Janelle Gifford, Soumya Mazumdar, Matthew Jennings, Bin Jalaludin, Sarah Dennis
{"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}
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
{"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}
Jacqueline Cunninghame, Mari Takashima, Lorelle Holland, Linda Nguyen, Abbey Diaz, Shuaijun Guo, Mitchell Dufficy, Craig F Munns, Amanda Ullman
{"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}
Tolesa Okuba, Zhisheng Sa, Tim Badgery-Parker, Janet C Long, Jeffrey Braithwaite, Angela Makris, Annie Hutton, Jean-Frederic Levesque, Diane E Watson, Johanna I Westbrook, Rebecca Mitchell
{"title":"Trajectories of hospital service use in the last 12 months of life by people with chronic kidney disease: a retrospective cohort study.","authors":"Tolesa Okuba, Zhisheng Sa, Tim Badgery-Parker, Janet C Long, Jeffrey Braithwaite, Angela Makris, Annie Hutton, Jean-Frederic Levesque, Diane E Watson, Johanna I Westbrook, Rebecca Mitchell","doi":"10.1071/AH24139","DOIUrl":"10.1071/AH24139","url":null,"abstract":"<p><p>Objective This study aimed to examine group-based trajectories of hospital service use by people with chronic kidney disease (CKD) in the last 12months of life. Methods A retrospective cohort study was conducted using hospital admission and mortality data in New South Wales, Australia. Individuals aged ≥18years who were hospitalised during 2014-2021 and who died during 2015-2021 were included. A group-based trajectory analysis was conducted including all-cause admissions and unplanned-only admissions. Multinomial logistic regression examined predictors of trajectory group membership. Results There were 10,653 adults who had at least one CKD hospital admission 12months prior to death. Four group-based trajectories of hospital service use were identified for all-cause admissions (i.e. Very-Low, Low, Moderate, High) and three group-based trajectories for unplanned-only admissions (i.e. Low, Moderate, High). The study identified associations between frequent hospitalisations and key patient characteristics and health conditions. Individuals in the High hospitalisation group were more likely to have cancer (OR 4.55; 95% CI: 2.54-8.16). Additionally, the High unplanned hospitalisation group showed increased likelihoods of being adults aged 18-64years (OR 1.94; 95% CI: 1.32-2.84) and having diagnosis of congestive heart failure (OR 1.80; 95% CI: 1.26-2.55), cancer (OR 2.25; 95% CI: 1.49-3.40), mental disorders (OR 1.88; 95% CI: 1.35-2.62) or smoking (OR 2.01; 95% CI: 1.49-2.70) compared with the Low hospitalisation group. Conclusions Group-based trajectory analysis revealed specific patterns in hospital service usage. Understanding these patterns helps in devising targeted strategies to decrease unplanned hospitalisations among these high-risk patients.</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":"142883891","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":"What factors affect the recruitment and retention of allied health professionals working in hospitals? A systematic literature review.","authors":"Laure Baumgartner, Olivia Wright, Katelyn Barne, Karly Bartrim, Amy Kirkegaard, Victoria Sullivan, Emily Burch, Lauren Ball","doi":"10.1071/AH24287","DOIUrl":"10.1071/AH24287","url":null,"abstract":"<p><p>Objective Workforce shortages in hospitals have necessitated a focus on recruitment and retention of health professionals. The aim of this systematic review was to synthesise literature relating to factors that affect recruitment and retention of allied health professionals working in hospital settings. Method PubMed, CINAHL (via EbscoHost), Embase (via Elsevier), and Scopus Advanced Search databases were used to retrieve 1665 studies, of which 16 were included. Herzberg's two-factor theory was used to synthesise study findings and develop key themes. Results Job advancement, company policies, supervision (leadership), working conditions, salary, recognition, and growth opportunities were factors identified as affecting recruitment and retention. Conclusion Identified factors are largely amenable to change and could contribute to a more sustainable allied health workforce in hospitals and enhance the quality of care. This research could significantly impact and enhance the evidence supporting interventions and strategies that are critical for retaining the allied health workforce in hospitals.</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":"142775539","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}
Forbes McGain, Kasun Wickramarachchi, Lu Aye, Brandon G Chan, Nicole Sheridan, Phong Tran, Scott McAlister
{"title":"The carbon footprint of total knee replacements.","authors":"Forbes McGain, Kasun Wickramarachchi, Lu Aye, Brandon G Chan, Nicole Sheridan, Phong Tran, Scott McAlister","doi":"10.1071/AH24154","DOIUrl":"10.1071/AH24154","url":null,"abstract":"<p><p>Objective Detailed quantifications of the environmental footprint of operations that include surgery, anaesthesia, and engineering are rare. We examined all such aspects to find the greenhouse gas emissions of an operation. Methods We undertook a life cycle assessment of 10 patients undergoing total knee replacements, collecting data for all surgical equipment, energy requirements for cleaning, and operating room energy use. Data for anaesthesia were sourced from our prior study. We used life cycle assessment software to convert inputs of energy and material use into outputs in kg CO2 e emissions, using Monte Carlo analyses with 95% confidence intervals. Results The average carbon footprint was 131.7kg CO2 e, (95% confidence interval: 117.7-148.5kg CO2 e); surgery was foremost (104/131.7kg CO2 e, 80%), with lesser contributions from anaesthesia (15.0/131.7kg CO2 e, 11%), and engineering (11.9/131.7kg CO2 e, 9%). The main surgical sources of greenhouse gas emissions were: energy used to disinfect and steam sterilise reusable equipment (43.4/131.7kg CO2 e, 33%), single-use equipment (34.2/131.7kg CO2 e, 26%), with polypropylene alone 13.7/131.7kg CO2 e (11%), and the knee prosthesis 19.6kg CO2 e (15%). For energy use, the main contributors were: gas heating (6.7kg CO2 e) and heating, cooling, and fans (4kg CO2 e). Conclusions The carbon footprint of a total knee replacement was equivalent to driving 914km in a standard 2022 Australian car, with surgery contributing 80%. Such data provide guidance in reducing an operation's carbon footprint through prudent equipment use, more efficient steam sterilisation with renewable electricity, and reduced single-use waste.