Towards the delivery of appropriate health care in Australia

Runciman, William B.; Coiera, Enrico; Day, Richard O.; Hannaford, Natalie; Hibbert, Peter; Hunt, Tamara D; Westbrook, Johanna I.; Braithwaite, Jeffrey

doi:10.5694/mja12.10799

Cited by 45 publications

(59 citation statements)

References 19 publications

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“…For over two decades, measuring the quality of end-of-life care through clinically meaningful standards,5 indicators and data collection tools has been recommended 6. These terms have been used interchangeably but in this article the following definitions apply: ‘standard’ is an agreed and preferably evidence-based process that should be undertaken or outcome to be achieved for a defined circumstance, symptom, sign or diagnosis7; ‘indicator’ is a measurable statement ‘with explicit criteria for inclusion, exclusion, time frame and setting’ (p. 79)7; ‘tool’ is a method and/or instrument used to gather data to inform a quality indicator and standard7 8 and ‘measure’ is used only as a verb to avoid ambiguity.…”

Section: Introductionmentioning

confidence: 99%

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan

Virdun

Luckett

Lorenz

et al. 2018

BMJ Support Palliat Care

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Section: Introductionmentioning

confidence: 99%

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan

Virdun

Luckett

Lorenz

et al. 2018

BMJ Support Palliat Care

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“…And yet implementation science is still seen as a minefield. Patients still receive substandard, variable care that is all too frequently inappropriate and unsafe . Implementation science has some way to go before research outcomes can be achieved that are consistently of a high quality and that impact on health services in such a way that can assure patients their health is in good hands .…”

Section: Resultsmentioning

confidence: 99%

“…Patients still receive substandard, variable care that is all too frequently inappropriate and unsafe. 38 Implementation science has some way to go before research outcomes can be achieved that are consistently of a high quality and that impact on health services in such a way that can assure patients their health is in good hands. 27,37 Until such a time, we urge health services researchers to return to first principles, to lay down the ground rules for their research, discuss rigorous, methodologically sound procedures, and consider how their findings will lead to implementable study outcomes.…”

Section: Discussionmentioning

confidence: 99%

The struggle of translating science into action: Foundational concepts of implementation science

Rapport

Clay‐Williams

Churruca

et al. 2017

Evaluation Clinical Practice

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234

223

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Rationale, aims, and objectives“Implementation science,” the scientific study of methods translating research findings into practical, useful outcomes, is contested and complex, with unpredictable use of results from routine clinical practice and different levels of continuing assessment of implementable interventions. The authors aim to reveal how implementation science is presented and understood in health services research contexts and clarify the foundational concepts: diffusion, dissemination, implementation, adoption, and sustainability, to progress knowledge in the field.MethodImplementation science models, theories, and frameworks are critiqued, and their value for laying the groundwork from which to implement a study's findings is emphasised. The paper highlights the challenges of turning research findings into practical outcomes that can be successfully implemented and the need for support from change agents, to ensure improvements to health care provision, health systems, and policy. The paper examines how researchers create implementation plans and what needs to be considered for study outputs to lead to sustainable interventions. This aspect needs clear planning, underpinned by appropriate theoretical paradigms that rigorously respond to a study's aims and objectives.ConclusionResearchers might benefit from a return to first principles in implementation science, whereby applications that result from research endeavours are both effective and readily disseminated and where interventions can be supported by appropriate health care personnel. These should be people specifically identified to promote change in service organisation, delivery, and policy that can be systematically evaluated over time, to ensure high‐quality, long‐term improvements to patients' health.

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“…22 For example, in the context of managing osteoporosis, simple GP--focussed management algorithms have improved patient care in WA in the context of osteoporosis. 23 Allied health information, such as physiotherapy and occupational therapy information and arrangements (other than mobility and physical activity restrictions), were largely considered useful by respondents. Discharge summaries are routinely developed by junior medical officers, on behalf of the consultant surgeons.…”

Section: Discussionmentioning

confidence: 99%

Hospital discharge information after elective total hip or knee joint replacement surgery: a clinical audit of preferences among general practitioners

Briggs

Lee

Sim³

et al. 2012

AMJ

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The demand for elective joint replacement (EJR) surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP) and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee.GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale.Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate). All discharge information options were ranked as 'essential' by a proportion of respondents, ranging from 14.8-88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as 'useful' information (47.5-56.7%).GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff, hospital administrators and information technology staff, supported in parallel by education provided to junior medical staff.

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Towards the delivery of appropriate health care in Australia

Cited by 45 publications

References 19 publications

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan

National quality indicators and policies from 15 countries leading in adult end-of-life care: a systematic environmental scan

The struggle of translating science into action: Foundational concepts of implementation science

Hospital discharge information after elective total hip or knee joint replacement surgery: a clinical audit of preferences among general practitioners

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