address the inequitable resource problem?" Future Oncology 16, no. 19 (July 2020): 1385–92. http://dx.doi.org/10.2217/fon-2020-0109.
Full textAbstract:
The present study reviewed the geographical variations in the delivery of pancreatic cancer therapy and whether this impacts overall survival. The evidence suggests a difference in the accessibility of pancreatic cancer care to patients in rural as compared with urban Australia. While centralization of pancreatic surgery is essential to deliver high quality care to patients, it may be interfering with the ease of access of this form of care to patients in regional areas. Access to chemotherapy in regional Australia is also limited. There is need for a concerted effort to improve the overall care and uptake of medical services to patients in metropolitan and remote Australia with the overarching aim of improving survival and meaningful quality of life.
10
Spurgeon, Peter, Paul Long, John Clark, and Frank Daly. "Do we need medical leadership or medical engagement?" Leadership in Health Services 28, no. 3 (July 6, 2015): 173–84. http://dx.doi.org/10.1108/lhs-03-2014-0029.
Full textAbstract:
Purpose – The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. Design/methodology/approach – The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Findings – Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. Research limitations/implications – There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). Practical implications – The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. Social implications – This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. Originality/value – The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.
11
Ahern, Susannah, Sue Evans, Ingrid Hopper, and John Zalcberg. "Towards a strategy for clinical quality registries in Australia." Australian Health Review 43, no. 3 (2019): 284. http://dx.doi.org/10.1071/ah17201.
Full textAbstract:
The healthcare value of Australian clinical quality registries (CQRs) has recently been highlighted by the Australian Commission of Safety and Quality in Health Care (ACSQHC) as being similar to the benefits of CQRs reported internationally. However, the development of CQRs in Australia is currently limited by a lack of coordination and strategic planning, leading to governance and funding processes that are varied and non-sustainable. Despite this, Australia has achieved recognised success with exemplar clinical registries where funding has been sustained at least partly by public funds. To this end, Australia can learn from international CQR governance and funding models to support CQR sustainability, most notably those from European and Scandinavian countries. Further, following the release of the ACSQHC’s prioritised domains for CQRs and anticipated funding from the Medical Research Future Fund, the ACSQHC is well positioned to lead a national strategic approach for clinical registries. Together with medical leadership and engagement, operational and data management support from the jurisdictions and financial support from both the public and private sectors, a prioritised and coordinated approach may soon become a reality.
12
Reilly, Jennifer R., Carolyn Deng, Wendy A. Brown, Dianne Brown, Belinda J. Gabbe, Carol L. Hodgson, and Paul S. Myles. "Towards a national perioperative outcomes registry: A survey of perioperative electronic medical record utilisation to support quality assurance and research at Australian and New Zealand College of Anaesthetists Clinical Trials Network hospitals in Australia." Anaesthesia and Intensive Care 50, no. 3 (January 18, 2022): 189–96. http://dx.doi.org/10.1177/0310057x211030284.
Full textAbstract:
In Australia, 2.7 million surgical procedures are performed annually. Historically, a lack of perioperative data standardisation and infrastructure has limited pooling of routinely collected data across institutions. We surveyed Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network hospitals to investigate current and potential uses of perioperative electronic medical record data for research and quality assurance. A targeted survey was sent to 131 ANZCA Clinical Trials Network–affiliated hospitals in Australia. The primary aim was to map current electronic data collection methods and data utilisation in six domains of the perioperative pathway. The survey response rate was 32%. Electronic data recording in the six domains ranged from 19% to 85%. Where electronic data exist, the ability of anaesthesiology departments to export them for analysis ranged from 27% to 100%. The proportion of departments with access to data exports that are regularly exporting the data for quality assurance or research ranged from 13% to 58%. The existence of a perioperative electronic medical record does not automatically lead to the data being used to measure and improve clinical outcomes. The first barrier is clinician access to data exports. Even when this barrier is overcome, a large gap remains between the proportion of departments able to access data exports and those using the data regularly to inform and improve clinical practice. We believe this gap can be addressed by establishing a national perioperative outcomes registry to lead high-quality multicentre registry research and quality assurance in Australia.
13
Li, Mian-Li, Jacqui Allen, Virginia Plummer, and Yan-Ling Dai. "Comparison of research hotspots and trends in long-term care for the elderly between China and Australia: a bibliometric analysis†." Frontiers of Nursing 9, no. 4 (December 1, 2022): 421–30. http://dx.doi.org/10.2478/fon-2022-0053.
Full textAbstract:
Abstract Objective: To explore the current status and development of long-term care (LTC) research in terms of publications in China and Australia, to identify the major contributing authors and institutions, and to compare the research hotspots and trends between China and Australia in order to encourage informed collaborations and work in future. Methods: We collected bibliometric data on the LTC of the elderly in China and Australia from 2009 to 2020 using Chinese National Knowledge Infrastructure (CNKI) and Web of Science (WOS). CiteSpace software was used to analyze co-authorships, co-institutions, and co-keywords. Results: A total of 826 articles in Chinese and 393 in English were included for analysis. The total number of publications showed an upward trend in both countries. The top 10 productive researchers and institutions in China and Australia were identified, and their collaboration network was revealed. Then, the knowledge maps of cooccurring keywords, respectively, showed the hotspots of “LTC insurance, disabled elderly, combination of medical and health care, nursing home” and “nursing home, dementia, quality of life, intervention” in China and Australia. Strong citation burst keywords illustrated the emerging trends of “combination of medical and health care, healthy aging” in China and “polypharmacy, prevention” in Australia. Conclusions: This article provided an insight into LTC of the elderly in China and Australia, and research in this field is developing rapidly and is being increasingly valued. The findings will be useful for future researchers to facilitate collaboration, identify new topics, and support urgently needed research of LTC in China.
14
McGrath, Pam, and Hamish Holewa. "End-of-life Care of Aboriginal Peoples in Remote Locations: Language Issues." Australian Journal of Primary Health 13, no. 1 (2007): 18. http://dx.doi.org/10.1071/py07003.
Full textAbstract:
To date, there is scant research literature that explores the provision of end-of-life care to Aboriginal peoples in Australia. In particular, there is a lack of published research available on issues at the interface of Aboriginal languages and English during palliative care. The complexity and importance of the issue for palliative care provision, however, is demonstrated by the fact that in Australia, Aboriginality is itself a very broad category, containing many distinct language groups and subcultures. Thus, although to date there is some mention of the problems associated with language in the literature, there is scant research on the topic of the provision of palliative care to Aboriginal peoples in remote areas. The following findings from a recent two-year National Health and Medical Research Council (NHMRC) study are provided to address this hiatus. The findings provide insights on the impact of language difference on palliative care practice for Aboriginal peoples in the Northern Territory of Australia.
15
Schofield, Deborah, Michelle M. Cunich, and Lucio Naccarella. "An evaluation of the quality of evidence underpinning diabetes management models: a review of the literature." Australian Health Review 38, no. 5 (2014): 495. http://dx.doi.org/10.1071/ah14018.
