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

{"title":"Staff and consumer experience of capabilities for successful governance and quality improvement committee partnerships: a coproduced cross-sectional qualitative survey.","authors":"Ruth Cox, Raeleen Parker, Melanie Lynch, Faiza El-Higzi, Jodie Nixon","doi":"10.1071/AH25132","DOIUrl":"10.1071/AH25132","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore expert staff and consumer awareness and experience of the partnership capabilities required to promote successful governance and quality improvement committee processes and outcomes.</p><p><strong>Methods: </strong>The study design was a coproduced, anonymous, online cross-sectional qualitative survey. Perceptions and examples of partnering with consumer experiences on governance committees were collected. Responses were mapped against an existing capability development framework.</p><p><strong>Results: </strong>There were 34 respondents: 19 (55.88%) staff and 15 (44.12%) consumers. Of the coded statements (n = 345), the most frequently mapped capability domain was Principles and practices (n = 154; 44.64%). The most frequently coded capability statement was Influencing organisational systems and policies (n = 105; 30%). Being flexible and developing confidence was more frequently reported by consumers (13%) than staff (3.2%; P = 0.014). Being self-aware and reflective was more frequently reported by staff (18%) than consumers (9.4%; P = 0.014), as was Equalising power, decision making and leadership (staff 7.8%; consumers 3.7%; P = 0.014). Participants provided many rich examples of partnership capabilities, experiences, and outcomes.</p><p><strong>Conclusion: </strong>Staff and consumers with >1 year of committee partnership experience were aware of the partnership capabilities required to support successful governance and quality improvement committees. Participant real-world examples demonstrated that collaborating on committees positively impacted across personal attributes, relationships and communication, organisational principles and practices, and equalising decision making, power and leadership. Findings suggested that committee consumer partnerships may build over time to address barriers including lack of opportunity, power imbalances, and tokenism.</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":"145484069","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":"Profile and clinical characteristics of alcohol-related hospital admissions within four public hospitals in New South Wales between 2011 and 2021.","authors":"Cameron McLean, Linda Tapsell, Isabella Fallas, Sara Grafenauer, Anne-Therese McMahon","doi":"10.1071/AH25048","DOIUrl":"10.1071/AH25048","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe the 10-year profile of alcohol-related admissions across four public hospitals within a health service in NSW.</p><p><strong>Methods: </strong>Alcohol-related hospital episode data were obtained from the NSW Admitted Patient Data Collection. The sample comprised episodes of patients (aged ≥18 years) admitted to four hospitals within one health service in Sydney between 1 July 2011 and 30 June 2021. The data were descriptively analysed, and binary logistic mixed modelling was performed to explore patient characteristics.</p><p><strong>Results: </strong>The sample comprised 6377 episodes representing 6280 admissions and 3334 individual patients. The sample was predominantly men (n = 2143, 64.3%) in their 40s (n = 792, 23.7%). A 4% significant increase per year in the rate of hospital admissions over the period was observed (incidence rate ratio 1.04, P = 0.005). Most admissions were ≤3 days (n = 4630, 73.7%). Being female and admitted on a Sunday was associated with same-day discharge and is of clinical relevance.</p><p><strong>Conclusions: </strong>Alcohol-related admissions significantly increased over the 10-year period in this Sydney health service. The sample consisted mostly of middle-aged men with alcohol intoxication, suggesting that local screening and interventions for hazardous alcohol consumption are warranted. Given that women are likely to have a shorter length of stay, further case exploration may be needed to ensure adequate and comprehensive care is provided for this subgroup.</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":"145508464","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":"Navigating medication safety with electronic medical records: insights from a dual-phase implementation in paediatric, neonatal and maternity care.","authors":"Dylan A Mordaunt, Nichola Johnson, Santosh Verghese, Rhys Parker, Katy Gibb, Lyle J Palmer","doi":"10.1071/AH24344","DOIUrl":"10.1071/AH24344","url":null,"abstract":"<p><strong>Objective: </strong>Electronic medical record (EMR) implementations can disrupt clinical workflows and impact medication safety. This study evaluated the effect of a two-phase EMR roll-out on medication safety events within the Women's and Children's Division of a large tertiary public hospital.</p><p><strong>Methods: </strong>We conducted a retrospective real-world difference-in-differences analysis using negative binomial regression to accommodate overdispersion in incident counts. Two activation phases (30 June 2021 and 1 January 2024) were compared against non-activated areas. Data spanning January 2020 to February 2024 were extracted from the Safety Learning System. Natural language processing (spaCy) identified both direct mentions and semantically similar references to 'electronic medical record,' 'EMR' and 'electronic prescribing' for supplementary sensitivity analyses.