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Publisher: RMIT Publishing   (Total: 400 journals)

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Showing 1 - 200 of 400 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 2)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 14)
Aboriginal Child at School     Full-text available via subscription   (Followers: 5)
About Performance     Full-text available via subscription   (Followers: 12)
Access     Full-text available via subscription   (Followers: 26)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 10)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 15)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 17, SJR: 0.103, h-index: 4)
Adelaide Law Review     Full-text available via subscription   (Followers: 20)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
Agenda: A J. of Policy Analysis and Reform     Full-text available via subscription   (Followers: 1)
Agora     Full-text available via subscription   (Followers: 3)
Agricultural Commodities     Full-text available via subscription   (SJR: 0.102, h-index: 8)
Agricultural Science     Full-text available via subscription   (Followers: 5)
AIMA Bulletin     Full-text available via subscription   (Followers: 4)
AJP : The Australian J. of Pharmacy     Full-text available via subscription   (Followers: 10, SJR: 0.102, h-index: 5)
Analysis     Full-text available via subscription   (Followers: 4)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 4)
Anglican Historical Society J.     Full-text available via subscription   (Followers: 3)
Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 4, SJR: 0.101, h-index: 11)
ANZSLA Commentator, The     Full-text available via subscription   (Followers: 4)
Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 11, SJR: 0.18, h-index: 27)
AQ - Australian Quarterly     Full-text available via subscription  
Arena J.     Full-text available via subscription   (Followers: 1)
Around the Globe     Full-text available via subscription   (Followers: 1)
Art + Law     Full-text available via subscription   (Followers: 12)
Art Monthly Australia     Full-text available via subscription   (Followers: 9)
Artefact : the journal of the Archaeological and Anthropological Society of Victoria     Full-text available via subscription   (Followers: 3)
Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 9, SJR: 0.672, h-index: 51)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 3)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (Followers: 1, SJR: 0.1, h-index: 8)
Australasian Catholic Record, The     Full-text available via subscription   (Followers: 6)
Australasian Drama Studies     Full-text available via subscription   (SJR: 0.101, h-index: 2)
Australasian Epidemiologist     Full-text available via subscription  
Australasian Historical Archaeology     Full-text available via subscription   (Followers: 7)
Australasian J. of Early Childhood     Full-text available via subscription   (Followers: 4, SJR: 0.174, h-index: 1)
Australasian J. of Gifted Education     Full-text available via subscription   (Followers: 4, SJR: 0.115, h-index: 3)
Australasian J. of Human Security, The     Full-text available via subscription   (Followers: 3)
Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 9)
Australasian J. of Regional Studies, The     Full-text available via subscription   (Followers: 1)
Australasian Law Management J.     Full-text available via subscription   (Followers: 9)
Australasian Leisure Management     Full-text available via subscription   (Followers: 1)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 2)
Australasian Music Research     Full-text available via subscription   (Followers: 3)
Australasian Parks and Leisure     Full-text available via subscription   (Followers: 2)
Australasian Plant Conservation: J. of the Australian Network for Plant Conservation     Full-text available via subscription   (Followers: 4)
Australasian Policing     Full-text available via subscription   (Followers: 5)
Australasian Public Libraries and Information Services     Full-text available via subscription   (Followers: 40)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 10, SJR: 0.109, h-index: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 5)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription  
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 3)
Australian and New Zealand Sports Law J.     Full-text available via subscription   (Followers: 8)
Australian Art Education     Full-text available via subscription   (Followers: 7)
Australian Bookseller & Publisher     Full-text available via subscription   (Followers: 1)
Australian Bulletin of Labour     Full-text available via subscription   (Followers: 3)
Australian Canegrower     Full-text available via subscription   (Followers: 2)
Australian Coeliac     Full-text available via subscription   (Followers: 2)
Australian Cottongrower, The     Full-text available via subscription   (Followers: 1)
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 7, SJR: 0.143, h-index: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3, SJR: 0.364, h-index: 31)
Australian Field Ornithology     Full-text available via subscription   (Followers: 4, SJR: 0.141, h-index: 6)
Australian Forest Grower     Full-text available via subscription   (Followers: 4)
Australian Forestry     Full-text available via subscription   (Followers: 2, SJR: 0.252, h-index: 24)
Australian Grain     Full-text available via subscription   (Followers: 3)
Australian Holstein J.     Full-text available via subscription   (Followers: 1)
Australian Humanist, The     Full-text available via subscription   (Followers: 3)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 20)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 27)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.106, h-index: 3)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 13, SJR: 0.159, h-index: 7)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 10, SJR: 0.225, h-index: 26)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 6)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 10)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 4, SJR: 0.17, h-index: 3)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 8, SJR: 0.401, h-index: 18)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.1, h-index: 5)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.109, h-index: 7)
Australian J. of Language and Literacy, The     Full-text available via subscription   (Followers: 4, SJR: 0.399, h-index: 9)
Australian J. of Legal History     Full-text available via subscription   (Followers: 18)
Australian J. of Mechanical Engineering     Full-text available via subscription   (Followers: 3, SJR: 0.129, h-index: 4)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 1, SJR: 0.122, h-index: 5)
Australian J. of Multi-Disciplinary Engineering     Full-text available via subscription   (Followers: 2)
Australian J. of Music Education     Full-text available via subscription   (Followers: 3)
Australian J. of Music Therapy     Full-text available via subscription   (Followers: 6)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 1)
Australian J. of Social Issues     Full-text available via subscription   (Followers: 6, SJR: 0.178, h-index: 20)
Australian J. of Structural Engineering     Full-text available via subscription   (Followers: 6, SJR: 0.296, h-index: 8)
Australian J. of Water Resources     Full-text available via subscription   (Followers: 6, SJR: 0.226, h-index: 9)
Australian J. on Volunteering     Full-text available via subscription   (Followers: 1)
Australian J.ism Review     Full-text available via subscription   (Followers: 7)
Australian Life Scientist     Full-text available via subscription   (Followers: 2, SJR: 0.1, h-index: 2)
Australian Literary Studies     Full-text available via subscription   (Followers: 5, SJR: 0.1, h-index: 6)
Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 7)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 6)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 3)
Australian Screen Education Online     Full-text available via subscription   (Followers: 2)
Australian Senior Mathematics J.     Full-text available via subscription   (Followers: 1)
Australian Sugarcane     Full-text available via subscription  
Australian TAFE Teacher     Full-text available via subscription   (Followers: 3)
Australian Tax Forum     Full-text available via subscription   (Followers: 3)
Australian Universities' Review, The     Full-text available via subscription   (Followers: 4)
Australian Voice     Full-text available via subscription   (Followers: 5)
Bar News: The J. of the NSW Bar Association     Full-text available via subscription   (Followers: 6)
Bioethics Research Notes     Full-text available via subscription   (Followers: 14)
BOCSAR NSW Alcohol Studies Bulletins     Full-text available via subscription   (Followers: 5)
Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 17, SJR: 0.31, h-index: 19)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 3)
Brolga: An Australian J. about Dance     Full-text available via subscription   (Followers: 1)
Cancer Forum     Full-text available via subscription   (SJR: 0.143, h-index: 10)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 6)
Chain Reaction     Full-text available via subscription  
Childrenz Issues: J. of the Children's Issues Centre     Full-text available via subscription  
Chiropractic J. of Australia     Full-text available via subscription   (SJR: 0.107, h-index: 3)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
Church Heritage     Full-text available via subscription   (Followers: 8)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 6)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.567, h-index: 27)
Communication, Politics & Culture     Open Access   (Followers: 14)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 2)
Connect     Full-text available via subscription   (Followers: 2)
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 8)
Corporate Governance Law Review, The     Full-text available via subscription   (Followers: 7)
Creative Approaches to Research     Full-text available via subscription   (Followers: 12)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 16, SJR: 1.737, h-index: 24)
Cultural Studies Review     Full-text available via subscription   (Followers: 16)
Culture Scope     Full-text available via subscription   (Followers: 2)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 10)
Dance Forum     Full-text available via subscription   (Followers: 2)
DANZ Quarterly: New Zealand Dance     Full-text available via subscription   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Deakin Law Review     Full-text available via subscription   (Followers: 15)
Developing Practice : The Child, Youth and Family Work J.     Full-text available via subscription   (Followers: 20)
Early Days: J. of the Royal Western Australian Historical Society     Full-text available via subscription  
Early Education     Full-text available via subscription   (Followers: 10)
EarthSong J.: Perspectives in Ecology, Spirituality and Education     Full-text available via subscription   (Followers: 1)
East Asian Archives of Psychiatry     Full-text available via subscription   (Followers: 2, SJR: 0.331, h-index: 7)
Educare News: The National Newspaper for All Non-government Schools     Full-text available via subscription  
Educating Young Children: Learning and Teaching in the Early Childhood Years     Full-text available via subscription   (Followers: 16)
Education in Rural Australia     Full-text available via subscription   (Followers: 1)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 12)
Educational Research J.     Full-text available via subscription   (Followers: 17)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 2)
English in Aotearoa     Full-text available via subscription   (Followers: 1)
English in Australia     Full-text available via subscription   (Followers: 2, SJR: 0.19, h-index: 6)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 8)
Ethos: Official Publication of the Law Society of the Australian Capital Territory     Full-text available via subscription   (Followers: 5)
Eureka Street     Full-text available via subscription   (Followers: 4)
Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 13, SJR: 0.259, h-index: 8)
Federal Law Review     Full-text available via subscription   (Followers: 23)
Fijian Studies: A J. of Contemporary Fiji     Full-text available via subscription  
Focus on Health Professional Education : A Multi-disciplinary J.     Full-text available via subscription   (Followers: 7)
Food New Zealand     Full-text available via subscription   (Followers: 5)
Fourth World J.     Full-text available via subscription  
Frontline     Full-text available via subscription   (Followers: 19)
Future Times     Full-text available via subscription   (Followers: 1)
Gambling Research: J. of the National Association for Gambling Studies (Australia)     Full-text available via subscription   (Followers: 5)
Gay and Lesbian Law J.     Full-text available via subscription   (Followers: 2)
Gender Impact Assessment     Full-text available via subscription  
Geographical Education     Full-text available via subscription   (Followers: 3)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Gestalt J. of Australia and New Zealand     Full-text available via subscription   (Followers: 2)
Globe, The     Full-text available via subscription   (Followers: 4)
Government News     Full-text available via subscription   (Followers: 2)
Great Circle: J. of the Australian Association for Maritime History, The     Full-text available via subscription   (Followers: 8)
Grief Matters : The Australian J. of Grief and Bereavement     Full-text available via subscription   (Followers: 11)
He Puna Korero: J. of Maori and Pacific Development     Full-text available via subscription   (Followers: 1)
Headmark     Full-text available via subscription   (Followers: 1)
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Health Issues     Full-text available via subscription   (Followers: 2)
Health Promotion J. of Australia : Official J. of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10, SJR: 0.606, h-index: 19)
Health Voices     Full-text available via subscription  
Heritage Matters : The Magazine for New Zealanders Restoring, Preserving and Enjoying Our Heritage     Full-text available via subscription   (Followers: 3)
High Court Quarterly Review, The     Full-text available via subscription   (Followers: 3)
History of Economics Review     Full-text available via subscription   (Followers: 10)
HIV Australia     Full-text available via subscription   (Followers: 3)
HLA News     Full-text available via subscription   (Followers: 6)
Hong Kong J. of Emergency Medicine     Full-text available via subscription   (Followers: 4, SJR: 0.173, h-index: 7)
Idiom     Full-text available via subscription   (Followers: 1)
Impact     Full-text available via subscription   (Followers: 1)
InCite     Full-text available via subscription   (Followers: 24)
Indigenous Law Bulletin     Full-text available via subscription   (Followers: 17)
InPsych : The Bulletin of the Australian Psychological Society Ltd     Full-text available via subscription   (Followers: 3)
Inside Film: If     Full-text available via subscription   (Followers: 8)
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Instyle     Full-text available via subscription   (Followers: 1)
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Interaction     Full-text available via subscription   (Followers: 3)
Intl. Employment Relations Review     Full-text available via subscription   (Followers: 2)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 2)

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Journal Cover Asia Pacific Journal of Health Management
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   ISSN (Print) 0833-3818
   Published by RMIT Publishing Homepage  [400 journals]
  • Volume 12 Issue 1 - Mainstreaming Human Immunodeficiency Virus (HIV)
           insurance in India: Opportunities and challenges
    • Abstract: Trivedi, M
      Millions of Indians fall into poverty because of the private high Out of Pocket pattern of health financing, due to the absence of insurance coverage. Conditions like HIV and AIDS also influence poverty due to a lifelong treatment requirement. Access to insurance coverage (commercial or voluntary) has been denied to People Living with HIV (PLHIV) through various clauses. However lately, there have been certain experiments on inclusion of HIV into new or existing schemes. This paper provides a systematic review of coverage, managerial and financial systems of selected cases of HIV insurance pilots in India with an objective to explore its sustainability and ability to be replicated.

