Journal articles on the topic 'Rural health services Victoria'
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1
Duckett, Stephen, and Amanda Kenny. "Hospital outpatient and emergencyservices in rural Victoria." Australian Health Review 23, no. 4 (2000): 115. http://dx.doi.org/10.1071/ah000115.
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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.
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Ansari, Z., MJ Ackland, NJ Carson, and BCK Choi. "Small Area Analysis of Diabetes Complications: Opportunities for Targeting Public Health and Health Services Interventions." Australian Journal of Primary Health 11, no. 3 (2005): 72. http://dx.doi.org/10.1071/py05045.
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The objective of this paper is to present small area analyses of diabetes complications in Victoria, Australia, and to illustrate their importance for targeting public health and health services interventions. Local government areas in Victoria were aggregated into 32 Primary Care Partnerships (PCP), which are voluntary alliances of primary care providers. The 32 PCP areas were used as the basic geographic units for small area analyses. Admission rates for diabetes complications were age and sex standardised using the direct method and the 1996 Victorian population as the reference. Admission rate ratios were calculated using the Victorian admission rates as the reference. The 95 per cent confidence intervals for the standardised admission rate ratios were based on the Poisson distribution. There was a wide variation (almost fivefold) in admission rates for diabetes complications across the PCP catchments, with the lowest standardised rate ratio of 0.37 and the highest of 1.75. There were 11 PCPs (seven metropolitan, four rural) with admission rate ratios significantly higher than the Victorian average. The seven metropolitan PCPs contributed more than 43% of all admissions and bed days for diabetes complications in Victoria. Small area analyses of diabetes complications are an exciting new development aimed at stimulating an evidence-based dialogue between local area health service providers, planners and policy-makers. The purpose is to provide opportunities to target public health and health services interventions at the local level to improve the management of diabetes complications in the community.
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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.
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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
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Ansari, M. Z., D. Simmon s, W. G. Hart, F. Cicuttin i, N. J. Carson, N. I. A. G. Brand, M. J. Ackland, and D. J. Lang. "Preventable Hospitalisations for Diabetic Complications in Rural and Urban Victoria." Australian Journal of Primary Health 6, no. 4 (2000): 261. http://dx.doi.org/10.1071/py00060.
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The objective of the study was to describe and explain variations in rates of hospital admissions for long-term complications of diabetes mellitus in rural and urban Victoria as an indicator of the adequacy of ambulatory care services. The Victorian Inpatient Minimum Database (VIMD), Health Insurance Commission data for 1998, Medical Labour Force Annual Survey 1998, Socioeconomic Indexes for Areas 1996 (SEIFA) and Accessibility/Remoteness Index of Australia (ARIA) were merged to determine the extent to which hospitalisation for complications of diabetes can be predicted from accessibility and utilisation of general practitioner services. The rural and urban differentials for long-term diabetic complications and their strong relationship with GP services, the degree of remoteness, lack of insurance, and Aboriginality reflect issues related to equity and access, patient and GP education, and inclination to seek care, all of which have implications for planning of primary health services in rural areas. This study describes a model for the analysis of ambulatory care sensitive conditions, and illustrates the important use of routine databases combined with other sources of information in quantifying the impact of factors related to primary care services.
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Gelber, Harry. "The experience of the Royal Children's Hospital mental health service videoconferencing project." Journal of Telemedicine and Telecare 4, no. 1_suppl (March 1998): 71–73. http://dx.doi.org/10.1258/1357633981931542.
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In April 1995 the Royal Children's Hospital Mental Health Service in Melbourne piloted the use of videoconferencing in providing access for rural service providers and their clients to specialist child and adolescent psychiatric input. What began as a pilot project has in two years become integrated into the service-delivery system for rural Victoria. The experience of the service in piloting and integrating the use of videoconferencing to rural Victoria has been an important development for child and adolescent mental health services in Australia.
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MacDonald, Catherine, Bill Genat, Sharon Thorpe, and Jennifer Browne. "Establishing health-promoting workplaces in Aboriginal community organisations: healthy eating policies." Australian Journal of Primary Health 22, no. 3 (2016): 239. http://dx.doi.org/10.1071/py14144.
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Aboriginal community controlled health organisations (ACCHOs) and cooperatives function at the centre of community life for local Aboriginal people across Victoria. Local Aboriginal people govern them, work within them as managers and service providers, access health and community services from them and form the constituents who determine their directions. Victorian ACCHOs reflect the unique characteristics of the local Aboriginal community. Thus, potentially, Victorian ACCHOs are key strategic sites for health promotion activities that seek to establish and nurture healthy community, family and peer norms. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) partnered five metropolitan, regional and rural ACCHOs in a pilot project towards the establishment of healthy food policies and practices in their organisations. Project activities combined both ‘top-down’ policy-oriented and ‘bottom-up’ practice-oriented strategies. This paper, drawing upon both baseline and follow-up quantitative and qualitative data, describes initiatives leading to increases in healthy catering choices and related challenges for Aboriginal workplace health promotion practice.
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Alford, Katrina. "Reforming Victoria's primary health and community service sector:rural implications." Australian Health Review 23, no. 3 (2000): 58. http://dx.doi.org/10.1071/ah000058.
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In 1999 the Victorian primary care and community support system began a process of substantial reform, involvingpurchasing reforms and a contested selection process between providers in large catchment areas across the State.The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questionsthe reforms from a rural perspective. They were based on a generic template that did not consider rural-urbandifferences in health needs or other differences including socio-economic status, and may have reinforced if notaggravated rural-urban differences in the quality of and access to primary health care in Victoria.
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McLennan, Fiona, Kate Vickers, Kylie Mason, Karen Bloomberg, Victoria Leadbetter, and Meg Engel. "Capacity Building and Complex Communication Needs: A New Approach to Specialist Speech Pathology Services in Rural Victoria." Australian Journal of Primary Health 12, no. 2 (2006): 66. http://dx.doi.org/10.1071/py06024.
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The aim of this article is to provide a description of the establishment of an innovative approach to improving speech pathology services and community inclusion of people with complex communication needs in rural Victoria. The East Hume Regional Communication Service was established by Ovens and King Community Health Service in partnership with Wodonga Regional Health Service in 2004 as part of a "hub and spoke" network of services across Victoria for people with complex communication needs. Unlike traditional speech pathology services that historically have focused on clinical one-to-one intervention, the Regional Communication Service has a strong focus on community capacity building, enhancing inclusion of people with complex communication needs through improved knowledge, skills and attitudes. This paper will review the relevant literature and outline the Victorian Government policy context within which the service was established. Service highlights and successful initiatives will be described and key factors contributing to the success of the East Hume Regional Communication Service will be explored. Areas for process improvement during the initial two years of operation will also be discussed. This article will provide an insight into establishment of a service delivery model addressing both individual needs and community inclusion that has the potential to be extended across multiple disciplines and areas of practice within rural Australia.
