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

{"title":"'The time for experimenting on patients is over': a policy scan and qualitative study of doctors' experience with the oversight of clinical innovation in Australia.","authors":"Miriam Wiersma, Ian Kerridge, Wendy Lipworth","doi":"10.1071/AH25184","DOIUrl":"10.1071/AH25184","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical innovation - the use outside of research of novel and unproven interventions - is subject to extensive federal and state oversight in Australia. Although the complexity of the regulatory environment is widely recognised, there have been no attempts to identify and summarise the policies governing clinical innovation or to understand how Australian clinicians navigate this environment. This study addresses these gaps by mapping the oversight of clinical innovation in Australia and exploring clinicians' experiences to understand practical challenges and identify opportunities for improvement.</p><p><strong>Methods: </strong>A policy scan of publicly available documents was conducted between 2020 and 2025, and a qualitative interview study undertaken. Participants included surgeons, cancer physicians and fertility specialists who were recruited using purposive and snowball sampling from Australian states and territories.</p><p><strong>Results: </strong>The policy scan revealed complicated oversight mechanisms across multiple jurisdictional levels, with both overlap and variation in regulatory approaches between states and territories. Participants described the practical challenges of navigating this complex system while highlighting the importance of peer support, training and long-term outcome monitoring as key mechanisms for supporting responsible clinical innovation.</p><p><strong>Conclusions: </strong>States and territories have developed fragmented, duplicative and sometimes opaque oversight mechanisms, creating unnecessary complexity and potential gaps in coordination. To improve the oversight of clinical innovation in Australia, a national framework is required that establishes clear processes for the introduction of innovative interventions while permitting jurisdictional modifications in local contexts.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558581","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":"Peripheral intravenous catheter policies and procedures across Queensland: a document review and analysis of underpinning evidence and alignment with clinical standards.","authors":"Josephine Lovegrove, Sally Havers, Alison Smith, Daner L Ball, Amanda J Ullman, Alice Bhasale, Claire M Rickard","doi":"10.1071/AH25234","DOIUrl":"10.1071/AH25234","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine peripheral intravenous catheter (PIVC) policies across Queensland public health services, their underpinning evidence, and alignment with the 2021 Australian PIVC Clinical Care Standard.</p><p><strong>Methods: </strong>A document review and analysis of public state and health service PIVC policies, procedures, and guidelines across Queensland was performed. Data were extracted using standardised forms, collated, reviewed, and compared for each health service and the state overall. Document characteristics and underpinning evidence (e.g. references, supporting resources, alignment with the 10 PIVC Standard Quality Statements) were analysed descriptively. Binary adherence (yes adherent, no not adherent, other) was assessed for the 10 PIVC Standard Quality Statements.</p><p><strong>Results: </strong>Documents included 17 health service procedures, one protocol, and one statewide guideline (total n = 19), released between 2015 and 2024. Most were PIVC-specific (90%), and four had exceeded their planned update timepoint. Three had no references, but had supporting resources described, whereas one document had both. One provided neither references nor supporting resources. All documents had hyperlinks to other internal and/or external resources. Of 15 released after Standard publication (post-2021), 13 (86.7%) referred to the Standard. No individual document adhered to all 10 Standard Quality Statements. None of the Quality Statements were met by all documents (adherence range 0-95%).</p><p><strong>Conclusions: </strong>Many PIVC policies lacked a strong evidence framework and did not align with the minimum level of care expected in Australia. This likely impacts the quality of clinical care and patient outcomes. There is an urgent need for rationalisation and system-wide standardisation of policies to reduce variation and ensure clinical standards are met.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607727","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 document analysis exploring Australian health service expectations of competency and training in recent Advanced Musculoskeletal Physiotherapy roles.","authors":"David Jovic, Matthew Beard, Marie-Louise Bird, Romany Martin, Steven Milanese","doi":"10.1071/AH25185","DOIUrl":"10.1071/AH25185","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify and analyse current health service expectations of Advanced Musculoskeletal Physiotherapists (AMPs), with a focus on the breadth and depth of competency.</p><p><strong>Methods: </strong>This qualitative study applied document analysis of recent Australian AMP statements of duty, advertised online from November 2023 to April 2024. Role demographics were collected, as well as pre-employment education expectations, selection criteria and post-employment duties. Selection criteria and duties statements were transformed into a recent advanced practice competency framework and Bloom's revised taxonomy. Data underwent manifest content analysis.</p><p><strong>Results: </strong>Advertisement extraction identified 44 statements of duty. The majority were from Queensland (N = 18, 41%) and Victoria (N = 9, 21%). Most roles were located, at least partially, within emergency departments (N = 23, 52%). A post-graduate master's level qualification (N = 37, 84%) was identified as a key training expectation, with musculoskeletal qualification being the most frequent. Manifest content analyses identified four main domains of competence that were predominant after data transformation: clinical expert practitioner, collaborator, scholar and leader. Cognitive complexity was highest in the domains of clinical expert practitioner and collaborator.