Full textAbstract:
Objective There is a paucity of research on the quality of evidence relating to primary care workforce models. Thus, the aim of the present study was to evaluate the quality of evidence on diabetes primary care workforce models in Australia. Methods The National Health and Medical Research Council of Australia’s (National Health and Medical Reseach Council; 2000, 2001) frameworks for evaluating scientific evidence and economic evaluations were used to assess the quality of studies involving primary care workforce models for diabetes care involving Australian adults. A search of medical databases (MEDLINE, AMED, RURAL, Australian Indigenous HealthInfoNet and The Cochrane Institute), journals for diabetes care (Diabetes Research and Clinical Practice, Diabetes Care, Diabetic Medicine, Population Health Management, Rural and Remote Health, Australian Journal of Primary Health, PLoS Medicine, Medical Journal of Australia, BMC Health Services Research, BMC Public Health, BMC Family Practice) and Commonwealth and state government health websites was undertaken to acquire Australian studies of diabetes workforce models published 2005–13. Various diabetes workforce models were examined, including ‘one-stop shops’, pharmacy care, Aboriginal services and telephone-delivered interventions. The quality of evidence was evaluated against several criteria, including relevance and replication, strength of evidence, effect size, transferability and representativeness, and value for money. Results Of the14 studies found, four were randomised controlled trials and one was a systematic review (i.e. Level II and I (best) evidence). Only three provided a replicable protocol or detailed intervention delivery. Eleven lacked a theoretical framework. Twelve reported significant improvements in clinical (patient) outcomes, commonly HbA1c, cholesterol and blood pressure; only four reported changes in short- and long-term outcomes (e.g. quality of life). Most studies used a small or targeted population. Only two studies assessed both benefits and costs of their intervention compared with usual care and cost effectiveness. Conclusions More rigorous studies of diabetes workforce models are needed to determine whether these interventions improve patient outcomes and, if they do, represent value for money. What is known about the topic? Although health systems with strong primary care orientations have been associated with enhanced access, equity and population health, the primary care workforce is facing several challenges. These include a mal-distribution of resources (supply side) and health outcomes (demand side), inconsistent support for teamwork care models, and a lack of enhanced clinical inter-professional education and/or training opportunities. These challenges are exacerbated by an ageing health workforce and general population, as well as a population that has increased prevalence of chronic conditions and multi-morbidity. Although several policy directions have been advocated to address these challenges, there is a lack of high-quality evidence about which primary care workforce models are best (and which models represent better value for money than current practice) and what the health effects are for patients. What does this paper add? This study demonstrated several strengths and weaknesses of Australian diabetes models of care studies. In particular, only five of the 14 studies assessed were designed in a way that enabled them to achieve a Level II or I rating (and hence the ‘best’ level of evidence), based on the NHMRC’s (2000, 2001) frameworks for assessing scientific evidence. The majority of studies risked the introduction of bias and thus may have incorrect conclusions. Only a few studies described clearly what the intervention and the comparator were and thus could be easily replicated. Only two studies included cost-effectiveness studies of their interventions compared with usual care. What are the implications for practitioners? Although there has been an increase in the number of primary care workforce models implemented in Australia, there is a need for more rigorous research to assess whether these interventions are effective in producing improved health outcomes and represent better value for money than current practice. Researchers and policymakers need to make decisions based on high-quality evidence; it is not obvious what effect the evidence is having on primary care workforce reform.
16
van Hecke, Oliver, and Kay M. Jones. "The Attitudes and Practices of General Practitioners about the Use of Chaperones in Melbourne, Australia." International Journal of Family Medicine 2012 (August 17, 2012): 1–6. http://dx.doi.org/10.1155/2012/768461.
Full textAbstract:
Introduction. To consider the use of medical chaperones during certain clinical examinations is important whether one practises as a specialist, nurse, medical student, or generalist. Chaperones have been used by doctors conducting intimate examinations for many years but their true extent remains largely unknown. Until recently, there was no national guidance in Australia. Aim. To explore the attitudes and practices of general practitioners (GP) regarding their use of chaperones in urban Melbourne, Australia. Method. Qualitative two focus groups involving seventeen GPs from two locations. Discussions were audio-taped, transcribed verbatim and analysed. Results. Common themes and subthemes emerged which were grouped into three main areas: (a) practitioner-related, (b) patient-related and (c) practice related. Discussion. This is the first study from an Australian primary care perspective to gauge the attitudes and experiences of GPs on their use of chaperones. It will provide vital information to inform the next step of extending this research to a national GP audience. From an international perspective, this study provides an excellent template for other primary care clinicians to conduct research in this important field of doctor-patient relationship.
17
Couper, Jeremy. "Chronic Fatigue Syndrome and Australian Psychiatry: Lessons from the UK Experience." Australian & New Zealand Journal of Psychiatry 34, no. 5 (October 2000): 762–69. http://dx.doi.org/10.1080/j.1440-1614.2000.00810.x.
Full textAbstract:
Objective: The aim of this paper is to outline the opportunities and dangers the chronic fatigue syndrome (CFS) issue presents to Australian psychiatry. Method: The scientific literature of the last 50 years on CFS in adults was reviewed and samples of recent media portrayals of CFS in the UK and Australia were collected. The author has worked in both the UK and Australia managing adult CFS patients in specialist outpatient consultation–liaison (C–L) psychiatry settings. Results: Chronic fatigue syndrome has been at the heart of an acrimonious debate in the UK, both within the medical profession and in the wider community. UK psychiatry has been drawn into the debate, at times being the target of strong and potentially damaging criticism, yet UK psychiatry, especially the C–L subspecialty, has played a crucial role in clarifying appropriate research questions and in devising management strategies. The issue has served to enhance and broaden psychiatry's perceived research and clinical role at the important medicine–psychiatry interface in that country. Conclusions: Handled properly, the CFS issue offers Australian psychiatry, especially C–L psychiatry, an opportunity to make a useful contribution to patient care in a clinically difficult and contentious area, while at the same time serving to help broaden psychiatry's scope in the Australian medical landscape.
18
Mulligan, Ea, and Annette Braunack-Mayer. "Why protect confidentiality in health records? A review of research evidence." Australian Health Review 28, no. 1 (2004): 48. http://dx.doi.org/10.1071/ah040048.
Full textAbstract:
We present the main arguments for protecting the confidentiality of health services, along with those for limiting confidentiality. These arguments are then substantiated by reference to research evidence. There is evidence that access to health care is restricted if confidentiality is not promised to some groups of patients. Fear of disclosure does diminish patients? candour, and this can compromise the quality of care. While patients are concerned about confidentiality and some are harmed by ?leaks? from health services, most people in Australia still trust health providers to keep their secrets, and patients rarely become aware of a breach of confidence. It has been claimed that strict protection of confidentiality may obstruct the pursuit of medical research and the use of electronic medical records. There is, as yet, no evidence that gaining full benefit from the use of electronic medical records entails reduced protection for confidentiality. The losses to epidemiological research if patient consent were always required are hotly debated. Confidentiality should be protected because it protects patients from harm, supports access to health care and produces better health outcomes.
19
Dudko, Yevgeni, Dennis E. Robey, Estie Kruger, and Marc Tennant. "Identifying and Ranking Areas of Relative Need for New Public Dental Clinics Using a State-of-the-Art Data Simulation Approach." Asia Pacific Journal of Health Management 12, no. 1 (April 25, 2017): 11–16. http://dx.doi.org/10.24083/apjhm.v12i1.91.
Full textAbstract:
Background: Lower socioeconomic groups and country residents are more likely to experience dental disease. Previous research has found that it is generally more cost effective to provide subsidised dental care through publically employed dentists when compared to subcontracting the work out to the private sector.
Objective: The primary objective of this study was to identify and rank areas of relative need for new public dental care facilities across Australia. The secondary objective was to gauge how many of these areas arelocated in the vicinity of an existing public hospital (medical) with a view to utilise existing infrastructure for future service rollout.
Methods: Usual resident population, employment status and socioeconomic distribution data was downloaded from the Australian Bureau of Statistics website at Statistical Area 1 level. A mathematical weighing formula was applied to those variables, which subsequently allowed for ranking of the results based on magnitude of the product values. The findings were considered in terms of proximity to existing public health infrastructure.
Results: A total of 49 SA1 areas were identified and preselected as potential sites for new public dental clinics across Australia. Eighty per cent of the identified areas of relative need were located outside metropolitanareas. Fifty per cent of those were found to be in close proximity to an existing public hospital (medical).
Conclusion: Offering subsidised dental care through existing public hospitals may be an option. Such an approach has a potential to improve access to subsidised dental care in regional centres while minimising capitalexpenditure on infrastructure.