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Cullinane, Meabh, Stefanie A. Zugna, Helen L. McLachlan, Michelle S. Newton, and Della A. Forster. "Evaluating the impact of a maternity and neonatal emergencies education programme in Australian regional and rural health services on clinician knowledge and confidence: a pre-test post-test study." BMJ Open 12, no. 5 (May 2022): e059921. http://dx.doi.org/10.1136/bmjopen-2021-059921.
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IntroductionAlmost 78 000 women gave birth in the state of Victoria, Australia, in 2019. While most births occurred in metropolitan Melbourne and large regional centres, a significant proportion of women birthed in rural services. In late 2016, to support clinicians to recognise and respond to clinical deterioration, the Victorian government mandated provision of an emergency training programme, called Maternity and Newborn Emergencies (MANE), to rural and regional maternity services across the state. This paper describes the evaluation of MANE.Design and settingA quasi-experimental study design was used; the Kirkpatrick Evaluation Model provided the framework.ParticipantsParticipants came from the 17 rural and regional Victorian maternity services who received MANE in 2018 and/or 2019.Outcome measuresBaseline data were collected from MANE attendees before MANE delivery, and at four time points up to 12 months post-delivery. Clinicians’ knowledge of the MANE learning objectives, and confidence ratings regarding the emergencies covered in MANE were evaluated. The Safety Attitudes Questionnaire (SAQ) assessed safety climate pre-MANE and 6 months post-MANE among all maternity providers at the sites.ResultsImmediately post-MANE, most attendees reported increased confidence to escalate clinical concerns (n=251/259). Knowledge in the non-technical and practical aspects of the programme increased. Management of perinatal emergencies was viewed as equally stressful pre-MANE and post-MANE, but confidence to manage these emergencies increased post-delivery. Pre-MANE SAQ scores showed consistently strong and poor performing services. Six months post-MANE, some services showed improvements in SAQ scores indicative of improved safety climate.ConclusionMANE delivery resulted in both short-term and sustained improvements in knowledge of, and confidence in, maternity emergencies. Further investigation of the SAQ across Victoria may facilitate identification of services with a poor safety climate who could benefit from frequent targeted interventions (such as the MANE programme) at these sites.
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Cullinane, Meabh, Helen L. McLachlan, Michelle S. Newton, Stefanie A. Zugna, and Della A. Forster. "Using the Kirkpatrick Model to evaluate the Maternity and Neonatal Emergencies (MANE) programme: Background and study protocol." BMJ Open 10, no. 1 (January 2020): e032873. http://dx.doi.org/10.1136/bmjopen-2019-032873.
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IntroductionOver 310 000 women gave birth in Australia in 2016, with approximately 80 000 births in the state of Victoria. While most of these births occur in metropolitan Melbourne and other large regional centres, a significant proportion of Victorian women birth in local rural health services. The Victorian state government recently mandated the provision of a maternal and neonatal emergency training programme, called Maternal and Newborn Emergencies (MANE), to rural and regional maternity service providers across the state. MANE aims to educate maternity and newborn care clinicians about recognising and responding to clinical deterioration in an effort to improve clinical outcomes. This paper describes the protocol for an evaluation of the MANE programme.Methods and analysisThis study will evaluate the effectiveness of MANE in relation to: clinician confidence, skills and knowledge; changes in teamwork and collaboration; and consumer experience and satisfaction, and will explore and describe any governance changes within the organisations after MANE implementation. The Kirkpatrick Evaluation Model will provide a framework for the evaluation. The participants of MANE, 27 rural and regional Victorian health services ranging in size from approximately 20 to 1000 births per year, will be invited to participate. Baseline data will be collected from maternity service staff and consumers at each health service before MANE delivery, and at four time-points post-MANE delivery. There will be four components to data collection: a survey of maternity services staff; follow-up interviews with Maternity Managers at health services 4 months after MANE delivery; consumer feedback from all health services collected through the Victorian Healthcare Experience Survey; case studies with five regional or rural health service providers.Ethics and disseminationThis evaluation has been approved by the La Trobe University Science, Health and Engineering College Human Ethics Sub-Committee. Findings will be presented to project stakeholders in a deidentified report, and disseminated through peer-reviewed publications and conference presentations.
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Loi, Samantha M., Leesa Bradshaw, and Vicky Gilbert. "Aged persons mental health service in rural Victoria." Australian Journal of Rural Health 25, no. 1 (May 6, 2015): 68–70. http://dx.doi.org/10.1111/ajr.12179.
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Penney, Randy. "Hemodialysis Unit at Renfrew Victoria Hospital." Healthcare Management Forum 8, no. 2 (July 1995): 5–10. http://dx.doi.org/10.1016/s0840-4704(10)60902-7.
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In June 1994, the Renfrew Victoria Hospital was selected as the first-ever recipient of the Health Care Quality Team Award in the “Small and Rural Provider” category. This award, offered by the Canadian College of Health Service Executives and 3M Health Care, was established to recognize health care organizations that have sustained measurable improvements in their network of services, and have done so through the use of a team. Renfrew Victoria Hospital's entry focused on the establishment of a hemodialysis unit for the residents of Renfrew County. This article summarizes the parameters of this award, as presented in our submission.
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Rowan, Sue. "Provider and consumer perceptions of allied health service needs." Australian Health Review 21, no. 1 (1998): 88. http://dx.doi.org/10.1071/ah980088.
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The study reported in this paper compared data from 20 separate focus groups,representing providers and consumers of health services in the Grampians region,Victoria, on their perceptions of the allied health service issues in that region. Theresults of the study indicated that providers and consumers raised many similar issuesin regard to allied health services ? access to allied health services, service delivery,social and rural issues ? but discussed the issues from different perspectives. Theprovider discussion was concerned with service delivery issues and the consumerdiscussion was focused on broader social issues which affect health.
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Kong, F., C. Kyle-Link, J. Hocking, and M. Hellard. "11. SEX AND SPORT: A COMMUNITY BASED PROJECT OF CHLAMYDIA TESTING AND TREATMENT IN RURAL AND REGIONAL VICTORIA." Sexual Health 4, no. 4 (2007): 288. http://dx.doi.org/10.1071/shv4n4ab11.
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Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.
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Iansek, Robert, and Mary Danoudis. "Patients’ Perspective of Comprehensive Parkinson Care in Rural Victoria." Parkinson's Disease 2020 (March 31, 2020): 1–7. http://dx.doi.org/10.1155/2020/2679501.
