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

{"title":"An illustrative guide to a Policy Lab model: contributing to evidence-informed policies for digital technology in youth mental health care.","authors":"David G Baker, Bridget Kenny, Sophie C Prober, Amanda Sabo, Matthew P Hamilton, Caroline X Gao, Shane Cross","doi":"10.1071/AH24222","DOIUrl":"10.1071/AH24222","url":null,"abstract":"<p><p>Objective This article provides researchers with an illustrative guide for a workshop model that facilitates evidence-informed policy. The Policy Lab model supports collaboration between experts and policymakers; in the example provided, participants considered digital technologies with near-term potential to improve youth mental health care. Method The Policy Lab model uses structured workshop activities to explore a policy question, before narrowing the focus on potential answers. The barriers, enablers, and implementation mechanisms of potential policies are then considered. From this data policy proposal(s) are drafted, reviewed, and reported. Results Through the Policy Lab activities, participants identified two priority technologies and generated data to inform the formulation of two policies. The policies were focused on (1) using artificial intelligence to improve the personalisation and precision of youth mental health care and (2) the expanded use of integrated data to improve youth mental health service quality. Conclusions Evidence-informed policy is a collaborative process. To potentially influence policy requires timely engagement with policymakers and an understanding of the policy context. Researchers considering using the model are encouraged to include a range of expertise.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070219","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":"Factors influencing participation in clinical supervision: a qualitative study reflecting physiotherapist and manager perspectives.","authors":"Sarah Osiurak, Nicholas F Taylor, Katherine Lawler, Kimberley Williams, Timothy Albiston, David A Snowdon","doi":"10.1071/AH24293","DOIUrl":"10.1071/AH24293","url":null,"abstract":"<p><p>Objective This study aimed to explore physiotherapist and manager perceptions of factors that influence physiotherapist participation in clinical supervision. Methods Individual semi-structured interviews were conducted with physiotherapists (n = 15) and managers (n = 10) from a publicly funded health network. Interviews were audiotaped and transcribed verbatim. Qualitative analysis of transcripts was completed using inductive thematic analysis. Results Three themes explained the factors perceived by participants to influence participation in clinical supervision: the value of clinical supervision; operationalisation of the organisational clinical supervision framework; and the clinical supervision culture. Identified factors influenced participation by either facilitating or discouraging access to supervision and prioritisation of supervision relative to competing professional demands. Conclusions Physiotherapist participation in clinical supervision is crucial for their professional development and to deliver high-quality care. Participation might be enhanced by initiatives that address factors identified in this study. These may include introducing processes that ensure supervisees and supervisors are accountable for their participation in supervision; providing alternative supervisory arrangements during leave, vacancies, or redeployment; allocating on-site supervisors to accommodate preferred supervision formats; and promoting a safe learning environment where physiotherapists can address knowledge or skill gaps without fear of judgement.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054477","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}

{"title":"The Living Well, Living Longer program: an integrated care strategy to improve the health of people living with severe mental illness.","authors":"Andrew Simpson, Lisa Parcsi, Andrew McDonald","doi":"10.1071/AH24169","DOIUrl":"10.1071/AH24169","url":null,"abstract":"<p><p>Living Well, Living Longer (The Program) is an integrated care strategy to improve the physical health of people living with severe mental illness within a public mental health service. The significant life expectancy gap experienced by this cohort is largely attributed to higher rates of cardiovascular disease and modifiable risk factors. The Program addresses this by guiding people through the four stages of screening, detection, treatment initiation, and ongoing management of coexisting chronic health conditions. The Program adopted an integrated care approach to ensure the provision of appropriate and coordinated care across hospital and primary care services. Key care pathways include a cardiometabolic health assessment clinic, shared care with general practitioners, oral health services partnership and employment of peer support workers, dietitians, exercise physiologists, and smoking cessation to provide targeted community support and interventions. There has been strong engagement with the care pathways introduced since The Program's inception in 2013 and evaluation is currently underway to consider the impact on cardiometabolic health outcomes for participants. Critical to The Program's effectiveness has been engagement with lived experience expertise, multidisciplinary collaboration, and strong executive support. However, significant challenges persist amid an Australian public health crisis characterised by reducing rates of free primary healthcare access for people living with severe mental illness and enduring communication challenges between primary and secondary health services. With the implementation of MyMedicare and the imminent Single Digital Patient Record across NSW Health, we stand at a critical juncture. It is imperative to establish robust systems to enhance care for this vulnerable population.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"688-692"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482839","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":"Accreditation as a lever for change in the development of the collaborative practitioner in the Australian health system.","authors":"Fiona Kent, Lynda Cardiff, Bronwyn Clark, Julie Gustavs, Brian Jolly, Josephine Maundu, Glenys Wilkinson, Sarah Meiklejohn","doi":"10.1071/AH24165","DOIUrl":"10.1071/AH24165","url":null,"abstract":"<p><p>Objective Patient expectations in the Australian healthcare system are for coordinated, collaborative practice. There is a need for education institutions, health services, accreditation authorities, and consumers to work together to achieve this goal. As part of a larger body of work, we sought to understand how these stakeholders contribute to the development of collaborative healthcare practice. Method Nineteen focus groups were conducted in 2022 with 84 participants consisting of education providers (n =62), consumers (n =10), representatives