Patient Journey Mapping Tools

The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. This paper describes the patient journey mapping tools and frameworks used in the Managing Two Worlds Together (MTWT) Project. It outlines the barriers and enablers, gaps and strategies in relation to country Aboriginal patient journeys from rural and remote locations to city hospitals and return, from the perspective of the patient/client, their carer/ family, and local health care providers.
The paper was written by Brita Pekarsky, Judith Dwyer and Janet Kelly and published by The Lowitja Institute.

World Health Statistics 2012

WHO's annual World Health Statistics reports present the most recent health statistics for the 194 WHO Member States. The report contains WHO’s annual compilation of health-related data, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets.
This year, it also includes highlight summaries on the topics of noncommunicable diseases, universal health coverage and civil registration coverage.

Recognising Early Symptoms of Ovarian Cancer.

NICE has launched a quality standard to help with recognising the early symptoms of ovarian cancer. It can be hard to diagnose the condition, since some of the symptoms of ovarian cancer are similar to those seen in more common conditions such as irritable bowel syndrome.
The quality standard consists of eight quality statements that describe high-quality, cost-effective care for the condition. It says women aged 50 or above and reporting one or more symptoms occurring persistently, or frequently suggesting ovarian cancer, should be offered a CA125 test. Furthermore, women with raised CA125 should have an ultrasound of their abdomen and pelvis within 2 weeks of receiving the CA125 test results.

'Recognising early symptoms of ovarian cancer' is an online learning tool covering the signs and symptoms of ovarian cancer and diagnostic tests. 'Ovarian cancer: recognising early symptoms in primary care' is an audio module examining the importance of early diagnosis and prognosis, risk factors, and signs and symptoms.

These resources were developed independently by Target Ovarian Cancer and BMJ Learning.

Tools to Improve Care

The Australian Commission on Safety and Quality in Health Care (ACSQHC) is a government agency which was established by the Commonwealth, with the support of State and Territory governments. Since ACSQHC was established, more than 200 implementation support tools have been developed and published. Click here to go to the site.

Cancer Surgery Waiting Times

New information on cancer surgery waiting times has been made available on MyHospitals, a website managed by the Australian Institute of Health and Welfare (AIHW).
The website presents cancer surgery waiting times for public hospitals, showing the median waiting times (in days) for selected cancer types in each hospital. The types of cancer for which waiting times are shown are: bladder cancer, bowel cancer, breast cancer, gynaecological cancer, kidney cancer, lung cancer, melanoma and prostate cancer. The website also presents information for each hospital on the total number of admissions for elective cancer surgery across the selected cancer types. You need to put in the postcode or name of the hospital to find the waiting time statistics.

Closing the Gap- New Publications

The Australian Institute of Health and Welfare has released three new Closing the Gap Clearinghouse reports:

* Education programs for Indigenous Australians about sexually transmitted infections and blood borne viruses
* Engaging Indigenous students through school-based health education
* Constructing and maintaining houses

These reports are Internet Only.

Cancer Directory website

Cancer Directory is a directory of resources, rather than services, and is maintained by the Cancer Council of NSW.  It provides the community and health professionals with an online collection of trusted Australian cancer care resources that have been published since 2000 in print, audiovisual (AV) or electronic formats.  It contains over 1800 printed, audio visual and electronic publications from over 80 trusted Australian cancer care organisations - the Cancer Councils, Australian and State governments, major health services and large not-for-profit agencies.  

You can search the directory by cancer type, by area of focus (prevention, diagnosis, treatment, etc.) and by format, and the resources cover a range of target audiences.  There is also a facility for adding new resources to the database, and an electronic newsletter providing updates.

Absolute CVD risk guidelines

The first Australian Guidelines for the management of absolute cardiovascular disease risk, developed by the National Vascular Disease Prevention Alliance (NVDPA) are now available.  

The guidelines make recommendations for assessing and managing absolute CVD risk in adults aged over 45 years (35 years for Aboriginal or Torres Strait Islander adults) who are without known CVD. Special sections providing advice on preventing CVD for those with diabetes and chronic kidney disease are included where relevant.