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Introduction. There is a higher prevalence of Parkinson’s disease (PD) in rural Australia and a poorer perceived quality of life of rural Australians with PD. Coordinated multidisciplinary teams specialised and experienced in the treatment of PD are recommended as the preferred model of care best able to manage the complexities of this disorder. There remains a lack of team-based specialised PD services in rural Australia available to people living with PD. This study aims to explore how the lack of specialised PD services impacts on the person’s experiences of the health care they receive in rural Victoria. This study compared the health-care experiences of two different cohorts of people with PD living in rural Victoria; one cohort living in East Gippsland have had an established comprehensive care model implemented with local trained teams and supported by a metropolitan PD centre, and the other cohort was recruited from the remainder of Victoria who had received standard rural care. Methods. This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale, part II. Results. Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P>0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P<0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion. Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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Hoodless, Mary, and Frank Evans. "The Multipurpose Service Program: The Best Health Service Option for Rural Australia." Australian Journal of Primary Health 7, no. 1 (2001): 90. http://dx.doi.org/10.1071/py01015.
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Small relatively isolated rural communities in Australia have been provided with the opportunity to address the difficulties surrounding the provision of health services. The Multi Purpose Services (MPS) program was initiated in 1991 when it was identified that small rural communities have been disadvantaged by separated Commonwealth and state funding arrangements and the criteria for these arrangements where services were often unable to be sustained separately. The MPS program provided the opportunity for sustainability through flexibility and pooling of resources. The application of a primary health care framework would enable more community consultation and participation in reorientating rural health services. Upper Murray Health and Community Services (UMH&CS), a small rural health service in North East Victoria, embraced the concept and undertook a rigorous Evidence Based Needs Assessment to reorientate its health service. The needs assessment combined a sociodemographic, epidemiological and community consultative approach. Evidence of best practice was identified and the recommendations were used for ongoing service development. UMH&CS represents a highly integrated health service and as such a number of strategies are used to enable the continuum of care. These include point of contact advocacy, continuum and coordination of care and the use of a standardised multidisciplinary assessment and outcome based care plan. This paper expands on these processes and the opportunities the MPS has provided to address the health needs of small rural communities.
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Humphreys, John S., Terri A. Meehan-Andrews, Judith A. Jones, Lynn D. Griffin, Bethia A. Wilson, and Karly B. Smith. "How do rural consumers contribute to quality assurance of health services?" Australian Health Review 29, no. 4 (2005): 447. http://dx.doi.org/10.1071/ah050447.
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Objective: To investigate the reasons for complaint or non-complaint by rural consumers of health services. Design: Qualitative study using focus group discussion of hypothetical scenarios. Setting: Selected rural communities in the Loddon- Mallee region of north-western Victoria. Participants: Sixty volunteer participants in eight focus groups recruited through advertising. Main outcome measure: Issues and themes concerning circumstances leading to, and factors inhibiting, complaints about a health service and awareness of complaints mechanisms. Results: Compared with residents of larger towns, those of small communities were more likely to report they would complain to the local provider, whereas those in larger towns were more likely to mention Hospital Boards or the Commissioner. Deterrents to making complaints included the lack of services, scepticism about the role of complaints in bringing about change and an attitude that it was more appropriate to try to fix the problem than complain about it. Lack of awareness of appropriate complaint mechanisms which feed into quality assurance processes was also identified.
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Finlay, Sarah, Elizabeth Meggetto, Anske Robinson, and Claire Davis. "Health literacy education for rural health professionals: shifting perspectives." Australian Health Review 43, no. 4 (2019): 404. http://dx.doi.org/10.1071/ah18019.
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Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants’ change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals’ knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. What is known about this topic? Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. What does this paper add? This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. What are the implications for practitioners? Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.
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Guzys, Diana, Guinever Threlkeld, Virginia Dickson-Swift, and Amanda Kenny. "Rural and regional community health service boards: perceptions of community health – a Delphi study." Australian Journal of Primary Health 23, no. 6 (2017): 543. http://dx.doi.org/10.1071/py16123.
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Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members’ understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community. The Delphi technique was employed to facilitate communication between participants from difference geographic locations. The findings of the study highlight the different ways that participants view the health of their community. Participants prioritised indicators of community health that do not align with standard measures used by government to plan for, fund or report on health. Devolved governance of healthcare services aims to improve local healthcare responsiveness. Yet, if not accompanied with the redistribution of resources and power, policy claimed to promote localised decision-making is simply tokenistic.
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Cosgrave, Catherine. "Context Matters: Findings from a Qualitative Study Exploring Service and Place Factors Influencing the Recruitment and Retention of Allied Health Professionals in Rural Australian Public Health Services." International Journal of Environmental Research and Public Health 17, no. 16 (August 11, 2020): 5815. http://dx.doi.org/10.3390/ijerph17165815.
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Chronic health workforce shortages significantly contribute to unmet health care needs in rural and remote communities. Of particular and growing concern are shortages of allied health professionals (AHPs). This study explored the contextual factors impacting the recruitment and retention of AHPs in rural Australia. A qualitative approach using a constructivist-interpretivist methodology was taken. Semi-structured interviews (n = 74) with executive staff, allied health (AH) managers and newly recruited AHPs working in two rural public health services in Victoria, Australia were conducted. Data was coded and categorised inductively and analysed thematically. The findings suggest that to support a stable and sustainable AH workforce, rural public sector health services need to be more efficient, strategic and visionary. This means ensuring that policies and procedures are equitable and accessible, processes are effective, and action is taken to develop local programs, opportunities and supports that allow AH staff to thrive and grow in place at all grade levels and life stages. This study reinforces the need for a whole-of-community approach to effectively support individual AH workers and their family members in adjusting to a new place and developing a sense of belonging in place. The recommendations arising from this study are likely to have utility for other high-income countries, particularly in guiding AH recruitment and retention strategies in rural public sector health services. Recommendations relating to community/place will likely benefit broader rural health workforce initiatives.
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MacDermott, Sean, Rebecca McKechnie, Dina LoGiudice, Debra Morgan, and Irene Blackberry. "Barriers and Facilitators to Screening for Cognitive Impairment in Australian Rural Health Services: A Pilot Study." Geriatrics 7, no. 2 (March 22, 2022): 35. http://dx.doi.org/10.3390/geriatrics7020035.
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Australian National standards recommend routine screening for all adults over 65 years by health organisations that provide care for patients with cognitive impairment. Despite this, screening rates are low and, when implemented, screening is often not done well. This qualitative pilot study investigates barriers and facilitators to cognitive screening for older people in rural and regional Victoria, Australia. Focus groups and interviews were undertaken with staff across two health services. Data were analysed via thematic analysis and contextualized within the i-PARIHS framework. Key facilitators of screening included legislation, staff buy-in, clinical experience, appropriate training, and interorganisational relationships. Collaborative implementation processes, time, and workloads were considerations in a recently accredited tertiary care setting. Lack of specialist services, familiarity with patients, and infrastructural issues may be barriers exacerbated in rural settings. In lieu of rural specialist services, interorganisational relationships should be leveraged to facilitate referring ‘outwards’ rather than ‘upwards’.
