Australian health review : a publication of the Australian Hospital Association最新文献

{"title":"Can I record this? A scoping review of Australian hospital policies governing consultation recording.","authors":"Megan Prictor, Nikka Milani, Amelia Hyatt","doi":"10.1071/AH24306","DOIUrl":"https://doi.org/10.1071/AH24306","url":null,"abstract":"<p><p>ObjectiveRecording consultations can benefit patients and healthcare providers, but advantageous recording practices are dogged by legal concerns. In Australia, relevant laws are poorly understood. We postulate that local policies are more important than law in guiding consultation recording. This study aimed to describe the availability and content of consultation recording policy in Australian hospitals.MethodsWe conducted a scoping review utilising JBI methods and our previously published protocol. We collected policies from Australian hospitals (April-October 2023) about the audio/video recording of patients, providers or others within the hospital. We reported findings descriptively and analysed policies' alignment with the law.ResultsOf the 43 hospitals examined, 17/43 (40%) had relevant policies, 17/43 (40%) had a partial policy and 9/43 (21%) had no policy. Policies were usually difficult to find and were stricter than relevant law.ConclusionsWhen patients want to record their appointments, it can be hard to identify relevant hospital policy. Policies generally weigh against consultation recording and are more restrictive than Australian law allows. These results indicate that healthcare services should develop clear, readily available policies on recording, balancing patients' and providers' interests.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' reasons for leaving an emergency department without being seen: results from a survey-based cohort study during the COVID-19 pandemic.","authors":"Irene Bryan, Anthony Austen-Wishart, Pratibha Ranjan, Luke Plant, Dana Forcey, Robert Millar","doi":"10.1071/AH24285","DOIUrl":"https://doi.org/10.1071/AH24285","url":null,"abstract":"<p><p>ObjectivePatients who do not wait (DNW) to be seen are a problem for emergency department (ED) care. The aim of this study was to identify the rate and reasons of DNW patients during 1month of the COVID-19 pandemic.MethodsAn observational cohort study of DNW patients presenting to Austin Hospital ED was carried out in August 2021. Patients were identified using hospital coding data and surveyed by telephone. DNW patients' reasons were explored, and their demographics and clinical outcomes compared with those who received care.ResultsOf 7641 patients presenting to ED in the study period, 6% (n=452) were DNW patients. Compared with those who received care, DNW patients were younger (P<0.001), had lower triage categories (P=0.001) and were more likely to have self-presented (P=0.006). A total of 47% of DNW patients (n=213) participated in the survey. Reasons for leaving included waiting time (61%, n=129), symptom improvement (13%, n=28), reassurance from staff (7%, n=15) and ED crowding (6%, n=12). A total of 75% of DNW patients (n=159) sought alternative medical care; 14% (n=29) reported hospitalisation within 7days. 64% (n=137) did not feel that the experience affected their likelihood of seeking future ED care; 32% (n=69) felt less likely to seek future ED care.ConclusionsDuring the month studied, the DNW rate was 6%. Reassuringly, most patients sought alternative medical care, although one-third were dissuaded from returning to the ED. Future research should focus on high-risk group delineation and qualitative description of the experiences and reasons of DNW patients.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's in a name? Why the proposed title change for podiatric surgeons is a step backward.","authors":"Mark F Gilheany","doi":"10.1071/AH24291","DOIUrl":"https://doi.org/10.1071/AH24291","url":null,"abstract":"<p><p>The Australian Podiatry Board's proposal to change the title 'podiatric surgeon' to 'surgical podiatrist' lacks evidence and is contrary to broader healthcare reform agendas. The current title 'podiatric surgeon' reflects scope of practice. Instead of a title change, regulators should focus on removing barriers to effective collaborative care.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication incidents at supported disability accommodation (group homes) in Victoria, Australia: a retrospective audit of calls to a poisons information centre.","authors":"Rita Hormiz, Beata Stanley, Rohan A Elliott","doi":"10.1071/AH24221","DOIUrl":"https://doi.org/10.1071/AH24221","url":null,"abstract":"<p><p>BackgroundMany residents of shared supported disability homes (sometimes referred to as group homes) require assistance from staff to manage their medicines. Disability support workers in Australia often call a 24-h emergency poisons information service for advice following a medication incident.ObjectiveTo describe the number, type and timing of medication incident calls to the Victorian Poisons Information Centre from supported disability homes in Victoria, Australia.MethodsThis was a retrospective audit of poisons centre calls from supported disability homes over a 3-month period (October to December 2021). Incidents not related to therapeutic medication use, including deliberate self-poisoning, were excluded. Calls were categorised by incident-type, time-of-call and risk of an adverse event (low/moderate/high) based on the type of medicine involved.ResultsA total of 391 medication incident calls were included (mean 4.3 per day). The most common incidents were missed doses (n=145/391, 37%) and accidental overdoses (e.g. double-dose) (n=80/391, 20%). Most calls to the poisons centre (n=284/391, 73%) were received outside business hours (before 9am or after 5pm). For incidents where the medicine(s) were known (n=326), a moderate-risk medicine (most commonly an anticonvulsant or antipsychotic) or high-risk medicine (most commonly an anticoagulant or opioid) was involved in two-thirds of cases (n=217, 66.6%).ConclusionsCalls to an emergency poisons information service about medication incidents were common, and were mostly outside business hours. Nearly half of the calls were about incidents unrelated to poisoning or toxicology, including missed doses. The study highlights a gap in medication management support for residents and disability support workers, especially after-hours, that needs to be addressed.