Quality Improvement and new technology

According to a recent article, healthcare providers have proven eager adopters of health care "apps," the software applications used on mobile devices to perform specific tasks, such as charting data points or aggregating information. A recent survey reported in Health Infomatics found that of the 4,000 US physicians they looked at, nearly 80 percent used smartphones capable of running apps—a far greater proportion than among the general public.

Health Care Quality Improvement: There's an App for That is an article by Martha Hostetta in the Quality Matters newsletter published by the Commonwealth Fund in the US.  Various apps useful to health workers are described.  "Disease management apps, in particular, can improve communication between patients and providers and promote adherence to recommended care. Still, for apps to achieve their potential to improve health care quality, they will need to be factored into reimbursement models and meet clear clinical needs."

Older people with chronic diseases study

"Community based service providers' perspectives on frequent and/or avoidable admission of older people with chronic disease in rural NSW: a qualitative study" is an article now available online in BMC Health Services Research.  Among the co-authors are our own local public health executives, Vahid Saberi and Paul Corben. They wished to establish some reasons why older people with chronic conditions were so often admitted to hospital.

The study involved intensive interviews with community health care providers to discover barriers which limited access to their services by older people with chronic disease.  Both external barriers (such as patients' lack of awareness of services, poverty, or actual lack of services) and internal barriers (such as the patients' fear or unwillingness to accept their health status) were identified.  The authors concluded that the reasons which prevent this group from accessing community health services, and thus being admitted to hospital, were complex.  "Improving accessibility of services ... includes consideration of patients’ social, emotional and psychological ability and willingness to use services as well as those services being available and easily accessed."

The hospital dementia services project: a study description

The Hospital Dementia Services Project is an innovative mixed-methods study to investigate how health and aged care system factors influence care outcomes for hospital patients with dementia. The project focuses on patients aged 50 or over who had an overnight stay in a public hospital in New South Wales during 2006-07.

Funded by the NHMRC, the project aims to inform health practitioners, health and aged care policy makers and planners, and consumers of how system factors influence care outcomes for patients with dementia. Read the AIHW publication on this project here.

Births, Australia, 2010

A new Australian Bureau of Statistics publication Births, Australia 2010 has been released this week. It contains statistics on live births and fertility for Australia, states and territories, and sub-state regions, based on calendar year of registration data. Information on characteristics of the child include place of usual residence, sex, Indigenous status, and age, martial status and country of birth of parents.

Testing Treatments: better research for better healthcare

The new edition of Testing Treatments, while building on the success of the first edition published 5 years ago, incorporates extensive revision and updating. There is expanded coverage of the benefits and harms of screening in a separate chapter (Chapter 4) entitled 'Earlier is not necessarily better.' And in 'Regulating tests of treatments: help or hindrance?' (Chapter 9) the authors describe how research can become over-policed to the detriment of patients. In an important chapter (Chapter 12) it is asked: ‘So what makes for better healthcare?’ and shows how the lines of evidence can be drawn together in ways that can make a real difference to all of us. The last chapter gives a blueprint for a better future and an action plan (Chapter 13).

As with the first edition of the book, the full text of the new edition is available for free download.

Windows into Safety and Quality in Health Care 2011

The Australian Commission on Safety and Quality in Health Care, in consultation with clinicians, consumers, public and private hospitals, and other healthcare provider organisations, has identified the priority national safety and quality areas for action in Australia. Windows into Safety and Quality in Health Care 2011 builds upon previous years’ Windows reports to offer perspectives on a range of healthcare safety and quality matters in a number of settings. 

Included in the report is a review of the Commission's activities over the past five years and a look at some of the emerging issues and challenges in the culture of health care, such as the importance of patient-centred care.  For the first time there is also an assessment of safety and quality in mental health care. The issue of technology and how it can be harnessed to improve safety and quality is also discussed.

Asthma in Australia 2011

The Australian Institute of Health and Welfare has just released Asthma in Australia 2011: with a focus chapter on chronic obstructive pulmonary disease.  Asthma remains a significant health problem in Australia, with prevalence rates that are high by international comparison - currently about one in ten people.  Although the mortality rate has decreased significantly over the past 20 years, it is still higher than in other countries.  All aspects of the disease are investigated, including information on the number of people who have asthma and who visit their general practitioner, are hospitalised or die due to asthma. Comorbidities and quality of life among people with asthma are also studied.