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Farmer, Jane, Hilary Davis, Irene Blackberry, and Tracy de Cotta. "Assessing the value of rural community health services." Australian Journal of Primary Health 24, no. 3 (2018): 221. http://dx.doi.org/10.1071/py17125.
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Rural health services are challenging to manage, a situation perhaps exacerbated by necessity to comply with one-size-fits-all performance frameworks designed for larger services. This raises the questions: do we know what rural health services are doing that is valuable and how should that be evaluated? Twenty-eight qualitative interviews with CEOs and staff of seven Victorian rural health services were conducted, exploring what they value about their ‘best practice’. Themes emergent from analysis were compared with 19 government-produced health planning and performance documents. It was found that most dimensions of rural services value aligned with current performance frameworks, but a significant theme about ‘community’ was missing. Highlighting the relevance of this theme, achieving community-oriented goals accounted for one-third of best practice case studies identified by health services personnel. It is concluded that generating community outcomes is a significant area of value aimed for by rural health services that is missing from current performance measurement frameworks applied to Victorian health services. In this study, a new Evaluative Framework is outlined and further steps needed are suggested.
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Robinson, Sanske. "Video-conferencing: under-used by rural general practitioners." Australian Health Review 25, no. 6 (2002): 131. http://dx.doi.org/10.1071/ah020131a.
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The objective was to investigate the use of and value General Practitioners place on video-conferencing as a tool in providing rural health care. The participants were 8 rural general practitioners in rural Victoria towns. I found that six out of the eight GPs did not value video-conferencing as a tool to assist with patient care, and the other two GPs were interested in the technology only for certain aspects of support with patient consultations and continuing education. I conclude that there needs to be a review of whether video-conferencing equipment should continue to be implemented in the same way that it has been so far in Victoria, and of the cost-effectiveness of providing video-conferencing facilities in rural health services. In particular, there needs to be a review of whether more training and support for rural general practitioners is needed to increase the uptake of video-conferencing. Alternatively, analysis can be undertaken of the intrinsic value of using video-conferencing as an interactive tool for obtaining specialist support for patient care or undertaking continuing education via video-conferencing, and the program discontinued if it is found to be unwarranted.
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Kenny, Amanda, Susan Kidd, Jenni Tuena, Melanie Jarvis, and Angela Roberston. "Falling Through the Cracks: Supporting Young People with Dual Diagnosis in Rural and Regional Victoria." Australian Journal of Primary Health 12, no. 3 (2006): 12. http://dx.doi.org/10.1071/py06040.
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Research has indicated that people with a dual diagnosis of mental illness and substance abuse are more difficult to manage than any other group of mentally ill clients. For young people with a dual diagnosis, particularly in rural and regional areas, there are significant barriers to the provision of optimal care. Currently, a lack of communication between mental health, drug and alcohol services and consumers results in the inadequate provision of treatment for young people, with a resultant significant service gap. Dual diagnosis programs that focus on both substance abuse and mental health issues demonstrate greatly improved client outcomes. Developing a peer education program provides one constructive way of involving dual diagnosis consumers in developing more responsive health services. It provides a highly structured and supported way of involving consumers who ordinarily find mental health services bewildering and inaccessible. By drawing on the knowledge and skills of young people with dual diagnosis, and involving them as peer educators, the notion of expertise in lived experience is captured and harnessed to provide the establishment of a consumer-focused service that better meets the needs of this complex, often neglected, client group.
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Nancarrow, Susan A., Gretchen Young, Katy O'Callaghan, Mathew Jenkins, Kathleen Philip, and Kegan Barlow. "Shape of allied health: an environmental scan of 27 allied health professions in Victoria." Australian Health Review 41, no. 3 (2017): 327. http://dx.doi.org/10.1071/ah16026.
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Objective In 2015, the Victorian Department of Health and Human Services commissioned the Victorian Allied Health Workforce Research Program to provide data on allied health professions in the Victorian public, private and not-for-profit sectors. Herein we present a snapshot of the demographic profiles and distribution of these professions in Victoria and discuss the workforce implications. Methods The program commenced with an environmental scan of 27 allied health professions in Victoria. This substantial scoping exercise identified existing data, resources and contexts for each profession to guide future data collection and research. Each environmental scan reviewed existing data relating to the 27 professions, augmented by an online questionnaire sent to the professional bodies representing each discipline. Results Workforce data were patchy but, based on the evidence available, the allied health professions in Victoria vary greatly in size (ranging from just 17 child life therapists to 6288 psychologists), are predominantly female (83% of professions are more than 50% female) and half the professions report that 30% of their workforce is aged under 30 years. New training programs have increased workforce inflows to many professions, but there is little understanding of attrition rates. Professions reported a lack of senior positions in the public sector and a concomitant lack of senior specialised staff available to support more junior staff. Increasing numbers of allied health graduates are being employed directly in private practice because of a lack of growth in new positions in the public sector and changing funding models. Smaller professions reported that their members are more likely to be professionally isolated within an allied health team or larger organisations. Uneven rural–urban workforce distribution was evident across most professions. Conclusions Workforce planning for allied health is extremely complex because of the lack of data, fragmented funding and regulatory frameworks and diverse employment contexts. What is known about this topic? There is a lack of good-quality workforce data on the allied health professions generally. The allied health workforce is highly feminised and unevenly distributed geographically, but there is little analysis of these issues across professions. What does this paper add? The juxtaposition of the health workforce demographics and distribution of 27 allied health professions in Victoria illustrates some clear trends and identifies several common themes across professions. What are the implications for practitioners? There are opportunities for the allied health professions to collectively address several of the common issues to achieve economies of scale, given the large number of professions and small size of many.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Penney, Randy. "Le Renfrew Victoria Hospital remporte le prix de la qualité décerné à des équipes de soins de santé." Healthcare Management Forum 8, no. 2 (July 1995): 11–16. http://dx.doi.org/10.1016/s0840-4704(10)60903-9.
