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

{"title":"Evaluating the outcomes of Australia's first all-age public hospital Sport and Exercise Medicine Outpatient Clinic: a retrospective cross-sectional study.","authors":"Dougal Middleton, Fintan Thompson, Kira James","doi":"10.1071/AH24245","DOIUrl":"10.1071/AH24245","url":null,"abstract":"<p><p>Objectives This study aimed to evaluate the outcomes of Australia's first public hospital all-age Sport and Exercise Medicine Outpatient Clinic (SEMOC). Methods A retrospective cross-sectional study of patients referred to and reviewed in the SEMOC, during a study period from March to October 2023, was performed. Outcomes were the number of appointments, number of patients reviewed, proportion reviewed within Queensland Health recommended timeframes, patient satisfaction, proportion of Aboriginal and Torres Strait Islander patients, and the rurality of the patients based on the Modified Monash Model of remoteness. Results There were 29 clinics, 472 allocated appointments, and 270 new patients referred to the SEMOC (1.7 appointments per patient). Almost a quarter (23.7%) of patients identified as Aboriginal and Torres Strait Islander peoples and a third (31.9%) were from rural or remote regions. Most (88.7%) patients referred during the study period were seen within the Queensland Health recommended timeframes, and almost all patients referred on for orthopaedic review were booked for surgery (93.6%). Over 90% of patients were satisfied with the quality of treatment they received and rated the overall service as good to excellent. Conclusion A SEMOC public hospital model has been shown to be feasible for providing care to patients with musculoskeletal conditions, reaching patients who face barriers to health care, reducing wait times, and improving referral for surgery. The model may assist in meeting Australia's growing demand for orthopaedic and musculoskeletal medicine and expand within Australia's public hospital system to become a nationally accepted practice.</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":"142883873","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":"Utility of a digital app to enhance patient-nurse communications and patient involvement in bedside handover: patient and nurse perceptions.","authors":"Penelope Casey, Eva Yuen, Raj Liskaser, Philippa Blencowe, Leanne Boyd, Mohamed Abdelrazek, Zoe Wang, Julie Considine","doi":"10.1071/AH23270","DOIUrl":"10.1071/AH23270","url":null,"abstract":"<p><p>Objective This study aimed to explore patient and nurse perceptions of using a prototype co-designed app to support patient-nurse communication and patient engagement in bedside handover. Methods This qualitative descriptive study evaluated usability of the app with a convenience sample of patient-nurse dyads in a 22-bed medical/oncology ward, during morning shifts. Participants were nurses, and patients proficient in English but without cognitive impairment or physical or mental distress. Patients entered healthcare questions and preferences into the app, nurses acknowledged the information in the app and responded during their usual workflow. Patient comfort level with app use was surveyed. Handovers were observed, and patient involvement rated. After handover, semi-structured interviews and feedback surveys on app usability were conducted. Interviews were recorded, transcribed, and then analysed thematically. Survey data were analysed using descriptive statistics. Results Patient-nurse dyads (n =18) used the app between March and May 2023. Patients were mostly older (median 69.5years; IQR 52.3, 75), female, and frequent users of smartphones. Nurses were mostly younger (median 23years; IQR 21, 40) and female. Five themes were identified, which indicated that using the app empowered patients to engage in healthcare communications, facilitated opportunities for patient-centred information sharing, and refocused nurses' attention onto patient-centred care. Views differed on the app's influence on patient involvement in handover. Surveys (n =36, 100%) indicated that the interface was easy to navigate, features were useful, and only minor amendments were suggested. Conclusion This prototype app shows potential to facilitate patient-centred communication and patient engagement with health care, including bedside handover. With further refinement and testing, this app could enhance experiences of care and reduce harm from miscommunication.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"673-681"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303280","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":"10.1071/AH24221","url":null,"abstract":"<p><p>Background Many 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. Objective To describe the number, type and timing of medication incident calls to the Victorian Poisons Information Centre from supported disability homes in Victoria, Australia. Methods This 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. Results A 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%). Conclusions Calls 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":"2024-12-01","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":"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":"10.1071/AH24306","url":null,"abstract":"<p><p>Objective Recording 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. Methods We 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. Results Of 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. Conclusions When 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":"2024-12-01","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":"Leading