Aust Health Rev
· 2025 Aug · PMID 40754459
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Objective Intravenous medications are frequently used within hospital settings. To safely administer these medications to patients, further instructions are required on preparation and administration details. We describe...Objective Intravenous medications are frequently used within hospital settings. To safely administer these medications to patients, further instructions are required on preparation and administration details. We describe a novel working group of hospital pharmacists (the Intravenous Medications Guidelines Working Group) formed with the aim to produce and maintain consistently high-quality, site-specific intravenous medication guidelines across a multi-site hospital group with complex needs. Methods The Intravenous Medications Guidelines Working Group consists of clinical pharmacists from multiple specialties and specialist pharmacists (medicines information, medication safety). The Intravenous Medications Guidelines Working Group meets monthly, and discusses feedback from end-users, improvements to consistency and readability of guidelines, as well as maintaining a robust review process. Results Since its inception nearly 10years ago, the Intravenous Medications Guidelines Working Group has reviewed 714 intravenous medication guidelines, maintaining a compliance review date for 98.4% of the 190 guidelines owned by the hospital group. Incident reports relating to high-risk intravenous medication preparation and administration are low (<1%). Informal feedback suggests the guidelines are also accessed from outside the hospital group via the state-based health intranet. Challenges remain in upskilling new pharmacy staff and further improving the usefulness of guidelines for end-user nursing staff. Conclusions A pharmacy team-based approach has consistently produced high-quality guidelines for hospital staff over a prolonged period with low clinical incident numbers. Ongoing staff investment, standardised processes and user feedback are key to maintaining a high standard.
Aust Health Rev
· 2025 Aug · PMID 40744656
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Health systems widely talk about value, but too rarely acknowledge meaning - the human cost of unmet need, eroded trust, and invisible exclusion. This commentary makes the case that meaning must be treated as foundationa...Health systems widely talk about value, but too rarely acknowledge meaning - the human cost of unmet need, eroded trust, and invisible exclusion. This commentary makes the case that meaning must be treated as foundational, arguing that equitable value-based care depends on consumer voice genuinely shaping decisions.
Aust Health Rev
· 2025 Aug · PMID 40744655
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The vast majority of inpatient procedures in private settings in Australia are performed either with no- or known-gaps. There is a suggestion that some doctors are using 'booking' fees in addition - if true, the reasons...The vast majority of inpatient procedures in private settings in Australia are performed either with no- or known-gaps. There is a suggestion that some doctors are using 'booking' fees in addition - if true, the reasons are very obvious and make good economic sense.
Aust Health Rev
· 2025 Aug · PMID 40744642
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A reflection of the effectiveness of national health funding reforms to improve system efficiency and improve patient outcomes. Despite the complexities, policy levers exist that can promote value. However, a pressing qu...A reflection of the effectiveness of national health funding reforms to improve system efficiency and improve patient outcomes. Despite the complexities, policy levers exist that can promote value. However, a pressing question remains will those levers be used when activity is required to balance the budgets of our economies' largest employers.
Aust Health Rev
· 2025 Aug · PMID 40744641
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Value-based healthcare incorporates patient experience into the delivery of cost-effective and efficient health care delivery, but this does not occur seamlessly or in an ethical vacuum. The incorporation of effective co...Value-based healthcare incorporates patient experience into the delivery of cost-effective and efficient health care delivery, but this does not occur seamlessly or in an ethical vacuum. The incorporation of effective complaints resolution processes, as a restorative justice mechanism, and robust integration of ethical principles into all aspects of clinical practice will create more patient-centred and compassionate healthcare.
Aust Health Rev
· 2025 Aug · PMID 40744639
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Online short summary What is known about the topic? Value-based health care (VBHC) is now enmeshed within Australian healthcare conversations as well as implementation strategies. What does this paper add? This paper exp...Online short summary What is known about the topic? Value-based health care (VBHC) is now enmeshed within Australian healthcare conversations as well as implementation strategies. What does this paper add? This paper explores the barriers and opportunities for VBHC and compares the differing paradigms of VBHC and health economics. What are the implications for practitioners? o harmonise the two, and realise VBHCs potential, we must bridge existing misalignments, experiment with hybrid models that integrate VBHC's focus on outcomes with health economic principles to ensure care is not just high value at the bedside, but also fair and efficient at the population level.
