The Quality Of Surgical Care Project: Quality Assurance, Clinical Audit And Outcomes Evaluation In Western Australia
Funder
National Health and Medical Research Council
Funding Amount
$346,018.00
Summary
The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA ....The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA. The QSCP is only possible because of the unique population-based record linkage available in this state and is consistent with priorities identified in the National Health Information Development Plan in the areas of record linkage and health outcomes, as well as with the monitoring of interventions recommended by the Taskforce on Quality in Australian Health Care. The surgical procedures reviewed are selected to include a broad range of surgical specialties on the basis of national priority, in consultation with the RACS and with input from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S). This application proposes to continue the core program in promoting best practice in procedural care by reviewing selected procedures including the outcomes of laparoscopic and endoscopic procedures, and endoluminal stenting surgery due to their rapid proliferation during the 1990's. This second stage of the QSCP proposes the introduction of two new quality assurance themes. Firstly, to promote the clinical safety and post-implementation surveillance of new surgical interventions and other medical technology by establishing the WA Registry and Surgical Audit of New Surgical Interventions. Secondly, to comprehensively and independently audit all surgical mortality at a population level. A dissemination strategy will be established to 'complete the loop' in the evaluation and audit processes.Read moreRead less
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$446,807.00
Summary
This study aims to improve the safety, quality and the provision of surgical care in WA by evaluating the patterns of underlying disease, health care utilisation, patient safety and health outcomes following admission to hospitals for surgical and medical procedures. The selected procedures are based on national priorities and and include the use of minimally invasive surgical techniques. Differences in the outcomes of surgical care in rural and metropolitan settings will also be evaluated.
Combined Randomised And Observational Study Of Type B Ankle Fracture Treatment
Funder
National Health and Medical Research Council
Funding Amount
$117,331.00
Summary
Ankle fractures are frequently seen in emergency departments, and isolated AO type B fibula fractures are the most common type of ankle fracture. Current treatment is equally divided between surgical, and non-surgical, as per surgeon preference. When managed surgically, these fractures consume considerable healthcare resources and expose patients to risks. This study will determine if surgery improves outcomes for patients with type B ankle fractures when compared with non-surgical management.
THE CONTROL OF TYPE 2 DIABETES THROUGH WEIGHT LOSS IN INDIGENOUS AUSTRALIANS: THE FEASIBILITY AND ACCEPTABILITY OF LAGB
Funder
National Health and Medical Research Council
Funding Amount
$600,854.00
Summary
Our recent clinical trial showed that 3 out of every 4 obese people with type 2 diabetes who undergo substantial weight loss have their diabetes go into remission. In this project we recognise in the Indigenous people specific cultural and socio-economic factors and family and community approach to health care and seek to test if the Lap-Band procedure is acceptable to them and if it is feasible to achieve substantial weight loss and control of diabetes as was seen in a European population.
The Western Australian Record Linkage Project: Population-Based Studies Of Health System Utilisation And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$975,923.00
Summary
Through the unique combination of the WA Record Linkage Project and research expertise applied consistently over a 5 year period, the project will provide information on the health system's performance, which is difficult to obtain in any other way. Five priority themes will be developed: (1) INEQUALITIES IN HEALTH CARE, in particular a better understanding of the effects of social disadvantage, lack of private health cover and living in rural and remote areas on health care access and outcomes. ....Through the unique combination of the WA Record Linkage Project and research expertise applied consistently over a 5 year period, the project will provide information on the health system's performance, which is difficult to obtain in any other way. Five priority themes will be developed: (1) INEQUALITIES IN HEALTH CARE, in particular a better understanding of the effects of social disadvantage, lack of private health cover and living in rural and remote areas on health care access and outcomes. (2) PREVENTABLE INPATIENT TIME through research into the causes of preventable inpatient time and the role of the hospital and general practice in reducing these risks. (3) PROMOTING BEST PRACTICE IN SURGICAL and PROCEDURAL CARE through systematic evaluation of the appropriateness and outcomes of surgical procedures. (4) CLINICAL SAFETY AND POST-IMPLEMENTATION SURVEILLANCE to ensure the safety of new technology. Finally, (5) METHODOLOGIC DEVELOPMENTS to provide better methods of record linkage to evaluate the health system. The project is consistent with priorities set in the National Health Information Development Plan in record linkage and health outcomes, as well as the monitoring of interventions recommended by the Taskforce on Quality in Australian Health Care, and the national agenda given to the Australian Council for Safety and Quality in Health Care. The work will examine health system access and outcomes for five of the six focus areas chosen by the Australian health ministers. Moreover, the results will be used to advocate on behalf of vulnerable populations in a country that prides itself on universal access to high quality health services. In view of the relevance of the project to existing priorities, and the unique opportunities afforded by the WA Record Linkage Project, a substantial, beneficial impact on health policy and practice is anticipated, as well as new research methods and findings that will contribute to international knowledge.Read moreRead less
CROSSFIRE: Combined Randomised And Observational Study Of Surgery For Fractures In The Distal Radius In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$551,077.00
Summary
Fractures (breaks) near the wrist are the most common fractures treated. Treatment previously consisted of straightening and plaster casting in the emergency department, but standard treatment now includes admission to hospital and surgery to apply a plate and screws to the bone. The best evidence we have (which is limited) is that surgical plating does not provide important benefits over plastering. We aim to perform a multicentre trial comparing plating to plaster for these common fractures.