You can also access the Stroke Foundation's Management Guideline Quick Reference Guide for health professionals and an online risk calculator. 

Fertility link to Circadian Rhythm

Scientists at Northwestern University in Illinois have gone a step further to working out why epidemiological studies of female shift workers have reported increased rates of reproductive abnormalities and adverse pregnancy outcomes.  Testing mice with a disruption of their circadian rhythms, they discovered a dramatically reduced pregnancy success, compared to the control group.  The good news is that the effect is reversible, so if this study can be extrapolated to female shift workers who are having trouble falling pregnant, once they revert to a ‘normal’ circadian clock there chances should improve.

PLoS ONE is an open access journal, so you can access the full text from their site.  Summa KC, Vitaterna MH, Turek FW (2012) Environmental Perturbation of the Circadian Clock Disrupts Pregnancy in the Mouse. PLoS ONE 7(5): e37668. doi:10.1371 

Consumer Engagement in the Aged Care Reform Process

This report, Consumer Engagement in the Aged Care Reform Process was commissioned by the Department of Health and Ageing (DoHA). Alzheimer’s Australia was chosen to conduct a series of consumer consultations in response to the Productivity Commission’s report Caring for older Australians. Sixteen consultations were held nationwide, as well as an online survey for those unable to attend. Approximately 1000 people attended the consultation and 200 responses were received. Across all consultations as well as responses to the online survey, the overwhelming view of consumers was that the aged care system is not working well for people with dementia, even less so for diverse communities. For those with younger onset dementia (YOD) there are no age appropriate services. Consumers are frustrated that they are unable to get the services they need and that the services that are available are often inflexible and of poor quality.

The consultations were a reminder that the quality of life of people with dementia is impacted by issues in the health system. A key concern was delays in diagnosis and failure to refer to support services. A number of consumers also had poor experiences with the acute care sector. Consumers were also concerned about the future and the need for investment in research. For the person with dementia the journey needs to start with a timely diagnosis, referral to support services, properly resourced assessment services and a link worker (not a call centre) to provide guidance when needed. For the family carer access to dementia education, support in managing BPSD and flexible respite is key.

Evaluation of the Indigenous Diabetic Foot Program

This paper, "Evaluation of the NSW Indigenous Diabetic Foot Program for Health Workers whose primary role is with Aboriginal People in the lower mid north coast" by Esher Townsend, a Clinical Education and Training Institute Rural Directorate report, assesses the effectiveness of a new diabetes education program for Indigenous Health Workers. The Indigenous diabetic foot program (IDFP) provides educational programs for both Indigenous Health Workers (IHWs) and Indigenous patients who have diabetes.

This evaluation assessed the effectiveness of the education program for IHWs by measuring the knowledge gained by the IHWs and the integration of the screening tools into clinical practice. Results showed that after the workshop IHW participants had increased their knowledge levels, and that this knowledge was sustained over at least a six month time period. The study also showed that while the participants found the IDFP to be beneficial, the uptake and implementation of the screening program was low (55%).

Living Longer, Living Better

The Commonwealth Government has released an aged care reform package  Living Longer Living Better which provides $3.7 billion over five years.
The package includes:
$955.4 million to help people to stay at home
$660.3 million to deliver better residential aged care
$39.8 million to support consumers and research
$80.2 million to ensure better health connections

From 1 July 2015, the Government will establish a national Commonwealth Home Support Program. This new and streamlined approach will bring together under the one program all the services currently providing basic home support - the existing Home and Community Care program for older people,the National Respite for Carers Program, the Day Therapy Centres program and the Assistance with Care and Housing for the Aged program.

