21 June 2017

Preventative Health: How Much Does Australia Spend and is it Enough

The report, Preventativehealth: How much does Australia spend and is it enough?, found that Australia compared poorly with OECD peers in terms of spending on prevention, at about $2 billion per year or $89 per capita. Chronic disease is responsible for 83 per cent of all premature deaths in Australia and 66 per cent of the burden of disease, making it our nation’s greatest health challenge.

Preventive health: How much does Australia spend and is it enough? by Hannah Jackson and Alan Shiell / Department of Public Health, La Trobe University and the Australian Prevention Partnership Centre.

Three Ways to Build Resilience

​Sophie Scott is the National Medical Reporter for the Australian Broadcasting Corporation. She has written an interesting blog post on resilience; "When life doesn’t go exactly the way you had hoped, what is it that helps some of us to be able to cope better, be resilient or even grow as a person through adversity?" Sophie tells the story of people who have overcome great tragedy in their lives.

In researching resilience, Sophie found that the creator of positive psychology Martin Seligman had found the best way to move past setbacks was to move beyond the three Ps:
Personalisation - the idea you are at fault,
Pervasiveness - the belief that an event will affect all areas of your life,
Permanence - the thought that the effect of the event will be life-long.

Read more on Sophie Scott's blog here: 

BAM: Body and Mind app

The Centers for Disease Control and Prevention’s (CDC) website, BAM!Body and Mind, offers kids information to make healthy lifestyle choices—focusing on the body, diseases, food and nutrition, physical activity, safety, and stress. BAM! serves as a classroom aide for teachers providing them with interactive and fun activities for students that are linked to national education standards. The BAM! site features games and quizzes that are both educational and entertaining and could prove an asset for dieticians, nutritionists and pediatricians.
It is free to download to your iPad, iPhone, or Android device.   

Elder Abuse—A National Legal Response

This new report includes 43 recommendations for law reform in elder abuse. The overall effect will be to safeguard older people from abuse and support their choices and wishes through:
  • improved responses to elder abuse in residential aged care;
  • enhanced employment screening of care workers;
  • greater scrutiny regarding the use of restrictive practices in aged care;
  • building trust and confidence in enduring documents as important advanced planning tools;
  • protecting older people when ‘assets for care’ arrangements go wrong;
  • banks and financial institutions protecting vulnerable customers from abuse;
  • better succession planning across the self-managed superannuation sector;
  • adult safeguarding regimes protecting and supporting at-risk adults.

Elder Abuse—A National Legal Response (ALRC Report 131). Australian Law Reform Commission, 2017.  

Mental health services in Australia / tranche 3, 2017

This latest release updates AIHWs Mental health services in Australia website. The following sections have been updated:
  • Psychiatric disability support services
  • Specialist homelessness services
  • Mental health workforce.
Download report: Mental health services in Australia

AIHW catalogue number WEB 174

Australian Atlas of Healthcare Variation 2017

This second Atlas, released in June 2017, examines four clinical themes: chronic disease and infection – potentially preventable hospitalisations, cardiovascular, women’s health and maternity, and surgical interventions. The Atlas shows rates of use of health care (hospitalisations, prescriptions, surgical procedures) in geographical local areas across Australia.

The Atlas includes the Commission’s recommendations for action across the health system to address variation where this appears to be unwarranted. The Atlas also provides information about hospitalisation rates for Aboriginal and Torres Strait Islander Australians, about the percentage of services funded publicly and privately, and includes analysis by socioeconomic status. 

The Atlas was developed by the Australian Commission on Safety and Quality in Health Care.

14 June 2017

PalliAGED is a new free online palliative care app funded by the Department of Health and developed by CareSearch. It’s full of tips and guidance on palliative care and will be helpful for older people, along with their families and support workers. PalliAGED collects under one umbrella a wide range of very important research evidence, including:
    • new medications;
    • clinical decision making tools;
    • models of care.
It also features advice on cultural and other considerations, symptoms and treatment decisions, risk analysis, ways to support people and their families and public and consumer experience.

palliAGED Apps with links to iTunes and online app store.  

07 June 2017

Royal Commission into Institutional Responses to Child Sexual Abuse

This evidence review aimed to identify current best evidence about the effectiveness and content of programs and practices, in Australia and internationally, aimed at treating children with problem sexual behaviour (aged under 10), harmful sexual behaviour (aged 10–17), and children who have sexually offended (aged 10–17).  
Sexually harmful behaviour is not limited to the sexual abuse of children by adults. It includes sexually problematic and harmful behaviour by other children. While the prevalence of sexually harmful behaviour by children is difficult to establish, emerging and ongoing research indicates that it is a significant problem that represents a substantial proportion of sexual harm to children.

Rapid evidence assessment: Current best evidence in the therapeutic treatment of children with problem or harmful sexual behaviours, and children who have sexually offended.

