Academic literature on the topic 'Public hospitals Victoria Archives'

In this paper, the author looks at the arguments for and against placing modern medical records in public archival facilities. She considers the various ethical, legal and practical issues involved in archiving patients' records with the intention of making them available for public access after seventy-five years from the date of last contact of the patient with the hospital or sooner under certain specified circumstances. The range of sampling and selection techniques available for reducing the volume of patient records to be retained is also discussed. Citing the experience of the Public Record Office Victoria, the author concludes that it is justifiable to breach confidentiality by placing modern medical records in public archives but that it will be many years before an assessment can be made of the appropriateness or otherwise of placing modern hospital records in public archives and whether it proves to be worth the effort. (AMRJ, 1989,19(4), 155–161).

Outpatient and emergency services in rural hospitals have rarely been studied. This paper analyses routinely collecteddata, together with data from a survey of hospitals, to provide a picture of these services in Victorian public hospitals.The larger rural hospitals provide the bulk of rural outpatients and emergency services, particularly so for medicaloutpatients. Cost per service varies with the size of the hospital, possibly reflecting differences in complexity. Fundingpolicies for rural hospital outpatient and emergency services should be sufficiently flexible to take into account thedifferences between rural hospitals.

The proportion of Victorians and Australians generally with private health insurance (PHI) increased from 31% in 1998 to 45% in 2001. We analysed a dataset containing all hospital separations throughout Victoria to determine whether changes in the level of private health insurance have had any impact on patterns of public and private hospital utilisation in Victoria. Total utilisation of private hospitals grew by 31% from 1998?99 to 2002?03, whereas utilisation of public hospitals increased by 18%. Total bed-days have increased in both private hospitals and public hospitals by 12%. The proportion of all separations at private hospitals has remained relatively stable between these 2 years, with 33% of all separations being private patients in private hospitals in 1998? 99, increasing slightly to 35% by 2002?03. Analysis of a number of specific DRGs shows that patients with more severe disease are more likely to be seen at public hospitals; notably this trend has strengthened between 1998?99 and 2002?03. The number of patients treated in Victorian public hospitals has continued to grow, despite a rapid increase in the utilisation of private hospitals. Given the limited extent of the shift in caseload share between the two sectors, the effectiveness of the Commonwealth?s subsidy of private health insurance as a mechanism to reduce pressure on the public sector needs to be carefully examined.

On 1 July 1993 Victoria became the first Australian state to use casemix information to set budgets for its public hospitals commencing with casemix funding for inpatient services. Victoria's casemix funding approach now embracesinpatient, outpatient and rehabilitation services.

Consumers regard access to hospital services as one of the key components of qualityin health care delivery. A mixed public/private system operates in Victoria, but amorbidity collection from private hospitals was commenced only relatively recently.In 1993?94 the collection covered 82- per cent of private hospital separations, andit was considered timely to examine the utilisation patterns in the private system andcompare them with those in the public system. Medical and surgical emergencies andother complex conditions and procedures are serviced largely in the public sector,whereas private hospitals are utilised for elective and less complex surgery and non-urgentconditions. Occupancy rates are around 79- per cent in public hospitals and67- per cent in private hospitals. Elective surgery waiting list data suggest that whileurgent cases are treated within a month, significant proportions wait six months ormore for non-urgent surgery. Private health insurance is the main factor indetermining access to and the utilisation private hospitals. The current MedicareAgreement and the move to separate the role of purchaser and provider may allowthe maximal utilisation of private hospitals and diminish the burden of chronicillness.

This paper specifies an econometric model to forecast State government expenditure on recognised public hospitals in Victoria. The OECD's recent cross-country econometric work exploring factors affecting health spending was instructive. The model found that Victorian Gross State Product, population aged under 4 years, the mix of public and private patients in public hospitals, introduction of case mix funding and funding cuts, the proportion of public beds to total beds in Victoria and technology significantly impacted on expenditure. The model may have application internationally for forecasting health costs, particularly in short and medium-term budgetary cycles.

In this follow-up article, we refer to the other public hospital facilities of Madras, viz. the Lock and Naval Hospitals, the Native Infirmary, Lunatic Asylum, Eye Infirmary, Maternity Hospital (Egmore), and the Queen Victoria Hospital for Caste and Gosha Women, some of which are operational today. We also include brief notes on a few of the pioneering men and women, who contributed to the development of these facilities.