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En juin 1994, le Renfrew Victoria Hospital a été le tout premier récipiendaire du prix de la qualité décerné à des équipes de soins de santé dans la catégorie «établissement rural». On a créé ce prix, présenté par le Collège canadien des directeurs de services de santé et 3M Soins de santé, aux établissements de soins de santé en reconnaissance des améliorations notables dans leur réseau de services réalisées en équipe. Les établissements de santé de tout le Canada furent invités à soumettre leur candidature. Cependant, seuls ont été retenus les projets ayant créé un changement important au sein d'un établissement. La demande d'admission consistait à soumettre un rapport écrit respectant plusieurs critères précis. Le projet du Renfrew Victoria Hospital concernait la création d'une unité d'hémodialyse pour les résidents du comté de Renfrew. Cet article résume les paramètres de ce prix, tels que présentés dans notre candidature.
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Gelber, Harry. "The experience in Victoria with telepsychiatry for the child and adolescent mental health service." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 32–34. http://dx.doi.org/10.1258/1357633011937065.
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In 1995, the Royal Children's Hospital Mental Health Service in Melbourne developed the first telepsychiatry programme in child and adolescent mental health services (CAMHS) in Australia. A survey of 25 CAMHS clinicians in five rural regions who had used videoconferencing showed that 64% had used the technology for more than 18 months, and 20% had used it for 7–12 months. Also, 60% had used the technology on over 30 occasions, and 24% had used it on 20–29 occasions. Respondents clearly recognized its benefits in terms of their increased knowledge and skills (96%), strengthening of relationships with colleagues (92%) and decreased sense of isolation (92%). To build on the success of telepsychiatry there are a number of challenges that health service managers will need to address. Telepsychiatry works most effectively as a tool to complement face-to-face contact. It cannot be promoted as the total solution to the issue of isolation from mainstream services.
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Ugalde, A., S. Aranda, C. Paul, L. Orellana, I. Plueckhahn, C. Segan, D. Baird, et al. "Improving Health Outcomes for People With Cancer in Rural and Regional Areas by Embedding Evidence-Based Smoking-Cessation Strategies Into Usual Care: A Study Protocol." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 95s. http://dx.doi.org/10.1200/jgo.18.10100.
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Background: Smoking following a diagnosis of cancer is a powerful clinical risk indicator, with known poorer health outcomes and associated health care costs. In Australia, smoking rates are higher in rural and regional areas. There are established and effective interventions to promote smoking cessation after a diagnosis of cancer yet these are not in routine practice. Aim: This protocol paper reports on a study that aims to embed evidence-based smoking cessation strategies for people with cancer who are current smokers into routine care, resulting in in system wide improvements, an implemented program and model for further dissemination. Methods: Across three rural/regional sites, and with partners Quit Victoria and Western Alliance, this study employs a variety of methodologies to embed smoking cessation support to improve outcomes for people with cancer who currently smoke. Specifically, the project will embed a system of responsibilities and training in rural and regional health services to routinely engage people with cancer who smoke in support services. The program will: · Promote routine delivery of smoking cessation care by trained oncology staff (oncologists/nurses/ allied health) · Establish referral pathways to Quitline · Correspond with general practitioners, to: i) outline the benefits of quitting in this context, ii) promote access to nicotine replacement therapy and iii) support quitting in the community. · Improve routine recording of smoking status and documentation of provision of brief intervention (personalised advice given, resources provided) and outcomes. Participants: are oncology staff and general practitioners across three health services: Ballarat Health Service, East Grampians Health Service (Ararat), Wimmera Health Care Group (Horsham), all located in Victoria, Australia. Data collection will occur across four sources: 1) Oncology staff: qualitative and quantitative data collection understanding confidence and views on provision on cessation advice; 2) Monitoring Quitline calls, 3) Interview with local general practitioners and 4) Medical record reviews to explore frequency of recording of smoking status. Data will be collected pre/postintervention. Results: The project is underway with the intervention manuals in development. The project is due for completion in 2020. Conclusion: This project takes a health services approach to integration of smoking cessation support in routine care for people with cancer in rural and regional areas. This program of work has capacity to determine best approaches to integrate smoking cessation into routine care, resulting in reduced mortality and morbidity, improved effectiveness of anticancer treatments, and reduced health care costs; by establishing internationally relevant, embedded health care interventions.
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Bradley, Donna Maree, Lisa Bourke, and Catherine Cosgrove. "Experiences of Nursing and Allied Health Students Undertaking a Rural Placement: Barriers and Enablers to Satisfaction and Wellbeing." Australian and International Journal of Rural Education 30, no. 1 (April 7, 2020): 51–63. http://dx.doi.org/10.47381/aijre.v30i1.239.
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Australia's rural health services commonly face serious and protracted workforce shortages. To help address such shortages in rural and remote areas, a range of programs exist to support university students to undertake placements in a rural setting. In particular, University Departments of Rural Health (UDRHs) are funded to support nursing and allied health students to undertake a rural placement. As UDRHs encourage students to 'go rural' and as they coordinate and facilitate placements in rural settings, a range of enablers and barriers emerge. This study investigates the lived experiences of nursing and allied health students on placement in public health services in rural and regional Victoria. Its purpose was to identify the enablers and barriers most strongly affecting placement satisfaction and personal wellbeing. The intended outcome was to identify modifiable factors that could potentially improve the rural placement experience. Eighteen students were interviewed by a student undertaking her placement. Interviews were 45-60 minutes in length and all face-to-face. The 18 participants were from five universities and were undertaking their placement at one of seven public hospitals operating in northeast Victoria. The researcher recruited participants by attending scheduled debrief meetings at their placement organisation, briefly discussing the research and inviting students to participate. Data were analysed using a thematic analysis approach. The study found that most participants were positive and enthusiastic about their rural placement, both professionally and personally. Three key enablers were identified: 1) enjoyment of the rural environment and community; 2) working in a positive, friendly and supportive workplace; and 3) exposure to broad practice and enhanced learning opportunities. Simultaneously many had also experienced significant barriers before, during or as a consequence of undertaking their placement, and these negatively affected placement satisfaction and personal wellbeing. Identified barriers were: 1) increased financial stress; 2) travel and accommodation challenges and concerns; 3) study-work-life balance and isolation issues; 4) encountering stressful work situations and/or personal events while on placement; and 5) communication issues with universities. The findings are strongly consistent with those identified in the extant literature. The findings add to previous research by deepening understanding about the financial burden and barriers experienced by nursing and allied health students as a result of undertaking rural placements. Disruption to students' lives socially, psychologically, financially and in terms of employment were significant. The study identified some important aspects of the placement experience, suggesting that nursing and allied health students can be dissatisfied with increased financial stress, isolation and inflexibility from universities.
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Llewellyn-Jones, Lorraine, and David Harvey. "The development of a Health Promotion Community Participation Framework." Australian Journal of Primary Health 11, no. 2 (2005): 136. http://dx.doi.org/10.1071/py05032.
