Standards of Care

2016

Supportive Care Screening Instruments Report. Prepared for Department of Health & Human Services (DHHS), Victoria

This Rapid Review identified population-based screening instruments for application in any cancer setting, for any patient, in any stage of the cancer journey, relevant to physical, social, information, spiritual and/or psychological needs. The review focus was population-based screening instruments. However, there were important secondary findings in terms of assessment instruments that facilitated identification, triage and/or referral of patients to appropriate care/interventions; instruments that could improve patient outcomes and experience (quality of life), and instruments that could improve the management of identified needs of cancer patients. The Review team used a debating process to differentiate between population-screening instruments, and assessment instruments of individual needs related to age, type or stage of cancer, and quality of life (general measures, or measures specific to cancer type).

Does Allied Health Quality of care make an impact on stroke patient’s length of stay and mortality in SA Health? Prepared for Department for Health and Ageing, South Australia

This project aimed to provide guidance for objectively measuring the impact of extended (seven days-a-week) allied health services in a manner that will inform strategic SA allied health planning processes. It was designed to evaluate the impact of quality indicator-compliant allied health (AH) services on length of stay (LOS) and mortality of stroke patients, and the marginal impact on these measures when patients were admitted during the weekend.

The findings suggest that higher compliance with evidence-based AH quality care indicators is associated with significantly reduced odds of dying in hospital, and more effective LOS. Increased compliance with quality indicators of AH-care quality for patients admitted during weekends could reduce their LOS by a half day. These findings are meaningful for the planning process towards increasing the level of compliance to indicators of AH care quality during weekend 

2015

Does publishing patient safety data improve the standard of care? A Rapid Review of the Literature. Prepared for Accident Compensation Corporation (New Zealand)

ACC Research, on behalf of the ACC Treatment Injury Prevention Team, sought a robust independent and informed evidence-based literature review that explored how publishing patient safety data improved the standard care received and would lead to a reduction in the number and severity of claims received.

This report summarises and discusses what is known of the effects of public reporting of patient safety data as of Sept 2015, identified from a rapid review of the peer-reviewed research literature. The review purpose was to investigate the research question of: What research evidence is there that publishing patient safety data improves the standard of care, and leads to a reduction in the number and severity of claims?

Summary of Evidence for Allied Health Extended Care. Prepared for Department for Health and Ageing, South Australia

In Australia, there is wide spread recognition that the traditional and historical models of care need to be reviewed, adapted and renewed to meet the emerging challenges and needs of the 21st century health system. As one of the three pillars of health, allied health professions, working in partnerships with medicine and nursing, can make a significant positive contribution to the new models of care. An area where allied health can play a critical role is in extending it to after hours, weekend etc. Historically much of the allied health professions were constrained to work within the “traditional” work hours and limited on-call services provided on an ad-hoc and opportunistic basis. In recent times, there has been some emerging evidence to indicate that there may be benefits to the health professional, patient and the health system overall through an allied health extended care model.

Using a pragmatic approach, and in collaboration with Allied & Scientific Health Office, iCAHE purposively identified literature from a range of sources which provided an overview of the processes and outcomes from allied health extended care initiatives from across the world. 

2014

The Victorian Clinical Quality Registries: A Rapid Review: Prepared for Victorian Cancer Agency, Department of Health Victoria

Clinical quality registries systematically and uniformly collect information from people who undergo a procedure, are diagnosed with a disease or use a health care resource. The ultimate goal of clinical quality registries is to improve health outcomes by stimulating improvements in the healthcare system. While the formulation, setting up and development of clinical quality registries is relatively new in Australia, Scandinavian countries such as Sweden and Denmark have a long history of clinical quality registries as part of their health care system. This rapid review identified 38 clinical quality registries in operation locally, nationally and internationally.

ASPIRE for quality: a new evidence-based tool to evaluate clinical service performance in South Australian Local Health Networks. Prepared for Allied and Scientific Health Office Department of Health, South Australia

A detailed consolidation of this report may be found here

This report describes the conceptualisation, development, and evaluation of an evidence-based performance evaluation system (ASPIRE) that can be used by allied health practitioners to assess their clinical service performance. The main objectives are to scope potential systems/models that can be used to deliver the following:

  • Embedded understanding of how to evaluate performance and productivity of clinical services in local health networks (LHNs) by Allied Health in line with contemporary key SA Health and LHN plans and strategies

  • Embedded understanding of how to promulgate the results of evaluation to achieve business change (including resources such as templates/toolkits)

  • Increased levels of evaluated Allied Health services in LHNs

  • Increased instances of Allied Health service improvement resulting from such evaluation

  • A suite of measures such as key performance indicators, clinical indicators, outcomes, inputs and outputs accessible to allied health to evaluate and improve their clinical services

  • To recommend one system/model including a robust system of evaluation of the model, in consultation with the Chief Allied and Scientific Health Advisor or delegate

  • To pilot the recommended system/model in a controlled area (e.g. Division, Department) within a LHN

  • To report results to the Allied and Scientific Health Office with detailed recommendation for further phases/rollout as appropriate

Traumatic Brain Injury Review: A systematic review of the evidence for paediatric traumatic brain injury, and for adults with mild traumatic brain injury. A technical report prepared for New Zealand’s ACC Traumatic Brain Injury Strategy.