Children's Mental Health

The Centre for Community Child Health at the Royal Children's Hospital Melbourne has prepared a Policy Brief on Children's Mental Health. Australia has seen significantly increased awareness of mental illness and a major increase in funding available to try to address the issue. However, the focus for attention and funding is primarily on 12-25 year olds and disadvantaged groups – only a tiny fraction of the available mental health funding in Australia is devoted to 0-12 year olds. The next step is to focus on mental illness prevention and mental health promotion from very early childhood; many of the mental health problems encountered in adolescence and adulthood have their origins in early childhood. The definition of mental health problems in early childhood is complex, but for the purposes of this Policy Brief it includes a range of social, emotional and behavioural concerns.

Investigation into the National Office of the Health Services Union

Fair Work Australia released its report into the National Branch of the Health Services Union (HSU) to the public on 7 May. The investigation found 181 contraventions of the HSU rules.
Background (by Fair Work Australia)
The investigation into the finances and financial management of the National Office of the Health Services Union was conducted by a senior manager of Fair Work Australia, known as the Delegate. It commenced on 27 March 2010 and concluded on 28 March 2012 when the Delegate provided the investigation report to the General Manager. An earlier inquiry, which preceded the investigation, commenced on 6 April 2009.
Documents made available by the Senate Standing Committees on Education, Employment and Workplace Relations:

• Correspondence to Fair Work Australia - (PDF 439KB)
• Response from Fair Work Australia - (PDF 87KB)
• Correspondence from Holding Redlich - (PDF 129KB)
• Correspondence to Commonwealth Director of Public Prosecutions - (PDF 571KB)
• Response from the Commonwealth Director of Public Prosecutions - (PDF 140KB)
• Fair Work Australia Report into the National Branch of the Health Services Union received by the Committee 7 May 2012 - (PDF 7396KB) 

Getting the Wind Up

This report, "Getting the wind up: exploring concern about the adverse health effects of wind turbines in Australia and Europe", by Neil Barrett of the Mount Alexander Sustainability Group, looks at the difference in the level of concern about adverse health effects from wind turbines in Australia, Denmark and Germany. In Denmark and Germany, where wind turbines are very common, there is hardly any debate, whereas in Australia the claims made by anti-wind groups threaten to bring the industry to a standstill. By providing evidence of the lack of concern about health effects in Europe, this report casts further doubt on the validity of 'wind turbine syndrome’.

Schizophrenia Awareness Week

May 14-20 is Schizophrenia Awareness Week in Australia.  the Minister for Mental Health and Ageing, Mark Butler, has welcomed the opportunity the week provides to promote greater community understanding of schizophrenia and mental illness generally.  His media release includes information about the prevalence and nature of schizophrenia and the Government’s efforts towards supporting sufferers and carers.

Sane Australia has some good information in their fact sheets and podcasts about many different disorders.  Find their schizophrenia information here.

Australian Indigenous HealthInfoNet research

The Australian Indigenous HealthInfoNet’s translational research contributes to ‘closing the gap’ in health between Indigenous and other Australians by informing practice and policy in Indigenous health. It does this by making the knowledge generated by various types of research and other information readily accessible to people working and studying in the area of Indigenous health.  

Translational Research and the Australian Indigenous HealthInfoNet is a working paper discussing the research being undertaken.  "In recognition of the fact that translational research (TR) is a new, inherently broad concept, the paper begins with a general overview of this important type of research. Drawing on the most recent international literature, the overview considers the various types of TR, with particular attention to its nature and methods at a population-level. The paper then summarises the various aspects of the HealthInfoNet's TR".
  

Causes of death statistics 2010

The Australian Bureau of Statistics has just released its publication 3303.0, Causes of Death, Australia 2010.  Causes of death statistics are key to understanding Australian society and health, providing insights into the diseases and factors contributing to reduced life expectancy.

