Thinking beyond maternal mortality

In 2012, WHO initiated a five‐year project, funded by the Bill & Melinda Gates Foundation, with the aim of developing the evidence base on maternal morbidity through improving the scientific basis for defining, measuring (and estimating), and monitoring it.  The aim was to close the gap between measuring morbidity for programmatic purposes and assessing its actual impact on a woman's life The International Journal of Gynecology & Obstetrics has published a new Supplement on reconceptualising and measuring maternal morbidity, published in conjunction with the WHO Department of Reproductive Health and Research as a result of the project.

2018, May. Thinking beyond maternal mortality: Re‐conceptualizing and measuring maternal morbidity. International Journal of Gynecology & Obstetrics, 141(S1) Free to download here.    

Admitted patient care 2016–17: Australian hospital statistics

In May each year the Australian Institute of Health and Welfare releases its report on admitted patient care in Australian hospitals. In 2016–17, the majority of admissions to public hospitals (83% or 5.5 million) were for public patients with admissions rising by 4.3% on average each year for public hospitals and 3.6% for private hospitals between 2012–13 and 2016–17. Public hospitals accounted for the majority of emergency admissions (92%), medical admissions (77%) and childbirth admissions (76%) in 2016-17. ‘By contrast, 59% of admissions for surgery were in private hospitals. Overall, the average length of stay in 2016-17 was 3.2 days in public hospitals and 2.2 days in private hospitals.
Admitted patient care 2016–17: Australian hospital statistics. Health Services Series Number 84, Australian Institute of Health and Welfare, Canberra. Cat. no. HSE 201 

Engaging Consumers in their Health Data Journey Report

Australians want ownership and control of their own health data and want to be asked for consent when their data is used by either government, private companies or researchers. This stand-out finding was revealed in the Engaging Consumers in their Health Data Journey Report  jointly published by Consumers Health Forum and NPS MedicineWise.
 The comprehensive report was generated through qualitative interviews, literature reviews, a round table discussion with key stakeholders and consumer representatives, and a nationally representative survey of 1,013 Australians.
 Survey results gave the clearest indication that Australians want control over their health data with 96% of Australians believing they should have access to their own health data and 90% of respondents agreeing they should be asked for permission if either a government department or a private organisation wants to use the data.

Consumers Health Forum of Australia and NPS MedicineWise. Engaging consumers in their health data journey. Canberra: CHF and NPS MedicineWise, 2018   

Palliative care services in Australia

The demand for palliative care has increased dramatically in the past 5 years, with a 28.2% increase in palliative care-related hospitalisations between 2011–12 and 2015–16, compared to a 14.6% increase in hospitalisations for all reasons over the same period. Whilst four out of five deaths are expected due to chronic illness, only one in two patients who died in hospital received palliative care.
Of the 226 specialist palliative care doctors; 190 work in major cities, 20 work in inner regional centres, 14 work in outer regional places and only 3 work in remote locations. The national average of 0.9 FTE per 100,000 population is well-short of the 2.0 FTE benchmark PCA is recommending in the Palliative Care Service Development Guidelines
For the future Governments and health services need to prioritise funding these positions, as well as ensuring the training pathways are there for doctors and nurses to be able to specialise in palliative care.
Palliative Care Services in Australia. Web report. AIHW 2018

Emergency Department Patient Survey

The fourth year of results from the Emergency Department Patient Survey are now available on Healthcare Observer. The 2016–17 data reflects the experiences of almost 18,000 patients who attended an emergency department at one of 82 NSW public hospitals.
Click here to see the results by hospital.  

Child visits to emergency departments for mental health issues triple

Australian children receive mental health care from a variety of community-based organisations, but recently it has been noted that an increasing number of children and young people are presenting to emergency departments (EDs) with mental health problems. It appears that current mental health services are failing to provide alternatives to emergency departments for adolescents in crisis.

Hiscock, H., Neely, R. J., Lei, S., & Freed, G. (2018). Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15. Medical journal of Australia, 208 (80, 343-348

You can also read the editorial on this topic in the same issue for free:

Sawyer, S. M., & Patton, G. C. (2018). Why are so many more adolescents presenting to our emergency departments with mental health problems?. The Medical Journal of Australia, 208(8), 339-340.  