      A cross-sectional descriptive analysis of existing literature and in-depth case studies of relevant health insurance schemes were used for the review. Data was compiled using qualitative data collection tools such as in-depth interviews with officials. The schemes were analysed using two frameworks viz. managerial ability and coverage ability. The managerial ability was analysed through a Strength-Weakness-Opportunity- Threat (SWOT) analysis. The coverage ability was analysed through three dimensions viz. a) breadth b) depth and c) height. In India, there are two types of insurance policies vis- -vis HIV coverage. These were categorised as HIV-specific and HIV-sensitive policies.

      Of the seven pilot schemes reviewed, the small-scale health insurance schemes show limited success owing to smaller pool and limited managerial capabilities. The large schemes offer avenues for mainstreaming but pose issues of governance as well as marketing among PLHIVs. The findings of the research identify a specific set of issues and challenges for sustainability and replication from three perspectives viz. a) market, b) cost recovery and sustainability and c) equitable coverage.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - The influence of politics on accountabilityof health
           professionals in Bangladesh: An analysis of the quality of health service
           delivery
    • Abstract: Islam, M
      This study explored the role and responsibility of elected officials including political actors and addressed the factors of politics, decentralisation, bureaucratic management, and political commitment to understanding accountability in health service delivery. This study used qualitative case studies for which a total of 68 in-depth interviews and five focus group discussions were conducted in two areas of rural and urban Bangladesh. The findings show that political actors have poor commitment to improving accountability and healthcare delivery. The elected officials are not interested in organising regular meetings and they are even reluctant to organise a health service committee to make health officials accountable. The opposition political parties have no participation in health service organisations as the existing political culture does not allow it. Moreover, elected officials have a limited administrative authority because of an inadequate decentralised health system that leads to poor accountability and inadequate healthcare delivery. Further, bureaucrats want to capture power and are unwilling to decentralise the health system. The policy recommendation includes the decentralisation of healthcare provision and increased participation of elected representatives in a decentralised system.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Understanding pharmacist communication and medication
           errors: A systematic literature review
    • Abstract: Sassoli, M; Day, G
      Objective: To better understand the inter-professional clinical communication between pharmacists, other health professionals and medication errors.

      Methods: This research study used a systematic literature review approach by searching online databases including Medline, PubMed and CINHAL to understand the relationship between pharmacist clinical communication and medication errors. The results of this study show that from 1158 studies that were screened and assessed, only 454 studies were initially selected after the application of inclusion and exclusion criteria. A PRISMA chart and descriptive analysis was used to present the result.

      Results: The results concluded that of the 18 studies, 17 showed a relationship between communication and medication errors, while only one study indicated no relationship. Thematic synthesis was used to classify the result of the 17 studies. The result was classified into five general themes based on the literature review and similarity among the studies.

      Conclusions: This systematic literature review investigated the interrelationship between communication and medication errors. In regards to patient safety, the research highlights that structured communication is effective in preventing medication errors. These errors can occur within the medication management cycle at any point of the drug distribution chain. This is due to the involvement of different health professionals, and different steps in the cycle from the correct prescription through to correct administration. Thus, to effectively prevent medication errors and reduce the rate of patient harm, structured communication (verbally and non-verbally) is highly recommended.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Remaking practices in the redesign of a primary
           healthcare program
    • Abstract: Rule, J; Dunston, R; Solomon, N
      Objective: To develop a detailed account of changed practices in everyday work in the redesign of primary healthcare program.

      Design: The research aimed to produce layered and rich descriptions of the complex and multidimensional remaking of health practices. Empirical data was gathered through ethnographic methods including; interviewing, self-reporting, observation and shadowing. The subjects of the research were involved as active participants in the research design, data gathering and analysis.

      Setting: HealthOne was a New South Wales government attempt to provide a local and responsive model to improve chronic disease management in primary and community healthcare settings. We report specifically on the HealthOne program implemented in a suburb of Western Sydney.

      Main outcome measures: The research did not aim to evaluate the program but to uncover instances of professional learning though identifying changes in professional practice. These were noted and observed by the researchers and research participants or through reflexive conversations with the program planners, healthcare workers and the research team.

      Results: Drawing on the work of a number of learning and practice-based theory writers, particularly those using a socio-material approach, we describe how practice change has occurred and how work practices have been remade at this site - especially in the role of the General Practice Liaison Nurse (GPLN).

      Conclusions: The research demonstrated the potential for new categories and practices of health work to emerge; this was especially seen in the work of the GPLN but also extended to new ways of working through General Practitioners and community health networks.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Flexible, capable, adaptable: A dynamic allied health
           workforce
    • Abstract: May, K; McAlinde, F; Splawa-Neyman, M; O'Rourke, M; Sturgess, T
      Objective: The Allied Health Executive at a major Metropolitan Health Service was experiencing an increasing number of flexible work requests and was keen to ensure that local and legislative requirements were met, our highly skilled and specialist staff were supported to remain in the workforce as their life outside work changed and the operational demands of a bed-based service delivery model were not negatively impacted.

      Design: A root cause analysis was completed identifying three main contributing factors for the current, adhoc approach to flexible work requests. Current and past flexible work participants were surveyed, along with their managers and the Nurse Unit Managers of the clinical work areas. A literature review and environmental scan regarding frameworks for decision making for and supporting flexible work requests was undertaken.

      Findings: There was a lack of consistent information as to how to establish and manage a flexible work request. There had been an historical view that flexible work requests were difficult to operationalise and there were missed experiences with flexible work arrangements for the people involved, their managers and their colleagues.

      Outcome measures: The combined data was then utilised to develop a framework to support decision-making around whether a role could operate as a flexible work arrangement. A framework on how to best support the staff considering and entering into these arrangements to ensure all the benefits of a flexible work arrangement are realised and many of the challenges minimised was also developed.

      Conclusion: Flexible work arrangements should be considered in appropriate circumstances, and will have the best opportunity for success when supported by a consistent, evidenced-based framework.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Introduction of the community rehabilitation Northern
           Queensland service
    • Abstract: Mervin, M; Barker, R; Sealey, C; Comans, T
      Objective: To analyse trends in length of hospital stay before and after the implementation of the Community Rehabilitation Northern Queensland Service (CRNQ) in Townsville, Australia.

      Design: Retrospective analysis of collected administrative data provided by the data custodian Townsville Hospital Health Service District.

      Setting: All patients discharged from the Townsville hospital between 1 July 2008 and 30 June 2013 for whom the Australian Refined Diagnosis Related Groups were stroke (B70), degenerative nervous system disorders (B67) or rehabilitation (Z60).

      Main outcome measures: Average length of stay and total number of inpatient episodes coded stroke, degenerative nervous system disorders or rehabilitation.

      Results: Length of stay for the selected diagnosis related groups was consistently ranging from 23 days to 25 days for the period 2008-2012. In the first year of full operational capacity of CRNQ (2012-13), there was an average reduction of six days in length of stay. The major reductions in length of stay occurred in patients admitted for rehabilitation care.

      Conclusions: This study adds additional evidence that earlier discharge can be facilitated for patients with neurological conditions living outside metropolitan areas when appropriate rehabilitation services are available in the community.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Leadership in allied health: A review of the
           literature
    • Abstract: Bradd, P; Travaglia, J; Hayen, A
      Background: It is well established that effective clinical leadership improves the quality of healthcare service provision and promotes leadership outcomes. [1,2] Leadership capacity and capability of allied health professionals is needed for successful clinical service provision, [3] but less is known about allied health leadership than about other clinical groups.

      Aims: The literature review aimed to identify research about leadership and leadership development of allied health practitioners in healthcare settings.

      Methods: A database review was undertaken using SCOPUS, CINAHL, Medline and Business Elite databases from December 2014-September 2015. Three leadership journals were also hand searched. A total of 1665 articles were identified. These were scanned and 129 articles were retrieved with 70 articles shortlisted for indepth review.

      Results: After application of inclusion and exclusion criteria, seven journal articles were included in the literature review. Review of the studies identified two areas of primary focus: leadership styles and outcomes and leadership development programs.

      Conclusions: Findings showed that there are currently a limited number of robust published reports in relation to leadership and allied health practitioners. Implications for Practice: Well-designed research studies to further evaluate leadership skills of allied health practitioners as well as to determine the effectiveness of leadership programs in developing transformational leaders are required.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Identifying and ranking areas of relative need for new
           public dental clinics using a state-of-the-art data simulation approach
    • Abstract: Dudko, Y; Robey, D; Kruger, E; Tennant, M
      Background: Lower socioeconomic groups and country residents are more likely to experience dental disease. Previous research has found that it is generally more cost effective to provide subsidised dental care through publically employed dentists when compared to subcontracting the work out to the private sector.

      Objective: The primary objective of this study was to identify and rank areas of relative need for new public dental care facilities across Australia. The secondary objective was to gauge how many of these areas are located in the vicinity of an existing public hospital (medical) with a view to utilise existing infrastructure for future service rollout.

      Methods: Usual resident population, employment status and socioeconomic distribution data was downloaded from the Australian Bureau of Statistics website at Statistical Area 1 level. A mathematical weighing formula was applied to those variables, which subsequently allowed for ranking of the results based on magnitude of the product values.

      The findings were considered in terms of proximity to existing public health infrastructure.

      Results: A total of 49 SA1 areas were identified and preselected as potential sites for new public dental clinics across Australia. Eighty per cent of the identified areas of relative need were located outside metropolitan areas. Fifty per cent of those were found to be in close proximity to an existing public hospital (medical).