The report also includes a chapter that focuses on chronic obstructive pulmonary diseases in Australians aged 55 years and over, which indicates that many more people in this age group are hospitalised or die due to COPD than to asthma.

Physical care of mental health consumers - Guidelines

"Clinical guidelines for the physical care of mental health consumers: a comprehensive assessment and monitoring package for mental health and primary care clinicians" has recently been published in the Australian and New Zealand Journal of Psychiatry [2011 Oct;45(10):824-9].

The authors have focused on the fact that Australian mental health patients have a low level of physical health compared to the general population.  They studied medication effects, lifestyle, existing or developing physical disorders, alcohol and illicit drug use, and psychosocial factors, and have produced a package containing a metabolic syndrome algorithm wall chart, a clinician handbook, a psychosocial assessment booklet,  and screening forms. 
 
Contact your hospital librarian for a copy of the guidelines.

Radiotherapy and survival in breast cancer

A major study of 11,000 women over the past 10 to 15 years has been published online in the Lancet .  "Radiotherapy and survival in breast cancer" [doi:10.1016/S0140-6736(11)61296-8], authored by Thomas Buchholz, indicated that a course of radiotherapy after a lumpectomy for breast cancer led to a 50% proportional reduction in the risk of recurrence.

Buchholz, stated on ABC Radio's AM program this week, that the trial showed that radiation therapy "reduces the chance of developing a breast cancer recurrence and most importantly it improves the chance of overall survival of a patient [and] improves the chance that they'll be cured of their disease."
 
To read the full text of the provisional article, go to CIAP and search "Articles in Press".  Contact your hospital librarian if you have trouble finding it.

The Science of Prevention For Children and Youth

The high prevalence of social, emotional and behavioural health problems in children and young people in Australia, and the high cost and relative ineffectiveness of treatments to ‘cure’ them, lead to the conclusion that the most efficient and cost effective approach is to prevent them from occurring. The challenge is in determining what to prevent and how to do so. While there are complex social and political aspects to prevention, it must also be guided by a solid scientific basis. This paper , published in Australian Review of Public Affairs, makes the case that prevention science provides a framework for ensuring that prevention initiatives are founded on robust evidence and implemented in a way that will allow progressive growth in knowledge of ‘what works’ in prevention. The paper examines some of the opportunities and challenges in a shift to an evidence-based prevention agenda to improve the lives of children and young people.

Predictive Risk Modelling in Health : Options for New Zealand and Australia

Predictive risk models (PRMs) are case-finding tools that enable health care systems to identify patients at risk of expensive and potentially avoidable events such as emergency hospitalisation. Examples include the PARR (Patients-at-Risk-of-Rehospitalisation) tool and Combined Predictive Model used by the National Health Service in England. When such models are coupled with an appropriate preventive intervention designed to avert the adverse event, they represent a useful strategy for improving the cost-effectiveness of preventive health care.

This article, published in the Australian Health Review, reviews the current knowledge about PRMs and explores some of the issues surrounding the potential introduction of a PRM to a public health system. We make a particular case for New Zealand, but also consider issues that are relevant to Australia. The authors of this article are Laura E. Panattoni, Rhema Vaithianathan, Toni Ashton, and Geraint H. Lewis.

Taste Disorders in Australian Aboriginal and Non-Aboriginal Children

Despite reports that taste disorders can lead to changes in eating behaviour, no study of the prevalence of taste disorders in children in the general community had been reported. Studies with adults report a range from 0.85% to 30% but provide no indication of the prevalence in children. A screening study of 432 Australian Aboriginal (12%) and non-Aboriginal children (7.9%) aged 8-12 years indicated that some had a taste dysfunction characterized by the loss of at least 1, and often more, taste qualities. The World Health Organization (WHO) defines a prevalence of <4% in a population as a massive public health problem. The cause of the disorders is unknown, so there is a need for a wider investigation of the causes and the consequences.