Abbreviations: ABS – Australian Bureau of Statistics; ASGS – Australian Statistical Geography Standard; SEIFA – Socio-Economic Indexes for Areas
20
Lawsin, Catalina, Kirsty McMillan, Phyllis Butow, Jane Turner, Patsy Yates, Moira Stephens, Sylvie D. Lambert, and Kathryn White. "Assessment of the current implementation and barriers to uptake of the guidelines for the psychosocial care of adults with cancer according to cancer nurses in Australia." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20615-e20615. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20615.
Full textAbstract:
e20615 Background: The Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (the Guidelines) were launched in 2003 to guide cancer care providers in the assessment of psychosocial issues and provision of evidence-based interventions. Despite multi-faceted Australia-wide dissemination efforts, the current study aimed to be the first to assess current implementation of the Guidelines across and barriers to uptake. Methods: A cross-sectional web-based survey was developed to assess clinical use of recommendations in the Guidelines in relation to the provision of psychosocial support, and assessment of distress and pain. Data was collected about perceived barriers to the provision of psychosocial support at participants’ place of employment, as well as roles and training needs. Cancer nurses were recruited through the Cancer Nurses Society of Australia, the Royal College of Nursing Australia, and the Haematology Society of Australia & New Zealand. Descriptive and correlational analyses were conducted. Results: Of 354 respondents, 266 completed the assessment. Relaxation training was the most prevalent form of psychosocial support (24%) and web-based support (20%) was the most common modality. While 26% of institutions had no systematic means of assessing distress amongst patients, those that did relied primarily on clinical interviews (37%). Once a patient was identified as distressed, most often the care coordinator was responsible for providing ensuing interventions. An organizational culture in which psychosocial issues are seen as less important than medical treatment (23%) and role ambiguity proved to be barriers to provision of psychosocial support, particularly when nurses did not perceive psychosocial support was beneficial and supervision was inadequate (R2= .313, F(1, 265) = 6.58, p < .001). Conclusions: Results confirmed that dissemination does not necessarily equal implementation. Clear pathways for assessment and treatment need to be established to reduce individual barriers and promote organizational cultures that appreciate the need to integrate psychosocial care in standard medical treatment.
21
Kruger, Estie, Irosha Perera, and Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia." Australian Journal of Primary Health 16, no. 4 (2010): 291. http://dx.doi.org/10.1071/py10028.
Full textAbstract:
Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
22
Hale, Andrew R., Danielle A. Stowasser, Ian D. Coombes, Julie Stokes, and Lisa Nissen. "An evaluation framework for non-medical prescribing research." Australian Health Review 36, no. 2 (2012): 224. http://dx.doi.org/10.1071/ah10986.
Full textAbstract:
Without robust and credible evidence for the benefits in health outcomes of non-medical prescribing, widespread implementation will be challenging. Our aim is to develop a consistent evaluation framework that could be applied to non-medical prescribing research. An informal collaboration was initiated in 2008 by a group of pharmacists from Australia and New Zealand to assist in information sharing, pilot design, methodologies and evaluation for pharmacist prescribing. Different pilots used different models, methodologies and evaluation. It was agreed that the development of a consistent evaluation framework to be applied to future research on non-medical prescribing was required. The framework would help to align the outcomes of different research pilots and enable the comparison of endpoints to determine the effectiveness of a non-medical prescribing intervention. This article presents the results of a workshop held at The University of Queensland in January 2009. Participants were asked to consider how to evaluate the effectiveness of different models of pharmacist prescribing. What is known about the topic? Little is known about the effectiveness and safety of non-medical prescribing services due to a lack of robust evidence. What does this paper add? This paper adds a methodology for clinicians and healthcare managers to be able to evaluate any new service of non-medical prescribing, either in the pilot phase or once introduced as a new model of care. What are the implications for practitioners? The implication for practitioners is the ability to prove to healthcare providers that non-medical prescribing services are at least as effective as usual care, so informing whether a change should be introduced in the way healthcare is delivered to patients.
23
Hume, Craig, Margee Hume, and Paul Johnston. "Creating Awareness and Practice." International Journal of Reliable and Quality E-Healthcare 5, no. 4 (October 2016): 1–14. http://dx.doi.org/10.4018/ijrqeh.2016100101.
Full textAbstract:
This paper focuses on the important area of aged care services as a national priority with this a priority for many countries worldwide. The paper uses the aged care sector as an exploratory artifact. The Australian aged care system is widely considered as innovative and provides the benchmark for many countries developing reforms and strategies for aged care. Many countries including Australia are faced with increasingly ageing populations, with this demographic burden creating the need for policy reform and the introduction of new programs to improve the quality of life of senior citizens. This research adopts a qualitative and exploratory approach advancing on previous research. The paper discusses the benefit of knowledge management and innovative approaches to patient medical records, funding reporting and basic accreditation records with particular emphasis on the long-term improvements in knowledge sharing for healthcare delivery. This paper proposes the ARCC@T framework for Knowledge Management in Aged Care.
24
Mazza, Danielle, Christopher Pearce, Lyle Robert Turner, Maria De Leon-Santiago, Adam McLeod, Jason Ferriggi, and Marianne Shearer. "The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research." Journal of Innovation in Health Informatics 23, no. 2 (July 4, 2016): 523. http://dx.doi.org/10.14236/jhi.v23i2.181.
Full textAbstract:
The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia. MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients. The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices. While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia
25
Rai, Sumeet, Rhonda Brown, Frank van Haren, Teresa Neeman, Arvind Rajamani, Krishnaswamy Sundararajan, and Imogen Mitchell. "Long-term follow-up for Psychological stRess in Intensive CarE (PRICE) survivors: study protocol for a multicentre, prospective observational cohort study in Australian intensive care units." BMJ Open 9, no. 1 (January 2019): e023310. http://dx.doi.org/10.1136/bmjopen-2018-023310.
Full textAbstract:
IntroductionThere are little published data on the long-term psychological outcomes in intensive care unit (ICU) survivors and their family members in Australian ICUs. In addition, there is scant literature evaluating the effects of psychological morbidity in intensive care survivors on their family members. The aims of this study are to describe and compare the long-term psychological outcomes of intubated and non-intubated ICU survivors and their family members in an Australian ICU setting.Methods and analysisThis will be a prospective observational cohort study across four ICUs in Australia. The study aims to recruit 150 (75 intubated and 75 non-intubated) adult ICU survivors and 150 family members of the survivors from 2015 to 2018. Long-term psychological outcomes and effects on health-related quality of life (HRQoL) will be evaluated at 3 and 12 months follow-up using validated and published screening tools. The primary objective is to compare the prevalence of affective symptoms in intubated and non-intubated survivors of intensive care and their families and its effects on HRQoL. The secondary objective is to explore dyadic relations of psychological outcomes in patients and their family members.Ethics and disseminationThe study has been approved by the relevant human research ethics committees (HREC) of Australian Capital Territory (ACT) Health (ETH.11.14.315), New South Wales (HREC/16/HNE/64), South Australia (HREC/15/RAH/346). The results of this study will be published in a peer-reviewed medical journal and presented to the local intensive care community and other stakeholders.Trial registration numberACTRN12615000880549; Pre-results.
26
Putrik, Polina, Rebecca Jessup, Rachelle Buchbinder, Paul Glasziou, Jonathan Karnon, and Denise A. O'Connor. "Prioritising models of healthcare service delivery for a more sustainable health system: a Delphi study of Australian health policy, clinical practice and management, academic and consumer stakeholders." Australian Health Review 45, no. 4 (2021): 425. http://dx.doi.org/10.1071/ah20160.