from the Health Profession's Education Standing Group (n =8), and health service practitioners (n =4). Framework analysis was initially undertaken to understand facilitators of, and barriers to, collaborative practice and learning. In a secondary analysis, the themes were re-organised according to the Bolman and Deal domains of organisational practice, to make explicit the structural, human resource, political, and symbolic factors deemed useful for re-imaging a process for learning about and incentivising collaborative practice. Results There are multiple factors across healthcare settings that both facilitate and challenge the development of collaborative practice. Co-location of professions and participation in formal interprofessional processes such as team meetings and handovers facilitated learning collaborative practice, although traditional cultures which perpetuate siloed models of healthcare, power differentials between the professions, funding structures, and information sharing limited opportunities. The 'value' of collaborative practice was facilitated through both consistent curriculum messages throughout health professional courses and positive role modelling. Conclusions Education institutions, health service practitioners, accreditation authorities, and consumers can work together to facilitate the development of collaborative practice through attention to policy and processes, curriculum activities, student participation, health service activities and practice, and resource allocation.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"705-710"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121315","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":"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. Methods A 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. Results Participants (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. Conclusions Our 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":"2024-12-01","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":"Predicting hospital bed utilisation for post-surgical care by means of the Monte Carlo method with historical data.","authors":"Andy Wong, Rob Eley, Paul Corry, Brendan Hoad, Prasad Yarlagadda","doi":"10.1071/AH24160","DOIUrl":"10.1071/AH24160","url":null,"abstract":"<p><p>Objective This study aim was to develop a predictive model of bed utilisation to support the decision process of elective surgery planning and bed management to improve post-surgical care. Methods This study undertook a retrospective analysis of de-identified data from a tertiary metropolitan hospital in Southeast Queensland, Australia. With a reference sample from 2years of historical data, a model based on the Monte Carlo method has been developed to predict hospital bed utilisation for post-surgical care of patients who have undergone surgical procedures. A separate test sample from comparable data of 8weeks of actual utilisation was employed to assess the performance of the prediction model. Results Applying the developed prediction model to an 8-week period test sample, the mean percentage error of the prediction was 1.5% and the mean absolute percentage error 5.4%. Conclusions The predictive model developed in this study may assist in bed management and the planning process of elective surgeries, and in so doing also reduce the likelihood of Emergency Department access block.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"642-647"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309352","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":"Models of care for voluntary assisted dying: a qualitative study of Queensland's approach in its first year of operation.","authors":"Ben P White, Amanda Ward, Rachel Feeney, Laura Ley Greaves, Lindy Willmott","doi":"10.1071/AH24199","DOIUrl":"10.1071/AH24199","url":null,"abstract":"<p><p>Objective Voluntary assisted dying (VAD) began in Queensland in January 2023 but little is known about its practical operation. This research examined models of care for providing VAD in Queensland. Methods Semi-structured interviews were conducted with 24 participants involved with VAD delivery across Queensland's 16 Health and Hospital Services (HHSs). Participants included HHS VAD Coordinators, nurse practitioners and nurses who acted as administering practitioners, and Queensland VAD Support and Pharmacy Service (QVAD SPS) staff. Results Five themes about Queensland VAD models of care were developed: VAD is accessed almost exclusively through the public sector via HHSs, influenced by a Health Service Directive; local models of care vary; nurses play significant roles facilitating access to and providing VAD; QVAD SPS has been instrumental supporting HHSs and ensuring statewide access as back-up VAD provider; and VAD services need more resourcing. Conclusions The Queensland approach to providing VAD has been largely successful in ensuring patient access across the state. However, it differs from previous Australian VAD models with access predominantly through the public sector, greater roles played by nurse practitioners/nurses, and VAD being provided by QVAD SPS. Under-resourcing and consistency in provision of VAD services remain challenges.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"693-699"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382732","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 digitally enabled health workforce for Australia.","authors":"Anna Janssen, Melissa Baysari, Christina Igasto, Kate Quirke, Petra Milnes, Tim Shaw, Adam Dunn","doi":"10.1071/AH24286","DOIUrl":"10.1071/AH24286","url":null,"abstract":"<p><p>Australia has world-class education for healthcare professionals and is recognised for its strength in digital health research but is yet to fill some important gaps in training healthcare professionals in the safe implementation and use of digital technologies. In this case study, we bring together the perspectives of clinicians, health system leaders, and academics to guide efforts in establishing a digitally enabled workforce in Australia. Building on published evidence, our recommendations include leveraging on recent momentum, building strong partnerships with healthcare organisations, academia, and the digital health industry, and ultimately an expansion of a digitally enabled clinical informatics and digital health workforce.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"700-704"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649966","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":"Response to 'A collaborative approach to support people with a disability living in Australian group homes during the COVID-19 pandemic: a case study'.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1071/AH24264","DOIUrl":"10.1071/AH24264","url":null,"abstract":"","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"739-740"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482838","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}