Transformational change in health and care

This recent Kings Fund report offers insights to help strengthen transformation efforts by looking at four sites in the UK that have been recognised as successful transformation initiatives.
The stories of Bromley by Bow, Birmingham, Northumbria and Buurtzorg illustrate that transformation is multi-layered, messy, fluid and emergent. It is not merely about changing how a service operates, but also about shifting mindsets, changing relationships and re-distributing power.
The report shows the power of staff and communities to drive transformation: the importance of giving people time and space to think through the purpose of transformation; to understand the struggles and worries they face; to offer support instead of demanding change with no time to prepare or engage.

Transformational change in health and care: Reports from the field. 2018 

Depression During and After Pregnancy

Many women experience depression during and after pregnancy, and it’s important to learn the symptoms of depression and to seek treatment if needed. Some people may experience a few symptoms, and others might experience many. How often symptoms occur, how long they last, and how intense they may feel can be different for each person.
The Center for Disease Control and Prevention (CDC) has released a feature article with information about maternal depression and treatment.  

This report focuses on trends in fall-related hospital care for people aged 65 and over from 2002-03 to 2014-15. Age-standardised rates of hospitalised fall injury cases increased over the period 2002-03 to 2014-15 for both men (3% per year) and women (2%). There was a decrease in the rate of hip fractures due to falls (-2% per year) between 2002-03 and 2014-15. In contrast, falls resulting in head injuries increased at a particularly high rate (7% per year).

Trends in hospitalised injury due to falls in older people 2002–03 to 2014–15 

My Health Record Guidelines for Pharmacists

The My Health Record provides electronic access to a patient’s key health information including medicines, allergies, medical conditions and test results, and supports improvements in the safety, quality and efficiency of Australia’s healthcare system.
A pharmacist’s contribution to medication safety and quality use of medicines will be enhanced by their ability to access a patient’s My Health Record. These new guidelines are intended to help increase the number of pharmacists using My Health Record.

My Health Record Guidelines for Pharmacists. Pharmaceutical Society of Australia Ltd., 2017. 

Alcohol & Breastfeeding Web Page

Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns.
The Centers for Disease Control and Prevention (CDC) recently launched a new web page to better inform health care providers and nursing mothers,to provide guidance on consuming alcohol while breastfeeding.

Alcohol and Other Drug Treatment Services in Australia

The report Alcohol and Other Drug Treatment Services in Australia 2016–17: key findings, shows that over 127,000 Australians received drug or alcohol treatment in 2016–17, equating to around 1 in every 170 people. The fastest growing treatment area is for amphetamine use, which has more than doubled over the last 10 years—in 2007–08.
The report from AIHW also shows that Aboriginal and Torres Strait Islander Australians were overrepresented among clients. Despite only comprising 2.7% of the Australian population (10 years and over), 1 in 7 clients (15%) receiving drug or alcohol treatment services were Indigenous.

Alcohol and Other Drug Treatment Services in Australia 2016-17: key findings.  

Treating Lyme Disease Early

The National Institute for Health and Care Excellence in the UK has published a new guideline on Lyme Disease. The guideline has advice for GPs and specialists on symptoms to look out for, tests to help confirm a diagnosis and what treatments to use. It also calls for more UK research into Lyme disease and the best long-term treatment options. Lyme disease symptoms are common with those of other conditions and so NICE says lab tests can be useful to help confirm a diagnosis. Typical symptoms can include combinations of headache, fever, joint pain or fatigue as well as others that are more specific such as problems with nerves or joints.
Lyme disease. NICE guideline [NG95] Published date: April 2018 

Bedside Burnout: Young Midwives

Nurse Uncut blog tells the story of one midwife who took a 20 year career break only to return to many of the same problems they worked through before. Burnout, too many shifts and not enough  staff, things haven't changed.

Bedside Burnout: Young Midwives With No Life Outside Work. By Nurse Uncut Editor, March 15, 2018.

1 in 20 Australian deaths caused by alcohol and illicit drugs

Alcohol and illicit drug use are serious and complex issues that contribute to substantial illness, disease, injury, and deaths in Australia. This new report from AIHW provides insight into the health impact of alcohol and illicit drug use in Australia;

• Nearly 5% of all deaths are from alcohol and illicit drug use.    
• One-third of road traffic injuries due to alcohol use
• Opioids are the largest contributor to the illicit drug use burden.

Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011, AIHW. 29 March 2018. Cat. no: BOD 19