ORCID Profile
0000-0003-4926-0906
Current Organisations
University of Tasmania
,
Department of Health
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Publisher: Emerald
Date: 28-01-2014
Abstract: – The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance. – A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team. – A modest negative relationship between this leadership style and hand hygiene compliance rates ( r =0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style. – The s le was relatively small, other attributes of leaders were not investigated. – Leadership development for clinicians may need to focus on situational or adaptive capacity rather than a specific style. In the case of improving patient safety through increasing HH compliance, a more directive approach with clear statements backed up by role modelling appears likely to produce better rates. – Little is known about patient safety and clinical leadership. Much of the current focus is on developing transformational, authentic or engaging style. This study provides some evidence that it should not be used exclusively.
Publisher: Wiley
Date: 05-12-2020
DOI: 10.1002/HPM.2934
Abstract: Understanding the influence of a telephone triage advice service (TTAS) on patients seeking care is critical to realize enhancements in patient care, functioning of emergency departments (EDs), and effectiveness of the health system. This study addresses the question: what influence does a TTAS have on a patient's attendance at an ED and the wider health system? Records from 2016 to 2017 of 12,741 calls from a national TTAS were linked to 72,577 ED presentations to a hospital in regional Australia, retrospectively. Matching criteria included patient within the hospital's statistical local area code, age, gender, and ED attendance within 8 hours of TTAS call. Five statistical analyses of the data were conducted. There were 2857 matches. TTAS patients accessing the ED had a slightly higher proportion of women and a greater proportion of children under 4 years than usual. When TTAS confirmed callers' inclination for ED care, however only up to 69% subsequently attended the ED. When TTAS redirected others initially less inclined to more urgent care, up to 62% attended the ED. TTAS empowers vulnerable patients to access appropriate and timely services and promotes clinical and functional integration of care. Improvements of TTAS can come through investigation of callers' compliance factors.
Publisher: Swansea University
Date: 13-04-2017
Abstract: ABSTRACTObjectivesTo measure compliance with telephone helpline advice to attend an emergency department (ED) and the acuity of patients who presented to ED following a call. ApproachPopulation based, observational cohort study of all calls (n=1.04 million) to the healthdirect helpline over four years made by residents of New South Wales (NSW), Australia, linked to records of ED presentations, hospital admissions and death registrations using probabilistic data linkage. Outcomes measured include: compliance with dispositions to attend an ED, self-referral to ED by patients given low urgency dispositions, predictors of compliance and self-referral, and triage levels at ED presentation. This helpline dataset had not been previously linked with clinical outcome data, and this is the largest population-based linkage of telephone triage data conducted internationally.Results67.2% of patients were compliant with dispositions to attend an ED and the great majority of these (95.2%) attended within four hours of the call. Compliance was highest in patients aged 10-14 years, in residents of major cities and inner regional areas, in middle socio-economic quintiles, in calls triaged after-hours by nurses, in patients who had not been frequent callers to the service, and in callers with an original intention matching the disposition. In patients receiving a low-urgency disposition, 6.2% attended ED within 24 hours of the call (50.4% of these within four hours). Predictors of self-referral included older patient age, and calls triaged after hours. Calls from remote areas and areas in high socio-economic quintiles and where the original intention was similar to the disposition, were less likely to self-refer to ED. After age-adjustment, healthdirect compliant patients who attended ED were significantly less likely (7.7%) to receive the least urgent triage category (Australasian Triage Scale [ATS] 5) compared to the general NSW ED population (16.9%). Compliant healthdirect ED attenders also included a significantly higher proportion of patients triaged as the more urgent ATS 3 (37.0%) compared to the general NSW population (30.0%).Conversely, patients who self-referred to the ED did not differ significantly from the general population in allocation to lower urgency categories. ConclusionThis large population-based data linkage study provides precise estimates of ED attendance following calls to a telephone triage service, and details the predictors of ED attendance. The findings with regard to triage categories at ED presentation indicate that the healthdirect helpline is not referring substantial numbers of low-urgency patients to EDs.
Publisher: Wiley
Date: 05-07-2017
DOI: 10.1111/AJR.12360
Abstract: Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases. A total of 2012 doctors graduated from 1971 to 2011 and 1707 (85%) were registered, most commonly in general practice (45.8%), medicine (13%), anaesthetics (7.9%), surgery (7.5%), psychiatry (4.3%), emergency medicine (35, 3.5%), paediatrics (3.4%) and pathology (3.3%). While 41.9% worked in Tasmania, they comprised 35.6% of the local workforce and were clustered around the two larger cities. The proportion entering general practice has fallen since 1980s. The contribution of the Tasmanian medical programme is substantial but appears less than other regional medical schools. Relatively few work in smaller communities, particularly in specialties other than general practice. Lifestyle choices and the availability of training opportunities and career positions might be contributing factors. The medical school has established clinical schools in rural communities, promoted admission of rural applicants and increased rural clinical placement opportunities, with some early signs of success. The Tasmanian medical programme is important in this regional, island economy, but the rural and remote communities have not benefited as much as the two larger cities. Sustaining a regional workforce mission over time might require frequent adjustments to admissions and curriculum processes.
Publisher: Springer Science and Business Media LLC
Date: 08-2017
Publisher: Oxford University Press (OUP)
Date: 26-12-2021
Abstract: The provision of population-oriented, on-demand digital health services in many countries exemplifies the perceived utility of digital health services in supporting population health. Yet, limited knowledge exists regarding the equity of these services. Using mixed-method research, we recruited users of a health website and general practice patients to surveys (n = 441) and telephone interviews (n = 40). We contribute specific evidence investigating barriers to access, use and benefit from digital health services within an equity framework that incorporates social determinant factors, eHealth Literacy and trust. Our research highlights the foundational role of trust in predicting use, showcases which groups are unlikely to benefit from population-oriented digital health services, and proposes strategies to enhance the equity of these services. The theoretical framework we developed serves as a roadmap for future health promotion research and action by outlining the complex and interrelated pathways that can promote and threaten digital health equity.
Publisher: Wiley
Date: 04-2012
Publisher: SAGE Publications
Date: 10-1996
DOI: 10.3109/00048679609062666
Abstract: Objective: Fiji is a Pacific nation with roughly equal numbers of indigenous Fijians and Indians. Previous studies, using police and medical records, have suggested significant racial, regional, age and gender differences in suicidal behaviour. The objective of the present study is to use a unique data set (autopsy reports) in the evaluation of earlier reports and to identify groups at greater risk. Method: Hanging and poisoning autopsy reports from two distinct regions were examined. Results: The rate of autopsy (per 100 000 population per year) among Indians (19.5) is significantly greater (p .0001) than among Fijians (1.53). In the north, among the Indians, there are more autopsies in females (21.2) than males (16.8), and hanging constitutes 85% of total suicides, while in the Central and Eastern Divisions hanging constitutes only 58% of the total. These are regional influences. Among Fijians, the rates of hanging autopsy are significantly greater (p .001) in males (1.98) than females (0.40) however, among Indians there is no significant difference. This is a racial difference. Hanging remains the preferred option for all groups. The mean age at autopsy is 31.7. There is no significant difference between the mean ages of the races, the sexes or the regions. There is no significant difference between the mean age of poisoning (31.5) and hanging (31.8). Conclusion: There is a significant racial difference in rates of suicide but the influences of region, age and method are relatively slight.
Publisher: Wiley
Date: 29-03-2018
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1071/HI12056
No related grants have been discovered for Anthony Lawler.