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  • 1
    Online Resource
    Online Resource
    ‘It sort of has the feel of being at home’: Mixed‐methods evaluation of a pilot community‐based palliative end‐of‐life service in a regional setting
    Wiley ; 2022
    In:  Australian Journal of Rural Health Vol. 30, No. 5 ( 2022-10), p. 582-592
    Details
    In: Australian Journal of Rural Health, Wiley, Vol. 30, No. 5 ( 2022-10), p. 582-592
    Abstract: To evaluate the acceptability and effectiveness of a small community‐based hospice on the end‐of‐life experiences of patients and families. Methods Mixed‐methods study. Design Patient admission data were used to assess utilisation of the hospice. Open‐ended interviews with hospice patients and their families/carers were used to understand the emotional effects of the service. Setting A small palliative end‐of‐life hospice in a rural town in NSW, Australia, during a 12‐month trial period that began in March 2019. Data were collected in October–November 2019. Participants Patients, families and carers who used the hospice during the trial period, as well as staff working at the hospice. Main outcome measure(s) Quantitative measures included the number of patients admitted to the hospice, the average length of stay and the overall occupancy rate of the hospice. Quantitative interviews were used to explore the experiences of patients and families who used the hospice, and whether the hospice met their end‐of‐life needs. Results During the trial, 58 patients were admitted to the hospice. The majority of admissions were less than 7 days. Two patients and nine family members were interviewed about their experiences, and six staff completed interviews. Experiences were consistently positive, with the community setting of the hospice contributing to a peaceful and home‐like end‐of‐life experience. Interviewees described meaningful relationships with staff, a pleasant physical environment and the comprehensive care provided were key elements of this experience. Conclusion This model, embedding end‐of‐life care within a residential aged care facility, facilitated a positive end‐of‐life experience for residents of this regional community. The development of local models to meet local needs is essential to enabling people nearing the end of life to remain in their location of choice, and ensure that their needs are met at this vulnerable time.
    Type of Medium: Online Resource
    ISSN: 1038-5282 , 1440-1584
    URL: Issue
    URL: Article
    DOI: 10.1111/ajr.v30.5
    DOI: 10.1111/ajr.12897
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2069573-1
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  • 2
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    “Slow science” for 21st century healthcare: reinventing health service research that serves fast-paced, high-complexity care organisations
    Emerald ; 2021
    In:  Journal of Health Organization and Management Vol. 35, No. 6 ( 2021-10-08), p. 701-716
    Details
    In: Journal of Health Organization and Management, Emerald, Vol. 35, No. 6 ( 2021-10-08), p. 701-716
    Abstract: The purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick. Design/methodology/approach The paper is structured in three parts. It first reviews the field of health services research and the approaches that dominate it. It then considers the healthcare research approaches whose principles and methodologies are more aligned with “slow science” before presenting a description of a “slow science” project in which the authors are currently engaged. Findings Current approaches to health service research struggle to offer adequate resources for resolving frontline complexity, principally because they set more store by knowledge generalisation, disciplinary continuity and integrity and the consolidation of expertise, than by engaging with frontline complexity on its terms, negotiating issues with frontline staff and patients on their terms and framing findings and solutions in ways that key in to the in situ dynamics and complexities that define health service delivery. Originality/value There is a need to engage in a paradigm shift that engages health services as co-researchers, prioritising practical change and local involvement over knowledge production. Economics is a research field where the products are of natural appeal to powerful health service managers. A “slow science” approach adopted by the embedded Economist Program with its emphasis on pre-implementation, knowledge mobilisation and parallel site capacity development sets out how research can be flexibly produced to improve health services.
