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

{"title":"The Hospital Harmony program improves interdisciplinary healthcare team functioning and communication.","authors":"Matthew J Y Kang, Ar Kar Aung, Rob Selzer, Ashlee Linck, Floyd F Dias, Eldho Paul, Jennifer S N Tang, Jo Gibbs, Harry Gibbs","doi":"10.1071/AH24276","DOIUrl":"https://doi.org/10.1071/AH24276","url":null,"abstract":"<p><p>OjectiveHospital wards, staffed by a multidisciplinary team, are complex environments where teamwork, communication and psychological safety are essential for coordinated care delivery, yet are faced with challenges such as staffing changes and complex care needs. There is little literature on interventions to assist staff to connect as a team. This study aimed to evaluate the effect of the Hospital Harmony program on team communication, psychological safety and overall team functioning in a multidisciplinary hospital ward.MethodsThe study was conducted at a major metropolitan academic health service involving a multidisciplinary general medicine team including nursing, medicine and allied health. A mixed-methods approach was used, combining quantitative surveys and qualitative focus groups, to evaluate Hospital Harmony, a 6-week brief daily group-based program designed to improve team function and mindfulness within the team. For our quantitative component, we used a questionnaire based on measures of team functioning: meeting effectiveness, psychological safety and individual focus. We used linear mixed models to assess the changes in each domain over time. A focus group was undertaken to obtain qualitative data that were thematically analysed.ResultsFifty-one unique participants from the multidisciplinary team completed the survey (mean age of 33.5years (s.d. 11.0) and 72% female). Following commencement of the program, there was a significant increase in the team's perception of the meeting's effectiveness (P=0.004), team morale (P<0.0001), focus (P<0.0001) and psychological safety (P=0.014). The focus group identified four broad themes of relationship building, improved psychological safety, the impact of the program on the team's behaviour and mindful self-reflections.ConclusionWe found that the Hospital Harmony program improved the multidisciplinary healthcare team by facilitating better communication, improving relationships and promoting psychological safety.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065353","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":"Use of artificial intelligence to generate emergency department discharge summaries.","authors":"Chuting Tang, Nilupul Mudunna, Ian Turner, Mohammad Asghari-Jafarabadi, Keith Joe, Lisa Brichko","doi":"10.1071/AH24326","DOIUrl":"https://doi.org/10.1071/AH24326","url":null,"abstract":"<p><p>ObjectiveThis study aims to evaluate the effectiveness of utilising an artificial intelligence (AI) model to generate emergency department (ED) discharge summaries in an easily accessible format.MethodsThis single-centre, proof-of-concept trial was conducted at a tertiary metropolitan private hospital. It involved 142 randomly selected patients who attended in 2023 and were able to be discharged home after care by a single ED doctor. A total of 284 documents were randomised, consisting of 142 de-identified ED medical notes and 142 AI-generated discharge summaries created by ChatGPT4 based on the corresponding ED medical notes. Both document types were distributed to six senior ED doctors, each of whom graded them individually and independently using a predetermined tool that assessed 17 items in four domains (expected contents, readability, medical accuracy, and internal consistency). The primary outcome was the graded score for the AI-generated discharge summaries, compared with that of the original ED medical notes.ResultsAcross the 17 items and four domains assessed, AI-generated discharge summaries rated comparably to ED medical notes in 12 items (including key information, reason for the ED visit, past medical history, allergies and medications, social history, history of presenting complaint, investigations, differential diagnoses list, grammar, formatting, appropriateness, and consistency) and three domains (expected contents, readability, and internal consistency). AI-generated discharge summaries demonstrated high mean scores in the remaining five items (examination findings, primary diagnosis, detailed plan, language clarity, and reflectiveness of treatment) and one domain (medical accuracy).ConclusionsAI-generated discharge summaries are potentially comparable to ED medical notes in most key performance domains of a discharge summary.