</p><p><strong>Conclusions: </strong>Health services highly value applicants with post-graduate qualifications. These qualifications likely support, at least to some degree, AMP competence in the most frequently stated and cognitively complex domains, including clinical expertise practitioner, leader, collaborator and scholar. Training and education for roles needs to meet AMP needs across the breadth and depth of competency domains.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433423","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":"Critical care survivors' reported satisfaction with experience of their general practitioner and general practice clinic: a multi-centre observational cohort study.","authors":"Nina Leggett, Yuhao Wang, Sarah Burleigh, Mayra Cuming, Adam M Deane, Craig French, Matthew J Maiden, Jo-Anne Manski-Nankervis, Mark Merolli, Thomas C Rollinson, Jonathan Stewart, Cindy Zhang, Yasmine Ali Abdelhamid, Kimberley J Haines","doi":"10.1071/AH25156","DOIUrl":"10.1071/AH25156","url":null,"abstract":"<p><strong>Background: </strong>Increased global attention on enhancing the support available for critical care survivors to improve their health outcomes has led to an exploration of the integration of care between intensive care and primary care. The satisfaction of the experience between critical care survivors and their general practitioner (GP) remains unknown.</p><p><strong>Objectives: </strong>To determine how satisfied Australian critical care survivors are with their GP and general practice experience.</p><p><strong>Methods: </strong>A prospective multi-centre observational cohort study of adult intensive care unit patients was completed across three tertiary hospitals in Victoria, Australia. Adult intensive care unit survivors who were mechanically ventilated for >24 h were eligible for inclusion. The primary outcome measure was the frequency scores of the General Practice Assessment Questionnaire domains. The General Practice Assessment Questionnaire is a 35-item survey measuring the domains of general practice reception, access, continuity of care, communication, enablement and overall satisfaction.</p><p><strong>Results: </strong>A total of 51 participants were recruited. Of these, 98% reported having a preferred GP, 96% reported confidence and trust in their GP and 88% would recommend their clinic to new patients. High satisfaction was reported across all General Practice Assessment Questionnaire domains.</p><p><strong>Conclusions: </strong>Survivors of critical illness report high satisfaction in their experience with their GP and general practice from participants from socioeconomically diverse areas.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596952","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":"Predictors of willingness to undergo back surgery: a survey of Australian privately insured adults with chronic back pain.","authors":"Daniel S Harvie, Catherine Keating, Neala Fulia, Manuela L Ferreira, Ian A Harris, Mark Catley","doi":"10.1071/AH25242","DOIUrl":"10.1071/AH25242","url":null,"abstract":"<p><strong>Objective: </strong>Spinal surgery rates in Australia continue to rise despite limited evidence for their effectiveness in managing uncomplicated chronic back pain. This study examined patient-level factors that influence willingness to undergo surgery, to informing future work promoting non-surgical care pathways.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey in March 2025 of 152 privately insured Australian adults with chronic low back pain. Participants reported pain characteristics, functional interference, prior imaging and pain-related beliefs (expectations of recovery, self-efficacy and catastrophising). Willingness to undergo spinal surgery within 5 years was assessed on a 5-point scale, and dichotomised into 'willing' (3-4) and 'unwilling' (0-1); respondents answering 'unsure' were excluded. Logistic regression examined predictors of willingness to consider surgery.</p><p><strong>Results: </strong>Of 152 participants (mean age 59.3 years, 64% female), 24% expressed willingness to undergo surgery. Negative pain beliefs, higher pain intensity and younger age significantly predicted willingness, with the strongest effect seen for negative pain beliefs (OR 2.62, 95% CI 1.16-5.92, P = 0.02). Functional interference, imaging history and gender showed positive, but non-significant, associations.</p><p><strong>Conclusion: </strong>Negative pain beliefs predict willingness to undergo spinal surgery. This finding has important policy implications, suggesting that addressing belief-driven demand may help reduce the economic burden of surgery by directing patients towards guideline-based, high-value, non-surgical care.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643900","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":"Corrigendum to: Chronic breathlessness is associated with much longer lengths of hospital stay.","authors":"David Currow, Slavica Kochovska, Rachael Evans, Janelle Yorke, Patricia M Davidson","doi":"10.1071/AH25253_CO","DOIUrl":"10.1071/AH25253_CO","url":null,"abstract":"","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650370","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 influence of specialty training selection criteria on medical students' career pathway choices in Australia.","authors":"Thomas Muecke, Dinan Perera, Jinara Devinuwara, Christina Gao, Shrirajh Satheakeerthy, Stephen Bacchi, Robert Casson, Weng Onn Chan","doi":"10.1071/AH25085","DOIUrl":"10.1071/AH25085","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the perspectives of Australian medical students on medical and surgical specialty training program selection criteria and examine their influence on career intentions.</p><p><strong>Methods: </strong>A cross-sectional online survey of Australian medical students assessed perspectives on the criteria utilised to select applicants into Australian specialty training programs for 2025. Likert-scale and free-text responses were collected. Quantitative analysis used the Wilcoxon signed-rank test, and free text responses underwent automated textual analysis using natural language processing techniques to classify sentiment and extract recurring themes and concerns.