</p><p><strong>Results: </strong>Following each activation, minor (Incident Severity Rating 3) and near miss (Incident Severity Rating 4) incidents showed a short-lived rise - peaking within 1 month of go-live - then returned to pre-implementation levels. No statistically significant long-term changes in overall medication safety event trends were observed (all P > 0.75). Natural language processing-detected EMR mentions increased immediately post-activation, but did not persist.</p><p><strong>Conclusions: </strong>Phased EMR implementation was not associated with sustained alterations in medication safety event rates. Transient near miss increases likely reflect heightened reporting awareness rather than true error surges. Future evaluations should broaden text-mining filters, incorporate manual content review and use mixed-methods designs to ensure comprehensive detection of EMR-related safety signals and to capture clinician workflow impacts.</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":"145508422","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":"Developing best practice principles for enhancing engagement with consumers from culturally and linguistically diverse backgrounds in cancer services.","authors":"Ashfaq Chauhan, Bronwyn Newman, Melvin Chin, Allan Ben Smith, Meron Pitcher, Holly Seale, Nyan Thit Tieu, Elizabeth Manias, Carlene Wilson, Reema Harrison","doi":"10.1071/AH25217","DOIUrl":"10.1071/AH25217","url":null,"abstract":"<p><strong>Objective: </strong>Although consumer engagement with culturally and linguistically diverse (CALD) communities in health service decision-making is a priority in Australia, there is limited knowledge of mechanisms to operationalise this. The objective of this study was to produce consensus-based best practice principles to promote engagement with CALD communities in cancer service level consumer engagement activities.</p><p><strong>Method: </strong>A Delphi study comprising a workshop with key stakeholders and two rounds of consensus surveys was conducted.</p><p><strong>Results: </strong>An initial set of 22 statements of best practice principles was produced through a stakeholder workshop. A total of 113 completed responses were received from eligible participants across the two rounds. Ratings and qualitative feedback provided by participants in each round were discussed with the project team to reach consensus on the final 10 best practice principles.</p><p><strong>Conclusion: </strong>The 10 best practice principles will complement existing consumer engagement strategies to promote engagement with CALD communities in cancer service level consumer engagement activities across Australia.</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":"145558173","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":"Surgical site infection surveillance in Australian public and private hospitals: a comparative analysis.","authors":"Ann L Bull, Lyn-Li Lim, Stephanie K Tanamas, Leon J Worth, Deborah N Friedman","doi":"10.1071/AH25058","DOIUrl":"10.1071/AH25058","url":null,"abstract":"<p><strong>Objectives: </strong>To utilise data submitted to the state coordinating centre for healthcare-associated infection surveillance to compare surgical site infection outcomes (SSIs) in public and private hospitals in Victoria, Australia.</p><p><strong>Methods: </strong>Coronary artery bypass graft, caesarean section (CSEC), hip (HPRO) and knee prostheses procedures reported between 2020 and 2023 were analysed. Patient characteristics included age, gender and American Society of Anaesthesiology (ASA) score. Procedure characteristics included duration, infection and surgical antibiotic prophylaxis. Logistic regression was used to model odds of SSI adjusted for patient and procedure characteristics.</p><p><strong>Results: </strong>This study analysed 153,264 records. Public hospitals reported more coronary artery bypass graft and CSEC procedures; private hospitals more knee prostheses and HPRO. Public hospital patients were generally younger, with longer procedure durations. Public hospitals reported more emergency procedures, proportionally more patients in high-risk categories, and longer lengths of stay for coronary artery bypass graft and HPRO. Odds of SSI were 51% lower in private hospitals for CSEC, but comparable for other procedures. Surgical antibiotic prophylaxis choice, timing and duration compliance was higher in public hospitals, except for CSEC and HPRO timing compliance, which was higher in private hospitals.</p><p><strong>Conclusions: </strong>In addition to patient and procedure characteristics, hospital sector is an important consideration when interpreting SSI data. For the studied procedures, although SSI outcomes were largely comparable across public and private sectors, public hospitals performed more emergency procedures and had a higher proportion of patients classified as high risk. Further studies comparing public and private hospitals should consider additional patient factors, including comorbidities, to better identify risks and inform prevention activities.</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":"145491077","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":"Telehealth use in Voluntary Assisted Dying: a systematic review.","authors":"Imogen Summers, Elizabeth Reymond, Helen M Haydon","doi":"10.1071/AH25113","DOIUrl":"10.1071/AH25113","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify how telehealth supports access to Voluntary Assisted Dying (VAD) globally and explore potential risks and benefits of telehealth for VAD consultations.