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994262","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":"Analysis of public dental waiting lists in Queensland - 2015-2024.","authors":"Ratilal Lalloo","doi":"10.1071/AH25013","DOIUrl":"https://doi.org/10.1071/AH25013","url":null,"abstract":"<p><p>ObjectiveAustralians often wait a long time for public oral healthcare. This research analyses the numbers of people waiting for care, and numbers and percentage waiting beyond a desirable time for their clinical priority group, from 2015 to 2024, in Queensland.MethodsData are publicly available as part of the Queensland Government Open Data Portal. Data report the numbers of people waiting by time category, clinical priority group and Hospital and Health Service. Data for the end of September for each year from 2015 to 2024 were analysed.ResultsAcross the 10-year period, there were always in excess of 100,000 people on the waiting list. In 2015 there were 116,046 people on the waiting list, peaking at 154,247 in 2020, and 150,485 in 2024. Of these, 80-90% are on the list for general care, desirable within 24months. Generally, across priority clinical groups the percentage waiting beyond the desirable time increased from 2015 to the pandemic period (2020-2021) and has since improved. For example, for Priority 1 (dental treatment desirable within 1month) the percentage waiting too long was 50% in 2015, which reached a peak of 80% in 2021 and decreased to 59% in 2024.ConclusionReducing waiting list numbers for public oral healthcare is a challenge. In Queensland there are about 150,000 people on this waiting list, however, the majority are within the desirable wait time. This challenge is identified in numerous state and federal government documents, however, clear and feasible strategies appear to be lacking to reduce waiting list numbers and times.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058796","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":"Assessing the unmet need for diabetic eye screening in regional Queensland.","authors":"Alexander Bremner, David Squirrell, Brett Sillars","doi":"10.1071/AH25053","DOIUrl":"https://doi.org/10.1071/AH25053","url":null,"abstract":"<p><p>Patients continue to self-present to ophthalmology with advanced diabetic retinopathy. An audit of people living with diabetes attending our regional diabetes clinic revealed a significant number had undetected vision-threatening diabetic retinopathy despite regular community optometry review. Further work is required to determine why and whether this is a more widespread issue.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026619","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 role of Medicare policy in fertility treatment decisions: perceptions of Australians considering, undertaking or who have undertaken medically assisted reproduction treatment.","authors":"Lauren Jaensch, Jessica A Grieger, Melissa Oxlad","doi":"10.1071/AH24300","DOIUrl":"https://doi.org/10.1071/AH24300","url":null,"abstract":"<p><p>ObjectiveFertility treatments offer the only pathway to parenthood for many people, including those with infertility, single people and those in same-sex relationships. We aimed to explore how current Medicare policy affects Australians' fertility treatment decision-making.MethodsTwenty-five people (22 females, 2 males, 1 agender/gender non-conforming) aged 26-54 who had used medically assisted reproduction treatments participated in semi-structured interviews. Data were analysed using reflexive thematic analysis.ResultsWe developed three themes. Theme 1: For those eligible, Medicare enhances accessibility - describes how Medicare influences affordability and, in turn, increases accessibility. Theme 2: Medicare alters treatment plans - demonstrates how Medicare influences who undertakes treatment, what treatment, when and how often. Theme 3: Medicare enables more treatment for some people - discusses how Medicare enables people to undertake more treatment than they could otherwise afford.ConclusionsFor eligible people, the current Medicare policy enhanced treatment accessibility and allowed them to undertake more treatment than they could have without financial assistance. However, Medicare policy also contributed to people altering their treatment plans, including who received treatment, the type, timing, frequency and amount of treatment. Given Medicare's influence on fertility treatment decisions, our findings support calls for changes to Medicare eligibility to enable equitable access to fertility treatment and a pathway to parenthood for all Australians.