In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states ....In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.Read moreRead less
Identifying EHealth Literacy And Readability Issues For Palliative Care Consumers
Funder
National Health and Medical Research Council
Funding Amount
$29,375.00
Summary
Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individ ....Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individual skills and experiences and how information is presented and made available. eHealth literacy is a measure of the mix of skills required by consumers to successfully access and understand palliative care information. Readability is one aspect of eHealth literacy and readability scales can be used to identify how effective websites are in providing appropriate written information for palliative care consumers. This research will help assess eHealth literacy levels and hence potential intervention needs of palliative care patients and carers as well as determining whether the readability requirement of palliative care websites and information is too high.Read moreRead less
Surveillance And Analysis Of Avian Influenza Viruses In Wild Birds In Australia
Funder
National Health and Medical Research Council
Funding Amount
$250,237.00
Summary
Birds are commonly infected with bird flu viruses but most of these viruses do not cause disease. However, certain types of bird flu viruses, such as the H5N1 strain, can cause severe illness and death in 100% of infected birds. There is currently an epidemic of H5N1 bird flu occurring in Asia. Occasionally humans become infected by bird to human transmission and since 2003, 130+ people have been infected with H5N1 resulting in 60+ deaths. There are 3 ways in which dangerous strains of the virus ....Birds are commonly infected with bird flu viruses but most of these viruses do not cause disease. However, certain types of bird flu viruses, such as the H5N1 strain, can cause severe illness and death in 100% of infected birds. There is currently an epidemic of H5N1 bird flu occurring in Asia. Occasionally humans become infected by bird to human transmission and since 2003, 130+ people have been infected with H5N1 resulting in 60+ deaths. There are 3 ways in which dangerous strains of the virus may be brought to Australia by; infected people, domestic birds and migratory wading birds. In order to monitor the import of these viruses by migratory birds we will catch and take samples from large numbers of these birds in important areas where they congregate close to humans and poultry farms. We will identify what types of bird flu viruses these birds are carrying and if the viruses are capable of causing disease in birds and humans. We will also see if they can be treated by the influenza drugs that we currently have and we will study these viruses to find new drug targets. These viruses are commonest in ducks. Migratory wading birds and local ducks live in the same habitats so there is the chance that the wading birds and ducks could pass the viruses to each other. There is an additional concern that non-disease causing viruses could mutate in ducks and become pathogenic and pass from bird to bird or even human to human transmission which could cause a major human epidemic of bird flu in Australia. So we will also take samples from local ducks that occur in the same areas as the wading birds and test them for viruses as well. Our results will show what kinds of viruses are being carried by wading birds and ducks and if these viruses are a danger to people and poultry. We can then manage important areas so that humans and poultry do not come into contact with these viruses.Read moreRead less
Potential Avian Influenza-induced Pandemic: Minimising Public Panic
Funder
National Health and Medical Research Council
Funding Amount
$249,854.00
Summary
Communication appearing in the Australian media regarding a potential bird flu epidemic can serve to accurately and effectively inform the public OR misinform and contribute to panic and undesirable behavioural responses. The Australian Government has time to develop communication strategies and specific messages that can effectively convey desired information at different stages of the anticipated pandemic. This research team proposes to develop communication strategies (including specific mess ....Communication appearing in the Australian media regarding a potential bird flu epidemic can serve to accurately and effectively inform the public OR misinform and contribute to panic and undesirable behavioural responses. The Australian Government has time to develop communication strategies and specific messages that can effectively convey desired information at different stages of the anticipated pandemic. This research team proposes to develop communication strategies (including specific messages, media vehicles, spokespeople, images etc for the different target audiences) that government, medical authorities, NGOs and other relevant organisations can use to increase the public's understanding of the risk. Such strategies will ensure that we can minimise fear, refute misinformation the public may encounter from individuals (e.g., co-workers) or media sources, and enhance the likelihood of the public taking the recommended preventive and remedial actions should an Avian Influenza pandemic occur. Additionally, the research team will then utilise these communication strategies to develop evidence-based guidelines for communication strategies to be used in cases of similar serious health threats in Australia. Based at the University of Wollongong, the project team is a sophisticated and synergistically qualified team of experts. The team includes: a main media health promotions expert (Associate Professor Sandra Jones); two marketing communications experts, one of whom has an academic focus and the other a practitioner focus (Professor John Rossiter and Dr Max Sutherland respectively); a public health and medical expert in health behaviour change (Professor Don Iverson); a senior public health campaigns expert (Professor Chris Puplick), and an expert in communicable diseases and infection control education and programs (Professor Julian Gold).Read moreRead less
A Computer Model Of Service Delivery For Behavioural And Psychological Symptoms Of Dementia: A Tool For Policy Makers An
Funder
National Health and Medical Research Council
Funding Amount
$400,108.00
Summary
Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementi ....Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementia and project associated costs of care into the future. It will also incorporate information about interventions for BPSD, and how they may affect prevalence and cost in the future.Read moreRead less
Models Of Care To Address Unmet Of Older Indigenous With Dementia Their Families And Communites Living In Remote WA
Funder
National Health and Medical Research Council
Funding Amount
$1,081,060.00
Summary
The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. O ....The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. Over the last 4 years the applicants of this project have started to address some of the health related problems faced by older Indigenous people, particularly the challenging area of dementia. The authors have developed a culturally appropriate assessment tool to help determine if an older Indigenous person has dementia. This has been very successful and is now frequently used by health professionals in remote and rural areas of Australia. A survey is in the final stages of completion to determine the estimated number of people in remote areas of the Kimberley who manifest signs and symptoms of dementia and associated old age diseases. Preliminary data sadly indicate that the frequency of dementia is higher than expected for people of this age group. The next phase of this project is to determine the unmet needs of this vulnerable group, by interviewing those with dementia and their families, communities and service providers in remote areas of Kimberley and Pilbara. This will determine culturally appropriate and practical ways to provide care to assist those with this condition and their families and communities.Read moreRead less
Determining Critical Points In The Potential Palliative Care Pathway In The Last Year Of Life
Funder
National Health and Medical Research Council
Funding Amount
$356,461.00
Summary
People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death ....People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death best introduced and how we can care for people from a diverse range of backgrounds and beliefs within our current health care system. We also need to identify and promote the best possible ways of supporting patients at the end of life and their families as they negotiate the often complex path towards a good death. With this kind of information, health care practitioners, particularly those involved in palliative care, can design better services that put in place pathways where assessment of patient and family needs, referral to the most appropriate services and coordination of all the aspects of care are easy to understand and access for all people. This kind of care can be expensive so we need to use the money allocated to palliative care wisely. This can be achieved with thoughtful research that identifies those most in need, at the time of most need and investigates the best approaches to alleviating pain in suffering in the weeks and months before death. A fair and equitable health care system is not just about keeping people healthy, but also about dealing humanely with the inevitability of deathRead moreRead less
Development And Implementation Of An Educational Program To Guide Palliative Care For People With Motor Neurone Disease
Funder
National Health and Medical Research Council
Funding Amount
$258,525.00
Summary
The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to peo ....The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to people with MND and their carers as a result of the implementation of the MND Education Program will be assessed and a national implementation plan will be developed.Read moreRead less