Scott IA, van der Vegt A, Canaris S
… +2 more, Nolan P, Pointon K
Aust Health Rev
· 2025 Jul · PMID 40717026
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Healthcare organisations (HCOs) must prepare for large-scale implementation of artificial intelligence (AI)-enabled tools that can demonstrably achieve one or more aims of better care, improved efficiency, enhanced profe...Healthcare organisations (HCOs) must prepare for large-scale implementation of artificial intelligence (AI)-enabled tools that can demonstrably achieve one or more aims of better care, improved efficiency, enhanced professional and patient experience, and greater equity. Failure to do so may disadvantage patients, staff, and the organisation itself. We outline key strategies Australian HCOs should enact in maximising successful AI implementations: (1) establish transparent and accountable governance structures tasked to ensure responsible use of AI, including shifting organisational culture towards AI; (2) invest in delivering the human talent, technical infrastructure, and organisational change management that underpin a sustainable AI ecosystem; (3) gain staff and patient trust in using AI tools by virtue of their value to real world care and minimal threats to patient safety and privacy, existence of reliable governance, provision of appropriate training and opportunity for user co-design, transparency in AI tool use and consent, and retention of user agency in responding to AI generated advice; (4) establish risk assessment and mitigation processes that delineate unacceptable, high, medium, and low risk AI tools, based on task criticality and rigour of performance evaluations, and monitor and respond to any adverse impacts on patient outcomes; and (5) determine when and how liability for patient harm associated with a specific AI tool rests with, or is shared between, staff, developers, and the deploying HCO itself. In realising the benefits of AI, HCOs must build the necessary AI infrastructure, literacy, and cultural adaptation with foresighted planning and procurement of resources.
Janetzki J, Johnson J, Kalisch Ellett L
… +4 more, Ho JN, Hall K, Ward M, Pratt N
Aust Health Rev
· 2025 Jul · PMID 40717025
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Objective Acute migraine episodes affect >18% of Australians. Triptans are most effective when taken early in migraine attacks, making timely access critical. Before February 2021, triptans were prescription-only, but a...Objective Acute migraine episodes affect >18% of Australians. Triptans are most effective when taken early in migraine attacks, making timely access critical. Before February 2021, triptans were prescription-only, but a downscheduling policy change enabled over-the-counter (OTC) purchase with pharmacist advice. This study examined the effect on subsidised Pharmaceutical Benefits Scheme (PBS) dispensing rates and illustrative patient costs. Methods Aggregated PBS dispensing data were used to estimate monthly triptan dispensing rates per 1000 people using population data from the Australian Bureau of Statistics. As PBS data excludes OTC supply, we projected dispensings, and illustrate potential costs based on pre-downscheduling trends to estimate the potential shift to OTC. PBS beneficiaries include concessional (social security recipients/low-income earners) and general (those ineligible for concessions). Prescription costs were based on a four-tablet PBS pack of sumatriptan 50mg (A$7.70 concessional; up to A$24.60 general). OTC costs were estimated using a two-tablet pack (A$10.00 standard pharmacy, A$7.00 discount pharmacy). Results Before downscheduling, triptan dispensings grew 1.4% monthly, slowing to 0.6% post-downscheduling. By illustration, we estimate that shift to OTC access would have led to a cost saving of up to A$2million for general patients, but an increased cost of A$2.3-5.8million for concessional patients, depending on pharmacy pricing models. Conclusion Downscheduling slowed PBS dispensing growth. If reduced PBS dispensing was offset by OTC access, the policy may have improved timely migraine treatment, although PBS use remains high. Cost benefits depend on patient concession status and potential offsets, such as reduced doctor visits, which should be considered in further policy evaluations.
Aust Health Rev
· 2025 Jul · PMID 40717022
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National regulation of health practitioners in Australia is 15years old. Raising the bar on public safety, national mobility and responding to future workforce needs were drivers of transformational reform. As the nation...National regulation of health practitioners in Australia is 15years old. Raising the bar on public safety, national mobility and responding to future workforce needs were drivers of transformational reform. As the national regulatory scheme has progressively matured, its benefits and progress have been substantial, although at times debated. These benefits include a substantial growth in the registered health workforce, national mobility underpinned by national standards and an on-line register which provides greater transparency about the registration status of health practitioners. Regulation can never stand still as the health system in which it works is ever changing. The rapid increase in entrepreneurial models of health care, as well as the acceleration of telehealth, social media and augmented intelligence technologies, create new challenges for accountability, transparency, equity and patient safety. While there are undoubtedly opportunities for further reform, the national, multi-professional set of regulatory arrangements provide a strong foundation from which to build and address new challenges and workforce needs.
