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  • 1
    Online Resource
    Online Resource
    Changes in public perceptions and experiences of the Australian health‐care system: A decade of change
    Wiley ; 2021
    In:  Health Expectations Vol. 24, No. 1 ( 2021-02), p. 95-110
    Details
    In: Health Expectations, Wiley, Vol. 24, No. 1 ( 2021-02), p. 95-110
    Abstract: The views and experiences of the Australian public are an important barometer of the health system. This study provides key findings about the changing views held by Australians over time regarding their individual experiences and perceptions of the overall performance of the health system. Methods A population‐based online survey was conducted in 2018 (N = 1024). Participants were recruited through market research panels. The results were compared with previous Australian population survey data sets from 2008 (N = 1146), 2010 (N = 1201) and 2012 (N = 1200), each of which used different population samples. The survey included questions consistent with previous surveys regarding self‐reported health status, and questions about use, opinions and experiences of the health system. Results Overall, there has been a shift in views from 2008 to 2018, with a higher proportion of respondents now viewing the Australian health‐care system more positively ( X 2 (2, N = 4543) = 96.59, P   〈  .001). In 2018, areas for attention continued to include the following: the need for more doctors, nurses and other health workers (29.0%); lower costs for care or Orion medicines (27.8%); more access to care (13.1%); and enhancements in residential aged care (17.3% rated these services as ‘bad’ or ‘very bad’). Conclusions This research suggests that Australians’ perceptions of their health‐care system have significantly improved over the last decade; however, concerns have emerged over access to medicines, inadequate workforce capacity and the quality of aged care facilities. Our study highlights the value of periodically conducting public sentiment surveys to identify potential emerging health system problems.
    Type of Medium: Online Resource
    ISSN: 1369-6513 , 1369-7625
    URL: Issue
    URL: Article
    DOI: 10.1111/hex.v24.1
    DOI: 10.1111/hex.13154
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2006357-X
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  • 2
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    Implementation of e‐mental health for depression and anxiety: A critical scoping review
    Wiley ; 2020
    In:  Journal of Community Psychology Vol. 48, No. 3 ( 2020-04), p. 904-920
    Details
    In: Journal of Community Psychology, Wiley, Vol. 48, No. 3 ( 2020-04), p. 904-920
    Abstract: The aim of this review was to scope the growth and development of implementation research of e‐mental healthcare programs for anxiety and depression, the research and evaluation tools used, and the specific implementation processes and outcomes examined. A search of four electronic databases (MEDLINE, EMBASE, PsycINFO, and CINAHL) was conducted from January 2000 to January 2019. Of 33 studies identified, most ( n  = 28) were published in the last five years. Only 10 used an implementation framework to guide implementation or evaluation. Most studies reported on acceptability ( n  = 28), appropriateness ( n  = 23), and feasibility ( n  = 17). Less commonly reported implementation outcomes were fidelity ( n  = 10) and adoption ( n  = 7); with penetration ( n  = 4), sustainability ( n  = 3), and implementation cost ( n  = 2) being studied rarely. Of the 21 studies that used surveys to study implementation outcomes, less than half used a previously published survey ( n  = 9). More rigorous implementation studies, underpinned by strong theory and real‐world understanding, are urgently needed.