Professor Aron Shlonsky, Bianca Albers, Dale Tolliday, Dr Sandra Jo Wilson, Jennifer Norvell and Lauren Kissinger, May 2017. ISBN 978-1-925622-15-7 (free to download)

Shared Decision Making in Australia

In 2017 the Australian Commission on Safety and Quality in Health Care plans to release the second version of the Australian ‘National Safety and Quality Health Services Standards’ and by 2019, all health services will be assessed against these standards for accreditation. The evolution of “Standard Two: Partnering with Consumers” in the 2012 version to the new version in 2017 demonstrates a clear shift towards patients being more actively involved in their own care if that is their preference.
This is a short paper summarising the state of and potential for shared decision making (SDM) in healthcare in Australia. It covers some of the practice and policy developments of recent time, including how national standards encouraging the greater engagement of patient, including the use of SDM, and other levers for uptake. It also describes some of the consumer and academic activity in this area, where a number of Australian-based academics have been instrumental. The paper also identifies a number of challenges, including the clarification of core competencies in SDM, meaningful measures of SDM implementation, certification of patient decision aids or other tools, tools for vulnerable and/or multicultural populations, along with issues of sustainability.

Shared Decision Making in Australia in 2017. (Partizipative Entscheidungsfindung in Australien im Jahr) 2017. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. available online May 18, 2017   

Implementing and Sustaining Evidence-based Practice in Healthcare Settings

The articles contained in this special virtual edition of Worldviews on Evidence-based Nursing equip you with the best and latest evidence to guide the implementation and sustainability of EBP in healthcare settings. Even though the positive benefits of evidence-based care are well established, healthcare systems still continue to struggle with its implementation and, most importantly, its sustainability.
even though there is high quality evidence to support what works well in many areas it takes years to transfer the findings from published studiesinto real world clinical settings.

Implementing and Sustaining Evidence-based Practice in Healthcare Settings: What Works! Virtual Issue from Worldviews on Evidence-Based Nursing. Published: October 2016
Read the full text free virtual issue here. 

31 May 2017

Mental health services in Australia - including the use of restraint

New data has been released on the AIHW's mental health services website, which for the first time includes information on the use of restraint in Australia's specialised mental health hospital services.. Restraint refers to "the restriction of an individual's freedom of movement by physical or mechanical means".

The data indicates that in 2015-16 there were about 9 physical restraint events and under 2 mecahnical restraints per 1000 bed days. Rates of physical restraint were highest for forensic services (which include prison based services), at about 110 events per 1,000 beds days. Associate Professor John Allan, Chair of the Australian Health Ministers' Advisory Council's Safety and Quality Partnership Standing Committee, said, "For the first time, we have visibility of what's really going on in our mental health services. This is a ground-breaking step in our efforts to reduce the use of restrictive practices."

Hip fracture care standard

The Australian Commission on Safety and Quality in Health Care published the Hip Fracture Care Clinical Care Standard, along with indicator specifications and consumer and clinician fact sheets in September last year. Now they have released Hip Fracture Care – the Case for Improvement, as well as a supporting PowerPoint presentation for clinicians and health services to use. These resources explain what each quality statement means, why it matters, and how use of the clinical care standard could improve patient outcomes.  

This latest document highlights the importance of the Standard, why we need it, and what could be achieved with a more consistent approach to the implementation of best practice.

Developing the rural health workforce

Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: A systematic review has been published recently in the Australian Health Review. 

26 papers were included in the study and four key findings were identified relating to the experiences Aboriginal people have in the health workforce and how that effects their engagement with education as well as their longevity.  One interesting finding was the importance of student placements affecting the likelihood of people eventually applying for rural and remote health jobs.  

Kylie Gwynne, Michelle Lincoln. Australian Health Review, 41(2), 234-238 2017. [Free full text]

26 May 2017

Building resilience in junior doctors

A recent article in The Conversation, What needs to happen to build resilience and improve mental health among junior doctors, highlighted the problems of young doctors coping with extraordinary psychological distress.

Authors Richard Murray and Brendan Crotty referred to two Beyond Blue reports: The Mental health of doctors: a systematic literature review, from 2010, and the 2013 National Mental Health Survey of Doctors and Medical Students. Female doctors particularly are at risk, with one study finding them to have a huge 146% higher risk of suicide than the general population.

Various factors are at play - a culture of not admitting weakness, long hours, workplace bullying, and intense competition for jobs with the current large numbers of medical graduates. Murray and Crotty offer various solutions and a need for changes in the nature of healthcare so that it is "more integrated, person-centred and community-based".

Cervical screening in Australia

Cervical screening in Australia 2014-2015  presents the latest national statistics monitoring the National Cervical Screening Program. The AIHW reports that
  • 56% of women in the target age group of 20-69 took part in the program during 2014 and 2015
  • Cervical cancer cases and deaths in Australia are low by international standards
  • About 9 new cases of cervical cancer were detected per 100,000 women, and 2 deaths per 100,000 women.  This rate has been stable for the past ten years, having halved after the introduction of the NCSP
  • There is strong evidence that Indigenous women have a lower screening rate and poorer outcomes than non-Indigenous women.