    Type of Medium: Online Resource
    ISSN: 1477-7266
    URL: Article
    DOI: 10.1108/JHOM-06-2020-0218
    Language: English
    Publisher: Emerald
    Publication Date: 2021
    detail.hit.zdb_id: 2109532-2
    SSG: 3,2
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  • 3
    Online Resource
    Online Resource
    A New Structure of Attention? : Open Disclosure of Adverse Events to Patients and Their Families
    SAGE Publications ; 2009
    In:  Journal of Language and Social Psychology Vol. 28, No. 2 ( 2009-06), p. 139-157
    Details
    In: Journal of Language and Social Psychology, SAGE Publications, Vol. 28, No. 2 ( 2009-06), p. 139-157
    Abstract: This article presents an inquiry into how clinicians realize a health policy reform initiative called Open Disclosure. Open Disclosure mandates that discussions with patients/family and team staff about “adverse events” are now no longer ad hoc, individualized, and without consequences for how the work is done, but planned, collaborative, and leading to systems change. The article presents an empirical analysis of a corpus of interviews about the impact of Open Disclosure on clinicians' practices. It situates Open Disclosure in the context of arguments that health care workers are increasingly expected to do “emotional labor” with patients and their families, in that staff are advised to practise “reflexive listening” as a means of managing patients' and family members' emotions in response to incidents. The analysis suggests that thanks to the intensity of Open Disclosure interactions, clinicians may be introduced to an affective-interactive space that they were hitherto unaware of and unable to enter or attain what Nigel Thrift calls “a new structure of attention.”
    Type of Medium: Online Resource
    ISSN: 0261-927X , 1552-6526
    URL: Article
    DOI: 10.1177/0261927X08330614
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 1500232-9
    SSG: 5,2
    SSG: 7,11
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  • 4
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    Knowledge and Power Relations in Older Patients’ Communication About Medications Across Transitions of Care
    SAGE Publications ; 2021
    In:  Qualitative Health Research Vol. 31, No. 14 ( 2021-12), p. 2678-2691
    Details
    In: Qualitative Health Research, SAGE Publications, Vol. 31, No. 14 ( 2021-12), p. 2678-2691
    Abstract: Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients’ experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observations, and focus groups. Following thematic analysis, data were analyzed using Fairclough’s Critical Discourse Analysis and Medication Communication Model. Older patients’ medication knowledge and family members’ advocacy challenged unequal power relations between clinicians and patients and families. Doctors’ use of authoritative discourse impeded older patients’ participation in the medication communication. Older patients perceived that nurses’ involvement in medication communication was limited due to their task-related routines. To reduce the unequal power relations, health professionals should be more proactive in sharing information about medications with older patients across transitions of care.
    Type of Medium: Online Resource
    ISSN: 1049-7323 , 1552-7557
    URL: Article
    DOI: 10.1177/10497323211043494
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2010333-5
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  • 5
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    Turning attention to clinician engagement in Victoria
    CSIRO Publishing ; 2019
    In:  Australian Health Review Vol. 43, No. 2 ( 2019), p. 123-
    Details
    In: Australian Health Review, CSIRO Publishing, Vol. 43, No. 2 ( 2019), p. 123-
    Abstract: The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels – from the clinical microsystem to state health policy making. Multiple interventions are possible to enhance clinician engagement and thus the care of future patients. A framework was developed to guide future Victorian work with four elements: setting the agenda, informing, involving and empowering clinicians. Concepts of work or employee engagement that are used in other industries don’t directly translate to healthcare and thus the definition of engagement chosen for use centred on involvement. This was designed to encourage system managers to ensure clinicians are full participants in design, planning and evaluation and in all decisions that affect them and their patients.
    Type of Medium: Online Resource
    ISSN: 0156-5788
    URL: Article
    DOI: 10.1071/AH17100
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2019
    detail.hit.zdb_id: 2082451-8
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  • 6
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    Patient safety — a balanced measurement framework
    CSIRO Publishing ; 2009
    In:  Australian Health Review Vol. 33, No. 3 ( 2009), p. 382-
    Details
    In: Australian Health Review, CSIRO Publishing, Vol. 33, No. 3 ( 2009), p. 382-
    Abstract: Evidence of the unacceptably high incidence of patient harm associated with health care has resulted in patient safety becoming a major reform agenda. Despite significant investment by governments on strategies to reduce patient harm, confusion still exists on how to measure patient safety. While the goal of patient safety is harm prevention, most of the measurement focus has been on counting incident reports. The (ab)use of reported incident data to measure both technical safety performance (injury rates) and evaluate the effectiveness of safety improvement initiatives continues to confuse and mislead consumers, funders and providers of health care. This paper proposes a simple measurement framework for patient safety which balances the elements of: learning, action, performance, patient experience, and staff attitudes and behaviour. Application of this framework to current priority areas should be used as a basis for patient safety improvement at clinical unit, hospital, state and national levels.