    Type of Medium: Online Resource
    ISSN: 0090-4392 , 1520-6629
    URL: Issue
    URL: Article
    DOI: 10.1002/jcop.v48.3
    DOI: 10.1002/jcop.22309
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1491194-2
    SSG: 5,2
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  • 3
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    Correction: The Science of Learning Health Systems: Scoping Review of Empirical Research
    JMIR Publications Inc. ; 2022
    In:  JMIR Medical Informatics Vol. 10, No. 8 ( 2022-8-4), p. e41424-
    Details
    In: JMIR Medical Informatics, JMIR Publications Inc., Vol. 10, No. 8 ( 2022-8-4), p. e41424-
    Type of Medium: Online Resource
    ISSN: 2291-9694
    URL: Article
    DOI: 10.2196/41424
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 2798261-0
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  • 4
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    An empirical application of “broken windows” and related theories in healthcare: examining disorder, patient safety, staff outcomes, and collective efficacy in hospitals
    Springer Science and Business Media LLC ; 2020
    In:  BMC Health Services Research Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Broken windows theory (BWT) proposes that visible signs of crime, disorder and anti-social behaviour – however minor – lead to further levels of crime, disorder and anti-social behaviour. While we acknowledge divisive and controversial policy developments that were based on BWT, theories of neighbourhood disorder have recently been proposed to have utility in healthcare, emphasising the potential negative effects of disorder on staff and patients, as well as the potential role of collective efficacy in mediating its effects. The aim of this study was to empirically examine the relationship between disorder, collective efficacy and outcome measures in hospital settings. We additionally sought to develop and validate a survey instrument for assessing BWT in hospital settings. Methods Cross-sectional survey of clinical and non-clinical staff from four major hospitals in Australia. The survey included the Disorder and Collective Efficacy Survey (DaCEs) (developed for the present study) and outcome measures: job satisfaction, burnout, and patient safety. Construct validity was evaluated by confirmatory factor analysis (CFA) and reliability was assessed by internal consistency. Structural equation modelling (SEM) was used to test a hypothesised model between disorder and patient safety and staff outcomes. Results The present study found that both social and physical disorder were positively related to burnout, and negatively related to job satisfaction and patient safety. Further, we found support for the hypothesis that the relationship from social disorder to outcomes (burnout, job satisfaction, patient safety) was mediated by collective efficacy (social cohesion, willingness to intervene). Conclusions As one of the first studies to empirically test theories of neighbourhood disorder in healthcare, we found that a positive, orderly, productive culture is likely to lead to wellbeing for staff and the delivery of safer care for patients.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    URL: Article
    DOI: 10.1186/s12913-020-05974-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2050434-2
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  • 5
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    Organisational change in hospitals: a qualitative case-study of staff perspectives
    Springer Science and Business Media LLC ; 2019
    In:  BMC Health Services Research Vol. 19, No. 1 ( 2019-12)
    Details
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Abstract: Organisational change in health systems is common. Success is often tied to the actors involved, including their awareness of the change, personal engagement and ownership of it. In many health systems, one of the most common changes we are witnessing is the redevelopment of long-standing hospitals. However, we know little about how hospital staff understand and experience such potentially far-reaching organisational change. The purpose of this study is to explore the understanding and experiences of hospital staff in the early stages of organisational change, using a hospital redevelopment in Sydney, Australia as a case study. Methods Semi-structured interviews were conducted with 46 clinical and non-clinical staff working at a large metropolitan hospital. Hospital staff were moving into a new building, not moving, or had moved into a different building two years prior. Questions asked staff about their level of awareness of the upcoming redevelopment and their experiences in the early stage of this change. Qualitative data were analysed using thematic analysis. Results Some staff expressed apprehension and held negative expectations regarding the organisational change. Concerns included inadequate staffing and potential for collaboration breakdown due to new layout of workspaces. These fears were compounded by current experiences of feeling uninformed about the change, as well as feelings of being fatigued and under-staffed in the constantly changing hospital environment. Nevertheless, balancing this, many staff reported positive expectations regarding the benefits to patients of the change and the potential for staff to adapt in the face of this change. Conclusions The results of this study suggest that it is important to understand prospectively how actors involved make sense of organisational change, in order to potentially assuage concerns and alleviate negative expectations. Throughout the processes of organisational change, such as a hospital redevelopment, staff need to be engaged, adequately informed, trained, and to feel supported by management. The use of champions of varying professions and lead departments, may be useful to address concerns, adequately inform, and promote a sense of engagement among staff.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    URL: Article
    DOI: 10.1186/s12913-019-4704-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2050434-2
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  • 6
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    Learning health systems: A review of key topic areas and bibliometric trends
    Wiley ; 2022
    In:  Learning Health Systems Vol. 6, No. 1 ( 2022-01)
    Details
    In: Learning Health Systems, Wiley, Vol. 6, No. 1 ( 2022-01)
    Abstract: The emergent field of learning health systems (LHSs) has been rapidly evolving as the concept continues to be embraced by researchers, managers, and clinicians. This paper reports on a scoping review and bibliometric analysis of the LHS literature to identify key topic areas and examine the influence and spread of recent research. Methods We conducted a scoping review of LHS literature published between January 2016 and May 2020. The authors extracted publication data (eg, journal, country, authors, citation count, keywords) and reviewed full‐texts to identify: type of study (empirical, non‐empirical, or review), degree of focus (general or specific), and the reference used when defining LHSs. Results A total of 272 publications were included in this review. Almost two thirds (65.1%) of the included articles were non‐empirical and over two‐thirds (68.4%) were from authors in the United States. More than half of the publications focused on specific areas, for example: oncology, cardiovascular care, and genomic medicine. Other key topic areas included: ethics, research, quality improvement, and electronic health records. We identified that definitions of the LHS concept are converging; however, many papers focused on data platforms and analytical processes rather than organisational and behavioural factors to support change and learning activities. Conclusions The literature on LHSs remains largely theoretical with definitions of LHSs focusing on technical processes to reuse data collected during the clinical process and embedding analysed data back into the system. A shift in the literature to empirical LHS studies with consideration of organisational and human factors is warranted.