The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

This research examines the impact, if any, of the introduction of casemix funding on public hospitals in Victoria. The results reported here show that in Victoria, during the period under observation, rural hospitals showed a significantly greater preponderance, relative to metropolitan hospitals, to either amalgamate or close down. Since 1 July 1993 public hospitals in Victoria have been compared for efficiency in the delivery of their services. The casemix funding arrangements were installed, among other reasons, to improve efficiency in the delivery of hospital services. Duckett, 1999, p 107 states that under casemix funding 'The hospital therefore becomes more clearly accountable for variation in the efficiency of the services it provides'. Also, 'Generally, case-mix funding is seen as being able to yield efficiency improvements more rapidly than negotiated funding'. Hospital comparisons provide State bodies with information on how to allocate funding between hospitals by means of annual capped budgets. Budgets are capped because funding is restricted to a given number of patients that can be treated in any given year. Thus, casemix funding relies heavily on cost comparisons between hospitals, and the way that hospital output is measured relies on the use of diagnosis related groups (DRGs).

This research examines the impact, if any, of the introduction of casemix funding on public hospitals in Victoria. The results reported here show that in Victoria, during the period under observation, rural hospitals showed a significantly greater preponderance, relative to metropolitan hospitals, to either amalgamate or close down. Since 1 July 1993 public hospitals in Victoria have been compared for efficiency in the delivery of their services. The casemix funding arrangements were installed, among other reasons, to improve efficiency in the delivery of hospital services. Duckett, 1999, p 107 states that under casemix funding 'The hospital therefore becomes more clearly accountable for variation in the efficiency of the services it provides'. Also, 'Generally, case-mix funding is seen as being able to yield efficiency improvements more rapidly than negotiated funding'. Hospital comparisons provide State bodies with information on how to allocate funding between hospitals by means of annual capped budgets. Budgets are capped because funding is restricted to a given number of patients that can be treated in any given year. Thus, casemix funding relies heavily on cost comparisons between hospitals, and the way that hospital output is measured relies on the use of diagnosis related groups (DRGs).

The aim of the research was to analyse the organisational dynamics surrounding a health care reform implementation process associated with the introduction of coordinated care, which is an Australian Government initiative to introduce structural changes to the funding and delivery of health-care in response to rising health care costs. A longitudinal case study of an implementation team was studied. This included the perceptions and experiences of individuals and institutions within hospitals, the general practice community and Divisions of General Practice. Furthermore, the case study explored organisational structures, decision-making processes and management systems of the Project and included an examination of the difficulties and conflicts that ensued. The broader context of health care reform was also considered. The study found that an effective change management strategy requires clarity around the definition of primary task in health care delivery, particularly when the task is complex and the environment uncertain. This requires a management and support structure able to accommodate the tensions that exists between providing care and managing cost, in a changing and complex system. The case study indicated that where tensions were not managed the functions of providing care and managing costs became disconnected, undermining the integrity of the task and impacting on the effective facilitation of the change process and hence, the capacity of stakeholders to embrace the model of co-ordinated care. Moreover, the micro dynamics of the project team seemed to parallel the macro dynamics of the broader system where economic and health care provision imperatives clash. Through its close analysis of change dynamics, the study provides suggestions for the improved engagement of stakeholders in health care change.

High quality of working life is vital for maintaining an adequate workforce, and given the current global nursing workforce shortage, the quality of nurses’ working lives is of particular importance. The literature suggests that ensuring working conditions are attractive enough to retain nurses in the workforce is the most cost-effective and sustainable strategy for addressing the nursing shortage. Drawing upon the Theory of Work Adjustment as a theoretical framework, this cross-sectional, mixed-method study sought to explore the opinions about quality of working life held by nurses working in public hospitals in Victoria. Differences in opinion about key aspects of working life between nurses who planned to continue a career in nursing and those who planned to make a career change were also sought. Data were collected using a Likert-style survey and semi-structured interviews and were analysed by means of the SPSS computer program and qualitative content analysis.