Full textAbstract:
ObjectivesHealthcare expenditure is growing at an unsustainable rate in developed countries. A recent scoping review identified several alternative healthcare delivery models with the potential to improve health system sustainability. Our objective was to obtain input and consensus from an expert Delphi panel about which alternative models they considered most promising for increasing value in healthcare delivery in Australia and to contribute to shaping a research agenda in the field. MethodsThe panel first reviewed a list of 84 models obtained through the preceding scoping review and contributed additional ideas in an open round. In a subsequent scoring round, the panel rated the priority of each model in terms of its potential to improve health care sustainability in Australia. Consensus was assumed when ≥50% of the panel rated a model as (very) high priority (consensus on high priority) or as not a priority or low priority (consensus on low priority). ResultsEighty-two of 149 invited participants (55%) representing all Australian states/territories and wide expertise completed round one; 71 completed round two. Consensus on high priority was achieved for 59 alternative models; 14 were rated as (very) high priority by ≥70% of the panel. Top priorities included improving medical service provision in aged care facilities, providing single-point-access multidisciplinary care for people with chronic conditions and providing tailored early discharge and hospital at home instead of in-patient care. No consensus was reached on 47 models, but no model was deemed low priority. ConclusionsInput from an expert stakeholder panel identified healthcare delivery models not previously synthesised in systematic reviews that are a priority to investigate. Strong consensus exists among stakeholders regarding which models require the most urgent attention in terms of (cost-)effectiveness research. These findings contribute to shaping a research agenda on healthcare delivery models and where stakeholder engagement in Australia is likely to be high. What is known about the topic?Healthcare expenditure is growing at an unsustainable rate in high-income countries worldwide. A recent scoping review of systematic reviews identified a substantial body of evidence about the effects of a wide range of models of healthcare service delivery that can inform health system improvements. Given the large number of systematic reviews available on numerous models of care, a method for gaining consensus on the models of highest priority for implementation (where evidence demonstrates this will lead to beneficial effects and resource savings) or for further research (where evidence about effects is uncertain) in the Australian context is warranted. What does this paper add?This paper describes a method for reaching consensus on high-priority alternative models of service delivery in Australia. Stakeholders with leadership roles in health policy and government organisations, hospital and primary care networks, academic institutions and consumer advocacy organisations were asked to identify and rate alternative models based on their knowledge of the healthcare system. We reached consensus among ≥70% of stakeholders that improving medical care in residential aged care facilities, providing single-point-access multidisciplinary care for patients with a range of chronic conditions and providing early discharge and hospital at home instead of in-patient stay for people with a range of conditions are of highest priority for further investigation. What are the implications for practitioners?Decision makers seeking to optimise the efficiency and sustainability of healthcare service delivery in Australia could consider the alternative models rated as high priority by the expert stakeholder panel in this Delphi study. These models reflect the most promising alternatives for increasing value in the delivery of health care in Australia based on stakeholders’ knowledge of the health system. Although they indicate areas where stakeholder engagement is likely to be high, further research is needed to demonstrate the effectiveness and cost-effectiveness of some of these models.
27
Davis, Jenny, Amee Morgans, and Joan Stewart. "Developing an Australian health and aged care research agenda: a systematic review of evidence at the subacute interface." Australian Health Review 40, no. 4 (2016): 420. http://dx.doi.org/10.1071/ah15005.
Full textAbstract:
Objective The aim of the present study was to systematically review articles describing recent interventions that aimed to improve access and outcomes for older people at the interface between health and aged care, with a focus on subacute care programs of palliative care, rehabilitation, geriatric evaluation and management (GEM) and psychogeriatrics. Methods Australian studies published between 2008 and 2013were evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and National Health and Medical Research Council of Australia (NHMRC) guidelines. Included studies were summarised according to focus areas and results discussed in the current Australian subacute health care context. Results Eleven Australian research articles were identified. Three did not achieve any NHMRC rating level because of methodological approach. Focus areas included: discharge planning; information management or communication; rehabilitation; hospital treatment in residential care; screening and intervention; and Telehealth. Interventions were primarily system centred; only three studies featured patient-level outcome measures. Conclusions There is limited high-quality research investigating the effectiveness of interventions at the health and aged care interface of subacute care. Further research is needed. What is known about the topic? Subacute care offers important healthcare programs for older people, operating at the interface between health and aged care. However, for the most part this has not been subject to research scrutiny. What does this paper add? Identified studies were predominantly hospital oriented and designed to avoid hospital admission and associated costs. Locally integrated, collaborative and multidiscipline based interventions improve system-level outcomes. Alternative and individualised models of care, particularly when provided in their home setting, yields positive outcomes for older people. What are the implications for practitioners? Health and aged care reforms and related research agenda must include the perspectives and experiences of patients and/or carers accessing subacute care programs, yet these are under-reported. The present review highlights opportunities to improve the quality of existing evidence and create a research agenda for the future.
28
Hansen, Emily, Andrew Robinson, Peter Mudge, and Geoff Crack. "Barriers to the provision of care for people with dementia and their carers in a rural community." Australian Journal of Primary Health 11, no. 1 (2005): 72. http://dx.doi.org/10.1071/py05010.
Full textAbstract:
This article describes results from a community initiated qualitative research project investigating barriers to the provision of care for people with dementia (PWD) and their carers. The study was conducted in a rural remote Tasmanian community ("Cape Coastal"). Focus group discussions were held with family member carers of PWD, members of the Aged Care Assessment Team (ACAT), nurses employed in the local hospital and a local nursing home, community health nurses and local general practitioners. In addition, two semi-structured interviews were conducted with a dementia support worker allocated to service the region and a single family member carer. Barriers to the effective provision of care for PWD and their carers were identified. These were: distance and isolation; perceptions of geographic and professional boundaries including issues of medical dominance; and gaps in health care provider and carers? knowledge about dementia and dementia services. These results demonstrate that while Cape Coastal has many points in common with other rural and remote communities in Australia and in Canada and the United States (Australian Institute of Health and Welfare [AIHW], 2002), it is important to recognise local context when planning and providing services for PWD and other chronic diseases.
29
Biondi, Christine, Vivienne Milch, Van Nguyen, Regina Ryan, David Roder, Alan Woods, Kristie Cooper, Rhona Wang, Cleola Anderiesz, and Dorothy Mary Kate Keefe. "The COVID-19 pandemic led to a reduction in cancer services in Australia." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18812-e18812. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18812.
Full textAbstract:
e18812 Background: Australian oncologists reported dramatic decreases in cancer referrals during the pandemic. As real time data were difficult to acquire, Cancer Australia used surrogate measures to infer where reductions in medical services occurred. We analysed data available through the Medicare Benefits Schedule (MBS), a list of the medical services and professional attendances subsidised by the Australian Government, for the five highest incidence cancers: breast, colorectal, lung, prostate, and skin cancers. Methods: We identified over 500 MBS item codes for diagnostic and treatment procedures for malignancies and pre-cancerous conditions. Item codes were categorised into analysis groups based on cancer type and/or similarities in type of service. Data were examined at national and jurisdictional levels for 2020 to determine reductions during the initial COVID-19 period and to monitor subsequent recovery. Data were compared to 2019 to account for normal seasonal variation. Results: Australia’s first wave of the pandemic ran from March to May, and a second wave in the state of Victoria alone ran from July to September 2020. We observed notable reductions across all diagnostic and surgical procedure groups examined, with initial reductions observed between March and April for diagnostic procedures, and a one-month delay for surgical procedures, between April and May. Some services showed an initial recovery in May, with many showing partial or full recovery by June. For some groups, analyses showed sustained reductions over the 12-month period. While COVID-19 case numbers were greater during the second wave, the impact on services was less pronounced, likely owing to more refined policy approaches to managing health system and workforce capacity. There was further recovery by September for some but not all services. Similar patterns of change were observed across all Australian states and territories, with some variation by jurisdiction. Conclusions: The pandemic has impacted the delivery of cancer care. Any potential delays in diagnoses and treatment due to these reductions in services may lead to more advanced cancer stage at diagnosis and poorer patient outcomes including recurrence and survival. Impact of COVID-19 on selected cancer services in Australia in 2020.[Table: see text]
30
Henderson, David, Pam D. McGrath, and Mary Anne Patton. "Experience of clinical supervisors of international medical graduates in an Australian district hospital." Australian Health Review 41, no. 4 (2017): 365. http://dx.doi.org/10.1071/ah15094.