      Conclusion: Offering subsidised dental care through existing public hospitals may be an option. Such an approach has a potential to improve access to subsidised dental care in regional centres while minimising capital expenditure on infrastructure.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Editorial
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - Building a culture of health
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 12 Issue 1 - The sociology of healthcare safety and quality [Book
           Review]
    • Abstract: Briggs, DS
      Review(s) of: The sociology of healthcare safety and quality, edited by Davina Allen, Jeffrey Braithwaite, Jane Sandall and Justin Waring, Published by WILEY Blackwell.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Balancing Yin and Yang: The development of a framework
           using Participatory action research for the translation and implementation
           (part 1) of new practices
    • Abstract: Fitzgerald, A; Ogrin, R; Hayes, K; Curry, J; Eljiz, K; Radford, K
      Context: Despite the demonstrable benefits of many healthcare innovations, embedding research findings into practice has been slow and sporadic. Many implementation frameworks exist, however most have been criticised for not having a strong theoretical underpinning. This study addresses this gap by reviewing the current models to propose a new, theoretically driven framework for change management and translation.

      Methods: This study is reported in two parts. In part 1, a systematically-based literature review was undertaken. Following this, part 2 included conducting focus groups with academics to verify the model and provide feedback on the new framework.

      Findings: The gaps in current implementation frameworks identified include deficiencies in the areas of individual and social behaviour, participatory action, operationalisation and evaluation of the frameworks. The Quality Implementation Framework (QIF) [3] was used to provide the basis to develop a robust extended model, which addressed those areas that were identified as deficient in the current frameworks. By combining the best parts of extant models with a translation and implementation foci, we developed the PARTI model that is underpinned by commitment to change (Ying) and change fidelity (Yang) at each of its four stages, which included a behavioural questionnaire and implementation checklist. PARTI stands for Participatory Action Research, Translation and Implementation.

      Conclusions: The implementation of change in healthcare delivery is difficult and demanding, and healthcare managers look to change frameworks for guidance. The PARTI model has been developed to provide a systematic approach to implementing changed practices that is repeatable, reliable and scalable.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Improving the health system with performance reporting
           - real gains or unnecessary work'
    • Abstract: Day, GE; South, L
      Aim: This paper will discuss current approaches to performance reporting and whether there are real benefits to healthcare organisations or whether it is a time consuming activity that adds little to improving quality healthcare and organisational performance. Most importantly, this paper will argue that performance reporting will not prevent another major healthcare scandal, such as that seen at Bundaberg Hospital or NHS Mid Staffordshire Trust. The paper will also outline learnings for Australia from other health systems where performance reporting is part of management practice.

      Approach: While performance reporting is largely designed to increase the efficiency and effectiveness of healthcare organisations, this paper will explore the approach from a practical managerial perspective.

      Context: This paper explores performance reporting across a range of Australian healthcare organisational settings to highlight differing approaches to improving performance.

      Main findings: Performance reporting can be an effective tool to improve organisational performance. For performance reporting to be successful, managers and clinicians need to work collaboratively to identify areas for performance improvement and useful measures to address these. Additionally, organisations must choose a meaningful suite of measurements that can help drive performance improvement. Real time performance reporting, such as through performance dashboards, provides managers with the opportunity to make timely, incremental improvements. Finally, performance reporting must be done in a way that does not detract from providing safe, quality patient care.

      Conclusions: Performance reporting can be a useful management tool for healthcare organisations, however organisations must consider timeliness of performance reporting and select a number of measurements that have impact for their given facilities and avoid the wholesale analysis of data that has little opportunity to improve practice or performance.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - In this issue
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Responding to the call for innovation: How do we
           develop health professionals' skills and operationalise innovation'
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Development of a consumer engagement framework
    • Abstract: Lizarondo, L; Kennedy, K; Kay, D
      Objective: The purpose of this project was to develop a Consumer Engagement Model to plan for effective baby boomer engagement to inform policy makers in the healthcare system. This is the first stage of that process.

      Design: Initial model development for healthcare systems based on literature review and author group experience in evidence-based practice and research, and consumer advocacy and engagement.

      Setting and population: South Australian health and community service systems, and healthcare professionals that work with baby boomers.

      Findings: To develop an evidence-based Consumer Engagement Plan, it is recommended that policy makers undertake the four steps outlined in this document to design a question, determine consumer and community segments and scope of engagement, determine the breadth and depth of engagement and address the implications, assess risk and develop strategic partnerships to ensure the Plan is evidencebased, reasonable and achievable.

      Conclusions: We believe this process provides a framework for planning consumer engagement and for implementation, monitoring, evaluation and review of consumer engagement for policy excellence. We propose to undertake a validation of the model thus populating the model with examples of practice-based strategies and revising the model accordingly.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Library bulletin
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - The importance of the physical environment for child
           and adolescent mental health services
    • Abstract: Rogers, SL; Edwards, SJ; Hudman, P; Perera, R
      Objective: This study examined the relationships between appraisals of the physical environment with the subjective experience of consumers, and work satisfaction of clinicians, in Child and Adolescent Mental Health Services (CAMHS).

      Design, setting, and outcome measures: A survey of clinicians, parent/guardians, and child/adolescents was conducted across eight community CAMHS in Western Australia. Respondents evaluated the waiting room and therapy rooms on a number of environmental attributes, and factor analysis was carried out to confirm that these ratings loaded on an overall appraisal of the physical environment measure. This measure was then correlated with self-reported subjective experience of consumers, and overall work satisfaction of staff members.

      Results: Clinicians were found to be much more critical of the physical environment compared with consumers. Moderate associations were found between appraisal of the physical environment and subjective experience of consumers. A strong positive association was found between clinician appraisal of the physical environment and overall work satisfaction.

      Conclusions: The present study adds to the limited existing research arguing for the important role that the physical environment can have upon both consumer and staff experience in mental health settings. The present study provides empirical evidence to justify steps being taken to enhance the physical environment in mental health clinics. The inter-relationship between physical environment attributes suggests there is potential for managers to improve the overall perception of clinic space via relatively small actions (e.g., adding a nice piece of artwork).

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Employability skills in health services management:
           Perceptions of recent graduates
    • Abstract: Messum, DG; Wilkes, LM; Jackson, D; Peters, K
      Background: Employer skill requirements of graduates are monitored by Graduate Careers Australia, but health services management (HSM) specific employability skills (ES) perceived by graduates to be important on the job and their perceptions of skills they need to improve are not well reported. Academics need this feedback to improve course employment outcomes by helping current students identify and articulate appropriate competencies to potential employers. Also teaching of industry requirements can help improve job matching for employers.

      Method: Recent graduates working in HSM in New South Wales, Australia were surveyed to rate ES for importance and rate their own skill levels on the same items. The gap between these two ratings was identified for 44 ES.

      Results: ES important to recent graduates in rank order were: verbal communication skills, integrity and ethical conduct, time management, teamwork, priority setting, ability to work independently, organisational skills, written communication, being flexible and open minded and networking. Highest self-ratings were found for integrity and ethical conduct, ability to work independently, being flexible and open minded, tertiary qualifications, interpersonal skills, written communication skills, time management, life-long learning, priority setting and administration skills. Generally graduates rated their skills lower than their ratings of importance.

      Conclusions: Recent graduates can provide valuable feedback to universities about ES required for HSM positions and identify their own skill gaps for development at work or through study. Generic skills rather than job-specific skills are what they rate as most important. Closer engagement of universities and employers is recommended especially through placements.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Using linked lung cancer registry and hospital data
           for guiding health service improvement
    • Abstract: Roder, D; You, H; Baker, D; Walton, R; McCaughan, B; Aranda, S; Currow, D
      Objective: To use linked NSW Cancer Registry and hospital lung cancer (LC) data for raising discussion points on how to improve outcomes. Design: Historical cohort - cases diagnosed in 2003-2007.

      Setting: New South Wales, Australia.

      Outcome Measures: Relative odds (OR) of localised disease and resection of non-small cases (NSCLC) using multiple logistic regression. Comparisons of risk of NSCLC death using competing risk regression.

      Findings: (1) Older patients have fewer resections of localised NSCLC [adjusted OR 95% CLs; 80+Vs
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Are clinical registries actually used': The level
           of medical staff participation in clinical registries and reporting within
           a major tertiary teaching hospital
    • Abstract: Dwyer, A; McNeil, J
      Clinical Registries are established to provide a clinically credible means for monitoring and benchmarking healthcare processes and outcomes, to identify areas for improvement, and drive strategies for improving patient care. Clinical Registries are used to assess changes in clinical practice, appropriateness of care and health outcomes over time. The American Heart Association Policy Statement in April 2011 called for expanding the application for existing and future Clinical Registries, with well-designed Clinical Registry programs. Concurrently, in Australia, and similarly within the United States and United Kingdom, there has been an increased focus on performance measurement for quality and patient safety. Within Victoria, the Victorian Clinical Governance Policy Framework outlines clinical effectiveness as one of the four domains of Clinical Governance.

      As Clinical Registries evaluate effectiveness and safety of patient care by measuring patient outcomes compared with peers, the use of Clinical Registries data to improve a health service's quality of care seems intuitive. A mixed methods approach was utilised, involving (1) semi-structured interviews and (2) documentation audit in this study conducted at Austin Health, a major tertiary teaching hospital in North- Eastern metropolitan Melbourne, affiliated with the University of Melbourne and various research institutes within Austin LifeSciences.

      Although many studies have highlighted the benefits of data collected via individual Clinical Registries, the level of voluntary medical staff participation in Clinical Registries at a health service level is yet to be established. The aim of this study was to document the level of medical staff involvement for Clinical Registries within a major tertiary teaching hospital, and the level of reporting into Quality Committees within the organisation.

      This study demonstrates that along with a very high level of medical staff participation in Clinical Registries, there is a lack of systematic reporting of Registries data into quality committees beyond unit level, and utilisation of such data to reflect upon practice and drive quality improvement.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Best practice pathology collection in Australia
    • Abstract: Pilbeam, V; Ridoutt, L; Badrick, T
      Objectives: The specific objectives of the study were to (a) identify current best practice in pathology specimen collection and assess the extent to which Australian pathology services currently satisfy best practice standards; and (b) identify training and other strategies that would mitigate any gaps between current and best practice.

      Methods: A total of 22 case studies were undertaken with pathology collector employers from public, not for profit and private pathology organisations and across urban and rural locations and eight focus groups with pathology collection services consumers were conducted in December 2012 in four different cities.

      Results: The preferred minimum qualification of the majority of case study employers for pathology collectors is the nationally recognised Certificate III in Pathology. This qualification maps well to an accepted international best practice guideline for pathology collection competency standards but has some noted deficiencies identified which need to be rectified. These particularly include competencies related to communicating with consumers. The preferred way of training for this qualification is largely through structured and supervised on the job learning experiences supported by theoretical classroom instruction delivered in-house or in off the job settings. The study found a need to ensure a greater proportion of the pathology collection workforce is appropriately qualified.