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045311","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":"Impacts of eHealth on hospitals: an updated narrative review of systematic reviews.","authors":"Mahmoud Abdelghani, Yi-Ting Yeh, Rebekah Eden, Leanna Woods, Graeme Mattison, Sophie Macklin, Oliver Canfell, Clair Sullivan","doi":"10.1071/AH24321","DOIUrl":"https://doi.org/10.1071/AH24321","url":null,"abstract":"<p><p>ObjectiveWith the digital transformation of hospitals having unfolded globally, it is important to understand the impacts of eHealth on hospital practice. This study aims to update two previous narrative reviews of systematic reviews and assess: (1) what is the current state of eHealth impacts in hospitals? and (2) how have these impacts changed over time?MethodsA narrative review of systematic reviews investigating the impact of eHealth (i.e. Electronic Medical Records (EMR), Clinical Decision Support System (CDSS), ePrescribing, and Computerised Provider Order Entry (CPOE)) published between 2 August 2017 and 31 December 2021 was conducted using PubMed and Medline. A meta-review was conducted to qualitatively compare the results of this review with two previous reviews, spanning from 2010 to 2021.ResultsFourteen studies were included in the narrative review and 42 studies informed the meta-review. eHealth technologies were associated with a diverse array of outcomes with varying degrees of sentiment (positive, negative, neutral, mixed) reported between 2017 and 2021. In contrast to EMR, CDSS, and ePrescribing, the outcomes of CPOE were reported less frequently and less favourably although improvements to resource utilisation were evident. The meta-review identified mixed findings for the outcomes of CPOE, EMR, and ePrescribing and largely positive findings for CDSS.ConclusionsThe mixed impacts reported for EMR, CPOE, and ePrescribing and the largely positive impacts for CDSS should provide confidence to healthcare stakeholders of the potential of eHealth for hospitals. However, the presence of mixed and negative impacts demonstrate that realising the potential of eHealth is not guaranteed and dedicated efforts are needed to improve its outcomes. Future research should seek to identify the mechanisms that can be used to improve the impacts of eHealth.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994199","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 'True North Statement for Care': charting the course to better care for all Australians.","authors":"Rebecca K Golley, Georgia Middleton, Michael T Lawless, Lucy Anastasi, Alison L Kitson, Raymond J Chan","doi":"10.1071/AH25063","DOIUrl":"https://doi.org/10.1071/AH25063","url":null,"abstract":"<p><p>ObjectiveTo shift the narrative from 'deficit dialogues' in health and social care in Australia, we aimed to generate a series of consensus 'ambition' statements representing what peak care stakeholders in Australia want health and social care to look like in the future.MethodsA multiphase co-design study with Australian 'care' stakeholders was undertaken. This consisted of a desk-based audit of Australian health and social care organisations (n=9) and a pre-forum survey (n=21 responses) (activity 1), the findings of which informed the national forum activities (activity 2, n=31 organisations), which became the content for the Delphi survey (activity 3, n=28 organisations).ResultsThrough this process we distilled five ambition statements and 39 descriptors. These statements are our True North Statement for Better Care, providing a starting point to guide individual, organisation and system redesign across the life span. The statements require action at individual consumer, workforce and system level.ConclusionsCreating the True North Statement for Better Care provides a united direction for heterogeneous groups to work together to improve care for consumers, their workforce and the systems they work in. This is an important initiative to change the way we value, talk about, do, own and research care. Further user testing is required to ensure the statements can be translated into action.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813100","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":"Advance care planning: empowering older frail people to document their end of life wishes.","authors":"Peter Gonski, Melissa Chan, Ken Hillman","doi":"10.1071/AH25060","DOIUrl":"https://doi.org/10.1071/AH25060","url":null,"abstract":"<p><p>ObjectiveTo determine the features that are required to increase uptake of advance care directives (ACDs).MethodsWe conducted a study involving older patients attending aged care outpatient clinics and/or receiving outreach services between March 2021 and December 2022. Patients were assessed using tools related to frailty, end of life and empowerment. If the person agreed to complete an ACD, they were guided through it, and it was subsequently uploaded on the electronic medical record.ResultsOf 170 patients referred to complete an ACD, 47% completed it. These patients had lower Rockwood Clinical Frailty Scale and SPICT (Supportive and Palliative Care Indicators Tool) scores. The Frailty and SPICT tools were easier to use, the PAM (Patient Activation Measure) was difficult to use and assess. Patients did, however, show satisfaction in the process.ConclusionsPatients completing an ACD tended to be a little less frail and less likely to die in the following 12months. Increased uptake of ACD is more likely if the less frail are targeted, and assisted through the process by a health professional at a time and place that suits the person.