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"664-672"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523809","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":"Chief executive officers retention model for Australian hospitals.","authors":"Nebu Mathew, Chaojie George Liu, Hanan Khalil","doi":"10.1071/AH24202","DOIUrl":"10.1071/AH24202","url":null,"abstract":"<p><p>Objective This study aims to develop a comprehensive chief executive officer (CEO) retention model for Australian hospitals, addressing high turnover rates by integrating key retention strategies to promote organisational stability and enhance patient care. Methods The study employed a sequential exploratory design with four stages: a scoping review, qualitative interviews, a quantitative survey, and comprehensive data analysis. The scoping review examined existing literature on CEO turnover and retention. Qualitative interviews with 14 Australian hospital CEOs provided in-depth insights. A quantitative survey with 51 CEOs validated the findings. Data triangulation ensured a robust and contextually relevant model aligned with Transformational Leadership Theory and a systems approach. Results Five key factors influencing CEO retention were identified: mutual respect and clear roles between CEOs and boards, fostering a positive organisational culture, competitive rewards, robust recruitment and retention practices, and ongoing professional development and mentorship. The model emphasises a supportive environment, equitable compensation, effective succession planning, and leadership development. Findings indicate a holistic approach addressing both professional environment and personal growth is essential for improving CEO retention rates. Conclusions The CEO retention model provides practical solutions to reduce turnover and enhance stability in Australian hospitals. By incorporating Transformational Leadership Theory and a systems approach, the model offers a comprehensive framework that addresses the multifaceted nature of CEO retention. Future research should refine these strategies and explore their applicability in different healthcare settings to further enhance effectiveness.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":"711-719"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303277","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}
Irene Bryan, Anthony Austen-Wishart, Pratibha Ranjan, Luke Plant, Dana Forcey, Robert Millar
{"title":"Patients' reasons for leaving an emergency department without being seen: results from a survey-based cohort study during the COVID-19 pandemic.","authors":"Irene Bryan, Anthony Austen-Wishart, Pratibha Ranjan, Luke Plant, Dana Forcey, Robert Millar","doi":"10.1071/AH24285","DOIUrl":"10.1071/AH24285","url":null,"abstract":"<p><p>Objective Patients who do not wait (DNW) to be seen are a problem for emergency department (ED) care. The aim of this study was to identify the rate and reasons of DNW patients during 1month of the COVID-19 pandemic. Methods An observational cohort study of DNW patients presenting to Austin Hospital ED was carried out in August 2021. Patients were identified using hospital coding data and surveyed by telephone. DNW patients' reasons were explored, and their demographics and clinical outcomes compared with those who received care. Results Of 7641 patients presenting to ED in the study period, 6% (n =452) were DNW patients. Compared with those who received care, DNW patients were younger (P <0.001), had lower triage categories (P =0.001) and were more likely to have self-presented (P =0.006). A total of 47% of DNW patients (n =213) participated in the survey. Reasons for leaving included waiting time (61%, n =129), symptom improvement (13%, n =28), reassurance from staff (7%, n =15) and ED crowding (6%, n =12). A total of 75% of DNW patients (n =159) sought alternative medical care; 14% (n =29) reported hospitalisation within 7days. 64% (n =137) did not feel that the experience affected their likelihood of seeking future ED care; 32% (n =69) felt less likely to seek future ED care. Conclusions During the month studied, the DNW rate was 6%. Reassuringly, most patients sought alternative medical care, although one-third were dissuaded from returning to the ED. Future research should focus on high-risk group delineation and qualitative description of the experiences and reasons of DNW patients.</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":"142878930","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":"What's in a name? Why the proposed title change for podiatric surgeons is a step backward.","authors":"Mark F Gilheany","doi":"10.1071/AH24291","DOIUrl":"10.1071/AH24291","url":null,"abstract":"<p><p>The Australian Podiatry Board's proposal to change the title 'podiatric surgeon' to 'surgical podiatrist' lacks evidence and is contrary to broader healthcare reform agendas. The current title 'podiatric surgeon' reflects scope of practice. Instead of a title change, regulators should focus on removing barriers to effective collaborative care.</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":"142840602","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}