This report provides a comprehensive review of the currently available secondary evidence (guidelines and systematic reviews) to inform the ACC Traumatic Brain Injury (TBI) Strategy. This review focuses on two areas identified as gaps in current understanding:

  1. Paediatric TBI (0-15 years)
  2. Adults with mild TBI

ACC research had provided subsection questions for each of these focus areas, making a total of 20 search questions to be addressed by this evidentiary review.

1. Paediatric TBI (0-15 years): Consider the issues specific to paediatric TBI throughout their developmental milestones and the continuum of care.

  • 1.1 Initial acute care
  • 1.2 In-patient and out-patient rehabilitation
  • 1.3 Transitions of care
  • 1.4 Cognitive, Educational and training issues
  • 1.5 Community integration
  • 1.6 Challenging behaviour
  • 1.7 Growth and developmental issues
  • 1.8 Ongoing follow-up care and monitoring
  • 1.9 Needs of carers

 2. Mild TBI: Consider the specific issues relevant to mild TBI in adults

  • 2.1 Screening for and early identification of mild TBI
  • 2.2 Initial acute care of those with a mild TBI
  • 2.3 Initial advice and outpatient rehabilitation
  • 2.4 Employment participation
  • 2.5 Community reintegration
  • 2.6 Substance abuse
  • 2.7 Depression
  • 2.8 Challenging behaviour
  • 2.9 Long-term impact and needs of mild TBI person
  • 2.10 Persistent symptoms and Issues specific to mild TBI: fatigue, headaches, pain
  • 2.11 Aging with mild TBI

2013

Report on Extended Scope of Physiotherapy Practice initiative in the Emergency Department at Canberra Hospital: Workload and Efficiency. Prepared for ACT Health

Extension of Scope of practice in allied health is an emerging workforce initiative in Australia, where new roles of practice are defined by the Australian Physiotherapy Association as: ‘outside the currently recognised scope of practice and requires legislative change. Extended scope of practice requires some method of credentialing following additional training, competency development and significant clinical experience. Examples include prescribing, injecting and surgery. This role describes the breadth of practice’. Extension of scope of practice in physiotherapy has been piloted at Canberra Hospital, ACT Health Directorate since 2010, as a way of:

  1. Establishing a formal skills escalator process for allied health
  2. Developing a highly skilled and credentialed extended-scope workforce in allied health which can provide mentoring and quality practice models for other allied health practitioners working within competency
  3. Providing practical formally-recognised examples of workforce redesign, and
  4. Relieving doctors of the management of more routine cases, in circumstances where there is a long waiting list of patients, so that patient care is not compromised (and is in fact enhanced) and doctors can focus on more complex cases.

This report described on a physiotherapy pilot program within the Emergency Department at Canberra Hospital. 

Building a complexity competent workforce project: Evidence informed development of a tool to screen for decline. A technical report prepared for the Southern Adelaide Local Health Network

Early identification and subsequent timely intervention older people has been reported as effective in improving health outcomes, as appropriate and timely community services can be put in place to Facilitate ongoing independent community living. Many risk factors for decline are potentially modifiable with community support interventions, or comprehensive geriatric assessment and management which target those most likely to benefit. It is in this context, support workers and allied health assistants can play a vital role in early detection of decline in elderly people. While support workers and allied health assistants could play an important role the early detection and timely intervention for decline, they need to be supported with adequate training, establishing competencies, support mechanisms (such are supervision and mentoring) and tools to detect decline. Provision of tools to detect decline may enable support workers and allied health assistants to accurately detect those elderly people who may be at risk of decline.

iCAHE performed a two stage investigation: a rapid review followed by tool development. The aim of this rapid review was to identify currently available tools from the literature which can be used by assist support workers and allied health assistants to accurately detect decline in older people.

A brief evidence summary for the parameters underpinning clinical supervision of health professionals. Prepared for SA Health

There is currently a paucity of high quality research evidence, such as systematic reviews, regarding the parameters (duration and frequency) underpinning clinical supervision of health professionals. A recent literature review on allied heath clinical supervision in Australia identified numbers of knowledge gaps in this field. This short report provided a brief summary of evidence for the parameters underpinning the clinical supervision of health professionals.

Areas of study and research

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