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This paper reports on research conducted through Monash University located in the state of Victoria, Australia. The outcome of the research was the development of a Health Promotion Community Participation Framework, providing guidelines for health professionals in community health centres and services to assist them with facilitating community participation in health promotion. A literature review was conducted and information collected from health professionals working in metropolitan and rural community health centres and services across the state of Victoria, Australia. The Framework does not emphasise levels of community participation as a hierarchy, but instead proposes using the levels or types of participation across a continuum. This has been done to encourage the use of appropriate transparent strategies that will enable both individual community members and different sections of communities to participate in health promotion activities. This is particularly important where government policies dictate the direction of health promotion, as this "top down" approach can lead to the community being excluded for health promotion processes. The use of a continuum promotes the concept that participation can be effective at different levels, even when the issue to be addressed has already been identified. The Framework also proposes that in order for community participation strategies to take place, there needs to be capacity building at both the organisational level and the community level.
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Morgans, Amee, Frank Archer, Tony Walker, and Evelyn Thuma. "Barriers to accessing ambulance services in rural Victoria for acute asthma: Patients' and medical professionals' perspectives." Australian Journal of Rural Health 13, no. 2 (April 2005): 116–20. http://dx.doi.org/10.1111/j.1440-1854.2005.00665.x.
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Liang, Zhanming, Peter F. Howard, Lee C. Koh, and Sandra Leggat. "Competency requirements for middle and senior managers in community health services." Australian Journal of Primary Health 19, no. 3 (2013): 256. http://dx.doi.org/10.1071/py12041.
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The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development.
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Tham, Rachel, Penny Buykx, Leigh Kinsman, Bernadette Ward, John S. Humphreys, Adel Asaid, Kathy Tuohey, and Rohan Jenner. "Staff perceptions of primary healthcare service change: influences on staff satisfaction." Australian Health Review 38, no. 5 (2014): 580. http://dx.doi.org/10.1071/ah14015.
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Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victoria, were surveyed. Qualitative methods were used to collect data to show how the key factors associated with the evolution of a once-struggling medical service into a successful and sustainable PHC service have influenced staff satisfaction. The success of the service was linked to visionary leadership, teamwork and community involvement while service sustainability was described in terms of inter-professional linkages and the role of the service in contributing to the broader community. These factors were reported to have a positive impact on staff satisfaction. The contribution of service delivery change and ongoing service sustainability to staff satisfaction in this rural setting has implications for planning service change in other primary health care settings. What is known about this topic? Integrated PHC services have an important role to play in achieving equitable population health outcomes. Many rural communities struggle to maintain viable PHC services. Innovative PHC models are needed to ensure equitable access to care and reduce the health differential between rural and metropolitan people. What does this paper add? Multidisciplinary teams, visionary leadership, strong community engagement combined with service partnerships are important factors in the building of a rural PHC service that substantially contributes to enhanced staff satisfaction and service sustainability. What are the implications for practitioners? Understanding and engaging local community members is a key driver in the success of service delivery changes in rural PHC services.
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Cockburn, Jill, David Hill, and Trudy Luise. "Preferences of rural Victorian women for screening mammography services." Australian Journal of Public Health 16, no. 1 (February 12, 2010): 82–83. http://dx.doi.org/10.1111/j.1753-6405.1992.tb00030.x.
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Adams, Catina, Leesa Hooker, and Angela Taft. "The Enhanced Maternal and Child Health nursing program in Victoria: a cross-sectional study of clinical practice." Australian Journal of Primary Health 25, no. 3 (2019): 281. http://dx.doi.org/10.1071/py18156.
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The Maternal and Child Health (MCH) service in Victoria comprises a universal service, an enhanced program providing additional support for vulnerable families (EMCH) and a 24-h MCH telephone line. There is anecdotal evidence of variation in EMCH programs between Local Government Areas, and this study aims to explore the variation in EMCH programs to inform future EMCH policy and practice. An online survey was sent to MCH coordinators in Victoria in December 2016 (n = 79), with a response rate of 70% (55/79). Quantitative data have been analysed using descriptive statistics, with open-ended questions examined using content analysis. The data confirms that EMCH programs vary significantly across the state. Differences include a variation in referral and intake criteria, different models of service and modes of delivery, differences in EMCH nurse working conditions, issues with data collection and a lack of systematic clinical tools. Variation in the EMCH program is greatest between urban and rural services and between advantaged and disadvantaged urban councils. Lack of consistent service delivery and data collection impairs program evaluation, including outcome measurement and evidence of program effectiveness.
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Morton, CC, JE Tomnay, SD Kauer, and JG Walker. "P12.18 Sexual and reproductive health in rural victoria: what urgent care services are available and are they adequate?" Sexually Transmitted Infections 91, Suppl 2 (September 2015): A192.2—A192. http://dx.doi.org/10.1136/sextrans-2015-052270.498.
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Jones, Judith A., Terri A. Meehan-Andrews, Karly B. Smith, John S. Humphreys, Lynn Griffin, and Beth Wilson. ""There's no point in complaining, nothing changes": rural disaffection with complaints as an improvement method." Australian Health Review 30, no. 3 (2006): 322. http://dx.doi.org/10.1071/ah060322.
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Objective: To validate earlier findings that lack of access to health services is the most likely issue of complaint by rural consumers, and that lack of knowledge about how to make effective complaints and scepticism that responses to complaints bring about service improvement account for the under-representation of complaints from rural consumers. Design: Unaddressed reply-paid mail survey to 100% of households in small communities, and 50%, 20% or 10% in progressively larger communities. Setting: Eight communities in the Loddon-Mallee region of Victoria. Participants: 983 householders most responsible for the health care of household members, responding to a mailed questionnaire. Main outcome measures: Issues of complaints actually made; issues of unsatisfactory situations when a complaint was not made; reasons for not complaining; to whom complaints are made; and plans for dealing with any future complaint. Results: Earlier findings were confirmed. Lack of access to health services was the most important issue, indicated by 54.8% of those who had made a complaint, and 72% of those who wanted to but did not. The most common reason given for not complaining was that it was futile to do so. Lack of knowledge of how to make effective complaints which might contribute to the quality assurance cycle was evident. Conclusions: Rural consumers? disaffection with health complaints as a means to quality improvement poses a significant barrier to consumer engagement in quality assurance processes. Provider practices may need to change to regain community confidence in quality improvement processes. CONSUMER VIEWS ABOUT the quality of health services provide a valuable source of information to those concerned with accountability and quality assurance in service provision.1,2 When such views are expressed as complaints which are responded to in ways which focus on quality improvement rather than allocation of blame, opportunities may arise to improve the quality of health services for all consumers.3,4
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Wilson, Elena, Amanda Kenny, and Virginia Dickson-Swift. "Rural health services and the task of community participation at the local community level: a case study." Australian Health Review 42, no. 1 (2018): 111. http://dx.doi.org/10.1071/ah16169.