innovation in transdisciplinary care.","authors":"Martin Chadwick, Jennifer R Hemler, Benjamin F Crabtree","doi":"10.1071/AH24089","DOIUrl":"10.1071/AH24089","url":null,"abstract":"<p><p>Background Benefits of effective team-based working in healthcare settings are well established, with the ultimate form being transdisciplinary teams. Achieving transdisciplinary teams at the large organisation or system level has not been extensively studied. Purpose To examine and describe exemplar organisations where transdisciplinary working was enabled and that can be reproduced in other organisations. Methods An expert panel reached consensus on three healthcare organisations in the USA that exemplified transdisciplinary working. Available public information about each organisation was reviewed and site visits with direct observation and interviews were conducted with two of the three exemplar sites (the third completed remotely due to the onset of COVID-19). The process of immersion-crystallisation was used to review the collated material and to identify key themes that were then repeatedly checked with the expert panel. Results Consistent themes were identified across all three organisations, although they each arrived at these commonalities via distinctly different routes. All had a clear and shared creation story as to how they came about as an entity, which was supported by consistent longitudinal leadership. This enabled an environment whereby each organisation created its own language that reflected their culture as an organisation, thus continually reinforcing the uniqueness of their organisation. Conclusions Large healthcare organisations can achieve the concepts of transdisciplinary practice. While no single achievement pathway was identified, common themes noted were a clear creation story, consistent leadership, and building a language that reflected the organisation.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"682-687"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482835","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":"External validation and comparative analysis of the HOSPITAL score and LACE index for predicting readmissions among patients hospitalised with community-acquired pneumonia in Australia.","authors":"Yogesh Sharma, Arduino A Mangoni, Chris Horwood, Campbell Thompson","doi":"10.1071/AH24204","DOIUrl":"10.1071/AH24204","url":null,"abstract":"<p><p>Objective Community-acquired pneumonia (CAP) is a leading cause of emergency hospitalisations globally and is associated with high readmission rates. Specific score systems developed for all medical conditions such as the HOSPITAL score and the LACE index can also usefully predict CAP readmissions. However, there is limited evidence regarding their performance in the Australian healthcare settings. Methods This multicentre retrospective study analysed adult CAP discharges from two metropolitan hospitals in South Australia between 1 January 2018 and 31 December 2023. Data for determining the HOSPITAL score and the LACE index were derived from electronic medical records. Demographic characteristics of patients readmitted within 30 days were compared with those who were not readmitted. The scores were evaluated for overall performance, discriminatory power and calibration, with discriminatory power assessed using the concordance statistic (C-statistic). Results Over 6years, 7245 CAP discharges were recorded, with 1329 (18.3%) readmissions within 30days. The mean (s.d.) age of the cohort was 74.4 (17.8) years. Readmitted patients were more likely to have multiple morbidities and frailty than those not readmitted (P <0.05). They also had a higher mean number of emergency department presentations and hospital admissions in the previous year and a longer initial hospital stay (P <0.05). Overall, the mean (s.d.) HOSPITAL score and LACE index were 3.4 (2.1) and 9.3 (3.6), respectively. Among readmissions, 28.4% occurred in patients with a HOSPITAL score >4 (intermediate and high-risk group), while 25.8% occurred in patients in the high-risk LACE category (LACE index>10). The C-statistic for the HOSPITAL score and LACE index was 0.62 (95% CI 0.61-0.64) and 0.63 (95% CI 0.61-0.65), respectively, with no significant difference in the area under the receiver operating characteristic curves (P >0.05). Conclusions The predictive abilities of the HOSPITAL score and the LACE index for CAP readmissions are modest and comparable in an Australian setting.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"656-663"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115892","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":"Feasibility of an allied health led, workplace delivered Long COVID service for hospital staff: a mixed-methods study.","authors":"Aruska N D'Souza, Catherine L Granger, Zoe Calulo Rivera, Aisling Burke, Riley Ngwenya, Carly Struck, Myvanwy Merrett, Timothy N Fazio, Genevieve Juj, Casey L Peiris","doi":"10.1071/AH24146","DOIUrl":"10.1071/AH24146","url":null,"abstract":"<p><p>Objective This study aimed to evaluate the feasibility of a workplace-delivered outpatient multidisciplinary service (ReCOV) for staff experiencing post COVID-19 condition ('Long COVID'). Methods A mixed-methods study of staff at a large, tertiary hospital with Long COVID who attended the service was conducted. Participants completed questionnaires to determine baseline symptoms and were offered allied health appointments for up to 12weeks each based on clinical indication. Acceptability, implementation, practicality and limited efficacy were evaluated via one-on-one semi-structured