    Type of Medium: Online Resource
    ISSN: 2379-6146 , 2379-6146
    URL: Issue
    URL: Article
    DOI: 10.1002/lrh2.v6.1
    DOI: 10.1002/lrh2.10265
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2868158-7
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  • 7
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    Mapping continuous learning using social network research: a social network study of Australian Genomics as a Learning Health System
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 10 ( 2022-10), p. e064663-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 10 ( 2022-10), p. e064663-
    Abstract: To explore a macrolevel Learning Health System (LHS) and examine if an intentionally designed network can foster a collaborative learning community over time. The secondary aim was to demonstrate the application of social network research to the field of LHS. Design Two longitudinal online questionnaires of the Australian Genomics learning community considering relationships between network members at three time points: 2016, 2018, 2019. The questionnaire included closed Likert response questions on collaborative learning patterns and open-response questions to capture general perceptions of the community. Social network data were analysed and visually constructed using Gephi V.0.9.2 software, Likert questions were analysed using SPSS, and open responses were analysed thematically using NVivo. Setting Australian Genomic Health Alliance. Participants Clinicians, scientists, researchers and community representatives. Results Australian Genomics members highlighted the collaborative benefits of the network as a learning community to foster continuous learning in the ever-evolving field of clinical genomics. The learning community grew from 186 members (2016), to 384 (2018), to 439 (2019). Network density increased (2016=0.023, 2018=0.043), then decreased (2019=0.036). Key players remained consistent with potential for new members to achieve focal positions in the network. Informal learning was identified as the most influential learning method for genomic practice. Conclusions This study shows that intentionally building a network provides a platform for continuous learning—a fundamental component for establishing an LHS. The Australian Genomics learning community shows evidence of maturity and sustainability in supporting the continuous learning culture of clinical genomics. The network provides a practical means to spread new knowledge and best practice across the entire field. We show that intentionally designed networks provide the opportunity and means for interdisciplinary learning between diverse agents over time and demonstrate the application of social network research to the LHS field.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-064663
    DOI: 10.1136/bmjopen-2022-064663.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 8
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    Comprehensive Researcher Achievement Model (CRAM): a framework for measuring researcher achievement, impact and influence derived from a systematic literature review of metrics and models
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 3 ( 2019-03), p. e025320-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 3 ( 2019-03), p. e025320-
    Abstract: Effective researcher assessment is key to decisions about funding allocations, promotion and tenure. We aimed to identify what is known about methods for assessing researcher achievements, leading to a new composite assessment model. Design We systematically reviewed the literature via the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols framework. Data sources All Web of Science databases (including Core Collection, MEDLINE and BIOSIS Citation Index) to the end of 2017. Eligibility criteria (1) English language, (2) published in the last 10 years (2007–2017), (3) full text was available and (4) the article discussed an approach to the assessment of an individual researcher’s achievements. Data extraction and synthesis Articles were allocated among four pairs of reviewers for screening, with each pair randomly assigned 5% of their allocation to review concurrently against inclusion criteria. Inter-rater reliability was assessed using Cohen’s Kappa (ĸ). The ĸ statistic showed agreement ranging from moderate to almost perfect (0.4848–0.9039). Following screening, selected articles underwent full-text review and bias was assessed. Results Four hundred and seventy-eight articles were included in the final review. Established approaches developed prior to our inclusion period (eg, citations and outputs, h-index and journal impact factor) remained dominant in the literature and in practice. New bibliometric methods and models emerged in the last 10 years including: measures based on PageRank algorithms or ‘altmetric’ data, methods to apply peer judgement and techniques to assign values to publication quantity and quality. Each assessment method tended to prioritise certain aspects of achievement over others. Conclusions All metrics and models focus on an element or elements at the expense of others. A new composite design, the Comprehensive Researcher Achievement Model (CRAM), is presented, which supersedes past anachronistic models. The CRAM is modifiable to a range of applications.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-025320