The results of this study have been published in the September 2011 issue of Acta Paediatrica (pages 1267-1271). You will need a subscription to this journal to access the paper by D.G. Laing et al (Available via CIAP for NSW Health)

Indigenous Disadvantage and Cultural Attachment

Only a small number of empirical studies in Australia, Canada, and New Zealand have examined the relationship between Indigenous people's levels of cultural attachment and their socio-economic outcomes. This paper, "Indigenous disadvantage : can strengthening cultural attachment help to Close the Gap?", examines whether strengthening cultural attachment can help reduce Indigenous disadvantage in Australia. It is an e-brief from the NSW Parliamentary Library Research Service.

Depression Stigma in Australian High School Students

To identify predictors of depression stigma in a group of Australian school students, participants (1,804 students aged 12–15 years) completed a questionnaire covering sociodemographic information, recognition of depression in a vignette, stigma towards a depressed peer, help-seeking intentions, information from teachers, and student mental health. The results suggested that depression stigma is a multidimensional construct with different factors predicting different aspects of stigma. Increased recognition of depression was associated with an increased belief in depression as a sickness rather than a weakness, but also with an increased belief that those with depression are dangerous and unpredictable. It is likely that multifaceted stigma-reduction interventions are needed, with emphasis on reducing the associations between depression and danger and targeting those of non-English-speaking backgrounds. The results of this study may be viewed in this journal article in Youth Studies Australia.

Single dose oral analgesics for acute post operative pain in adults

All analgesic drugs (painkillers) are tested in standardised clinical studies of people with established pain following surgery, and often after removal of third molar (wisdom) teeth. In all these studies the participants have to have at least moderate pain in order for there to be a sensitive measure of pain-relieving properties. The Cochrane Library has 35 reviews of oral analgesic interventions, with 38 different drugs, at various doses involving 45,000 participants in about 350 studies. This overview sought to bring all this information together, and to report the results for those drugs with reliable evidence about how well they work or any harm they may do in single oral doses.
Click here to find out more about this important overview

Parental mental health and families eLearning program

The Social Care Institute for Excellence (SCIE) has launched a new, free-of-charge Parental mental health and families eLearning program, which provides online resources to help guide mental health and social care professionals in the delivery of appropriate and timely support.

One Day at a Time

One Day at a Time is a new and innovative resource that includes information about child development and ideas to help parents and early childhood professionals match activities with each child’s developmental levels.

For Kids' Sake

This report, "For Kids’ Sake: Repairing the Social Environment for Australian Children and Young People" examines trends in child and youth wellbeing across Australia, and finds that there has been a rise in child abuse and neglect and deterioration in psychological wellbeing for many children. The report offers hope to Governments and communities searching for answers to the crisis affecting our nation’s troubled children. The author Patrick Parkinson AM is a Professor of Law at the University of Sydney. Read or download the report here.

Preventing Multiple Risky Behaviors among Adolescents: Seven Strategies

This Research Brief brings together findings from developmental science and from rigorous program evaluations to identify seven actionable, feasible strategies and relevant programs that have been found to affect two or more risky behaviors in adolescents.

Access to Eye Health Services Among Indigenous Australians

This paper, accessible here, explores Indigenous people's access to eye health services at a community level. This project examined equity of access to eye health services at a community level by examining the relationship between the percentage of Indigenous people living in an area, socioeconomic status and remoteness and access to ophthalmic and optometric services and the professionals that provide them. This was done in three stages:
1. Mapping the location of eye health professionals,
2. Mapping the distribution of eye health services and the relationship between different types of service provision and
3. Examining the relationship between the provisions of eye services and health outcomes.

The authors of this paper are: Margaret Kelaher, Angeline Ferdinand, Samantha Ngo, Nilofer Tambuwla, Hugh R Taylor

Dementia Across Australia 2011-2050

Without a significant medical breakthrough, the number of Australians with dementia is expected to soar from an estimated 267,000 in 2011 to almost one million people by 2050. Deloitte Access Economics was commissioned by Alzheimer’s Australia to provide updated dementia prevalence estimates and projections for Australia. Specifically, this report estimates the number of people with dementia in Australia in 2011, and predicts the number of people who will be living with dementia in Australia in the future, from 2012 until 2050. Click here to access this report.

Investing in Mental Health: The Great Push.

In recognition of World Mental Health Day (October 10th), sponsored by the United Nations' World Health Organization, Wiley is presenting a selection of free scholarly and professional research and practice on the 2011 World Mental Health Day theme, Investing in Mental Health: The Great Push.