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the research capacity and culture of an urban Mental Health and Wellbeing Program.","authors":"Stanley Innes, David Taylor, Judith Hope","doi":"10.1071/AH24223","DOIUrl":"https://doi.org/10.1071/AH24223","url":null,"abstract":"<p><p>ObjectiveResearch capacity in health care involves the ability to conduct, access, evaluate, and apply research evidence and results in elevated quality of care. Despite its significance, mental health organisations face challenges in assessing and enhancing their research capacity. This study aimed to evaluate the research capacity and culture within a large metropolitan health service's Mental Health and Wellbeing Program (MHWP).MethodsA cross-sectional, observational study using the Research Capacity and Culture (RCC) tool was conducted among approximately 1081 MHWP employees. An online survey recorded staff views on research readiness, interest, motivators, and barriers.ResultsOf 220 survey entries, 100 were completed. The majority were female (n=68), under 40years old (n=51), and employed full-time (n=54). The highest RCC domain score was for organisational culture. Half of the respondents thought research was not part of their role, yet 70% wanted more involvement. Motivators included skill development, while barriers included a lack of time and funds.ConclusionsThe findings emphasise the need for targeted strategies to enhance research culture at the individual level. However, opportunities also exist at the team and organisational levels. The study provided insights that can guide future interventions and capacity-building initiatives.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based model of indicators of allied health workforce needs: proof-of-concept in podiatry.","authors":"Joshua Horsley, Susan Nancarrow","doi":"10.1071/AH24191","DOIUrl":"https://doi.org/10.1071/AH24191","url":null,"abstract":"<p><p>ObjectiveAllied health workforce planning faces challenges because of insufficient metrics that accurately reflect population need for services. This paper presents a method and proof-of-concept in the podiatry profession for developing population-based need indicators and indices suitable for allied health workforce planning and comparative benchmarking.MethodsPopulation-based indicators of podiatry need were selected and combined into an index of need by Statistical Area Level 3 (SA3) in Australia. Medicare patient age and sex distributions for relevant item numbers were used to determine the inclusion of specific population age groups and sex as indicators. Other indicators included diabetes, socioeconomic status, and Aboriginal and Torres Strait Islander status. The need index was calculated based by aggregating these indicators at the SA3 level. The resulting need index was compared with podiatry supply (per capita clinician counts) using a population-weighted correlation coefficient (pwCorr).ResultsAnalysis of Medicare usage data led to the inclusion of indicators: population aged 65 and over, and female gender. The need index had a small but significant negative correlation with supply at the SA3-level (pwCorr =-0.12, P=0.03) and positively, but not significantly, correlated at the state/territory-level (pwCorr=0.42, P=0.30).ConclusionsDeveloping profession-specific population-based need indices provides a valuable tool for allied health workforce planners to benchmark need and supply within professions. Combining single need indicators with supply metrics offers a concise framework for effective workforce planning and advocacy.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placement poverty has major implications for the future health and education workforce: a cross-sectional survey.","authors":"Kelly Lambert, Kylie Austin, Karen Charlton, Rebecca Heins, Meredith Kennedy, Katherine Kent, Janna Lutze, Natalie Nicholls, Gabrielle O'Flynn, Yasmine Probst, Karen Walton, Anne McMahon","doi":"10.1071/AH24233","DOIUrl":"https://doi.org/10.1071/AH24233","url":null,"abstract":"<p><p>Objective'Placement poverty' refers to the financial burdens imposed upon students by the completion of mandatory professional placement. We aimed to identify the financial implications of mandatory professional placements on student wellbeing.MethodsA cross-sectional online survey (August 2023 to January 2024) completed during students' most recent professional placement in the final year of their degree. Eligible participants were health or teaching students studying at Australian and New Zealand universities in degrees requiring mandatory professional placement. Questions included total and accommodation costs, financial support, impact of finances on placement preferences, presence of food insecurity, and implications for student wellbeing.ResultsParticipants (n=530) were mostly health professional (65%) students (median, 25; interquartile range (IQR), 22-30 years, 95.3% domestic, 88.3% full time, 2.0% New Zealand). Health students had higher total costs (in Australian dollars) for the recent placement ($1500; IQR, 600-3453) compared to teaching students ($1200; IQR, 600-2757) (P=0.02), likely due to longer placement duration (6weeks for health students). A higher proportion of health students required financial support (P=0.0001). Placement preferences were always or sometimes (63.8%) determined by cost rather than learning opportunity. Food insecurity was experienced by most students (70.2%) (10.4% marginal, 32.1% moderate, 27.7% severe), with no difference by degree type. Thematic analysis identified themes of burnout, emotional distress, inability to focus on learning, postponing care of oneself, urgent need for financial support, unanticipated family and other circumstances, and worsened societal inequity.ConclusionsOur study identified widespread financial difficulty in students undertaking placement that adversely impacted personal wellbeing. Strategies are needed to support wellbeing and ameliorate the financial burden.