      Conclusion: The most effective pathway to best practice pathology collection requires strong policies that define how pathology samples are to be collected, stored and transported and a pathology collection workforce that is competent and presents to consumers with a credible qualification and in a professional manner.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 1 - Factors affecting hospital choice decisions: An
           exploratory study of healthcare consumers in Northern India
    • Abstract: Kamra, V; Singh, H; De, KK
      This study examines the factors affecting hospital choice decisions by patients for tertiary level healthcare services and the relationships of these factors with respondent demographics. It also categorises the decision makers involved in the selection of hospitals. Data were collected from in-patients of multispecialty hospitals located in northern India with the help of a structured questionnaire. Factor analysis, ANOVA and t-test techniques have been employed to analyse the data. The study has revealed that the factors that affect hospital choice decisions of patients are basic amenities, reputation and quality, building and infrastructure, ease and affordability, personal substances (experiences), responsiveness of services, recommendations and suggestions, clinical support, privacy and information sharing, and range of services. The study has also revealed that various categories of respondent demographics, namely, age, gender, residence, education and monthly family income are significantly different statistically (P < .05) with respect to the identified factors. It has been found that most of the time family members, doctors or a combination of family members and doctors make the decisions to choose the hospital. It has also been found that friends/ relatives and patients themselves choose the hospital in some cases.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - To the editor
    • Abstract: Day, GE
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - In this issue
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Developing and implementing a framework for system
           level measures: Lessons from New Zealand
    • Abstract: Doolan-Noble, F; Lyndon, M; Hill, A; Gray, J; Gauld, R
      Background: Measuring performance is now the norm in health systems. System Level Measures (SLMs), implemented at New Zealand's Counties Manukau Health (CMH) are designed to support quality improvement activities undertaken across the health system using only a small set of measures. While the healthcare and performance measurement literature contains information regarding the facilitators and barriers to quality improvement initiatives, there is an absence of studies into whether these factors are germane to the establishment and implementation of a SLM framework.

      Methods: A purposive sample of thirteen senior managers and clinicians involved in the construction and implementation of SLMs were invited to participate. Semi-structured telephone interviews were completed and recordings transcribed verbatim. Transcriptions were thematically analysed using a general inductive approach.

      Findings: In total, ten interviews took place. Six facilitative themes were identified including: dispersed and focused leadership; communication; data; alignment of the measures with organisational strategic data; alignment of the measures with organisational strategic plans and values; stakeholder engagement; and a dedicated project team. Conversely, five themes were identified that hindered the process. These were: reaching consensus; perfection versus pragmatism; duplication and process burden; achieving buy-in and workload.

      Discussion: The factors that facilitate and hinder establishing and implementing a framework of SLMs are common to other quality improvement approaches. However, this study demonstrated that these factors were also germane to SLMs. These findings are of particular relevance as researchers and policy makers elsewhere increasingly aim to adopt measurement arrangements for health systems that address equity, safety, quality, access and cost.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Implementation of shared decision-making in Australia
    • Abstract: Ervin, K; Blackberry, I; Haines, H
      Shared decision-making (SDM) is the process of clinicians and patients participating jointly in making healthcare decisions, having discussed evidence-based treatment options and the potential risks and benefits of each option, taking into consideration the patient's individual preferences and values. SDM is ubiquitous in Australian healthcare policy. While there is good evidence for utilising SDM, clinicians' knowledge of SDM, the current uptake, effectiveness and acceptability of SDM in Australia is largely unknown. The challenges perceived by clinicians to implementing SDM in clinical practice and potential moral, legal and ethical dilemmas require further debate and consideration.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Co-creating and developing health management theory
           and practice: A global opportunity'
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - A review of the ACHS clinical indicator program after
           20 years
    • Abstract: Collopy, B; Dennis, C; O'Connor, L; Nathan, M
      The Clinical Indicator Program, which was introduced into the Australian Council on Healthcare Standards' accreditation program two decades ago, has grown from one set addressed by 115 healthcare organisations to 22 sets with data received from over 800 healthcare organisations, resulting in a national database which is unique in its clinical diversity, reflecting every major medical discipline involved in hospital practice. The process for Clinical Indicator selection and review remains with the providers of the care, but the selection criteria are better defined and the evidence base strengthened. Early responses to their introduction were encouraging as improvements in patient management and outcomes were sought and achieved following review of comparative data, and some examples of these are provided. Clinical Indicator revision remains an important and major task and the original Hospital- Wide set of Clinical Indicators is now in its 12th version. The development and use of Clinical Indicators is increasing world-wide, and in Australia there are other organisations, including the Australian Commission on Safety and Quality in Healthcare, looking at Clinical Indicators to further understand the performance of healthcare organisations.

      As clinical care changes, the challenges for the Australian Council on Healthcare Standards are to ensure the Clinical Indicators continue to reflect current practice, to retain clinician support, and also to ensure that the existence of its extensive and long-standing national clinical database is more widely known and utilised.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Making hospital governance healthier for nurses
    • Abstract: Clark, K; Beatty, S
      The current research examined front line nurse expectations of non-metropolitan public hospital governance. In doing so, it explored the relevance of two dominant, competing Agency and Stewardship governance theories to these organisations.

      Two studies were conducted with the first establishing an inventory of notional nurse preferences for governance and the second testing these with a random sample of front-line non-metropolitan hospital nurses across one Australian State, with the aim of identifying valid and reliable measures.

      The study data suggest nurses working in nonmetropolitan public hospitals expect governance practices to reflect: respect for and engagement with clinical perspectives; utilisation of evidence-based planning; and effective engagement with local communities. Scales with good consistency and criterion and construct validity measuring these three components were identified.

      The study provides evidence that nurses expect and value a style of hospital governance that is consistent with Stewardship Theory. The results also suggest that governance is an important enough issue for nurses that it significantly affects their turnover intentions. This has important implications for healthcare leaders concerned about the sustainability of public hospitals.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Financing healthcare in Indonesia
    • Abstract: Plummer, V; Boyle, M
      Introduction: There have been two major transitions for healthcare in Indonesia: the implementation of government decentralisation and universal health insurance. A universal public health insurance called Badan Penyelenggara Jaminan Sosial (BPJS) was launched in January 2014 and aims to cover all Indonesian people.

      Objective: The objective of this paper is to discuss the funding of healthcare in Indonesia through a comparison with other South East Asian countries.

      Methodology: A search for relevant literature was undertaken using electronic databases, Ovid Medline, ProQuest Central, and Scopus from their commencement date until December 2015. The grey literature from the Indonesian government, the WHO's and World Bank's website, has been included.

      Results: There were nine articles from Ovid Medline, eight from ProQuest Central, and 12 from Scopus that met the criteria. Seventeen articles were duplicates leaving 12 articles to be reviewed. Nine documents have been identified from grey literature.

      Discussion: Most people in Indonesia sought health services from the private sector and were out-ofpocket financially or did not receive the required care. The private sector delivered 62.1% of health services compared to 37.9% by the government. Despite some inappropriate use of previous health insurance, the BPJS is expected to have improved management and will cover all citizens by the end of 2019.

      Conclusion: Indonesia has undergone a series of changes to health system funding and health insurance. There are lessons that can be learnt from other countries, such as Thailand, Cambodia, and Vietnam, so that Indonesia can improve its health funding.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Assessing the adoption of a home health provisioning
           system in India: An analysis of doctors' knowledge, attitudes and
           perceptions
    • Abstract: Agarwal, N; Sebastian, MP; Agarwal, S
      Background: Unlike developed countries, home healthcare provision systems (HHPS) are not widely prevalent in developing countries like India. Our objective was to study the knowledge, attitudes and perceptions of doctors in India about the adoption of HHPS.

      Methods: Our survey included 180 doctors across India, working in local hospitals. Using online and paperbased questionnaires, we used bar charts and pie charts to represent the frequency distributions. We also conducted multivariate logistic regression analysis to understand the importance of the selected factors upon the dependent variables of interest such as willingness to work during non-office hours, desire for increased remuneration, and willingness to enrol in HHPS.

      Results: The desire for an increase in remuneration made doctors more willing to enrol in HHPS. Possible reasons for doctors to enrol included the ability to answer follow-up queries through email or video chat and HHPS being integrated with the local healthcare system in the hospital. Young male doctors were most likely willing to provide services through HHPS during nonoffice hours as compared to females. A large majority of doctors indicated hospital visits to be important for follow-up queries, but several doctors indicated that simple patient queries could be addressed by nonpersonal interactions like video chat or email.

      Conclusions: The desire for extra remuneration could be the primary reason for the willingness of doctors to work during non-office hours and thus enrol in HHPS. The majority of doctors considered hospital visits to be important, but several doctors also indicated that nonpersonal interactions using text messages, telephone, email and video chat might serve as important methods to respond to simple follow-up queries from patients.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Addressing health insurance deductions through an
           interventional study: The case of a large Central Hospital
    • Abstract: Kharazmi, E; Salehi, A; Hashemi, N; Ghaderi, S; Hatam, N
      Objective: A large proportion of hospitals' private income is provided by insurance organisations. Hospitals in Iran face various problems in terms of insurance deductions from insurance organisations resulting from inefficient performance by both the hospitals and the insurers. These problems necessitate more specific cost control in this area. This research assesses the causes of insurance deductions by using the Failure Mode Effects Analysis (FMEA) technique, and addresses the issues resulting in deductions by providing some interventions through the Pareto technique.

      Design: The 10-step pattern of FMEA was implemented for assessing the main causes of insurance deduction in this study.

      Setting: Data was collected from deduced amounts by three main/largest contracting party insurance organisations (e.g. the Social Security Insurance Organisation, Medical Services Insurance Organisation and Armed Forces Medical Services Insurance Organisation of Namazi Hospital, a large healthcare provider in the South of Iran, in 2014.

      Findings: Sixty-five potential failure causes were identified, of which 26 were related to the anaesthesia unit, 23 were related to the surgery room unit and 16 were related to the hospitalisation unit. Deductions in the anaesthesia and hospitalisation units and the surgery room were reduced after intervention programs by 14.42%, 57.76%, and 51.52%, respectively.

      Conclusions: Using the FMEA technique in a large healthcare provider in Iran resulted in identifying the main causes of insurance deductions and provided intervention programs in order to increase the efficiency and productivity of healthcare services.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 2 - Correlations and organisational effects of
           compensation and benefits, job satisfaction, career satisfaction and job
           stress in public and private hospitals in Lucknow, India
    • Abstract: Saxena, N; Rai, H
      The present study compares the organisational effect of compensation and benefits in public and private hospitals. It was observed that private hospital employees were more satisfied with their compensation and benefits as compared to the employees of government hospitals. Furthermore, the employees who were satisfied with their compensation and benefits were also found to be satisfied with their jobs.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - What problem is being solved: 'Preventability' and the
           case of pricing for safety and quality
    • Abstract: Duckett, S
      One of the critical issues facing healthcare systems internationally is to improve safety of care. Unfortunately, safety discussions, both in hospitals and in policy documents, often quickly turn to identifying and acting on 'preventable' mishaps. But preventability is a slippery concept, which this paper discusses.

      A contemporary policy response is to introduce financial incentives in hospitals and/or states to improve safety, proposed for national implementation in Australia from 1 July 2017. This has the potential to change the internal dynamic of hospitals to enhance the focus on safety. The implications for hospitals of this change are also discussed.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Equitable care for indigenous people: Every health
           service can do it
    • Abstract: Dwyer, J; O'Donnell, K; Willis, E; Kelly, J
      Problem and its context: Indigenous peoples in many countries suffer poorer health and poorer access to good healthcare than their non-Indigenous counterparts. In Australia, enduring barriers to good health and good healthcare remain, in spite of long-standing policy priorities. These barriers include the ongoing reality of colonisation, and silence about its implications. People working in and using the health system need to relate across cultures, but they approach this endeavour with a complex mixture of goodwill, defensiveness, guilt and anxiety.

      Methods: We analysed what is known in Australia about differentials in access to good care, and the underlying factors that entrench them, as well as strategies for developing mainstream competence in care for Aboriginal and Torres Strait Islander patients and communities.