Full textAbstract:
Objective Herein we record the experience of clinical supervisors of international medical graduates (IMGs) working as junior staff in a district hospital by examining supervisor perspectives on IMG performance, the factors affecting their performance and the requirements of supervision under these circumstances. Methods The present study had an open-ended exploratory qualitative design. Thirteen 13 open-ended, in-depth interviews were undertaken with supervisors of IMGs employed in a public district hospital in Queensland, Australia. Results The supervisors reported that, although performance was an individual and variable characteristic, IMGs tended to perform less well than Australian graduates and required more intensive supervision. Factors that affected performance were motivation and experience, and specifically lack of familiarity with the Australian healthcare system, lack of recent of practice, education, language, communication and cultural factors. English language proficiency was regarded as crucial to performance. Conclusions The additional work required to supervise IMGs in order to enable them to perform at a satisfactory level and successfully integrate into the Australian healthcare system needs to be recognised and resourced. Assistance with attaining proficiency in English and with communication skills over and above the standard required to pass the International English Language Testing System examination should be seriously considered as a means of improving performance. What is known about the topic? To date, there is little research available about the experience of supervisors of IMGs in Australia. What does this paper add? The findings of the present study make an important contribution to the literature by examining the critical role clinical supervisors of IMGs have in helping IMGs adapt to the Australian healthcare system and ensuring that they are able to provide quality health care. It identifies current challenges and highlights areas in need of attention to ensure a strong healthcare system for Australia. What are the implications for practitioners? Supervisors of IMGs need recognition of the extra time and expertise required in their role if they are to be effectively supported in their endeavours to integrate IMGs into the Australian health workforce. More attention needs to be given to the development of English language proficiency of IMGs, including colloquial usage, and communication in medical practice.
31
Carmichael, Allan. "Teaching, learning and research: essential elements of health care and the next Australian Health Care Agreements." Australian Health Review 31, no. 5 (2007): 25. http://dx.doi.org/10.1071/ah070s25.
Full textAbstract:
Australian Health Care Agreements must set out the roles and responsibilities of the Australian, state and territory governments in ensuring the provision of appropriate clinical placements for the additional medical student allocation. The roles of universities and public and private health agencies must also be specified.
32
Renwick, Manoa. "Quality Assurance in Australian Hospitals: How Far Does it Go?" Australian Medical Record Journal 18, no. 3 (September 1988): 97–101. http://dx.doi.org/10.1177/183335838801800304.
Full textAbstract:
The Australian Institute of Health (AIH) surveyed all acute hospitals in Australia to discover the extent of quality assurance (QA) activities, the types of programs being run and the processes being used. This paper explains the Institute's research strategy and puts the survey into the context of QA in Australia today. It describes the research method, identifies sources of bias, and presents some of the results. These show that medical record administrators (MRAs) play an active role in QA by coordinating hospital programs, by implementing individual reviews of their own departments, and by servicing other departmental reviews. The results pertaining to the extent and nature of QA are discussed and it is concluded that there seems to be some review of the quality of care for the majority of hospital patients. The effectiveness of that review, and whether or not it is quality assurance, still has to be investigated. (AMRJ 1988, 18(3), 97–101).
33
Eeles, Abbey L., Alice C. Burnett, Jeanie LY Cheong, Alex Aldis, Louise Pallot, Tien Polonidis, Krista Rust, Rod W. Hunt, Clare Delany, and Alicia J. Spittle. "Identifying research priorities in newborn medicine: a Delphi study of parents’ views." BMJ Open 11, no. 11 (November 2021): e044836. http://dx.doi.org/10.1136/bmjopen-2020-044836.
Full textAbstract:
ObjectiveNeonatal conditions can have lifelong implications for the health and well-being of children and families. Traditionally, parents and patients have not been included in shaping the agenda for research and yet they are profoundly affected by the neonatal experience and its consequences. This study aimed to identify consensus research priorities among parents/patients of newborn medicine in Australia and New Zealand.DesignParents/patients with experience of neonatal care in Australia and New Zealand completed an online Delphi study to identify research priorities across four epochs (neonatal admission, early childhood, childhood/adolescence and adulthood). Parents/patients first generated key challenges in each of these epochs. Through inductive thematic analysis, recurring topics were identified and research questions generated. Parents/patients rated these questions in terms of priorities and a list of questions consistently rated as high priority was identified.Participants393 individuals participated, 388 parents whose children had received neonatal care and 5 adults who had received neonatal care themselves.ResultsMany research questions were identified as high-priority across the lifespan. These included how to best support parental mental health, relationships between parents and neonatal clinical staff (including involvement in care and communication), bonding and the parent–child relationship, improving neonatal medical care and addressing long-term impacts on child health and neurodevelopment.ConclusionsParents with experience of newborn medicine have strong, clear and recurring research priorities spanning neonatal care practices, psychological and other impacts on families, and impacts on child development. These findings should guide neonatal research efforts. In addition to generating new knowledge, improved translation of existing evidence to parents is also needed.
34
Luckett, Tim, Priyanka Bhattarai, Jane Phillips, Meera Agar, David Currow, Yordanka Krastev, and Patricia M. Davidson. "Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria." Australian Health Review 39, no. 5 (2015): 552. http://dx.doi.org/10.1071/ah14187.
Full textAbstract:
Objectives A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. Methods A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Framework for Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Results Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment – the Dying with Dignity Victoria Advance Healthcare Directive. Conclusions More research is needed to understand how online resources can optimally elicit and record consumers’ individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement. What is known about the topic? Online availability of ACD templates provides consumers with an opportunity for advance care planning outside of formal healthcare settings. While online availability has advantages, there is a risk that templates may be biased either for or against medical treatment and may not elicit directives that are appropriately informed by reflection on personal values and discussion with family and health professionals. What does this paper add? This is the first attempt at monitoring the quality and bias of online ACD templates designed for use in Australia. What are the implications for practitioners? The results of this review provide a description and quality index to assist consumers and clinicians in deciding which online ACD template to use or recommend.
35
Cosman, Rasha, Chris Brown, Kevin DeBraganca, and Mustafa Khasraw. "Patterns of care study of adult medulloblastoma." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 2086. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.2086.
Full textAbstract:
2086 Background: Medulloblastoma (MB) accounts for less than 1% of adult intracranial tumours. While pediatric MB has been investigated in several randomized studies, the evidence in adults is limited to case reports and retrospective series, with no accepted standard of care. The Australian Cooperative Trials Group for Neuro-Oncology (COGNO) sought to determine the range and consistency of clinicians’ approaches to management as a basis for future trials. Methods: We aimed to identify current treatment strategies for adult MB through an international electronic survey launched at the 2012 meeting of the Society of Neuro-Oncology and by email invitation. Clinicians who had treated at least 1 adult patient with MB, central primitive neuroectodermal tumor (cPNET), or pinealoblastoma in the preceding year were asked about their most recent patient and asked to discuss their approach to management of a typical clinical scenario. Results: Between Nov 2012 and Jan 2013, 45 clinicians (11 medical oncologists, 7 radiation oncologists, 5 pediatric oncologists, and 22 others) from Australia (n = 24), USA (n = 3), Europe (n = 4) and other countries (n = 14) completed the survey. Responding clinicians had treated 54 cases in the past 12 months. The commonest histological type was MB (64%), followed by cPNET (20%). Most patients were male (68%), and most had high-risk disease (65%). 56% had complete surgical resection and 32% had molecular testing. Radiotherapy was predominantly craniospinal (92%) and mostly post-resection (80%). Combination chemotherapy was more common than single agent. Vincristine, cisplatin, cyclophosphamide was the most common protocol (43%). Others included carboplatin, etoposide, ifosfamide (29%), vincristine, lomustine, cisplatin (19%), vincristine, lomustine, prednisone (5%). Further details will be presented at the 2013 ASCO Annual Meeting. Conclusions: Our study has shown substantial international variation in the treatment of adult MB, most pronounced in the choice of chemotherapeutic agents, highlighting the need for further collaborative research to guide evidence-based treatment strategies.