Healthcare is a complex arena of multi-skilled interaction. In recent years, it has grown extensively out of the simple act of treating the sick by a noble healer to taking measures of preventing illness not only of the clients but also of the community. It is no more a deal between two persons: the sick and the healer (like a doctor). Community healthcare is regulated by several agencies including legislative agencies (like government, international health organisations), professional bodies, industrial regulators, consumer advocates and commercial entities (such as insurance companies and pharmaceuticals). Healthcare service providers or professionals are not the sole regulators rather their actions need to balance the legal obligations to the client (such as client satisfaction), to staff (such as workplace safety) and to business (to maintain competitive advantage in the industry). Current healthcare service provision is challenged by many factors including diversification of the task, diversity of workforce characteristics due to globalisation and increased service demand by knowledgeable customers searching proactive healthcare and not just curative care. To overcome these challenges along with maintaining quality service, organisations need skilled staff. This, however, is threatened by occupational hazards like occupational violence against staff (OVAS) which is well documented globally and across Australia. The impact of OVAS is not limited only to disruption of service but also to the quality of service and shortage of human resources in some cases. Regulatory agencies like the Department of Health, Comcare, Safe Work Australia and Worksafe Victoria (VAGO, 2013) are providing guidelines on OVAS management. Most healthcare providers are considering some actions, but not with any universal consensus. According to the hierarchy of control in Work Health and Safety Management System (WHSMS) a hazard could best be controlled by eliminating it, but if not then training of staff is an option. Training will always be needed whether or not other measures of hazard and risk control are implemented. This encourages research to develop effective training in terms of trainers’ perspective (in delivery), learners’ perspective (of appreciating the sessions) and management’ perspective (of the outcome of hazard control). Literature shows that the workforce training in hospitals to control OVAS lacks consistency and uniformity across Australian hospitals. ‘Management of Violence and Aggression International Training’ (MSVT) is one training programme run by the BN123 Health, Victoria, since 1990. With that background the main aim of this qualitative case study research project was to “identify the effectiveness of the existing training programme (MSVT) in prevention of occupational violence against staff (OVAS) “. Occupational violence is a part of work health and safety issue. So, the research intended to enquire: ‘Is the existing MSVT in prevention of OVAS achieving its purpose, particularly in the current WHSMS setting of the hospital?’ The literature review assisted in identifying the causes of OVAS, types, prevalence and the factors associated with it. It also helped to analyse the published incidents. Among different training evaluation methods, the Kirkpatrick’s model was found most suitable to evaluate MSVT. Analysis attempted to correlate the outcome of the training against existing objectives. Limited access to information meant that I could not perform in-depth analyses, but the findings of this study are expected to guide future research on the effectiveness of MSVT at BN123 Health with more integration to the WHSMS and other safety programmes This research used a qualitative case study with Actor-Network Theory (ANT) to fulfil the goal. The limited access to health facilities both due to obstacle in sensitive data collection and accessing busy participants of different sections of the hospital in a limited time frame. This study explored actors related to OVAS and suggested adoption of an innovative approach to improve workplace safety through the formation of new networks. It did this by looking through the lens of Actor-Network Theory (ANT). The present vision of the government in digitalising the health sector in Australia is a prime opportunity to re-align the network in the WHSMS of the hospital for better impact of training on the OVAS situation. Limited guidance from top management was an issue. MSVT was under the control of the Psychiatric Department at its inception but was then moved under Human Resources (HR), which seems to have reduced its importance and resource management ability. Hospitals are dominated by clinical priorities rather than HR issues. Being a part of the general training programme administered by HR has limited the ability of MSVT as it struggled to receive funding to recruit enough full-time trainers to undertake research on OVAS incidents, promote the programme across the whole organisation, publish materials to create awareness to all staff and develop resources to help retain the knowledge of the participants in the post-training period. Limited flow of information on OVAS was another issue. Even though BN123 Health invests in innovation like RSKSOFT, for reporting it did not purchase all the modules of that programme to improve the flow of information to the trainers of MSVT. BN123 Health demonstrated a proactive attitude in managing OVAS by procuring and trademarking MSVT but is lacking continuity of efforts in it, maybe due to its commitment to clinical aspects of the service. This could be verified by further research. The research identified scope for innovation. Firstly, the training programme could be strengthened by incorporating recent updates on organisational objectives and legislative changes and standardisation with industry practices. It could also be strengthened by incorporation of an improved audio-visual component, distance learning facilities for beginners and refreshers, updating resources including books and journals, inter-organisation exchange programmes and inclusion of regular research results in booklets and handouts. Targeted delivery would also assist, with constant vigilance on incidents and inclusion of vulnerable groups in training. Another worthwhile innovation would be to change the focus from staff only programmes to involve customer or client interest. This could include arranging training for clients and carers as they are a party in the conflict. Management training would be useful to prepare resources for the population of the catchment area, bringing together all healthcare providers (including GPs) who refer clients to the hospital. Updating real-time information collection, storage and analysis by professionals as well as information access to trainers would also be a worthwhile innovation. With the availability of mobile technology, BN123 Health has scope to improve its ability to get real-time information from the incident spot and to develop better management to control events. This could also provide arrangements for easy data entry by general staff.