      Analysis and Conclusions: The available evidence of differentials in access and quality that are not explained by clinical or demographic variables is unequivocal. Official policy needs to be implemented at the system and organisation level through operational policies, programs and protocols, and through relationships with Aboriginal healthcare providers and community organisations. The concept of racism anxiety provides a way of making one important barrier visible, and moving beyond it can enable people of goodwill to 'see' where change is needed, and to see themselves as part of the solution. It is time to get beyond the barriers and attend to practical improvements in care, focused on the care system, not simply on the skills and knowledge of individuals within it.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Night lights
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - In this issue a point of view: What problem is being
           solved': Critical issues in health systems management
    • Abstract: Briggs, DS
      This issue represents the 10th year anniversary edition of the Asia Pacific Journal of Health Management (APJHM) that was established by the Australasian College of Health Services Management (ACHSM). Due recognition of those who contributed to the development of the Journal is expressed in the Editorial contributed by Bill Lawrence. To recognise and celebrate this milestone the editorial team agreed to publish a special issue anniversary edition. It was decided to be an invited article only edition around the theme 'What problem is being solved' Critical Issues in health systems management'. This theme is an adaption of a similar challenge issued more than a decade before.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - The journal - a critical development in the
           professional journey of the college
    • Abstract: Lawrence, Bill
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Library bulletin
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Health workforce migration in the Asia Pacific:
           Implications for the achievement of sustainable development goals
    • Abstract: Short, SD; Marcus, K; Balasubramanian, M
      The maldistribution of health workers globally and within the Asia Pacific region remains problematic. While globalisation, and the increasing mobility of capital and labour, helps to reduce inequalities between countries, it increases inequality within countries. This study examines health workforce data and densities in the Asia Pacific region through a health workforce migration lens. The main implication relevant to achievement of sustainable development goals is the need for countries to work in a co-ordinated way in this region to increase substantially health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing states, most notably the Maldives, Timor- Leste, Kiribati, Samoa, Solomon Islands, Tuvalu and Vanuatu.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Federalism and Australia's national health and health
           insurance system
    • Abstract: Podger, A
      While health reform in Australia has been marked by piecemeal, incremental changes, the overall trend to increasing Commonwealth involvement has not been accidental or driven by power-hungry centralists: it has been shaped by broader national and international developments including technological change and the maturing of our nation and its place internationally, and by a widespread desire for a national universal health insurance system. In many respects the Australian health system performs well, but the emerging challenges demand a more integrated, patient-oriented system. This is likely to require a further shift towards the Commonwealth in terms of financial responsibility, as the national insurer. But it also requires close cooperation with the States, who could play a firmer role in service delivery and in supporting regional planning and coordination. The likelihood of sharing overall responsibility for the health system also suggests there is a need to involve the States more fully in processes for setting national policies.

      This article draws heavily on a lecture presented at the Australian National University in October 2015. It includes an overview of Australia's evolving federal arrangements and the context within which the current Federalism Review is being conducted. It suggests Australia will not return to 'coordinate federalism' with clearly distinct responsibilities, and that greater priority should be given to improving how we manage shared responsibilities.

      There is a long history of Commonwealth involvement in health, and future reform should build on that rather than try to reverse direction. While critical of the proposals from the Commission of Audit and in the 2014 Budget, the lecture welcomed the more pragmatic approaches that seemed to be emerging from the Federalism Review discussion papers and contributions from some Premiers which could promote more sensible measures to improve both the effectiveness and the financial sustainability of Australia's health and health insurance system.

      The Commonwealth's new political leadership in 2015 seemed interested in such measures and in moving away from the Abbott Government's approach. But the legacy of that approach severely damaged the Turnbull Government in the 2016 federal election as it gave traction to Labor's 'Mediscare' campaign. In addition to resetting the federalism debate as it affects health, the Turnbull Government now needs to articulate the principles of Medicare and to clarify the role of the private sector, including private health insurance, in Australia's universal health insurance system. Labor also needs to address more honestly the role of the private sector and develop a more coherent policy itself.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - The language of health reform and health management:
           Critical issues in the management of health systems
    • Abstract: Briggs, DS; Isouard, G
      Health reform has been a constant feature of most health systems for a number of decades and has often focused on structural change. The lexicon of health reform and health management has also become intertwined with managers reporting that reform has become a constant and that rather than influencing that change they are in fact influenced by it and by its impact on their role, professional development and career. There is a challenge for health service managers to return to a leadership role in enabling health reform. In doing so will this challenge us to think differently about management'

      This article addresses the significant body of research into health reform and health management through the lens of language used in reporting the context and the significant impact that it has had on the management role. It describes what directions that role might take, the qualities required in selecting capable managers and questions the current status quo in the education, training and development of this significant sector of the health system workforce.

      It concludes by proposing a way forward that acknowledges that contemporary health reform is shifting the paradigm of healthcare delivery in a way that requires the dominant view of health management to be challenged. This might be achieved by the use of a critical lens on the language of management, a focus on a grounded approach about what managers need to do and an acceptance of variability in that role in adaptive complex contexts.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Towards more meaningful measures in healthcare
    • Abstract: Leeder, S; Russell, L; Beaton, A
      Most health systems continue to be restructured and modified without much thought to underlying public policy. Patient safety, quality and innovation are monitored through a range of agencies while performance measures are regularly measured and the results published. Primary healthcare in many systems remains fragmented. To achieve value of the whole health system as well as its component parts, the development of an outcomes-based approach to performance measurement is required to guide the delivery of constantly improving health services. This is a critical issue in health systems management.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Health systems in Australia and four other countries:
           Choices and challenges
    • Abstract: Martins, JM
      The purpose of health systems is the pursuit of healthy lives. The performance of the Australian health system over the last decade is compared with the United Kingdom and its three other offshoots: the United States, Canada and New Zealand. In the first instance, system performance is assessed in terms of threats to healthy lives from risk factors and changes that have taken place during the decade. In view of the emphasis of the five systems on the return to health after trauma and illness, and the human-resource intensity of health services, an appraisal is made of changes in the number of the major health professionals in relation to the growing populations. Then related changes in hospital, medical practitioner and dentist services are assessed. Changes in pharmaceutical drug prescriptions in Australian are also examined. The levels of national expenditures arising from the provision health services are then considered in the context of the costs of administration of the varied organisational modes, use of expensive medical technologies, pharmaceutical drug consumption and remuneration of health professionals. Finally, health outcomes in Australia and the other four countries are assessed in accordance with their human development level, life expectancy, potential years of life lost from different causes, as well as healthy life expectancies. Further, gaps in health and life expectancy of Indigenous people in the United States, Canada, New Zealand and Australia are reviewed, as well as health and survival inequalities among people in different social strata in each country.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Healthcare system restructuring in New Zealand:
           Problems and proposed solutions
    • Abstract: Gauld, R
      New Zealand's healthcare system is, like most, in a continual process of restructuring and change. While the country has endured several major system-wide changes in recent decades, more recent change has been incremental and evolutionary. Current changes are in response to a set of challenges, which are not unique to New Zealand. This article overviews the New Zealand healthcare system. It then describes a series of problems facing the system and proposed solutions. These include the need for team care, providing services closer to patients' homes, focusing on a population of interest, connecting up the system, and engaging patients more closely in care design and delivery.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - The tyranny of size: Challenges of health
           administration in Pacific Island States
    • Abstract: Taylor, R
      There is great diversity among Pacific Island states (n=22) in geography, history, population size, political status, endemic disease, resources, economic and social development and positions in the demographic and health transitions and their variants. Excluding Papua New Guinea, all Pacific states are less than one million, and half of them (11) are less than 100,000.

      Smallness also means fewer resources available for health, even if percentage allocations are similar to larger countries, and a disproportionate amount may derive from international aid.

      Specialisation is not cost-effective or even possible in clinical, administrative or public health domains in small populations, even if resources or personnel were available, since such staff would lose their skills. In instances where only one to two staff are required, retirement or migration means decimation of the workforce.

      Training doctors within the Pacific Island region provides appropriately trained personnel who are more likely to remain, including those trained in the major specialities. Nursing training should be in-country, although in very small entities, training in neighbouring states is necessary.

      Outmigration is a significant issue, however, opportunities in Pacific Rim countries for medical doctors are contracting, and there is now a more fluid workforce among Pacific health personnel, including those resident in Pacific Rim countries.

      International and regional agencies have a disproportionate influence in small states which can mean that global policies intended for larger polities are often promulgated inappropriately in small Pacific states. Smallness also leads to strong personal relationships between health staff, and contributes to teamwork, but can also create issues in supervision.

      Small health services are not just scaled-down versions of large health services; they are qualitatively different. Smallness is usually intractable, and its effects require creative and particularistic solutions involving other more endowed Pacific states and Pacific Rim countries.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - Launching Hong Kong's healthcare financing reform: Why
           continued inaction'
    • Abstract: Lieu, G
      Hong Kong has sought without progress in the past 25 years to introduce reform proposals to enhance the long-term financial sustainability of its healthcare system. Through a systematic review of the consultation documents released over the years, this paper examines what might have been done right or wrong and pinpoints lessons learned for healthcare leaders, executives and reformers facing looming opportunities for reform. The findings suggest that the phased-approach of introducing reform options, involving step-by-step public consultations, to engaging the community to give their views on the healthcare financing reform options has not been effective. Other factors, including changes in the stewardship of the reform initiatives and the top-down elitist-led preparations of pre-launch work, added to the resultant inaction of not taking any of the reform proposals forward for launch and to produce reform. The study proposes that a broadly participatory approach, involving a wider base of members of the community in an inclusive guiding coalition charged to drive the reform from pre-launch to implementation, be undertaken. This coalition should start afresh and, based on renewed evidence-based assessments of the need and urgency of reform, proceed accordingly to formulate, if indicated, an overarching healthcare financing reform agenda that motivates people with conflicting interests to take mutually beneficial actions or that gives stakeholders the right incentives to work effectively together.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 11 Issue 3 - From global to local: Strengthening district health
           systems management as entry point to achieve health-related sustainable
           development goals
    • Abstract: Tejativaddhana, P; Briggs, DS; Thonglor, R
      Thailand has performed admirably in its health reform over the last few decades. Healthcare is provided at a relatively low cost and healthcare needs have transitioned to begin to address diseases and mortality of developed countries. The challenges now faced by Thailand are similar to most developed countries reflecting adult mortality and risk factors of an uppermiddle income population and the need to modify institutional structures to reflect these changing circumstances.

      The approach to these challenges has focused on the 'implementation of knowledge based health development' and critically identifies 'the triangle that moves the mountain' (health reform) as a movement that mobilises; the creation of relevant knowledge, social movement and political involvement' to address 'inter-connected, complex and extremely difficult to solve' problems. The move to District Health Systems as the access point to healthcare and the service delivery structure demands competent qualified leadership and management. It requires an understanding of the differences in managing professionally dominated complex adaptive systems compared to traditional approaches of managing within bureaucratic structures.

      This can be best described as managing connected, integrated care focused both on individuals as patients and communities with a strong emphasis on primary healthcare, prevention and evidence-based practice. It also requires an understanding of how distributed networks of practice (DNOP) provide the potential for researchers, practitioners and other agencies and communities to collaborate, learn and improve healthcare across geographic, jurisdictional and organisational boundaries.