Drinkwater VK, Giles M, O'Brien AP
… +2 more, Harmon C, Tynan RJ
Aust Health Rev
· 2025 Jul · PMID 40717018
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Objective The role of mental health nurses (MHNs) working in inpatient units involves providing care to patients with complex needs and challenging behaviours, with reporting and documenting findings from brief interacti...Objective The role of mental health nurses (MHNs) working in inpatient units involves providing care to patients with complex needs and challenging behaviours, with reporting and documenting findings from brief interactions a critical part of their duties. Despite this, there is no agreed-upon instrument to document a patient's mental state or recognise signs of progress or deterioration. The aim of this study was to assess the impact of implementing a standardised instrument known as the SMART card on MHNs documentation, knowledge, and self-efficacy in assessing and reporting a patient's mental state. Methods The SMART card was implemented across eight mental health inpatient units. Completion rates of the SMART card and quality of assessments were measured using a file/chart audit before and 3months post-implementation. A pre/post-implementation survey measured changes in MHNs' perceived knowledge and self-efficacy, with the post survey evaluating attitudes towards training and SMART card acceptability. Results Clinical file audits showed significant improvement in completion rates in documentation of key clinical/symptom domains. Survey results showed a positive attitude towards the SMART card, with training having increased MHNs' understanding of psychiatric terminology and significantly improved confidence and self-efficacy. Conclusions This study demonstrates how the implementation of a standardised instrument significantly improved MHNs' reporting of patient mental health status.
Robertson M, Muecke T, Bacchi S
… +2 more, Casson R, Chan WO
Aust Health Rev
· 2025 Jul · PMID 40716960
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Objective This study aims to evaluate how extracurricular involvement, such as sports, music, volunteering and teaching, are weighted within standardised curriculum vitae (CV) scoring criteria for medical officers applyi...Objective This study aims to evaluate how extracurricular involvement, such as sports, music, volunteering and teaching, are weighted within standardised curriculum vitae (CV) scoring criteria for medical officers applying to medical and surgical specialty training programs in Australia. Methods A cross-sectional observational analysis of point allocations for extracurricular involvement was performed, as detailed by publicly available standardised CV scoring criteria for medical and surgical training programs. The analysis includes all specialty training programs in Australian and New Zealand listed by the Australian Health Practitioner Regulation Agency that publish these criteria for the 2023 intake. Results Of the 47 reviewed specialty training programs, 14 publish publicly available standardised CV scoring criteria, and 8 of these allocate points for extracurricular involvement. The mean weighting for extracurricular involvement was 11.5% (range 4.5-20%), compared with 42.5% for research. The allocation of points varies by training program and subdomain. Conclusion The weighting of extracurricular involvement within standardised CV scoring criteria is limited and varied among specialty training programs, despite alignment with non-cognitive competencies emphasised by training frameworks. Current emphasis on academic achievements may disadvantage applicants with limited access to research opportunities. Greater clarity and consistency in evaluating non-academic attributes may support fairer, more holistic selection processes.
Aust Health Rev
· 2025 Jul · PMID 40716958
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Objective The aim of this study was to develop a taxonomy of urgent care service models and their relationships within healthcare systems through concept mapping, and by addressing inconsistent terminology and service cl...Objective The aim of this study was to develop a taxonomy of urgent care service models and their relationships within healthcare systems through concept mapping, and by addressing inconsistent terminology and service classifications. Methods This descriptive study used an iterative mapping methodology to analyse and categorise urgent care services. Data collection involved literature describing urgent care models across international healthcare systems, focusing on terminology, operational characteristics, and integration points with primary and emergency care. This was complemented by an Australian urgent care model analysis, that is, a comparative review of publicly declared service characteristics and clinical scopes across Australian urgent care models, coded to ICD-10 (International Classification of Diseases, 10th Revision) and presented in tabular form. Results The concept map presents a taxonomy of healthcare services across three distinct care pathways based on condition acuity: primary care for non-urgent needs, urgent care for non-life-threatening conditions requiring prompt, non-scheduled treatment, and emergency care for acute emergencies. The map establishes standardised nomenclature, including intersectoral areas such as co-located facilities and nurse practitioner walk-in services. Supplementary analysis highlights scope variation between models, particularly differences in procedural capability, diagnostics access and mental health response. These findings inform current Australian policy directions, particularly the Medicare Urgent Care Clinics rollout. Conclusions This concept map provides a framework for examining urgent care services within the broader healthcare landscape. Alongside a comparative analysis of Australian models, it supports systematic investigation, highlights variation in service scope and design, and informs planning, integration and policy development across diverse urgent care settings.