36
Marquess, John, Wenbiao Hu, Graeme R. Nimmo, and Archie C. A. Clements. "Spatial Analysis of Community-OnsetStaphylococcus aureusBacteremia in Queensland, Australia." Infection Control & Hospital Epidemiology 34, no. 3 (March 2013): 291–98. http://dx.doi.org/10.1086/669522.
Full textAbstract:
Objectives.TO investigate and describe the relationship between indigenous Australian populations, residential aged care services, and community-onsetStaphylococcus aureusbacteremia (SAB) among patients admitted to public hospitals in Queensland, Australia.Design.Ecological study.Methods.We used administrative healthcare data linked to microbiology results from patients with SAB admitted to Queensland public hospitals from 2005 through 2010 to identify community-onset infections. Data about indigenous Australian population and residential aged care services at the local government area level were obtained from the Queensland Office of Economic and Statistical Research. Associations between community-onset SAB and indigenous Australian population and residential aged care services were calculated using Poisson regression models in a Bayesian framework. Choropleth maps were used to describe the spatial patterns of SAB risk.Results.We observed a 21% increase in relative risk (RR) of bacteremia with methicillin-susceptibleS. aureus(MSSA; RR, 1.21 [95% credible interval, 1.15–1.26]) and a 24% increase in RR with nonmultiresistant methicillin-resistantS. aureus(nmMRSA; RR, 1.24 [95% credible interval, 1.13–1.34]) with a 10% increase in the indigenous Australian population proportion. There was no significant association between RR of SAB and the number of residential aged care services. Areas with the highest RR for nmMRSA and MSSA bacteremia were identified in the northern and western regions of Queensland.Conclusions.The RR of community-onset SAB varied spatially across Queensland. There was increased RR of community-onset SAB with nmMRSA and MSSA in areas of Queensland with increased indigenous population proportions. Additional research should be undertaken to understand other factors that increase the risk of infection due to this organism.
37
Grant, Suzanne, Bruce Guthrie, Vikki Entwistle, and Brian Williams. "A meta-ethnography of organisational culture in primary care medical practice." Journal of Health Organization and Management 28, no. 1 (March 11, 2014): 21–40. http://dx.doi.org/10.1108/jhom-07-2012-0125.
Full textAbstract:
Purpose – Over the past decade, there has been growing international interest in shaping local organisational cultures in primary healthcare. However, the contextual relevance of extant culture assessment instruments to the primary care context has been questioned. The aim of this paper is to derive a new contextually appropriate understanding of the key dimensions of primary care medical practice organisational culture and their inter-relationship through a synthesis of published qualitative research. Design/methodology/approach – A systematic search of six electronic databases followed by a synthesis using techniques of meta-ethnography involving translation and re-interpretation. Findings – A total of 16 papers were included in the meta-ethnography from the UK, the USA, Canada, Australia and New Zealand that fell into two related groups: those focused on practice organisational characteristics and narratives of practice individuality; and those focused on sub-practice variation across professional, managerial and administrative lines. It was found that primary care organisational culture was characterised by four key dimensions, i.e. responsiveness, team hierarchy, care philosophy and communication. These dimensions are multi-level and inter-professional in nature, spanning both practice and sub-practice levels. Research limitations/implications – The research contributes to organisational culture theory development. The four new cultural dimensions provide a synthesized conceptual framework for researchers to evaluate and understand primary care cultural and sub-cultural levels. Practical implications – The synthesised cultural dimensions present a framework for practitioners to understand and change organisational culture in primary care teams. Originality/value – The research uses an innovative research methodology to synthesise the existing qualitative research and is one of the first to develop systematically a qualitative conceptual framing of primary care organisational culture.
38
Hilton, Deborah Joy. "A literature review on COVID-19 [coronavirus] research specific to Australia including manuscripts on policy and media releases." Journal of Evidence-Based Healthcare 4 (March 8, 2022): e3846. http://dx.doi.org/10.17267/2675-021xevidence.2022.e3846.
Full textAbstract:
INTRODUCTION / OBJECTIVES: Comprehending the avalanche of statistical research on COVID-19 [coronavirus] is laborious. Predictions, forecasts, and diagnostic algorithms are important for planning, allocation, and meeting the needs of the increasing population disease burden. Statisticians must be aware of spreadsheets, databases, and calculation methodology to produce valid estimates. Policymakers, government officials, and planners interpret results and read reports without knowing calculation intricacies. Health care workers must be aware of scientific websites whilst they are under increasing stress due to aging populations and improved technology. It is important that context-specific information is sought, read, and understood. METHODS: A literature review was undertaken to find context-specific statistical research information on COVID-19. The author performed a Pubmed search, a search utilising the coronavirus MeSH terms (Medical Subject Headings), adding the additional MeSH terms of Australia AND policy, and then another search with media as a text word. RESULTS: The Pubmed search, utilising the MeSH (Medical Subject Headings) on coronavirus, adding the MeSH terms [Australia AND Policy] resulted in 52 records being retrieved. The Australian Government Department of Health website dedicated link listing coronavirus (COVID-19) news reports, statements, and media releases included 347 departmental media retrievals. CONCLUSION: The COVID-19 pandemic has posed itself as the most critical health issue of the 21st century. It is important to understand the quality evidence-based information within the context, specific to the reason for seeking information so that well-informed decisions are made that relate to preventative actions, early detection, and treatment options.
39
Kitsos, Alex, Gregory M. Peterson, Matthew D. Jose, Masuma Akter Khanam, Ronald L. Castelino, and Jan C. Radford. "Variation in Documenting Diagnosable Chronic Kidney Disease in General Medical Practice: Implications for Quality Improvement and Research." Journal of Primary Care & Community Health 10 (January 2019): 215013271983329. http://dx.doi.org/10.1177/2150132719833298.
Full textAbstract:
Background: National health surveys indicate that chronic kidney disease (CKD) is an increasingly prevalent condition in Australia, placing a significant burden on the health budget and on the affected individuals themselves. Yet, there are relatively limited data on the prevalence of CKD within Australian general practice patients. In part, this could be due to variation in the terminology used by general practitioners (GPs) to identify and document a diagnosis of CKD. This project sought to investigate the variation in terms used when recording a diagnosis of CKD in general practice. Methods: A search of routinely collected de-identified Australian general practice patient data (NPS MedicineWise MedicineInsight from January 1, 2013, to June 1, 2016; collected from 329 general practices) was conducted to determine the terms used. Manual searches were conducted on coded and on “free-text” or narrative information in the medical history, reason for encounter, and reason for prescription data fields. Results: From this data set, 61 102 patients were potentially diagnosable with CKD on the basis of pathology results, but only 14 172 (23.2%) of these had a term representing CKD in their electronic record. Younger patients with pathology evidence of CKD were more likely to have documented CKD compared with older patients. There were a total of 2090 unique recorded documentation terms used by the GPs for CKD. The most commonly used terms tended to be those included as “pick-list” options within the various general practice software packages’ standard “classifications,” accounting for 84% of use. Conclusions: A diagnosis of CKD was often not documented and, when recorded, it was in a variety of ways. While recording CKD with various terms and in free-text fields may allow GPs to flexibly document disease qualifiers and enter patient specific information, it might inadvertently decrease the quality of data collected from general practice records for clinical audit or research purposes.
40
Barnett, Stephen, Joan Henderson, Adam Hodgkins, Christopher Harrison, Abhijeet Ghosh, Bridget Dijkmans-Hadley, Helena Britt, and Andrew Bonney. "A valuable approach to the use of electronic medical data in primary care research: Panning for gold." Health Information Management Journal 46, no. 2 (October 12, 2016): 51–57. http://dx.doi.org/10.1177/1833358316669888.