Case records examined here are those of inmates in two public institutions for the insane in colonial Victoria, Australia, and in Auckland, New Zealand, between 1870 and 1910. In the international field of mental health studies and histories of psychiatry, intellectual disability has been the subject of detailed historical inquiry and forms part of the critical discussion about how institutions for the “insane” housed a range of inmates in the nineteenth century. Yet the archival records of mental hospitals have rarely been examined in any sustained way for their detail about the physically disabled or those whose records denote bodily difference. References to the physical manifestations of various forms of intellectual or emotional disability, as well as to bodily difference and “deformity,” were part of the culture of the colonial institution, which sought to categorize, label, and ascribe identities to institutional inmates.

Abstract Case records examined here are those of inmates in two public institutions for the insane in colonial Victoria, Australia, and in Auckland, New Zealand, between 1870 and 1910. In the international field of mental health studies and histories of psychiatry, intellectual disability has been the subject of detailed historical inquiry and forms part of the critical discussion about how institutions for the “insane” housed a range of inmates in the nineteenth century. Yet the archival records of mental hospitals have rarely been examined in any sustained way for their detail about the physically disabled or those whose records denote bodily difference. References to the physical manifestations of various forms of intellectual or emotional disability, as well as to bodily difference and “deformity,” were part of the culture of the colonial institution, which sought to categorize, label, and ascribe identities to institutional inmates.

For the past 100 years, film has been almost the exclusive medium for capturing, storing, and displaying radiographic images. Film is a fixed medium with usually only one set of images available. Today, the radiologic sciences are on the brink of a new age. In particular, Picture Archiving and Communication System (PACS) technology allows for a near filmless process with all of the flexibility of digital systems. PACS consists of image acquisition devices, storage archiving units, display stations, computer processors, and database management systems. These components are integrated by a communications network system. Filmless radiology is a method of digitizing traditional films into electronic files that can be viewed and saved on a computer. This technology generates clearer and easier-to-read images, allowing the patient the chance of a faster evaluation and diagnosis. The time saved may prove to be a crucial element in facilitating the patient’s treatment process. With filmless radiology, images taken from various medical sources can be manipulated to enhance resolution, increasing the clarity of the image. Images can also be transferred internally within hospital departments and externally to other locations such as the office of the patient’s doctor or medical specialist in other parts of the world. This is made possible through the picture-archiving and communication system (Dreyer, Mehta, & Thrall, 2001), which electronically captures, transmits, displays, and saves images into digital archives for use at any given time. The PACS functions as a state-of-the-art repository for long-term archiving of digital images, and includes the backup and bandwidth to safeguard uninterrupted network availability. The objective of the picture-archiving and communications system is to improve the speed and quality of clinical care by streamlining radiological service and consultation. With instant access to images from virtually anywhere, hospital doctors and clinicians can improve their work processes and speed up the delivery of patient care. Besides making film a thing of the past, the likely benefits would include reduced waiting times for images and reports, and the augmented ability of clinicians since they can get patient information and act upon it much more quickly. It also removes all the costs associated with hard film and releases valuable space currently used for storage. According to Dr. Lillian Leong, Chairman of the Radiology IT Steering Group of the Hong Kong Medical Authroity, a single hospital can typically save up to 2.5 million Hong Kong dollars (approximately US$321,000) a year in film processing cost (Intel, 2007). The growing importance of PACS on the fight against highly infectious disease such as Severe Acute Respiratory Syndrome (SARS) is also identified (Zhang & Xue, 2003). In Hong Kong, there was no PACS-related project until the establishment of Tseung Kwan O Hospital (TKOH) in 1998. The TKOH is a 600-bed acute hospital with a hospital PACS installed for the provision of filmless radiological service. The design and management of the PACS for patient care was discussed in the first edition of this encyclopedia (Tong & Wong, 2005). The TKOH was opened in 1999 with PACS installed. At the beginning, due to immature PACS technologies, the radiology service was operating with film printing. A major upgrade was done in 2003 for the implementation of server clustering, network resilience, liquid crystal display (LCD), smart card, and storage-area-network (SAN) technologies. This upgrade has greatly improved the reliability of the system. Since November 2003, TKOH has started filmless radiology service for the whole hospital. It has become one of the first filmless hospitals in the Greater China region (Seto, Tsang, Yung, Ching, Ng, & Ho, 2003; Tsou, Goh, Kaw, & Chee, 2003).