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting Indigenous status, ethnicity, language and country of birth to build equity in international paediatric clinical trials with Australian sites: a scoping review.","authors":"Jacqueline Cunninghame, Mari Takashima, Lorelle Holland, Linda Nguyen, Abbey Diaz, Shuaijun Guo, Mitchell Dufficy, Craig F Munns, Amanda Ullman","doi":"10.1071/AH24184","DOIUrl":"https://doi.org/10.1071/AH24184","url":null,"abstract":"<p><p>ObjectiveEnsuring equitable access to clinical trials for children from Indigenous and ethnically and linguistically diverse backgrounds should be central to clinical trial design. This review aims to expansively review the reporting of Indigenous status (Aboriginal and/or Torres Strait Islander origin), ethnicity, culture, location, language and country of birth in paediatric clinical trials with Australian sites.MethodsThis scoping review systematically searched PubMed, CINAHL and Embase for international clinical trials with Australian sites conducted between 2018 and 2022 involving children (aged <18years) to determine the reporting of Indigenous status, race, ethnicity, language and country of birth.ResultsOf the 262 studies included, 154 (58.8%) clinical trials did not report any of the variables of interest. When reported, terms used by authors were heterogeneous. 'Indigenous status' was most reported (n=40, 15.3%) and self-identification was the most common method to determine this (n=14, 35.9%). International clinical trials had higher rates of reporting for ethnicity, cultural background and race. Overall, more than 60 terms were used to categorise study participants in relation to 'Indigenous status', 'ethnicity and cultural background', 'race', 'race and ethnicity' or 'natural skin colour'.ConclusionsThis review demonstrated low rates of reporting of demographic variables in paediatric clinical trials. Clear reporting standards, partnering with consumers to co-design trials and self-identification during collection are required. Ensuring adequate access to clinical trials for Indigenous children and children from ethnically, linguistically and geographically diverse backgrounds is essential in building health equity and ensuring patient safety.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What factors affect the recruitment and retention of allied health professionals working in hospitals? A systematic literature review.","authors":"Laure Baumgartner, Olivia Wright, Katelyn Barne, Karly Bartrim, Amy Kirkegaard, Victoria Sullivan, Emily Burch, Lauren Ball","doi":"10.1071/AH24287","DOIUrl":"https://doi.org/10.1071/AH24287","url":null,"abstract":"<p><p>ObjectiveWorkforce shortages in hospitals have necessitated a focus on recruitment and retention of health professionals. The aim of this systematic review was to synthesise literature relating to factors that affect recruitment and retention of allied health professionals working in hospital settings.MethodPubMed, CINAHL (via EbscoHost), Embase (via Elsevier), and Scopus Advanced Search databases were used to retrieve 1665 studies, of which 16 were included. Herzberg's two-factor theory was used to synthesise study findings and develop key themes.ResultsJob advancement, company policies, supervision (leadership), working conditions, salary, recognition, and growth opportunities were factors identified as affecting recruitment and retention.ConclusionIdentified factors are largely amenable to change and could contribute to a more sustainable allied health workforce in hospitals and enhance the quality of care. This research could significantly impact and enhance the evidence supporting interventions and strategies that are critical for retaining the allied health workforce in hospitals.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicare-reimbursed psychiatric consultations before and after telehealth expansion in Australia: a time series study.","authors":"Luke Sy-Cherng Woon, Paul A Maguire, Rebecca E Reay, Murthy Mittinty, Tarun Bastiampillai, Jeffrey C L Looi","doi":"10.1071/AH24196","DOIUrl":"10.1071/AH24196","url":null,"abstract":"<p><p>Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth items. It was unclear how much telehealth expansion independently impacted overall and face-to-face consultation trends after accounting for lockdown severity. Methods We extracted monthly MBS Item Reports for psychiatric consultations (January 2012-December 2023). The monthly average Stringency Index (SI) for Australia represented lockdown severity from January 2020 to December 2022. A dichotomous variable denoted telehealth expansion (March 2020 onward). We constructed consecutive multiple linear regression models for combined consultations and face-to-face consultations to include seasonality, trend, SI, and telehealth expansion. We compared model performance using information criteria. Results Median monthly total consultations increased from 148,413 (Interquartile range, IQR: 138,219-153,709) pre-expansion (January 2012-February 2020) to 173,016 (IQR: 158,292-182,463) post-expansion (March 2020-December 2023). Contrarily, median monthly face-to-face consultations decreased from 143,726 (IQR: 135,812-150,153) to 99,272 (IQR: 87,513-107,778). Seasonality and trend were present in both time series. The time series regression model with expansion but excluding SI best explained all consultations, while both telehealth expansion and SI were significant in the best-fit model for face-to-face consultations. Conclusion MBS telehealth expansion was associated with total and face-to-face consultations independent of lockdown severity changes. Policy changes allowing wider access to new telehealth services have possibly led to increased uptake of psychiatric care and addressed previously unmet needs.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"617-625"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}