In 2010, there were 143,473 deaths registered in Australia, 2,713 (1.9%) more than the number recorder in 2009.  Males accounted for 51.2% of deaths, and females 48.8%.  Ischaemic heart disease was the leading cause of death, at 15.1%.  It has been the leading cause since 2000

Bipolar II disorder in rural New South Wales

This study, published recently in Australasian Psychiatry, aimed to determine the frequency with which bipolar II disorder was diagnosed in clinics held in four rural towns in New South Wales over a period of two years and nine months.  
Of 559 patients seen for the first time during the study period, 20% were diagnosed with BD II, and this diagnosis was made for the first time in 61% of these.  The authors concluded that BD II was commonly seen in these rural clinics, and appears to be often under-diagnosed in general practice, as has been found to be the case in urban centres. This is seen as a serious public health problem which needs to be addressed.
Robertson A, Moore G, Boyce P (2012). Australasian Psychiatry, doi: 10.1177/1039856212437900.  The article is available in full-text via CIAP, or contact your health library.

eHealth Learning Centre

Health Minister Tanya Plibersek has launched an online “learning centre” which details how the Government’s new electronic health record system will work for patients and practitioners.  She said the new learning centre will inform and educate the public and healthcare professionals about eHealth and the personally controlled electronic health record system in the lead up to the July launch. To see more go to www.ehealth.gov.au and follow the link to the learning centre.

Australian Government 2012-13 Health and Ageing Portfolio Budget Statements

Information for the Health and Ageing Portfolio 2012-13 Budget and related Media Releases are available for viewing. Click here.

Management of tracheal extubation

Tracheal extubation is a high risk procedure in anaesthesia and critical care. Until now most guidelines have focused on intubation, with little to guide the process of extubation.
The Difficult Airway Society in the UK has now published guidelines for the management of tracheal extubation, describing four steps:
Step 1: plan extubation.
Step 2: prepare for extubation.
Step 3: perform extubation.
Step 4: post-extubation care: recovery and follow-up.

Overcoming challenges to improving quality

In the UK the Health Foundation has been working with the NHS to deliver improvement through service and staff development programmes. All Health Foundation improvement programmes are evaluated so as to gather evidence of their impact and to better understand how it has been achieved. A team of researchers looked at the factors that affected the likelihood of improvement methods being applied and new interventions adopted. 10 key challenges to improvement were identified that consistently emerged in the programmes evaluated. Download the full report here.

Complementary and Alternative Therapies

Complementary therapies work with conventional medical treatment, while alternative therapies are those which offer alternatives to conventional diagnosis and therapies. Complementary medicine used together with conventional medicine is known as integrative medicine. HealthInsite the Australian health information service, lists a large number of treatments and therapies with links to good sources of further information.

Australia's hospitals 2010-11 at a glance

This summary report presents an overview of statistics on our hospitals. In 2010-11, there were 8.9 million hospitalisations, including 2.2 million admissions involving surgery, with hospital spending  increasing faster than inflation. These facts and more can be found in Australia's hospitals 2010-11 at a glance, published by AIHW.

Osteoporosis model of care

ARCHI is a great resource for clinicians interested in innovation.  See what others are doing and share your ideas. A new resource published there recently is the Osteoporosis Model of Care by a group from the Bone and Joint Institute in the  Hunter New England Local Health District.  

It is a multidisciplinary team-based model which has created efficiencies in detecting and management of osteoporosis with improved patient outcomes. It is designed for patients over 50 years of age, presenting to the Emergency Department with a minimal trauma fracture. The patients are identified, referred and managed with intervention and follow up.  There's a lot more information at the ARCHI site, including presentations, fact sheets and contact details for the team responsible.

Cervical screening in Australia 2009-2010

Cervical screening in Australia 2009-2010 is a new AIHW report presenting the latest national statistics from the National Cervical Screening Program, which aims to reduce incidence, morbidity and mortality from cervical cancer. About 57% of women in the target age group of 20-69 took part in the program, with more than 3.6 million women screened in 2009 and 2010. Cervical cancer incidence in this age group remains at a historical low of 9 new cases per 100,000 women, and deaths are also low, historically and by international standards, at 2 deaths per 100,000 women. 