The Australian Catholic University (ACU National at www.acu.edu.au) is a public university funded by the Australian Government. There are six campuses across the country, located in Brisbane, Queensland; North Sydney, New South Wales; Strathfield, New South Wales; Canberra, Australian Capital Territory (ACT); Ballarat, Victoria; and Melbourne, Victoria. The university serves a total of approximately 27,000 students, including both full- and part-time students, and those enrolled in undergraduate and postgraduate studies. Through fostering and advancing knowledge in education, health, commerce, the humanities, science and technology, and the creative arts, ACU National seeks to make specific and targeted contributions to its local, national, and international communities. The university explicitly engages the social, ethical, and religious dimensions of the questions it faces in teaching, research, and service. In its endeavors, it is guided by a fundamental concern for social justice, equity, and inclusivity. The university is open to all, irrespective of religious belief or background. ACU National opened its doors in 1991 following the amalgamation of four Catholic tertiary institutions in eastern Australia. The institutions that merged to form the university had their origins in the mid-17th century when religious orders and institutes became involved in the preparation of teachers for Catholic schools and, later, nurses for Catholic hospitals. As a result of a series of amalgamations, relocations, transfers of responsibilities, and diocesan initiatives, more than twenty historical entities have contributed to the creation of ACU National. Today, ACU National operates within a rapidly changing educational and industrial context. Student numbers are increasing, areas of teaching and learning have changed and expanded, e-learning plays an important role, and there is greater emphasis on research. In its 2005–2009 Strategic Plan, the university commits to the adoption of quality teaching, an internationalized curriculum, as well as the cultivation of generic skills in students, to meet the challenges of the dynamic university and information environment (ACU National, 2008). The Graduate Diploma of Education (Secondary) Program at ACU Canberra Situated in Australia’s capital city, the Canberra campus is one of the smallest campuses of ACU National, where there are approximately 800 undergraduate and 200 postgraduate students studying to be primary or secondary school teachers through the School of Education (ACT). Other programs offered at this campus include nursing, theology, social work, arts, and religious education. A new model of pre-service secondary teacher education commenced with the introduction of the Graduate Diploma of Education (Secondary) program at this campus in 2005. It marked an innovative collaboration between the university and a cohort of experienced secondary school teachers in the ACT and its surrounding region. This partnership was forged to allow student teachers undertaking the program to be inducted into the teaching profession with the cooperation of leading practitioners from schools in and around the ACT. In the preparation of novices for the teaching profession, an enduring challenge is to create learning experiences capable of transforming practice, and to instill in the novices an array of professional skills, attributes, and competencies (Putnam & Borko, 2000). Another dimension of the beginning teacher experience is the need to bridge theory and practice, and to apply pedagogical content knowledge in real-life classroom practice. During the one-year Graduate Diploma program, the student teachers undertake two four-week block practicum placements, during which they have the opportunity to observe exemplary lessons, as well as to commence teaching. The goals of the practicum include improving participants’ access to innovative pedagogy and educational theory, helping them situate their own prior knowledge regarding pedagogy, and assisting them in reflecting on and evaluating their own practice. Each student teacher is paired with a more experienced teacher based at the school where he/she is placed, who serves as a supervisor and mentor. In 2007, a new dimension to the teaching practicum was added to facilitate online peer mentoring among the pre-service teachers at the Canberra campus of ACU National, and provide them with opportunities to reflect on teaching prior to entering full-time employment at a school. The creation of an online community to facilitate this mentorship and professional development process forms the context for the present case study. While on their practicum, students used social software in the form of collaborative web logging (blogging) and threaded voice discussion tools that were integrated into the university’s course management system (CMS), to share and reflect on their experiences, identify critical incidents, and invite comment on their responses and reactions from peers.