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Community participation in health service decision making is entrenched in health policy, with a strong directive to develop sustainable, effective, locally responsive services. However, it is recognised that community participation is challenging to achieve. The aim of the present study was to explore how a rural health service in Victoria enacts community participation at the local level. Using case study methodology, the findings indicate that enactment of community participation is desired by the health service, but a lack of understanding of the concept and how to enact associated policy are barriers that are exacerbated by a lack of resources and community capacity. The findings reveal a disconnect between community participation policy and practice. What is known about the topic? The need to involve communities in health service planning, implementation and evaluation is a feature of health policy across major Western countries. However, researchers have identified a dearth of research on how community participation is enacted at the local service level. What does this paper add? The study that is presented herein addresses a gap in knowledge of community participation policy enactment within a rural health service. Insights are provided into the challenges faced by rural health services, with a disconnect between policy ideal and the reality of implementation. What are the implications for practitioners? Health service staff need clear direction from chief executive officers about the purpose of community participation policy and the expectations for individual roles. Community advisory committees need clarity about the community member role and the processes for making decisions. Services and their boards would benefit from targeted government funding to resource community participation activity.
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MWANGA, J. R., P. MAGNUSSEN, THE LATE C. L. MUGASHE, THE LATE R. M. GABONE, and J. AAGAARD-HANSEN. "SCHISTOSOMIASIS-RELATED PERCEPTIONS, ATTITUDES AND TREATMENT-SEEKING PRACTICES IN MAGU DISTRICT, TANZANIA: PUBLIC HEALTH IMPLICATIONS." Journal of Biosocial Science 36, no. 1 (January 2004): 63–81. http://dx.doi.org/10.1017/s0021932003006114.
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A study on perceptions, attitudes and treatment-seeking practices related to schistosomiasis was conducted among the Wasukuma in the rural Magu district of Tanzania at the shore of Lake Victoria where Schistosoma haematobium and mansoni infections are endemic. The study applied in-depth interviews, focus group discussions and a questionnaire survey among adults and primary school children. The perceived symptoms and causes were incongruous with the biomedical perspective and a number of respondents found schistosomiasis to be a shameful disease. Lack of diagnostic and curative services at the government health care facilities was common, but there was a willingness from the biomedical health care services to collaborate with the traditional healers. Recommendations to the District Health Management Team were: that collaboration between biomedical and traditional health care providers should be strengthened and that the government facilities’ diagnostic and curative capacity with regard to schistosomiasis should be upgraded. Culturally compatible health education programmes should be developed in collaboration with the local community.
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Hegarty, Kelsey, Rhian Parker, Danielle Newton, Laura Forrest, Janelle Seymour, and Lena Sanci. "Feasibility and acceptability of nurse-led youth clinics in Australian general practice." Australian Journal of Primary Health 19, no. 2 (2013): 159. http://dx.doi.org/10.1071/py12025.
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Internationally, youth access to primary health care is problematic due to documented barriers such as cost, concerns about confidentiality, and knowledge about when to attend and available services. The treatment of health problems earlier in life together with engagement in prevention and health education can optimise youth health and maximise the potential of future wellbeing. This study investigated the feasibility, acceptability and cost of establishing nurse-led youth clinics in Victoria, Australia. Three general practices in rural and regional areas of Victoria implemented the nurse-led youth health clinics. The clinics were poorly attended by young people. Practice nurses identified several barriers to the clinic attendance including the short timeframe of the study, set times of the clinics and a lack of support for the clinics by some GPs and external youth health clinics, resulting in few referrals. The clinics cost from $5912 to $8557 to establish, which included training the practice nurses. Benefits of the clinics included increased staff knowledge about youth health issues and improved relationships within the general practice staff teams. The implementation of youth health clinics is not feasible in a short timeframe and to maximise use of the clinics, all members of the general practice team need to find the clinics acceptable.
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Ervin, Kaye, Jacqueline Phillips, and Jane Tomnay. "Establishing a clinic for young people in a rural setting: a community initiative to meet the needs of rural adolescents." Australian Journal of Primary Health 20, no. 2 (2014): 128. http://dx.doi.org/10.1071/py12157.
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This paper describes the establishment and evaluation of a rural clinic for young people. A conceptual approach to community development was used to establish the clinic in a small north Victorian rural health service, with qualitative methods used to evaluate services. Study participants were members of an operational committee and advisory committee for the establishment of the rural clinic for young people. The clinic was evaluated against the World Health Organization framework for the development of youth-friendly services. With robust community support, the clinic was established and is operational. Most consultations have been for sexual and mental health. Qualitative evaluation identifies that not all the World Health Organization benchmarks have been met, but this is hampered predominantly by financial constraints. In conclusion, establishing clinic for young people in a small rural setting can be achieved with community support and the development of referral pathways.
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Kennedy, Alison, Jessie Adams, Jeremy Dwyer, Muhammad Aziz Rahman, and Susan Brumby. "Suicide in Rural Australia: Are Farming-Related Suicides Different?" International Journal of Environmental Research and Public Health 17, no. 6 (March 18, 2020): 2010. http://dx.doi.org/10.3390/ijerph17062010.
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Rural Australians experience a range of health inequities—including higher rates of suicide—when compared to the general population. This retrospective cohort study compares demographic characteristics and suicide death circumstances of farming- and non-farming-related suicides in rural Victoria with the aim of: (a) exploring the contributing factors to farming-related suicide in Australia’s largest agricultural producing state; and (b) examining whether farming-related suicides differ from suicide in rural communities. Farming-related suicide deaths were more likely to: (a) be employed at the time of death (52.6% vs. 37.7%, OR = 1.84, 95% CIs 1.28–2.64); and, (b) have died through use of a firearm (30.1% vs. 8.7%, OR = 4.51, 95% CIs 2.97–6.92). However, farming-related suicides were less likely to (a) have a diagnosed mental illness (36.1% vs. 46.1%, OR=0.66, 95% CIs 0.46–0.96) and, (b) have received mental health support more than six weeks prior to death (39.8% vs. 50.0%, OR = 0.66, 95% CIs 0.46–0.95). A range of suicide prevention strategies need adopting across all segments of the rural population irrespective of farming status. However, data from farming-related suicides highlight the need for targeted firearm-related suicide prevention measures and appropriate, tailored and accessible support services to support health, well-being and safety for members of farming communities.
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Miller, Elizabeth M., Joanne E. Porter, and Rebecca Peel. "Palliative and End-of-Life Care in the Home in Regional/Rural Victoria, Australia: The Role and Lived Experience of Primary Carers." SAGE Open Nursing 7 (January 2021): 237796082110362. http://dx.doi.org/10.1177/23779608211036284.