Aust Health Rev
· 2025 Aug · PMID 40623680
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OBJECTIVE: This study aimed to highlight trends in the utilisation of selected endometriosis treatments before and after the launch of the National Action Plan for Endometriosis and observe the impact of the action plan...OBJECTIVE: This study aimed to highlight trends in the utilisation of selected endometriosis treatments before and after the launch of the National Action Plan for Endometriosis and observe the impact of the action plan on the utilisation of these interventions. METHODS: Monthly Medicare and Pharmaceutical Benefits Scheme claims were used to represent the utilisation of laparoscopic resection and nafarelin for endometriosis. Time series analysis using autoregressive integrated moving average models was used to establish the trend in the utilisation of these treatments. An interruption was then applied at the launch of the plan, and a counterfactual prediction was modelled based on the claims made before the interruption. Factual values and counterfactual predictions were compared to evaluate the impact of the plan. RESULTS: The action plan was associated with an immediate increase of 3.94 Medicare Benefits Schedule claims per month (95% CI -44.61 to 52.50) and an estimated change in slope of 1.30 claims per month (95% confidence interval (CI) -3.80 to 6.30) for laparoscopic resection. Nafarelin dispensing after the launch of the action plan had an immediate increase of 68.30 dispensing claims per month (95% CI -4.34 to 141.03), with a slope change of -2.84 claims per month (95% CI -10.975 to 5.293). CONCLUSIONS: The results suggest that although the action plan was linked with a marked immediate spike in the utilisation of nafarelin, it did not make any difference in the long term. However, it may have contributed to a small but steady increase in the utilisation of laparoscopic resection, used in severe cases of the condition.
Aust Health Rev
· 2025 Aug · PMID 40619158
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OBJECTIVE: Palliative and end-of-life care should be considered core business for aged care and healthcare teams in these settings. With a growing ageing population, the primary care workforce faces growing demand to del...OBJECTIVE: Palliative and end-of-life care should be considered core business for aged care and healthcare teams in these settings. With a growing ageing population, the primary care workforce faces growing demand to deliver palliative care. This study aimed to explore the experiences of allied health clinicians and tertiary educators working in, and teaching, palliative care with an ageing focus in Australia. METHODS: We undertook a qualitative study using semi-structured interviews with clinicians experienced in aged and palliative care and tertiary educators delivering aged and palliative care curriculum content from four allied health disciplines (dietetics, occupational therapy, physiotherapy, speech pathology). Guided by critical realism ontology and a constructivist epistemology, reflexive thematic analysis was used for data analysis. RESULTS: Eleven participants were interviewed. Thematic analysis yielded two key themes and five subthemes. The two key themes were: (i) Barriers to best practice (n = 4 subthemes) and (ii) Enablers of palliative care best practice (n = 2 subthemes). Key barriers were that curriculum content is lacking and the medical model limits the volume and quality of care delivered. Enablers to quality care were self-directed learning and clinical experience. CONCLUSION: Palliative and end-of-life care in aged care should foster reablement to support continuing agency and dignity through person-centred care. Allied health professionals are well-positioned to support this approach. However, facilitating allied health best practice will require addressing the reported barriers, including clinician preparedness and funding sufficient to meet demand and need.
Aust Health Rev
· 2025 Aug · PMID 40603085
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This case study sought to determine if a dietitian universal nutrition assessment (DUNA) with initial nutrition care plan and high-quality documentation was a cost-effective way of delivering nutrition care within the ca...This case study sought to determine if a dietitian universal nutrition assessment (DUNA) with initial nutrition care plan and high-quality documentation was a cost-effective way of delivering nutrition care within the cancer service of a tertiary hospital. A 2-week pilot project of universal nutrition assessment by dietitians for admitted patients demonstrated a high prevalence of cancer-related malnutrition (57%, n = 39). The episodes for malnourished patients not identified through usual referral processes (18%, n = 7) were examined to determine the National Weighted Activity Unit (NWAU) with and without the malnutrition diagnosis. The additional malnutrition diagnoses were responsible for an NWAU uplift of 8.1. A larger 10-month project was undertaken where patients underwent DUNA on admission with an initial nutrition care plan and high-quality documentation of malnutrition. Fifty-one percent of patients were malnourished with an increase in the number of coded malnutrition diagnoses as compared to baseline. Financial modelling from the pilot project indicated an NWAU uplift of 66.96. With a National Efficient Price (NEP) of AUD$6032 (2023/24), this equated to an uplift of AUD$403,902.72 in 10 months. Universal nutrition assessment and high-quality documentation of malnutrition by dietitians enabled a greater number of patients with cancer-related malnutrition to receive nutrition care while generating improved revenue through clinical coding complexity. This revenue was used to fund an additional dietitian position. Areas of high prevalence of malnutrition may be better served by DUNA rather than nutrition risk screening followed by dietetic referral for nutrition assessment.