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813212","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":"Accuracy of medication allergy documentation in My Health Record after severe adverse drug reactions.","authors":"Juliana Yang, William Lay, Linda V Graudins, Melissa Walker, Celia Zubrinich, Ar Kar Aung","doi":"10.1071/AH25005","DOIUrl":"https://doi.org/10.1071/AH25005","url":null,"abstract":"<p><p>BackgroundInaccurate or incomplete documentation of severe medication allergies, such as anaphylaxis and severe cutaneous adverse drug reactions (SCAR), may lead to harm from inadvertent re-exposure to implicated medications. My Health Record (MHR) is a national patient-controlled electronic health record in Australia linking hospital, general practitioner and community pharmacy records. The medication allergy/adverse reaction section should contain accurate information to aid prescribing.ObjectiveTo investigate the accuracy of documentation in MHR of confirmed medication-related anaphylaxis and SCAR and to determine barriers and facilitators to documentation.MethodsA retrospective cohort study of patients with medication-related anaphylaxis and SCAR, validated between January 2019 and June 2023. Medication allergy documentation in MHR was reviewed after patient consent to determine accuracy with medication and reaction type, against the assessment made by the hospital Adverse Drug Reaction Review Committee and/or allergy clinic consultation.ResultsForty-eight patients with anaphylaxis and 40 patients with SCAR (total 88) were included, involving 134 medications. Fourteen (15.9%) patients had their reactions documented accurately in MHR. When analysed per medication, 21 medications (15.7%) were documented accurately. Anaphylaxis, allergy clinic follow-up and life-threatening severity were factors significantly associated with a higher frequency of accurate allergy documentation in the MHR.ConclusionThe accuracy of medication allergy documentation for severe allergies in the MHR is low, representing a risk of harm from inadvertent re-exposure. This study identifies several system level issues and makes recommendations to improve patient safety.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813210","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":"Sociodemographic and clinical factors affecting advance care planning: results from a large community cohort in New South Wales, Australia.","authors":"E Yang, A Kabir, J Rhee, C O'Callaghan, M Barr","doi":"10.1071/AH24327","DOIUrl":"https://doi.org/10.1071/AH24327","url":null,"abstract":"<p><p>ObjectivesThe ageing population and increasing chronic illness pose significant healthcare challenges, including care late in life. Advance care planning (ACP) is an ongoing process of making decisions regarding future health care for patients. This process can include formal completion of an advance care directive (ACD), which is a legally binding document. ACP can improve patient outcomes and satisfaction, but rates are low across Australia. This study assessed the sociodemographic and clinical predictors of individuals engaging with ACP and ACDs using data from the 45 and Up Study cohort in New South Wales.MethodsA cross-sectional cohort study of 28,626 people responded to ACP-related questions in the wave 2 questionnaire of the Sax Institute's 45 and Up Study. ACP completion was recorded if people responded 'yes' to any of the three ACP questions, and ACD was recorded if they responded 'yes' to the ACD question. Poisson regression modelling was used to estimate the prevalence ratio and the 95%CI.ResultsA total of 28,626 people completed the ACP- and/or ACD-related questions, of whom 17,458 (61%) completed ACP and 3744 (13.1%) completed ACD. The predictors associated with an increased likelihood of ACP and ACD completion included having a will, advancing age, being female, having private health insurance, not currently working, and having one or more self-reported medical conditions. Predictors unique to increased overall ACP completion included having a university degree or higher, being married and having a health care concession card (Health Care Card). Being a carer increased ACD rates, whereas being married or in a de facto relationship decreased ACD completion.ConclusionsThese findings could inform interventions aimed at improving ACP uptake by identifying groups that engage less in ACP and provide a basis for future research.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805098","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}