</p><p><strong>Methods: </strong>A systematic review of peer-reviewed articles on telehealth and VAD examining global use of telehealth to support access to VAD, global restrictions to telehealth-enabled VAD, and practical and clinical implications of using telehealth in supporting VAD was performed. PubMed, Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Scopus were searched and supplemented by handsearching relevant articles. Study quality was assessed using the SQUIRE (The Standard for Quality Improvement Reporting Excellence) guidelines.</p><p><strong>Results: </strong>Two hundred and thirty articles were identified and then screened by two reviewers. Data were extracted from 26 included articles. Guided by Braun and Clarke's thematic analysis methodology, manual open coding was undertaken, and peer debriefing meetings resulted in the final key themes. Overall, findings indicate that telehealth can facilitate VAD services, enhance patient and provider experiences, and mitigate access inequities. The analysis highlighted that telehealth could further improve VAD access, especially in rural and remote areas. Until then, there are ongoing legal ambiguities for providers in Australia.</p><p><strong>Conclusions: </strong>Telehealth can improve access to VAD, particularly in remote areas, reducing travel burdens for terminally ill patients. Global evidence from VAD and other sensitive medical fields supports the conclusion that telehealth's benefits outweigh its risks. Legislative clarity in Australia is necessary to resolve conflicts between federal and state laws and to provide clarity for healthcare providers and improve access for eligible patients. Future research should include more robust measures of the efficacy of telehealth.</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":"145607699","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.","authors":"Daniel Harvie, Catherine Keating, Neala Fulia, Manuela Ferreira, Ian 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 pirivately 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 catastrophizing). Willingness to undergo spinal surgery within five 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 toward guideline-based, high-value non-surgical care.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607709","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":"Australia's healthcare workforce at breaking point: time for bold reform.","authors":"Sonĵ Elizabeth Hall","doi":"10.1071/AH25229","DOIUrl":"10.1071/AH25229","url":null,"abstract":"","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208661","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":"Driving excellence in aged care and healthy ageing.","authors":"Leonie M Short","doi":"10.1071/AH25207","DOIUrl":"10.1071/AH25207","url":null,"abstract":"<p><p>This policy reflection asks why there is so much attention paid to persons receiving aged and home care at the expense of those in the unpaid economy? Why do some calls for a new initiative for older Australians fall on deaf ears. It answers these questions by presenting an example of failed efforts by a range of key lobby groups for a Senior Dental Benefits Scheme and discusses the differences between a preventive social model of health versus a reactive medical model of health for older Australians.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194136","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":"Is a wholistic quality improvement program to reduce hospital-acquired complications economically viable in an Australian local health service?","authors":"Qun Catherine Li, Jonathan Karnon, Dana A Hince, Jim Codde","doi":"10.1071/AH25136","DOIUrl":"10.1071/AH25136","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to estimate avoidance of hospital bed-days and the resulting cost savings from a wholistic quality improvement program that was implemented to systematically reduce hospital-acquired complications (HACs) in an Australian local health service between 2018 and 2023.</p><p><strong>Methods: </strong>This was an uncontrolled retrospective observational analysis of prospectively collected data. An association between HAC and length of stay (LOS) was explored through a zero truncated negative binomial regression model for two LOS cohorts, using 21 days as the threshold for long-stay share of bed-days. Bed-day cost avoidance was estimated by applying the adjusted marginal effect of HAC on LOS, multiplied by the estimated number of HAC episodes averted, average weighted average units per bed-day, and the national efficiency price in respective years.</p><p><strong>Results: </strong>HACs were found to increase hospital bed-days by an average of 5.5 days (95% CI: 5.19-5.86) for episodes with LOS of 1-21 days, and by 7.1 days (95% CI: 6.78-7.48) for episodes with LOS exceeding 21 days. The program resulted in an estimated avoidance of HACs in 2991 episodes of care over a 5-year period, averaging 598 episodes per year. This equated to avoidance of a total of 16,751 hospital bed-days, or 3350 annually. Annual cost voidance from bed-days ranged from A$6.4 to A$11.5 million between 2019 and 2023. The budget for program management was A$514,500 per year, resulting in average net benefits of A$7.1 to A$8.2 million, a 14-16-fold return on investment for the health service.</p><p><strong>Conclusion: </strong>Findings suggest that financially viable opportunities are available for hospitals to achieve sustained reduction in HACs, which have the potential for wider adoption to tackle the challenges associated with adverse events in hospitals.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194158","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}