Aust Health Rev
· 2025 Aug · PMID 40588778
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OBJECTIVES: To investigate the prevalence of 10 long-term health conditions in the Australian-born and Eastern Mediterranean region (EMRO)-born populations of Australia. METHOD: Using the 2021 Australia census we calcula...OBJECTIVES: To investigate the prevalence of 10 long-term health conditions in the Australian-born and Eastern Mediterranean region (EMRO)-born populations of Australia. METHOD: Using the 2021 Australia census we calculated age-specific and sex-specific prevalence, age-standardised prevalence (ASP), and age-standardised prevalence ratio (ASPR) of 10 conditions. For EMRO-born people who had a health condition, we reported English proficiency, education, income and years lived in Australia. RESULTS: Australian-born and EMRO-born individuals had a similar ASP of heart disease (3.2% in men, 1.8% in women) and stroke (0.7% in men and 0.5% in women). There were small differences between the two groups in terms of the ASP of arthritis (ASPR: 0.9) and kidney disease (ASPR: 1.1) in women and dementia (ASPR: 1.1) in men. For EMRO-born compared with Australian-born individuals, the ASPs of asthma (ASPR women and men: 0.4), cancer (ASPR women: 0.6, men: 0.5), lung conditions (ASPR women: 0.4, men: 0.5), and mental health conditions (ASPR women and men: 0.4) were lower, and the ASP of diabetes (ASPR women: 1.8, men: 1.7) was higher. For men, the ASP of arthritis (ASPR: 0.6) was lower, and the ASP of kidney disease (ASPR: 1.4) was higher in EMRO-born individuals. For women, the ASP of dementia (ASPR: 1.4) was higher in EMRO-born individuals. EMRO-born individuals who arrived in Australia ≥10 years ago, at the time of the census, compared with those who arrived <10 years ago had a higher ASP of arthritis, asthma, cancer and lung and mental health conditions; a lower ASP of heart disease, stroke, kidney disease and dementia; and the same ASP of diabetes. Depending on the long-term conditions, 24.1-53.5% of EMRO-born individuals had low English proficiency, 9.4-23.8% did not go to school, and 51.7-89% had a weekly income (in Australian dollars) <A$500. CONCLUSION: To promote health equity, prevention and management strategies for long-term health conditions based on the health needs of migrants are needed.
Aust Health Rev
· 2025 Aug · PMID 40588231
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Human embryo research can provide important scientific insights to help humanity. But it also poses ethical questions that remain contested. Since 2002, Australian law has limited human embryo research under strict licen...Human embryo research can provide important scientific insights to help humanity. But it also poses ethical questions that remain contested. Since 2002, Australian law has limited human embryo research under strict licensing conditions, but there has been no formal review in almost 15 years. The development of stem cell-based embryo models that closely resemble human embryos, and improved culturing techniques that allow human embryos to be grown to potentially beyond 14 days, have pushed the limits of current legislation. We argue that a comprehensive review is needed to address recent scientific advances and to better account for public sentiment.
Delany K, Wood A, Mayr H
… +4 more, Phillips R, Thomson B, Fellows N, Stoikov S
Aust Health Rev
· 2025 Aug · PMID 40588229
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OBJECTIVE: Interprofessional collaborative practice (IPCP) is integral to a high-functioning healthcare system, yet little is understood about whether attitudes, knowledge and beliefs towards IPCP differ between professi...OBJECTIVE: Interprofessional collaborative practice (IPCP) is integral to a high-functioning healthcare system, yet little is understood about whether attitudes, knowledge and beliefs towards IPCP differ between professional groups or clinical settings. METHODS: This cross-sectional study used three surveys: the Systems Thinking Scale, Attitudes Towards Health Care Teams, and the adapted Interprofessional Collaboration Scale, to compare systems thinking and the perceptions and attitudes of healthcare professionals in a large metropolitan health service. Participants included medical, nursing, allied health and oral health professionals across hospital and community settings. RESULTS: A total of 293 participants (57% hospital-based, 43% community; 40% nursing, 8% medicine, 46% allied health, 6% oral health) completed the surveys. Results demonstrated differences in communication and attitudes towards IPCP across professional groups. CONCLUSIONS: While all professional groups acknowledged the importance of IPCP, distinctions persisted across professions and settings. Understanding attitudes within various professions and contexts establishes the foundation for targeted strategies aimed at promoting interprofessional collaboration in health care.