Full textAbstract:
Background: Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable. Objective: The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research. Method: EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit. Results: The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age ( p = 0.36) or sex ( p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns. Conclusion: Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.
41
Seehusen, Dean A., Meghan F. Raleigh, Julie P. Phillips, Jacob Prunuske, Christopher P. Morley, Molly E. Polverento, Iris Kovar-Gough, and Andrea L. Wendling. "Institutional Characteristics Influencing Medical Student Selection of Primary Care Careers: A Narrative Review and Synthesis." Family Medicine 54, no. 7 (July 5, 2022): 522–30. http://dx.doi.org/10.22454/fammed.2022.837424.
Full textAbstract:
Background and Objectives: There is an ongoing shortage of primary care physicians in the United States. Medical schools are under pressure to address this threat to the nation’s health by producing more primary care graduates, including family physicians. Our objective was to identify institutional characteristics associated with more medical students choosing primary care. Methods: We conducted a systematic literature review with narrative synthesis to identify medical school characteristics associated with increased numbers or proportions of primary care graduates. We included peer-reviewed, published research from the United States, Canada, Australia, and New Zealand. The existing literature on characteristics, including institutional geography, funding and governance, mission, and research emphasis, was analyzed and synthesized into summary statements. Results: Ensuring a strong standing of the specialty of family medicine and creating an atmosphere of acceptance of the pursuit of primary care as a career are likely to increase an institution’s percentage of medical students entering primary care. Training on regional campuses or providing primary care experiences in rural settings also correlates with a larger percentage of graduates entering primary care. A research-intensive culture is inversely correlated with primary care physician production among private, but not public, institutions. The literature on institutional financial incentives is not of high enough quality to make a firm statement about influence on specialty choice. Conclusions: To produce more primary care providers, medical schools must create an environment where primary care is supported as a career choice. Medical schools should also consider educational models that incorporate regional campuses or rural educational settings.
42
Girgis, A., and R. W. Sanson-Fisher. "Breaking bad news: consensus guidelines for medical practitioners." Journal of Clinical Oncology 13, no. 9 (September 1995): 2449–56. http://dx.doi.org/10.1200/jco.1995.13.9.2449.
Full textAbstract:
PURPOSE AND DESIGN: One of the more difficult tasks that clinicians must perform as part of their care of patients is that of conveying bad news, such as a severe diagnosis or death. However, there is a paucity of empirically founded information that relates to the specific steps for breaking bad news. We report on a set of guidelines for breaking bad news that was developed using a consensus process and incorporates the views of medical oncologists, general practitioners, surgeons, nurse consultants, social workers, clergy, human rights representatives, cancer patients, hospital interns, and clinical directors of medical schools in Australia. RESULTS AND CONCLUSION: It is recommended that further research be undertaken in a number of areas. First, there is a need to assess patients' versus providers' perceptions of the importance of each of the steps in breaking bad news, in order to define criteria for minimal levels of competence in this area. Second, controlled trials are needed to assess the effectiveness of the guidelines in changing clinical practice, and to identify the most effective strategies for breaking bad news to patients.
43
Harrison, Kristie H., KS Kylie Lee, Timothy Dobbins, Scott Wilson, Noel Hayman, Rowena Ivers, Paul S. Haber, et al. "Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: protocol for a cluster randomised controlled trial." BMJ Open 9, no. 11 (November 2019): e030909. http://dx.doi.org/10.1136/bmjopen-2019-030909.
Full textAbstract:
IntroductionIndigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs.Methods and analysisA randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines).SettingTwenty-two ACCHSs across Australia.RandomisationServices will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or ‘early support’); half receive support 2 years later (wait-control or ‘late support’).The supportCore support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision.Outcomes and analysisPrimary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support.Ethics and disseminationEthical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent’s Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779).Trial registration numberACTRN12618001892202; Pre-results.
44
Yam, Carrie H. K., Sian M. Griffiths, S. Liu, Eliza L. Y. Wong, Vincent C. H. Chung, and E. K. Yeoh. "Medical Regulation." Journal of Medical Regulation 102, no. 1 (January 1, 2016): 16–27. http://dx.doi.org/10.30770/2572-1852-102.1.16.
Full textAbstract:
The licensing and regulation of physicians is an important topic worldwide and is often tied to discussions in various countries of health care system reform. We conducted a review of current practices for regulating physicians as a key group of health care professionals in eight jurisdictions in Asia and other parts of the world in order to draw implications for the development of future regulatory policies in Hong Kong. Jurisdictions studied included Australia, Canada, China, Malaysia, New Zealand, Singapore, the United Kingdom and the United States. A literature search, supplemented by interviews, was conducted. In analyzing information gathered about global regulatory systems, we used a framework for comparing regulatory typology, developed by the RAND Europe research institute. Our review found that the jurisdictions studied exhibited both similarities and differences in terms of how physicians are regulated and by whom. As a result of our search, we were able to identify 10 key trends in international medical regulation of importance to Hong Kong as it considers reforms to its health care system overall:Changes in medical regulation are seen as a way of improving the quality of patient care.Reform of medical regulation often requires government legislation.The creation of common principles for policies, structures and the organization of regulation between professions is an emerging practice.The involvement of lay people on boards and in inquiries is increasingly common.Medical regulation is moving away from models of self-regulation and toward regulatory models that emphasize partnership between professions and the public, physicians and patients.Health care providers and institutional regulators play complementary roles in medical regulation.Regulation impacts the quality of care — not just the detection and remediation of poor performance.Investigatory and disciplinary functions are increasingly separated and organized independently of each other.Continuous Professional Development (CPD) is compulsory for physicians in many jurisdictions.Overseas medical graduates are admitted into practice in different ways from country to country. These trends are important for regulators in all countries to note as they assess the basic structure and effectiveness of their own medical regulatory systems.
45
Chan, David L., Lesley Moody, Eva Segelov, David C. Metz, Jonathan R. Strosberg, Nick Pavlakis, and Simron Singh. "Follow-Up for Resected Gastroenteropancreatic Neuroendocrine Tumours: A Practice Survey of the Commonwealth Neuroendocrine Tumour Collaboration (CommNETS) and the North American Neuroendocrine Tumor Society (NANETS)." Neuroendocrinology 107, no. 1 (2018): 32–41. http://dx.doi.org/10.1159/000488394.
Full textAbstract:
Objectives: There is no consensus regarding optimal follow-up in resected gastroenteropancreatic neuroendocrine tumours (NETs). We aimed to perform a practice survey to ascertain follow-up patterns by health care practitioners and highlight areas of variation that may benefit from further quantitative research. Methods: A Web-based survey targeted at NET health care providers in Australia, New Zealand, Canada, and the USA was developed by a steering committee of medical oncologists and a research methodologist. Thirty-seven questions elicited information regarding adherence to guidelines, the influence of risk factors on follow-up, and the frequency and choice of modality in follow-up. Results: There were 163 respondents: 59 from Australia, 25 from New Zealand, 46 from Canada, and 33 from the USA (50% medical oncology, 23% surgery, 13% nuclear medicine, and 15% other). Thirty-eight percent of the respondents were “very familiar” with the NCCN NET guidelines, 33% with the ENETS guidelines, and 17% with the ESMO guidelines; however, only 15, 27, and 10%, respectively, found them “very useful”; 63% reported not using guidelines at their institution. The commonest investigations used were CT scans (66%) and chromogranin A (86%). The US respondents were more likely to follow patients up past 5 years, and the Australian respondents utilized more functional and less cross-sectional imaging. When poor prognostic factors were introduced, the respondents recommended more visits and tests. Conclusions: This large international survey highlights variation in current follow-up practices not well addressed by the current guidelines. More quantitative research is required to inform the development of evidence-based guidelines tailored to the pattern of recurrence in NETs.