Dialogue: latest issue

The latest isue of Dialogue, the journal of the Academy of the Social Sciences in Australia, has been released with the bulk of the issue is devoted to health issues relating to "A healthy society - How to get it? How to keep it?" The contents include:
Designing the health system for the 21st century - Jane Hall
Mental health care reform: more, please - Alan Rosen
Directions for ageing well in a healthy Australia - Hal Kendig and Colette Browning
Landmark moment in ehealth for Australia - Mukesh Haikerwal
Healing, empowerment and resilience across the lifespan: views from an academic unit - Lisa R Jackson Pulver, Melissa R Haswell and Sally A Fitzpatrick
Economics informed policy can drive better health; but there will be few gains without structural change - Leonie Segal, Kim Dalziel and Ron Donato
Subjective wellbeing as a key to a healthy society - Robert A. Cummins

Anne Manne on Disabliltiy

Listen to this riveting talk at Lunchbox/Soapbox by Anne Manne on Australia's desperate need for more genuine engagement with ability issues. She asks us to look at the care and support we provide to the differently-abled.
Lunchbox/Soapbox is a simple idea: an old-fashioned Speakers’ Corner in the middle of the city, in the middle of the day made possible by the Wheeler Centre in Melbourne.

Anne Manne is a Melbourne writer, essayist and social philosopher and has been a regular columnist for The Australian and The Age.
Download or watch the video here.

Maternity data in Australia: a review of sources and gaps

A new bulletin from AIHW presents the results of a review of the depth and breadth of maternal data capture in Australia. Gaps in national data were identified, as well as opportunities for future improvements, A key output of the review is the Maternity Information Matrix, an electronic inventory of maternity data collections and data items.
Read or download the publication here.

Essentials of Care

Essentials of Care is a framework to support the development and ongoing evaluation of nursing and midwifery practice and patient care. Using transformational practice development methodologies healthcare teams are engaged in the evaluation and development of the clinical care provided.
The aims of the project are to improve patient safety and outcomes through the implementation of a NSW state-wide framework that focuses on the essentials of clinical care, and to enhance the experiences of patients, families and carers as well as staff involved in the delivery of care. You can watch the introductory video on EOC or read about the structure or facilitation of the program.

Visit the NSW Health EOC site.

HIV/AIDS, hepatitis and sexually transmissible infections in Australia: Annual report of trends in behaviour 2011

This National Centre for HIV Research 2011 report reviews social and behavioural research on HIV, viral hepatitis and sexually transmitted infections. Stigma remains a major issue for people affected by HIV, hepatitis C or drug dependence. The report is freely available online.

2011 Strategic roadmap for Australian research infrastructure: final report

Outlining the priority areas for national, collaborative research infrastructure over the next five to ten years, the elements outlined in the 2011 Roadmap are an important element in strengthening Australia's innovation system. Research infrastructure is a prime determinant of Australia’s ability to undertake excellent and world‑leading research. A strong and thriving research sector is a fundamental component of an advanced innovation system. Many ideas that inspire transformative innovation are born from research.
Download the full Department of Innovation, Industry, Science and Research here.

Physical Activity in Australia: A Snapshot, 2007-08

This publication provides an overview of the physical activity levels of adults in Australia, including information on a range of factors which may influence these levels and the long-term health risks associated with physical inactivity. Read or download the Australian Bureau of Statistics publication: 4835.0.55.001 - Physical Activity in Australia: A Snapshot, 2007-08

Clinical Obesity

Clinical Obesity is a journal publishing translational and clinical research papers and reviews focusing on obesity and its co-morbidities. As a newly launched journal, all content published in 2011 will be FREE online to all.

Ben Goldacre - How the media influences people's perceptions of health & why it's important to unpick dodgy claims.

The public and patients perception of health is influenced dramatically through media reporting. Dr. Ben Goldacre explores the role of the media and the importance of “unpicking” bad science and dodgy scientific claims. Ben Goldacre is an award-winning writer, broadcaster, and medical doctor who authored the book “Bad Science”. Watch the online video here of his presentation at the 2010 Evidence Live conference.

Evidence Live is a leading conference on understanding and using evidence in the delivery and implementation of effective and affordable healthcare presented by BMJ, Oxford University and the Centre for Evidence-Based Medicine.