Health Workforce 2025

Health Workforce 2025 was commissioned by the Australian Health Ministers and estimates the numbers of professional entry students, postgraduate and specialist trainees that will be required for doctors, nurses and midwives between 2012 and 2025. It also contains detailed modelling on workforce supply, demand, training and distribution. There are three volumes of this report, with the first two being currently available: 

• Volume 1 contains the overall findings from a workforce planning analysis of the trends in the supply and demand of doctors, nurses and midwives in Australia. 
• Volume 2 contains detailed supply and demand projection results for midwives and registered and enrolled nurses by area of practice, as well as state and territory projections for all professions. 
• Volume 3 will contain detailed supply and demand projection results for the medical workforce, by specialty. It will be delivered to Health Ministers in late 2012.

8700kJ app popular with consumers

The NSW Food Authority’s 8700kJ app has been downloaded by more than 22,000 people since its launch at the beginning of March, showing a high level of interest amongst consumers in the kilojoules they are consuming. NSW Food Authority CEO, Polly Bennett said the 8700kJ website and app make information on the number of kilojoules in fast food products more user-friendly for NSW consumers. “Feedback from the public on the 8700kJ campaign has been very positive with many commenting on how eye-opening the information is when it comes to the number of kilojoules in their favourite fast foods. Even people who thought they were label-savvy are surprised by what they’re learning about the food they eat. Our research suggests that by providing information on kilojoules at the point of purchase along with effective online tools, consumers will be better able to make informed choices about the food they eat.”

Innovative program improving care for people with arthritis

A new model of care program to reduce pain, improve mobility and make life more comfortable for people with chronic osteoarthritis has been launched by the Agency for Clinical Innovation. "The new model of care developed by the ACI Musculoskeletal Network shows how comprehensive multi-disciplinary management in people with osteoarthritis can relieve pain, minimise disability, and delay or avoid the need for surgery,”  (ACI) Chief Executive Dr Lyons said.

A guide to understanding and working with General Practice in NSW

Providing an outline of general practice, this resource considers its uniformity and diversity; its funding arrangements, service delivery, workforce, training, capacity and supporting structures. The Guide draws on published literature as well as the experience of an expert group.

Developed by GP NSW and funded by NSW Health, the publication is available to download.

Reaching for health: The Australian Women's Health Movement and Public Policy

This book by Gwendolyn Gray Jamieson presents an account of the ideas, the diverse and shared efforts and the enduring hard work of women’s health activists, drawn together in one volume for the first time.

Reaching for Health: The Australian Women’s Health Movement and Public Policy also identifies the opportunities for health reform that were created along the way, opportunities which deserve to be more fully embraced. The book is free to download or available to purchase in hard copy.

Physiobank

PhysioBank is a large and growing archive of well-characterized digital recordings of physiologic signals and related data for use by the biomedical research community. PhysioBank currently includes databases of multi-parameter cardiopulmonary, neural, and other biomedical signals from healthy subjects and patients with a variety of conditions with major public health implications, including sudden cardiac death, congestive heart failure, epilepsy, gait disorders, sleep apnea, and aging.
PhysioBank now contains over 50 databases that may be freely downloaded. Follow the links from the PhysioBank Archives for details about the databases and for access to the data files.

YourHealthNet website: explaining Cochrane Reviews

The Cochrane Consumers & Communication Review Group has developed a new web site which explains Cochrane systematic reviews with easy diagrams, text and audio, including stories from people who used reviews. The site is called YourHealthNet and is at http://navigatingeffectivetreatments.org.au/. It has been written to be relevant to all types of Cochrane Reviews.

The paramedic role in rural Australia

This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a Rural Expanded Scope of Practice (RESP) model. "Extending the paramedic role in rural Australia: a story of flexibility and innovation" published by the International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy.

Evaluating Interventions in Cerebral Palsy

The journal Developmental Medicine & Child Neurology has made freely available a virtual issue on "Evaluating Interventions in Cerebral Palsy". All articles in this virtual issue are freely available and have been specially selected by the editors. Cerebral palsy (CP) is the most common cause of physical disability in children and around 90% of children born with CP survive into adulthood. Various therapeutic approaches aim to meet the challenge of improving function and quality of life in individuals with CP.