      This approach provides recognition of the need to build the capacity and capability of health professionals in the management and leadership of health systems and Thailand is moving towards this goal in implementing specific health systems management curriculum which focuses on action-based research and learning together at the District health level augurs well for continued ability to address current health challenges and to achieve SDGs.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - A model of home-based care for people with
           disabilities: Better practice in rural Thailand
    • Abstract: Wanaratwichit, C; Hills, D; Cruickshank, M; Newman, B
      Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.

      Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.

      Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p < 0.01).

      Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Do peer leaders in the workplace improve
           implementation of self-management support training'
    • Abstract: Ervin, KE; Jeffery, V
      Objective: The study aimed to detect changes in implementation rates of self management support, utilising health coaching training, when staff are provided with increased workplace support through peer leaders.

      Design: This study used a quantitative research approach. With organisational consent, staff who had recently completed health coaching (HC) training, were emailed an electronic survey. The survey sought information about staff knowledge and confidence in implementing their HC training and perception of workplace support to implement and embed the training into practice.

      Setting: Nineteen staff trained in HC, from 10 different healthcare organisations completed an electronic survey. Sixty eligible primary healthcare staff from twelve healthcare organisations in rural Victoria, were invited to participate in the study.

      Main outcome measures: Measures used included a visual analogue scale of staff confidence levels of using the training in their work role, perceived barriers to implementation, the presence of structured opportunities to practice training in the workplace and ongoing colleague support in the workplace post training.

      Results: Despite increased workplace support through the presence of peer leaders in some organisations, staff confidence and implementation rates of HC training has not improved since previous evaluations. Conclusion: HC training for primary healthcare staff requires an organisational post training plan to support and improve implementation rates.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - The clinical and economic value of health libraries in
           patient care
    • Abstract: Peterson, M; Harris, L; Siemensma, G
      Clinicians have long recognised the value of current, authoritative information to support and inform their practice. The concept of evidence-based practice has itself gained acceptance through a substantial body of literature demonstrating how improvements in health care delivery and outcomes can be achieved through the application of the best evidence of clinical practice. Health libraries are core to the provision of information resources in all health-care settings. They have played a leading role in the adoption and dissemination of an unprecedented range of information resources and digital services in a rapidly changing health environment. There is a substantial and growing, body of evidence that health libraries are vital to the delivery of healthcare, both financially and clinically.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Library bulletin
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - The getting of wisdom
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - In this issue
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - An evidence-based framework: Competencies and skills
           for managers in Australian health services
    • Abstract: Martins, J; Isouard, G
      This paper is concerned with competencies and skills that enhance the capacity of health service managers to handle changes that medical technology and other factors have brought about. The paper takes a strategic rather than an all encompassing approach to identify the systemic changes that have taken place in the last decade. Statistical analysis and other information available were used in this process. One of the reasons for this approach is to take a real-world perspective of contemporary health management issues as the underpinning of the research. The salient systemic changes identified are classified under three major categories: practice evolution, service capacity and inputs and structural changes in public sector administration. The methodology involves a framework that led from systemic changes to related management issues and thence to competencies and skills of relevance. The latter relied on the inventory of health service management competencies and skills identified by academic research.

      The framework structure took into account the competence/skill domain and context. It led to groups of predisposing, enabling and transforming competencies and skills related to the management issues arising from the systemic changes identified. The findings will help examine strengths of current post-graduate courses in health service management. They also provide an agenda and opportunities for continuing education by relevant professional organisations.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Combatting staff burnout in mental health: Key
           managerial and leadership tasks that are fundamental to staff wellbeing
           and retention
    • Abstract: Coates, D; Howe, D
      Mental health services in Australia are struggling to recruit and retain adequately qualified and experienced staff. High turnover rates and understaffing is a significant problem faced by mental health services around the world and the most common reason for this is high levels of stress and staff burnout in this field. Mental health workers are at high risk of burnout, and this not only impacts negatively on the employee, but also on the quality of the service for clients and the functioning of organisations. While staff stress and burnout can be, at least in part, attributed to the emotional demands of mental health work, organisational management and leadership style plays a critical role in protecting staff against burnout and creating workplace environments that buffer against it. This paper outlines a range of key managerial and leadership tasks that are important to staff wellbeing and retention. A discussion of these tasks is the focus of this paper.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Characteristics of doctors transitioning to a
           non-clinical role in the MABEL study
    • Abstract: Vaswani, N; Eyre, H; Wang, WC; Joyce, C
      Objective: To investigate the characteristics and satisfaction of medical doctors transitioning from a clinical into an entirely non-clinical role.

      Design and setting: Wave 1 to Wave 5 data from 2008- 2012 in the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal, populationbased survey were analysed.

      Participants: Medical doctors including general practitioners (GPs), specialists, specialists in training (SIT) and hospital non-specialists (HNS). Hospital nonspecialists represent doctors working in a hospital who were not enrolled in a specialty training program. The total number of participants surveyed across the 5 waves was 15,195 doctors.

      Main outcome measures: The number of medical doctors making the transition from a clinical role to a nonclinical role from one wave of data to the subsequent wave of data. Individuals who responded 'Yes' to the question 'Are you currently doing any clinical medical work in Australia'' were defined as working in a clinical role. Individuals who stated that they were 'Doing medical work in Australia that is non-clinical' were defined as working in a completely non-clinical role. Each doctor's characteristics while partaking in clinical work prior to making the change to a non-clinical role were noted.

      Results: Over 5 years, there were a total of 498 individuals who made the transition from a clinical role to a completely non-clinical role out of a possible 15,195 doctors. Increasing age was the strongest predictor for transition to a non-clinical role. With regards to doctor type, specialists, hospital non-specialists and specialists-in- training were more likely to make the transition to a totally non-clinical role compared to GPs. There was minimal evidence of a relationship between lower job satisfaction and making a transition, and also between higher life satisfaction and making a transition.

      Conclusions: Understanding the characteristics of, and reasons for non-clinical career transition are important for workforce training, planning and development.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Leading and managing in health services - an
           Australasian perspective [Book Review]
    • Abstract: Lawrence, W
      Review(s) of: Leading and managing in health services - an Australasian perspective, by Day G and Leggat S, Port Melbourne: Cambridge University Press, 2015, ISBN: 978-1-107-48639-3.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - The changing face of healthcare accreditation in
           Australia
    • Abstract: McPhail, R; Avery, M; Fisher, R; Fitzgerald, A; Fulop, L
      Objective: To review the background of accreditation in healthcare. We examine the National Safety Quality Health Service (NSQHS) standards development and the perceptions of some of the NSQHS accredited accreditation providers in Australia.

      Design: An exploratory qualitative study in which the researchers use interviews and content comparison analysis to examine the Australian NSQHS standards (the Standards), the approving accrediting agencies and the perceived impact of the changes on the healthcare system.

      Setting: The researchers focus on providers' accreditation products and services, and how the Standards will impact on the Australian Healthcare system. Australia is not alone in undergoing reforms in accreditation and performance in healthcare. Other countries and international organisations have recently revised and renewed their interest in how healthcare systems perform.

      Outcome: This has led to the development of revised standards; quality and safety review frameworks; performance indicators for monitoring, assessing and managing healthcare systems to achieve effectiveness, equity, efficiency and quality.

      Measures: Analysis of qualitative data using the constant comparison method.

      Findings: Five major themes are found from in-depth interviews with accreditation program providers: the multiple levels of accreditation that are offered; the importance of assessor recruitment and training; the aspiration of service excellence; improved processes; and the importance of value versus price to those who are accredited by the participants of this study.

      Conclusions: The findings focus on optimisation of the regulatory environment to drive performance and quality in health facilities and the importance of the assessors, in what is expected to continue to be, a valuedriven accreditation market.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 2 - Is it time to stop writing discharge summaries'
    • Abstract: Arya, DK
      Writing of a 'Discharge Summary' has been an integral part of discharge from hospital or transfer of care. With the move from paper-based to electronic clinical records, is there an opportunity to eliminate the practice of 'writing' a discharge summary'

      One potential benefit of electronic clinical records is that they provide a facility to automate the retrieval of key information without having to re-enter, re-orientate or manually re-format the information contained in the dataset. Equally importantly, they exclude the subjective errors of commission and omission and the personal bias of the person writing a discharge summary who most often is a junior doctor, either intern or a resident.

      In developing the electronic clinical records systems we should endeavour to make the contextual information, the results of procedures and investigations and the plan of management automatically visible and accessible without recourse to `writing' a separate or additional discharge summary.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - An efficient alternative methodology for bed occupancy
           data collection
    • Abstract: Spencer, LM; Wong, A; Eley, R; Cook, DA; Sinnott, M; Kozan, E
      Introduction: The newly developed Bed Unit Day Investigation and Implementation (BUDII) information technology platform links a number of separate and distinct hospital data bases to provide a spatio-temporal map of inpatient movements and facilitate operational and research enquiries. The Bed Occupancy Audit Tool (BOAT) is used by the study hospital to conduct an annual census of the in-patient status of its operations. It is undertaken manually during one week each year and at two time slots within each of the seven days: 10am to 12 midday and 4pm to 6pm.

      Objective: The objective of the study was to compare outcomes using the BUDII platform with outcomes from a BOAT audit.

      Design: An experimental design was adopted. Data were assembled from two separate information systems for BUDII: the Hospital Based Corporate Information System (HBCIS) which tracks patients from in-patient admission to discharge and the Emergency Department Information System (EDIS) which contains patient data from presentation at, to departure from the ED. Data for BOAT were obtained from the manual census of the hospital.

      Setting: The study was conducted in a tertiary Queensland hospital.

      Findings: Figures from the 2012 BUDII trial and the 2012 BOAT census provided evidence that BUDII achieves comparable outcomes with BOAT with the added advantages of being low cost, with flexible census dates/times, and the provision of 24 hour a day data.

      Conclusions: The BUDII platform is an effective source from which to measure bed occupancy and patient movements.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Content analysis of mission, vision and value
           statements in Australian public and private hospitals: Implications for
           healthcare management
    • Abstract: Leggat, SG; Holmes, M
      Background: Effective use of a mission statement has been linked with better organisational performance. We have seen increasing importance placed on mission statements in hospital accreditation and in performance reporting.

      Purpose: The aim of this study was to document the content of the mission, vision and value statements of Australian hospitals to better understand the focus of mission statements currently in use. A secondary aim was to compare the content of the mission statements of public and private hospitals located in metropolitan and regional and rural areas.

      Methodology: Mission, vision and value statements from 43 public and 16 private hospitals in one state in Australia were analysed in relation to 23 previously identified mission statement components.

      Findings: The analysis revealed a focus on communicating purpose and enhancing legitimacy and identity by the Australian public hospitals. There were significant differences among public and private hospitals with the private hospitals showing a greater focus on competitive strategy and providing direction for staff in their mission statements.