interviews and analysed using inductive thematic analysis. Limited efficacy was evaluated via pre- and post-questionnaires and demand via multidisciplinary utilisation. Results Twenty-three (median age 37 [interquartile range 30-45] years, 52% female) participants were included. Participants had appointments with a median of 4 [3-5] different professions; most commonly exercise physiology (n =19, 83%), occupational therapy (n =17, 74%) and neuropsychology (n =15, 65%). Median time spent on the ReCOV service was 15 [9-19] weeks. Thirteen semi-structured interviews were completed and analysed. Participants valued ReCOV for being a COVID-19 specific, convenient, flexible and multidisciplinary service at their workplace. Participants preferred the service to have been available for longer than 12weeks to achieve further benefits as many participants perceived little change in physical health. Conclusions Attending a multidisciplinary service located at their workplace was feasible for staff to manage post COVID-19 symptoms. Further research is required to confirm the efficacy on patient outcomes.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"729-738"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395877","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":"Spatial clusters of potentially preventable hospitalisations and access to allied health services in South Western Sydney: a geospatial study.","authors":"Janelle Gifford, Soumya Mazumdar, Matthew Jennings, Bin Jalaludin, Sarah Dennis","doi":"10.1071/AH24200","DOIUrl":"10.1071/AH24200","url":null,"abstract":"<p><p>Objective To explore the association between geographic access to allied health services and potentially preventable hospitalisations. Methods This is a retrospective observational study. Adults aged 18years or older with a potentially preventable hospitalisation for a chronic condition(s) to a public hospital in South Western Sydney Local Health District between 1 July 2016 and 30 June 2019 were identified from the Secure Analytic for Population Health and Intelligence portal at NSW Health. Locations of allied health amenities or practices in the same geographic area were identified from the 2019 National Health Service Directory. Geospatial analysis was used to identify geographic hotspots and coldspots of potentially preventable hospitalisations. Association with access to allied health services was investigated using linear models. Results Hotspots of potentially preventable hospitalisations were significantly more disadvantaged than coldspots. Hotspots also had poorer access to allied health services than coldspots. Conclusion In South Western Sydney, populations with higher burden of chronic disease, as measured through preventable hospitalisations, have poorer access to allied health services than populations with lesser need.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"648-655"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334250","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":"10.1071/AH24184","url":null,"abstract":"<p><p>Objective Ensuring 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. Methods This 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. Results Of 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'. Conclusions This 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":"2024-12-01","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":"Standardising workforce cost estimates across Australian jurisdictions: genomic testing as a use case.","authors":"Dylan A Mordaunt","doi":"10.1071/AH24126","DOIUrl":"10.1071/AH24126","url":null,"abstract":"<p><p>Introduction Labour costs are a key driver of healthcare costs and a key component of economic evaluations in healthcare. We undertook the current study to collect information about workforce costs related to clinical genomic testing in Australia, identifying key components of pay scales and contracts, and incorporating these into a matrix to enable modelling of disaggregated costs. Methods We undertook a microcosting study of health workforce labour costs in Australia, from a health services perspective. We mapped the genomic testing processes, identifying the relevant workforce. Data was collected on the identified workforce from publicly available pay scales. Estimates were used to model the total cost from a public health services employer perspective, undertaking deterministic and probabilistic sensitivity analyses. Results We identified significant variability in the way in which pay scales and related conditions are both structured and the levels between jurisdictions. The total costs (2023-2024 Australian dollars) ranged from 160,794 (113,848-233,350) for administrative staff to 703,206 (548,011-923,661) for pathology staff (full-time equivalent). Deterministic sensitivity analysis identified that the base salary accounts for the greatest source of uncertainty, from 24.8% (20.0-32.9%) for laboratory technicians to 53.6% (52.8-54.4%) for medical scientists. Conclusion Variations in remuneration levels and conditions between Australian jurisdictions account for considerable variation in the estimated cost of labour and may contribute significantly to the uncertainty of economic assessments of genomic testing and other labour-intensive health technologies. We outline an approach to standardise the collection and estimation of uncertainty for Australian health workforce costs and provide current estimates for labour costs.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"634-641"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514548","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}