    Language: English
    Publisher: BMJ
    Publication Date: 2019
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  • 9
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    Exploring the ripple effects of an Australian hospital redevelopment: a protocol for a longitudinal, mixed-methods study
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 7 ( 2019-07), p. e027186-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 7 ( 2019-07), p. e027186-
    Abstract: Hospital redevelopment projects typically intend to improve hospital functioning and modernise the delivery of care. There is research support for the proposition that redevelopment along evidence-based design principles can lead to improved quality and safety. However, it is not clear how redevelopment influences the wider context of the hospital and its functioning. That is, beyond a limited examination of intended outcomes (eg, improved patient satisfaction), are there additional consequences (positive, negative or unintended) occurring within the hospital after the physical environment is changed? Is new always better? The primary purpose of this study is to explore the ripple effects of how hospital redevelopment may influence the organisation, staff and patients in both intended and unintended ways. Methods and analysis We propose to conduct a longitudinal, mixed-methods, case study of a large metropolitan hospital in Australia. The study design consists of a series of measurements over time that are interrupted by the natural intervention of a hospital redevelopment. How hospital redevelopment influences the wider context of the hospital will be assessed in six domains: expectations and reflections of hospital redevelopment, organisational culture, staff interactions, staff well-being, efficiency of care delivery and patient experience. Methods of data collection include a hospital-wide staff survey, semistructured interviews, a network survey, a patient experience survey, analysis of routinely collected hospital data and observations. In addition to a hospital-level analysis, a total of four wards will be examined in-depth, with two acting as controls. Data will be analysed using thematic, statistical and network analyses, respectively, for the qualitative, quantitative and relational data. Ethics and dissemination The study has been reviewed and approved by the relevant Ethics Committee in New South Wales, Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations and in report format to the stakeholders.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2018-027186
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 10
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    Predictors of response rates of safety culture questionnaires in healthcare: a systematic review and analysis
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 9 ( 2022-09), p. e065320-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 9 ( 2022-09), p. e065320-
    Abstract: Safety culture questionnaires are widely used in healthcare to understand how staff feel at work, their attitudes and views, and the influence this has on safe and high-quality patient care. A known challenge of safety culture questionnaires is achieving high response rates to enhance reliability and validity. This review examines predictors of response rates, explores reasons provided for low response rates and identifies strategies to improve those rates. Methods Four bibliometric databases were searched for studies assessing safety culture in hospitals from January 2008 to May 2022. Data were extracted from 893 studies that included a safety culture questionnaire conducted in the hospital setting. Regression was used to predict response rate based on recruitment and data collection methods (incentives, reminders, method of survey administration) and country income classification. Reasons for low response were thematically analysed and used to identify strategies to improve response rates. Results Of the 893 studies that used a questionnaire to assess safety culture in hospitals, 75.6% reported a response rate. Response rates varied from 4.2% to 100%, with a mean response rate of 66.5% (SD=21.0). Regression analyses showed that safety culture questionnaires conducted in low-income and middle-income countries were significantly more likely to yield a higher response rate compared with high-income countries. Mode of administration, questionnaire length and timing of administration were identified as key factors. Remote methods of questionnaire data collection (electronic and by post) were significantly less likely to result in a higher response rate. Reasons provided for low response included: survey fatigue, time constraints, and lack of resources. Conclusion This review presents strategies for researchers and hospital staff to implement when conducting safety culture questionnaires: principally, distribute questionnaires in-person, during meetings or team training sessions; use a local champion; and consider the appropriate time of distribution to manage survey fatigue.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-065320
    DOI: 10.1136/bmjopen-2022-065320.supp1
    DOI: 10.1136/bmjopen-2022-065320.supp2
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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