    Type of Medium: Online Resource
    ISSN: 0156-5788
    URL: Article
    DOI: 10.1071/AH090382
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2009
    detail.hit.zdb_id: 2082451-8
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  • 7
    Online Resource
    Online Resource
    Using research to make health care safer
    CSIRO Publishing ; 2009
    In:  Australian Health Review Vol. 33, No. 3 ( 2009), p. 400-
    Details
    In: Australian Health Review, CSIRO Publishing, Vol. 33, No. 3 ( 2009), p. 400-
    Abstract: There is a fine balance that needs to be maintained between research and improvement in safety and quality in health care ? when do we need more research and when can we just get on with it? The moral imperative to improve care may have been a distractor, preventing adequate attention to research. Three research areas are proposed as current priorities for patient safety: getting evidence into practice, measurement of safety, and the evaluation of complex interventions. A focus on these areas should ensure that research becomes more central to the process of making health care safer.
    Type of Medium: Online Resource
    ISSN: 0156-5788
    URL: Article
    DOI: 10.1071/AH090400
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2009
    detail.hit.zdb_id: 2082451-8
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  • 8
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    Medical leadership is the New Black: or is it?
    CSIRO Publishing ; 2015
    In:  Australian Health Review Vol. 39, No. 2 ( 2015), p. 217-
    Details
    In: Australian Health Review, CSIRO Publishing, Vol. 39, No. 2 ( 2015), p. 217-
    Abstract: Considerable resources are being invested in healthcare leadership development programs and there is a new requirement for leadership teaching for Australian medical students. The new attention to medical leadership may be a reaction to loss of medical status and power. There is little evidence for return on investment from such programs. It is simply not clear what kind of leadership training is needed for collaborative work to improve healthcare nor what kind of organisational structures enable productive exercise of medical leadership skills. Caution is recommended. What is known about the topic? Considerable resources are being invested in healthcare leadership development programs and there is a new requirement to add leadership to the curricula for Australian medical students. What does this paper add? The lack of logic in calls for mass leadership training is explored. This may not only be a poor return on investment but also potentially reinforce medical attitudes that are unhelpful for modern healthcare. What are the implications for practitioners? A cautious approach to training large numbers of doctors and students is recommended.
    Type of Medium: Online Resource
    ISSN: 0156-5788
    URL: Article
    DOI: 10.1071/AH14013
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2015
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  • 9
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    Time to establish comprehensive long-term monitoring of Australian medical graduates?
    CSIRO Publishing ; 2018
    In:  Australian Health Review Vol. 42, No. 6 ( 2018), p. 635-
    Details
    In: Australian Health Review, CSIRO Publishing, Vol. 42, No. 6 ( 2018), p. 635-
    Abstract: We believe that the well being of our medical students (and medical staff throughout the continuum of practice) matters too much not to ask, ‘How do they feel?’ Society, and students themselves, have invested too much in their education not to query ‘How well are they performing in the workplace?’. Our accountability to the community demands we ask, ‘How are their patients going?’ This article presents a schema for building long-term monitoring in Australia, using linked and reliable data, that will enable these questions to be answered. Although the answers will be of interest to many, medical schools will then be well placed to alter their programs and processes based on these three domains of graduate well being, workplace performance and patient outcomes.
    Type of Medium: Online Resource
    ISSN: 0156-5788
    URL: Article
    DOI: 10.1071/AH16292
    Language: English
    Publisher: CSIRO Publishing
    Publication Date: 2018
    detail.hit.zdb_id: 2082451-8
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  • 10
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    Influencing Student Attitudes Through a Student-Directed Interprofessional Learning Activity: A pilot study
    Coventry University, Lanchester Library ; 2016
    In:  International Journal of Practice-based Learning in Health and Social Care ( 2016-07), p. 1-15
    Details
    In: International Journal of Practice-based Learning in Health and Social Care, Coventry University, Lanchester Library, ( 2016-07), p. 1-15
    Type of Medium: Online Resource
    ISSN: 2051-6223
    URL: Issue
    URL: Article
    DOI: 10.18552/ijpblhsc.v4i1
    DOI: 10.18552/ijpblhsc.v4i1.236
    Language: Unknown
    Publisher: Coventry University, Lanchester Library
    Publication Date: 2016
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