      Practice implications: While our findings are consistent with how public and private hospitals currently operate in the Australian health system, we suggest that both public and private hospitals can improve mission statement content.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Building research capacity in a regional Australian
           health service: A management strategy analysis
    • Abstract: Murphy, K; Stockton, D; Kolbe, A; Hulme-Chambers, A; Smythe, G
      Research capacity building (RCB) can be challenging for health services, especially in non-metropolitan areas. This management analysis documents the RCB strategy recently initiated by Albury Wodonga Health (AWH), a large health service in regional Australia. AWH's strategy addresses three steps believed to be crucial in planning effective RCB: an initial needs assessment, identification of clear success indicators and multi-level structural considerations. In particular, AWH's strategy is based on current evidence pointing to the importance of external partnerships, the need for whole-of-organisation leadership, and the need to involve appropriate personnel. Early achievements of AWH's strategy include Executive-endorsed organisational research priorities, wide awareness of RCB as a whole-of organisation goal, agreed protocols for initiating and reviewing research proposals, formalised university partnerships, the establishment of a vibrant Research Interest Group, a number of current and planned collaborative projects, improved communication about research activities within AWH, and a program logic and evaluation framework to assist in maintaining focus and assessing the effectiveness of the strategy over the longer term. AWH's RCB strategy may serve as a modifiable model for managers of other similar health services pursuing a stronger research culture.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Asia Pacific journal of health management call for
           papers
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Strife with fiscal hygiene: Are health costs out of
           control'
    • Abstract: Martins, Jo M
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - In this issue
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Clarifying what the problem is by asking the right
           questions: A better approach to health reform
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - What employability skills are required of new health
           managers'
    • Abstract: Messum, D; Wilkes, L; Jackson, D
      Background: Employability Skills (ES) for graduates are monitored by Graduate Careers Australia but not specifically in health management. Generic skills are increasingly important especially to help cope with increasing complexity and rapid change. There is little research in the health arena to identify specific skill requirements and gaps in observed skills to requirements. The study was conducted to inform curriculum development, help facilitate employment outcomes for new graduates and improve job matching for employers.

      Method: Senior New South Wales health managers were surveyed to rate ES for importance and skill levels observed in recent graduates they employ. The ES gap between these two ratings was identified for 44 ES.

      Results: Generic ES namely integrity and ethical conduct, interpersonal skills, teamwork, being flexible and open minded, written and oral communication skills, self-awareness, collaborative, planning and lifelong learning are more important to health managers than job specific skills. Leadership skills were not found important. The largest gaps between observed skills and importance ratings were found for written skills, collaboration, negotiation, teamwork, cultural awareness, computing and software skills, strategic thinking, ability to scan the environment and self-awareness.

      Conclusions: Generic rather than job specific skills are what health managers rate as important ES on the job. These findings can be used to inform curriculum development because other than writing skills, they are not the traditional skills taught by higher education institutions (HEIs). Employers also need to consider the essential skills used in job advertisements to better fill vacancies.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Health LEADS Australia: Implementation and integration
           into theory and practice
    • Abstract: Shannon, EA
      This article reviews the development, implementation and impact of the national health leadership framework, Health LEADS Australia. While influenced by the Canadian LEADS in a caring environment approach, the Australian model had significant stakeholder engagement due to the collaborative and consensual process led by Health Workforce Australia.

      As stakeholder ownership has passed to formal licensees and other interested parties, adoption and adaptation has raised concerns about framework fidelity. The danger of fragmentation associated with the development of local variants is decreased by two elements of a 'second wave' of implementation. The incorporation of the framework into the academic curricula, where it becomes part of the existing body of knowledge, provides greater depth of intellectual resources. The development of practical resources and tools, such as a related competency framework, assists in jurisdictional implementation. Framework implementation within the Tasmanian Department of Health and Human Services and the University of Tasmania School of Medicine postgraduate program demonstrates these dynamics in this article.

      Mapping the relationship of Health LEADS Australia domains to mainstream leadership theory, this article contributes to the small, but growing, literature associated with this new field. The article concludes by discussing the disestablishment of Health Workforce Australia and the implications for the future of the Framework. The national and international connections formed during the development of Health LEADS Australia has resulted in a 'policy community' that provides the basis for future work.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Pharmacists as managers: What is being looked for by
           the sector in New Zealand community pharmacy'
    • Abstract: Ram, S; Jensen, M; Blucher, C; Lilly, R; Kim, R; Scahill, S
      Aim: To identify employers' requirements when recruiting a pharmacy manager and evaluate the critical skills, knowledge and abilities sought.

      Methods: Thirty to sixty minute, semi-structured interviews were carried out with employers of pharmacy managers (n=12) within the pharmacy sector in urban and semi-rural Auckland. Interviews were transcribed and thematically analysed.

      Findings: The key domains that employers look for in pharmacy managers include humanistic characteristics of professionalism, empathy, trust and integrity. Important technical aspects such as clinical expertise, business acumen as well as leadership skills were sought.

      Conclusion: Human (eg, communication skills to manage and motivate) and technical skills (eg, knowledge of pharmaceuticals) seem to be well recognised and articulated with conceptual skills (eg, executive and strategic skills) less so. The use of external consultants to manage pharmacies was dominant. The tension between being a healthcare provider and a retail business was manifest, which has implications for policy and future management practice. Further research in the area of leadership orientation within different models of pharmacy service delivery will be of benefit.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 1 - Library bulletin
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Library bulletin
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Back to the future: Using the ethical climate
           questionnaire to understand ethical behaviour in not for profits
    • Abstract: Dark, DL; Rix, M
      The ethical climate of an organisation can be described as the lens by which employees determine what comprises 'correct' behaviour within that organisation. As an outcome of the organisation's culture, many factors influence an ethical climate's design and configuration, including the organisation's history, its structure and management systems, the external environment and the individuals working within it. In order to work out the best ethical structure or ethical framework to support ethical behaviour, ethical climate must first be understood. The ethical climate questionnaire, (ECQ) a tool developed more than 25 years ago, has been applied and refined in empirical research with a focus on private and public organisations, but what about not-for-profit organisations'

      Through a focused literature review, this paper finds that the volume of empirical studies involving the ECQ in not-for-profit organisations is quite limited. Sample size, composition of the populations sampled and corresponding diversity in the intent or focus of these studies also limits broader application of their findings.

      However, the admittedly limited research findings so far suggest that ethical climates in not-for-profits are different to those found in organisations from the private and public sectors, and cannot be established using a compliance or rule-based approach to instilling ethics and integrity in organisations. Recent regulatory reform in the not-for-profit sector, increased community expectations, and the fact that services are often provided to vulnerable populations suggest a focus on the systems that support and demonstrate ethical decision-making is long overdue.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Analysis of management practice strategic planning: A
           comprehensive approach
    • Abstract: Schneider, S
      Objective: To describe a comprehensive approach to crafting a strategic plan for a health service organisation which incorporates the pillars of: corporate governance; service master planning; facilities master planning; business planning; clinical governance; and organisational culture to provide the framework for its development and subsequent implementation.

      Background: As a senior heath executive spanning 25 years, the author experienced first hand the negative consequences of a health service not developing and maintaining a comprehensive contemporary strategic plan through key stakeholder engagement. Throughout subsequent appointments the author refined his approach to strategic planning and draws on these experiences to write this article.

      Discussion: Each of the pillars is briefly discussed for the purposes of providing a definition and a considered rationale for inclusion in a comprehensive strategic plan. As each pillar is discussed, a number of elements are identified which are considered essential inclusions in this planning framework. Five key additional considerations that must be made during the development or crafting and implementation of a health service organisation's comprehensive strategic plan are also identified and discussed. These are: multi-site organisation; functional integration; resource requirements; implementation; and monitoring the strategy.

      Conclusion: The crafting of a contemporary strategic plan with six inherent pillars through key stakeholder engagement is fundamental for any organisation's long-term survival. Multi-site and functional integration challenges, resource implications, implementation needs and monitoring requirements are crucial in ensuring the successful implementation of such a strategic plan.

      Through the development and successful implementation of such a plan, a health service organisation will have significantly greater confidence that the risks it confronts in the future are mitigated. A health service's board and its executive would have every justification to be optimistic of their ability to future proof the organisation when adopting the strategic planning approach discussed in this article.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - A taxonomic approach to understanding managerial
           ethical decision-making approaches of clinically and non-clinically
           trained healthcare managers in Australia
    • Abstract: Casali, GL; Day, GE
      Objective: To understand differences in the managerial ethical decision-making styles of Australian healthcare managers through the exploratory use of the Managerial Ethical Profiles (MEP) Scale.

      Background: Healthcare managers (doctors, nurses, allied health practitioners and non-clinically trained professionals) are faced with a raft of variables when making decisions within the workplace. In the absence of clear protocols and policies healthcare managers rely on a range of personal experiences, personal ethical philosophies, personal factors and organisational factors to arrive at a decision. Understanding the dominant approaches to managerial ethical decisionmaking, particularly for clinically trained healthcare managers, is a fundamental step in both increasing awareness of the importance of how managers make decisions, but also as a basis for ongoing development of healthcare managers.

      Design: Cross-sectional.

      Methods: The study adopts a taxonomic approach that simultaneously considers multiple ethical factors that potentially influence managerial ethical decisionmaking. These factors are used as inputs into cluster analysis to identify distinct patterns of influence on managerial ethical decision-making.

      Results: Data analysis from the participants (n=441) showed a similar spread of the five managerial ethical profiles (Knights, Guardian Angels, Duty Followers, Defenders and Chameleons) across clinically trained and non-clinically trained healthcare managers. There was no substantial statistical difference between the two manager types (clinical and non-clinical) across the five profiles. Conclusion: This paper demonstrated that managers that came from clinical backgrounds have similar ethical decision-making profiles to non-clinically trained managers. This is an important finding in terms of manager development and how organisations understand the various approaches of managerial decision-making across the different ethical profiles.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - The observer effect: Can being watched enhance
           compliance with hand hygiene behaviour': A randomised trial
    • Abstract: Bolton, PGM; Rivas, K; Prachar, V; Jones, MP
      Bateson and Shelby provide evidence that cues of being watched can be a powerful mechanism inducing those observed to change behaviour. We designed and conducted a randomised controlled trial to assess the impact of visual cues of being watched on hand hygiene compliance. This did not demonstrate improved hand hygiene compliance associated with cues of being watched: compliance for wards with a 'cleanse your hands' poster was 87.3% and for wards without the poster it was 84.9%. This difference failed to reach statistical significance (OR=1.73, 95% CI 0.71- to 4.24, p=0.23).

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - The ethics of managing and leading health services: A
           view from the United Kingdom
    • Abstract: Armit, K; Oldham, M
      The financial challenges facing the NHS in England show no signs of abating. The well-publicised events of Mid Staffordshire NHS Foundation Trust between 2005-2009 show what can happen when leaders and managers focus on finances at the expense of the health and wellbeing of staff and patients. Leading and managing health services in a financially pressured environment is considerably challenging but those responsible for doing so need to learn from the lessons from Mid Staffordshire and be highly aware of, understand and fulfill the ethical responsibilities expected of them. Expectations of ethical behaviours are well articulated through the NHS Constitution and various professional codes of conduct and standards. Critically, if we want individual leaders and managers, no matter what their professional background, to behave ethically, all the players in the system - professional bodies, regulators, politicians need to create and support the culture and climate in which this can be achieved.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Ethics of managing and leading health
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - The ethics of managing health services: Why does it
           matter'
    • Abstract: Day, Gary E; Casali, Gian Luca
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Leading ethical decision-making: Clinical ethics
           services in Australia
    • Abstract: Jones, J; Milligan, E
      Decision-making in healthcare demands consideration of not only the clinical, operational or financial aspects of care but increasingly complex ethical issues. Meeting the physical and emotional needs of patients ethically, while acknowledging the distress and conflicting expectations and needs of staff, can be extremely difficult for all involved. It is vital that staff be provided with a 'safe space' to speak of the ethical challenges they are encountering if we are to take staff safety as seriously as we take patient safety. A Clinical Ethics Service (CES) established in accordance with the recently released National Health and Medical Research Council (NHMRC) consensus statement and the 'NHMRC Clinical Ethics Resource Manual' can provide such a space.