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Introduction Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results Two themes emerged: “ Negotiating healthcare systems” which described the needs for multidisciplinary supports and “ The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system.
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Young, Suzanne. "Outsourcing: two case studies from the Victorian public hospital sector." Australian Health Review 31, no. 1 (2007): 140. http://dx.doi.org/10.1071/ah070140.
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Outsourcing was one process of privatisation used in the Victorian public health sector in the 1990s. However it was used to varying degrees and across a variety of different services. This paper attempts to answer the questions: Why have managers outsourced? What have managers considered when they have decided to outsource? The research was carried out in a rural hospital and a metropolitan network in Victoria. The key findings highlight the factors that decision makers considered to be important and those that led to negative outcomes. Economic factors, such as frequency of exchange, length of relationships between the parties, and information availability, were often ignored. However, other factors such as outcome measurability, technology, risk, labour market characteristics and goal conflict, and political factors such as relative power of management over labour were often perceived as important in the decision-making process. Negative outcomes from outsourcing were due to the short length of relationships and accompanying difficulties with trust, commitment and loyalty; poor quality; and excessive monitoring and the measurement of outcomes.
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Wotherspoon, Craig, and Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service." Australian Health Review 43, no. 2 (2019): 217. http://dx.doi.org/10.1071/ah17096.
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Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.
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Zhou, Y., B. D. Hambly, D. Simmons, and C. S. McLachlan. "Sex-specific educational attainment is associated with telomere length in an Australian rural population." QJM: An International Journal of Medicine 113, no. 7 (February 19, 2020): 469–73. http://dx.doi.org/10.1093/qjmed/hcaa031.
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Abstract Background There is limited understanding on whether and how socioeconomic status (SES), particularly educational attainment and household income, impacts on telomere length in an Australian rural context. Additionally, it is unknown whether access to health services via the Australian public or private health system influences telomere length. Aim This study investigates whether there is a relationship between telomere length and SES indicators (income, education) as well as health insurance status in a rural Australian population. Methods Samples were drawn from the Australian Rural Victoria cross-sectional Crossroads Study. Leucocyte telomere length (LTL) was measured using a multiplex quantitative polymerase chain reaction method. Results Among 1424 participants, we did not find a significant main effect association with LTL across education, income level and health insurance. An exploratory finding was sex may influence the relationship between educational attainment and LTL (P = 0.021). In males, but not females, higher education was associated with longer LTL by 0.033 [95% confidence interval (CI) 0.002–0.063, P = 0.035]; in those with low education attainment, male participants had shorter LTL by 0.058 (95% CI −0.086 to −0.029) than female participants (P < 0.0001). Conclusion Being male and having lower education attainment was associated with shorter telomere length in our rural population. Evidence from our study supports the importance of education on LTL in males in rural Australia. Our studies also support previous findings that LTL in later life may not be closely associated with indicators of SES.
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Somerville, Lisa, Annette Davis, Andrea L. Elliott, Desiree Terrill, Nicole Austin, and Kathleen Philip. "Building allied health workforce capacity: a strategic approach to workforce innovation." Australian Health Review 39, no. 3 (2015): 264. http://dx.doi.org/10.1071/ah14211.
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Objective The aim of the present study was to identify areas where allied health assistants (AHAs) are not working to their full scope of practice in order to improve the effectiveness of the allied health workforce. Methods Qualitative data collected via focus groups identified suitable AHA tasks and a quantitative survey with allied health professionals (AHPs) measured the magnitude of work the current AHP workforce spends undertaking these tasks. Results Quantification survey results indicate that Victoria’s AHP workforce spends up to 17% of time undertaking tasks that could be delegated to an AHA who has relevant training and adequate supervision. Over half this time is spent on clinical tasks. Conclusions The skills of AHAs are not being optimally utilised. Significant opportunity exists to reform the current allied health workforce. Such reform should result in increased capacity of the workforce to meet future demands. What is known about the topic? Increasing skill shortages across Australia’s health workforce necessitates that the capabilities of all healthcare team members should be used optimally. AHA roles are an important and growing response to current health workforce needs. Increasing workforce capacity will ensure the right health workers are matched to the right task by skill, experience and expertise. What does this paper add? This paper presents a model that assists services to identify tasks suitable for delegation to an AHA by an AHP. The model is unique because it describes a process that quantifies the need for AHAs and it has been successfully implemented in rural, regional and metropolitan health services in Victoria. What are the implications for practitioners? Working collaboratively, with executive support, will lead to a sustainable and integrated approach to support workforce capacity building. Altering the skill mix of healthcare teams through increasing the role of AHAs has benefits for AHPs, patients and the healthcare system.
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Ssetaala, Ali, Julius Ssempiira, Mathias Wambuzi, Gertrude Nanyonjo, Brenda Okech, Kundai Chinyenze, Bernard Bagaya, Matt A. Price, Noah Kiwanuka, and Olivier Degomme. "Improving access to maternal health services among rural hard-to-reach fishing communities in Uganda, the role of community health workers." Women's Health 18 (January 2022): 174550572211039. http://dx.doi.org/10.1177/17455057221103993.
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Objectives: To explore whether community health worker household-based maternal health visits improve antenatal care and skilled birth attendance among hard-to-reach fishing villages on Lake Victoria, Uganda. Methods: This quasi-experimental 18-month prospective study involved 486 consenting women aged 15–49 years, who were pregnant or had a pregnancy outcome in the past 6 months, from 6 island fishing communities. The community health worker household-based intervention (community health workers’ household visits to provide counseling, blood pressure measurement, anemia, and HIV testing) involved 243 women from three fishing communities. Random effects logistic regression was used to determine the association between the community health worker intervention and antenatal care and skilled birth attendance among women who had at least 5 months of pregnancy or childbirth at follow-up. Results: Almost all women accepted the community health worker intervention (90.9% (221/243)). Hypertension was at 12.5% (27/216) among those who accepted blood pressure measurements, a third (33.3% (9/27)) were pregnant. HIV prevalence was 23.5% (52/221). Over a third (34.2% (69/202)) of women tested had anemia (hemoglobin levels less than 11 g/dL). The community health worker intervention was associated with attendance of first antenatal care visit within 20 weeks of pregnancy (adjusted odd ratio = 2.1 (95% confidence interval 0.6–7.6)), attendance of at least four antenatal care visits (adjusted odd ratio = 0.9 (95% confidence interval 0.4–2.0)), and skilled birth attendance (adjusted odd ratio = 0.5 (95% confidence interval 0.1–1.5)), though not statistically significant. Conclusion: Community health workers have a crucial role in improving early antenatal care attendance, early community-based diagnosis of anemia, hypertensive disorders, and HIV among women in these hard-to-reach fishing communities.