</p><p><strong>Results: </strong>Student interest in pursuing multiple specialties decreased significantly after exposure to their current selection criteria, particularly in ophthalmology, intensive care, neurology, and obstetrics and gynaecology. Automated textual analysis revealed a clear negative sentiment across most surgical specialties. Respondents' main concerns of selection criteria related to research requirements, competitiveness, time commitment, requirement of academic achievement despite a lack of awards in medical school, burnout, and affect on family planning.</p><p><strong>Conclusions: </strong>Understanding the perspectives of medical students on specialty training selection processes may help inform strategies to improve equity and address workforce imbalances. Student suggestions to improve specialty training selection processes included earlier education on specialty pathways, clearer guidance to build a competitive curriculum vitae, and more equitable access to research, mentorship, and professional development opportunities. Future research may consider investigating the perspectives of prevocational medical graduates and medical students across multiple Australian institutions.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357163","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":"Corrigendum to: Lived Experience Advisor Program initiative: harnessing consumer leadership for best care.","authors":"Rebecca Barbara, Jodie Lydeker, Alex Potter, Debra Kerr","doi":"10.1071/AH24311_CO","DOIUrl":"10.1071/AH24311_CO","url":null,"abstract":"","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590293","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":"Equity of delivery: access to voluntary assisted dying substances using a centralised pharmacy model.","authors":"Elisha Cole, Liz Reymond, Enna Stroil-Salama, Caroline Phelan","doi":"10.1071/AH25250","DOIUrl":"10.1071/AH25250","url":null,"abstract":"<p><strong>Objective: </strong>Queensland implemented a centralised voluntary assisted dying (VAD) pharmacy model to promote safety, consistency and equitable access to VAD substances. In a geographically dispersed state, such as Queensland, a potential concern is whether centralisation affects time-to-delivery (TTD) for patients in regional and rural areas. This audit examined whether differences exist in TTD between South East Queensland (SEQ; metropolitan) and non-SEQ (non-metropolitan) patients, and explored reasons for prescription and visit cancellations to determine whether geographic factors, particularly remoteness, influenced service reliability.</p><p><strong>Methods: </strong>All VAD substance deliveries between 1 January 2023 and 31 January 2024 were analysed. TTD was defined as the difference between the patient's preferred and actual supply dates. Comparisons were made across region (SEQ vs non-SEQ), hospital and health service districts, and Modified Monash Model categories. Reasons for prescription and visit cancellations were also explored, as these cases were not captured in the TTD dataset if a delivery did not proceed, and may reveal potential geographic barriers for timely access.</p><p><strong>Results: </strong>Of 911 patients, 723 (83%) received the VAD substance on their preferred date. No statistically significant differences in TTD were observed across region, hospital and health service districts or Modified Monash Model classifications, demonstrating consistent and reliable statewide delivery - an indicator of safety and standardised practice. Cancellations (prescriptions n = 58, visits n = 56) were geographically uniform and most commonly due to patient death.</p><p><strong>Conclusions: </strong>Queensland's centralised VAD pharmacy enables equity of access and safe delivery of VAD substances regardless of geography, supporting standardised practice and mitigating operational risks through centralised oversight.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607398","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 scoping review of multi-component suicide and self-harm prevention programs for young people in Australia.","authors":"Anna Morrison, Charlotte Comben, Claudia Pagliaro, Eryn Wright","doi":"10.1071/AH25145","DOIUrl":"10.1071/AH25145","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aimed to describe current multi-component services and programs with the primary purpose of preventing suicide and self-harming behaviours among adolescents and young adults aged 12-25 years in Australia and summarise evaluations of these initiatives.</p><p><strong>Method: </strong>A systematic search of Embase, PsycINFO, PubMed, Scopus, and grey literature was conducted to identify relevant publications from 2014 to 2024. Data on identified services and programs were then analysed using a narrative synthesis approach. A quality assessment of evidence was also employed.</p><p><strong>Results: </strong>The review included six journal articles and six grey literature reports, detailing five different multi-component services and programs. Findings indicated relatively few existing multi-component strategies, with most targeting suicide or suicide and self-harm prevention. No identified multi-component programs focused solely on preventing self-harm. Three programs were delivered in community-based settings, one was web-based, and one was school-based. Common program components included psychoeducational materials/interventions, peer-to-peer support, and professional support/counselling. There was significant variation in how initiatives were evaluated.</p><p><strong>Conclusions: </strong>The review suggests that there are few multi-component strategies for preventing suicide and self-harm among young Australians. Most of those identified were only introduced within the past 6 years, leaving little opportunity for comprehensive, long-term evaluations. Although available evidence indicates promising results, the scarcity of completed evaluations limits understanding of their overall effectiveness. The absence of multi-component programs specifically addressing self-harm highlights a key gap, emphasising the need for targeted, evidence-based prevention strategies that distinguish between self-harm with suicidal intent and non-suicidal self-harm.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607954","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}