      This paper explores the who, what and why questions embedded in ethical decision-making. The work of a CES will be outlined. Drawing of the Roger L Martin's concept of heroic leadership, stakeholder roles and moral orientations will also be explored. In addition, the often unspoken attitudes towards certain patients, 'likeable' and 'unlikable' for instance, which threaten to influence views of 'worthiness' of care will also be explored.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Do health inquiries lead to health system change':
           What have we learnt from recent inquiries and will the same mistakes
           happen again'
    • Abstract: Day, GE; Casali, GL
      Since 2001 there have been numerous Commissions of Inquiry into health system failures across the world. While the Inquiries were established to examine poor patient outcomes, each has identified a range of leadership and management shortcomings that have contributed to a poor standard of patient care. While there is an acknowledgement that different heath systems have different contexts, this paper highlights a number of themes that are common across Inquiries. It will discuss a number of common system failures in Inquiries spanning from 2001 to 2013 and pose questions as to why these types of failures are likely to re-occur, as well as possible learnings for health service management and leadership to address a number of these common themes.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Do our leaders have the technical expertise to lead
           health sector reform'
    • Abstract: Arya, D
      The healthcare delivery paradigm has changed. This requires health care leaders implementing reform to think differently. It requires organising ourselves differently and even behaving differently. It is incumbent on health professionals with technical skills, experience and expertise to remain cognisant of the changing landscape, culture and community, understand patient and community expectations and lead development of a new vision, strategy and clinical systems and processes.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Raising the bar for health leadership in Australia
    • Abstract: Sebastian, A
      An insider's view of two national conversations leading to an agreed and approved health leadership framework for Australia, this perspective highlights the national aspirations for developing leadership for a people focused health system that is equitable, effective and sustainable. Admired in Canada and in many places around Australia, development of the tools and programs to accompany Health LEADS Australia faltered in the transfer of custodianship from Health Workforce Australia to the Department of Health. On hold too, is a national approach to health leadership built into early career education and professional development. Despite this, authors and stakeholders in State and Territory Health Departments and independent health agencies are using Health LEADS Australia in ways that continue to highlight its potential for raising the bar of health leadership in Australia.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Editor's note
    • Abstract: Briggs, DS
      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - On the use/misuse of health research gatekeeping
           powers in Australia: An underconsidered problem'
    • Abstract: Murgatroyd, P; Karimi, L; Robinson, P; Rada, J
      Significant investments have been made internationally, including in Australia, to enhance evidence generation and implementation in healthcare. Nevertheless, large knowledge gaps persist, and changes in clinical settings are slow to appear. This impacts service efficiency and efficacy, and ultimately the health and wellbeing of individuals and communities.

      However, despite this situation, surprisingly negative attitudes to research exist within healthcare. This paper describes a number of cases where research has been blocked at various levels by Australian health organisations, managers and clinicians for reasons of corporate and individual self-interest, rather than ethical or resource-related concerns. We call this tendency nimbyism in healthcare research and suggest it often operates through the misuse of gatekeeping powers at the nexus between potential research participants and would-be researchers. We identify three levels where research nimbyism can operate: 1) institutional control of research activities 2) dissemination of findings 3) vested interests of individuals in the status quo. We propose that nimbyism may not be an unusual phenomenon.

      Ethical aspects of research gatekeeping, including societal and individual aspects, are considered together with possible motivations. We ask whether patterned, covert and unauthorised misuse of gatekeeping powers is an under-considered problem affecting evidencebased practice and the right to research participation and call for more research into this phenomenon.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - The challenges of a relational leadership and the
           implications for efficacious decision- making in healthcare
    • Abstract: Harden, H; Fulop, L
      Objective: To demonstrate how decision-making can be made more efficacious in healthcare contexts, such as cancer care networks, by adopting relational leadership practices.

      Design: Empirical material was collected through video-recordings over a 12-month period of fifty-three meetings of seven cancer networks in Australia. Using an interpretive approach, analysis was conducted on the meeting conversations of service improvement subcommittees of the networks. Only one sub-committee was described as 'narrative rich' meaning, personal narratives or stories were evident in their conversations. The sub-committee is characterised as displaying elements of multi-ontology sense making. Drawing on the Cynefin framework, conversations were classified as simple, complicated, complex or crisis-based depending on the nature of their decisions and the contextual constraints. This allowed conversations to be tagged as examples of either single or multi-ontology sense making.

      Setting: Cancer networks in Australia tasked with the dilemma of enhancing multi-disciplinary cancer care.

      Main outcome: Relational leadership practices can generate narrative rich conversations in decisionmaking through enabling multi-ontology sense making.

      Results: Sufficient evidence was found to demonstrate that narrative rich conversations offered potentially new and innovative ideas for service improvement but lacking relational leadership practices, networks simply produced interventions that amounted to 'more of the same.'

      Conclusions: The ability to skilfully relate helps create contexts in which multi-ontology sense making can flourish. Skilful relating, as a leadership practice, is essential to making healthcare professionals more innovative and creative in how they deal with organisational dilemmas, allowing them to engage in robust, informed and inclusive decision-making processes.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Understanding the need for the introduction of the
           multi-purpose service model in rural Australia
    • Abstract: Malone, L; Anderson, JK
      Aim: This article provides a commentary on the implementation of the Multi Purpose Service (MPS) healthcare program and the underlying principles that govern the administration of MPS within the Australian public health system.

      Background: Existing funding models for acute care services do not apply to MPS, which increases the pressure on small rural areas with decreasing populations to maintain health care services.

      Evaluation: A database search yielded 147 articles and 23 were identified as being relevant to the topic.

      Key Issues: Key issues were identified from the evaluation of the literature and included: poor health in rural communities; the need for collaboration between governments; unique design of an MPS; and the need to consider community and staff perspectives.

      Conclusions: In the absence of any other sustainable model of health care delivery being developed or implemented within Australian rural and regional areas, the MPS model of care is the most practical use of financial and human resources to provide healthcare services for these small communities.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - General supplement
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - Developing an instrument for a state-wide palliative
           care satisfaction survey in Australia
    • Abstract: O'Connor, M
      In the State of Victoria, Australia, there was an identified need for a validated instrument to measure the satisfaction of people receiving palliative care. The process of gaining sector-wide cooperation to collect satisfaction data across many settings and models of care had been a challenge for many years. This was finally achieved in 2007, particularly when driven by the requirement that funding was contingent on meeting the Victorian Government's key performance indicators in relation to satisfaction. What has emerged is the ability to report to government and the sector, to compare and contrast service satisfaction and these data being used to enable improved care provision.

      This paper outlines the process of developing and validating the Palliative Care Satisfaction Instrument (VPCSI). Continued annual use of the instrument enables ongoing collection of benchmark data for subgroups, confirmation of core components and other psychometric consolidation measures.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - A study on patient satisfaction at Khanh Hoa
           Provincial general hospital
    • Abstract: Le, Phung Tan; Fitzgerald, G
      Patient satisfaction has been considered an indispensable measure in the process of evaluating hospital performance. A patient satisfaction survey can help explore possible gaps in hospital service to improve its quality.

      The study was conducted based on a random sample of 985 in-patients who were already discharged within three months. A 26-item patient satisfaction scale was used to evaluate respondents' satisfaction with the hospital service. Univariate and multiple analyses were used to examine the relationship between satisfaction and patients' socio demographic characteristics. T test, ANOVA, and regression model were used for analysis.

      The results showed a proportion of 68 per cent satisfaction with the hospital's service. The most dissatisfied dimension was Responsiveness that relates to waiting time for doctors' and nurses' responses and administrative procedures. There were no significant differences in satisfaction regarding patients' gender, religion and health insurance status. Older people were likely to be more satisfied than younger ones. Patients who were living in remote areas were likely to be more satisfied with the hospital service.

      Further studies should be conducted to confirm the five-factor structure of the scale. More attention should be paid to the dimensions of Assurance, Reliability and Empathy to improve hospital service quality.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 10 Issue 3 - It's time: The poor culture regarding safety and
           quality in Australian hospitals must be addressed!
    • Abstract: Davis, E; Beale, N
      This review article demonstrates the causal relationship between a poor safety and quality culture in Australian and overseas hospitals and the occurrence of adverse patient events (AEs). The evidence of serious adverse events occurring in these hospitals is unquestionable.

      Awareness of the importance of that poor safety and quality culture in hospitals and its linkage with AEs is not as widespread as is warranted, but there is mounting evidence of its rapidly increasing recognition. The concept of technical and non-technical competence in workers in different industries is also well developed, with an increasing consensus that the non-technical aspects of healthcare delivery are responsible for a majority of the adverse events, rather than issues of technical competence.

      The need to provide patient safety education, particularly in a multi-professional setting has been established through the World Health Organisation's (WHO) Patient Safety Curriculum Guide: Multi- Professional Edition in 2011. This document also stresses the importance of multi-disciplinary care teams. A corollary of this is the need to extend this education to more senior members of healthcare teams, who did not experience these concepts in their education.

      Following completion of the education of those senior members in the issues of a safety and quality culture, all members of those professions must then have periodic mandatory reviews of these lessons incorporated into their continuing professional development (CPD) activities.

      One manifestation of that poor safety and quality culture is bullying, which is extensive in hospitals and which is rapidly being recognised in the Australian environment.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 9 Issue 1 - Manuscript preparation and submission
    • PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 9 Issue 1 - The clinical communication program: An effective
           intervention for reducing future risk for high-risk physicians
    • Abstract: O'Brien, M; Dinwoodie, M; Hartwig, B; Blaney, D
      Objective: To evaluate the effectiveness of the Clinical Communication Programme (CCP) as a remedial intervention for high-risk physicians. Design: Physicians with a high-risk profile within the Medical Protection Society (MPS) were identified via a scoring system developed by its membership governance department. If communication issues were considered to have contributed to their risk the member was invited to attend an intensive communication skills training (CCP). Event data (claims, preclaims, disciplinary and regulatory episodes) was recorded and analysed pre and post CCP. Setting: The intervention took place in the various centres in the United Kingdom and was attended by British Physicians who were members of MPS. Outcome Measures: Change in incidence of event following communication skills training. Findings: Post CCP incidence rate fell for all but four physicians. Post CCP these four physicians accounted for 75% of events. Conclusions: The Clinical Communication Program is an effective remedial intervention for most physicians with a high-risk of future claims. There is a small group who did not benefit.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
  • Volume 9 Issue 1 - Measuring aspects of eXcellent care (MAXC): Easing the
           burden of auditing for the national safety and quality health service
           standards
    • Abstract: Jessing, M; Brookes, K; Rubin, G
      From 1 January 2013, all public and private health services in Australia are required to be accredited against National Safety and Quality Health Service Standards promulgated by the Australian Commission for Safety and Quality in Healthcare (ACSQHC). The new accreditation requirements specify the completion of forty-seven clinical audits. As it is anticipated that administering the audits will be time-consuming and this will reduce time spent delivering clinical care, South Eastern Sydney Local Health District (SESLHD) has developed a system of audits to meet the requirements. The Measuring Aspects of Excellent Care (MAXC) system of audits is based on the measurement of process indicators. This paper describes the design process and implementation strategies used. The MAXC system of audits has been used by two facilities to achieve accreditation under the new standards.

      PubDate: Thu, 2 Nov 2017 11:47:32 GMT
       
 
 
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