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$583,500.00
Summary
The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the W ....The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the WA Data Linkage System, which brings together 15 million records from hospital morbidity, death, cancer, midwives notification and mental health databases. Surgical procedures have been selected for review based on national priorities and after consultation with the WA Branch of the Royal Australasian College of Surgeons (RACS) and other clinical Colleges. This application proposes to continue the core research activities of the SQSCP. A special focus will be on the use of minimally invasive surgical techniques including laparoscopic, endoscopic and endoluminal procedures, which have increased dramatically during the last decade. The study will also evaluate differences in the outcomes of surgical care in rural and metropolitan settings. The findings of the SQSCP will be comprehensively disseminated to surgeons, the RACS, hospital managers, health policy makers and consumers. The rationale of this project is that by providing high quality data on the epidemiology, utilisation and outcomes of surgical care, we will be able to increase the knowledge-base that will contribute to improvements in the safety, quality and provision of surgical care in Australia and internationally. The aims of the SQSCP are consistent with national health priorities and the recommendations of the Taskforce on Quality of Australian Health Care Study, the Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies.Read moreRead less
Delayed Loss Of Acoustic Hearing After Cochlear Implantation: Mechanisms And Clinical Identification With New Cochlear Implant Technology
Funder
National Health and Medical Research Council
Funding Amount
$1,040,157.00
Summary
Natural hearing can be combined with a cochlear implant to improve sound quality and speech understanding. However, natural hearing frequently deteriorates weeks to months after cochlear implantation. This seems to occur when cochlear fluid buildup (hydrops) or fibrosis within the inner ear disrupts cochlear mechanics. We plan to monitor these processes in patients by recording directly from the cochlear implant, and conduct laboratory experiments to find therapies to alleviate their effects.
Application Of 3D Morphometrics To The Assessment Of Typical And Disordered Craniofacial Growth
Funder
National Health and Medical Research Council
Funding Amount
$48,065.00
Summary
Traditionally, assessing the growth of the head and face has relied on measuring changes in distances and angles between landmarks on either patients, photographs or x-rays. This is not only slow but also not very accurate. This project will automate the identification of these landmarks on 3D images and quantify normal growth of the head and face. From this we can develop methods of quantifying abnormal growth and use these to understand the impact of surgical interventions on children.
Randomised Controlled Trial Of Surgical Skin Preparation For Prevention Of Superficial Wound Complications In Prosthetic Hip And Knee Replacement Surgery
Funder
National Health and Medical Research Council
Funding Amount
$403,128.00
Summary
The demand for prosthetic joint replacement surgery will double over the next decade. Complications involving the surgical wound are a devastating complication of this surgery. This randomised controlled trial aims to investigate whether skin cleansing prior to surgical incision with alcoholic iodine reduces the number of patients with superficial wound complications when compared to alcoholic chlorhexidine. The study will be performed in patients undergoing orthopaedic joint replacement surgery ....The demand for prosthetic joint replacement surgery will double over the next decade. Complications involving the surgical wound are a devastating complication of this surgery. This randomised controlled trial aims to investigate whether skin cleansing prior to surgical incision with alcoholic iodine reduces the number of patients with superficial wound complications when compared to alcoholic chlorhexidine. The study will be performed in patients undergoing orthopaedic joint replacement surgery: a high volume, high cost surgery.Read moreRead less