46
Marr, I., and S. Sabesan. "Video linked medical oncology clinics: A novel way to improve patients’ access to medical oncology services in rural Australia." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e17573-e17573. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e17573.
Full textAbstract:
e17573 Background: To improve the access of Mt Isa patients to medical oncologists, Townsville Cancer Centre runs weekly medical oncology clinics via videolink. Aim of this study was to assess patient satisfaction, safety of chemotherapy delivery, and cost effectiveness of such technology. Methods: Between 2006 and 2008, 42 patients were seen. A questionnaire based survey was conducted by telephone to assess patient's level of satisfaction and quality of communication. Safety of chemotherapy delivery was evaluated by retrospective chart audit. Results: 25 patients completed the questionnaire. Six were new patients and the rest were for review leading to more than 90 encounters. Satisfaction: 100% of those interviewed were satisfied with the care given by the Townsville Cancer Centre. Of these 88% felt they developed a friendly relationship with the specialist. 90% felt medication could be taken without any concerns after videolink. 27% of patients interviewed felt examination was needed by the specialist, but 92% of the patients would rather see the specialist via videolink than travel to Townsville. Overall 96% felt it saved time, money and was convenient. Responses, apart from the question about the need for physical examination by the specialist, were more than 80% in agreement. Safety: 32 patients received active therapy. 60% were treated with palliative intent and the rest adjuvant. The median number of cycles was 5 (1–8). A total of 4 patients were admitted for complications- 2 for febrile neutropenia and 2 for emesis.There were no treatment related deaths. Cost effectiveness: Factors for consideration were cost of patient and specialist travel and accommodation,cost of interruption of routine clinics at specialists’ home, cost of video link apparatus and maintenance and cost of disturbance of quality of life for patients and doctors resulting from travel. Conclusions: Satisfaction with video linked clinics is high. It saves travel time for the patients and specialists and seems to be cost effective. It is safe to supervise chemotherapy administration using this technology. Therefore, this method of service delivery could be adopted by medical oncology departments to improve services to the rural and remote areas. No significant financial relationships to disclose.
47
Comino, Elizabeth J., Nicholas A. Zwar, and Oshana Hermiz. "The Macarthur GP After-hours Service: a model of after-hours care for Australia." Australian Health Review 31, no. 2 (2007): 223. http://dx.doi.org/10.1071/ah070223.
Full textAbstract:
Introduction: The Macarthur GP After-hours Service (MGPAS) was established to streamline the provision of after-hours medical care in an outer-urban community. This paper reports on a process evaluation of the MGPAS. Methods: A mixed methods approach involving surveys, stakeholder interviews and analysis of administrative data was used. Results and discussion: This model of care was well accepted and regarded by general practitioners, Macarthur Health Service staff and the community. The MGPAS was found to be an acceptable and efficient model of after-hours medical care. Areas that required further review included the need for telephone triage, home visiting and improved communication and referral to the health service. The financial viability of the MGPAS depends on supplementary funding due to the constraints of the Medicare rebate, and limited opportunities to reduce costs or increase revenue. Further research, including an economic evaluation to identify opportunity costs of the service, is needed.
48
Mackean, Tamara, Elizabeth Withall, Judith Dwyer, and Annabelle Wilson. "Role of Aboriginal Health Workers and Liaison Officers in quality care in the Australian acute care setting: a systematic review." Australian Health Review 44, no. 3 (2020): 427. http://dx.doi.org/10.1071/ah19101.
Full textAbstract:
ObjectiveThe aim of this study was to identify the contribution of Aboriginal Health Workers and Liaison Officers (AHWLOs) to quality of care in the acute health care setting in Australia. MethodsA systematic review of peer-reviewed literature focused on the role of AHWLOs and quality processed and quality outcomes. Authors undertook study selection based on inclusion criteria and performed quality assessment using critical appraisal tools from the Joanna Briggs Institute. ResultsThe search revealed limited literature that met the inclusion criteria, namely four quantitative studies and one mixed-methods study. The settings of the included studies were mental health and cardiac care units within various hospitals. The studies indicated that AHWLOs may have a positive effect on communication between healthcare professionals and patients, rates of discharge against medical advice and continuity of care. Methodological constraints among the included studies made it difficult to establish specific contributions of AHWLOs to quality care markers across acute care units. ConclusionsThe role of AHWLOs in providing quality care in the acute care setting has received minimal research. The limited existing research highlights the importance of the AHWLO role. For example, AHWLOs may influence patient communication, discharge against medical advice and continuity of care within mental health and cardiac care units. Further, because of methodological constraints among the limited studies, research into the role of AHWLOs in these and other acute care settings is needed to assess effects on a range of specific clinical quality markers. What is known about the topic?Aboriginal and Torres Strait Islander people experience unacceptable health inequities. AHWLOs are a unique workforce introduced to increase access to culturally safe care and, ultimately, help to address these inequities. What does this paper add?This review explores the current evidence for the contribution of AHWLOs to quality care in the acute care setting. The findings suggest that these professionals may improve communication between patients and medical staff, improve continuity of care and reduce patient discharge against medical advice. However, these findings highlight that the use of quality care markers across acute care settings is needed to generate tangible evidence to help establish the legitimacy of these health professionals. What are the implications for practitioners?AHWLOs have a place in the acute care team. Although further research is required to expand the preliminary evidence base of their effect on quality acute care, this workforce should be supported at the individual, organisational and policy levels to enhance the health and well-being of one the most vulnerable communities in Australia.
49
Ellerton, Kirrily, Harishan Tharmarajah, Rimma Medres, Lona Brown, David Ringelblum, Kateena Vogel, Amanda Dolphin, et al. "The VRIMM study: Virtual Reality for IMMunisation pain in young children—protocol for a randomised controlled trial." BMJ Open 10, no. 8 (August 2020): e038354. http://dx.doi.org/10.1136/bmjopen-2020-038354.
Full textAbstract:
IntroductionPain caused by routine immunisations is distressing to children, their parents and those administering injections. If poorly managed, it can lead to anxiety about future medical procedures, needle phobia and avoidance of future vaccinations and other medical treatment. Several strategies, such as distraction, are used to manage the distress associated with routine immunisations. Virtual reality (VR), a technology which transports users into an immersive ‘virtual world’, has been used to manage pain and distress in various settings such as burns dressing changes and dental treatments. In this study, we aim to compare the effectiveness of VR to standard care in a general practice setting as a distraction technique to reduce pain and distress in 4-year-old children receiving routine immunisations.Methods and analysisThe study is a randomised controlled clinical trial comparing VR with standard care in 100 children receiving routine 4-year-old vaccination. Children attending a single general practice in metropolitan Melbourne, Australia will be allocated using blocked randomisation to either VR or standard care. Children in the intervention group will receive VR intervention prior to vaccination in addition to standard care; the control group will receive standard care. The primary outcome is the difference in the child’s self-rated pain scores between the VR intervention and control groups measured using The Faces Pain Scale-Revised. Secondary outcomes include another measure of self-rated pain (the Poker Chip Tool), parent/guardian and healthcare provider ratings of pain (standard 100 mm visual analogue scales) and adverse effects.Ethics and disseminationEthics approval has been obtained in Australia from the Royal Australian College of General Practitioners National Research and Evaluation Ethics Committee (NREEC 18-010). Recruitment commenced in July 2019. We plan to submit study findings for publication in a peer-reviewed journal and presentation at relevant conferences.Trial registration numberACTRN12618001363279.
50
Bail, Kasia, Paul Arbon, Marlene Eggert, Anne Gardner, Sonia Hogan, Christine Phillips, Nicole van Dieman, and Gordon Waddington. "Potential scope and impact of a transboundary model of nurse practitioners in aged care." Australian Journal of Primary Health 15, no. 3 (2009): 232. http://dx.doi.org/10.1071/py09009.
Full textAbstract:
Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.