IMPROVING HEALTH OUTCOMES IN CHILDREN SUFFERING MAJOR INJURY
Funder
National Health and Medical Research Council
Funding Amount
$521,876.00
Summary
In Australia injury is the leading cause of childhood morbidity - more than cancer and heart disease combined. Yet, there has been no published comprehensive analysis of the processes of care or the systems for treating severe paediatric injury in Australia. Partnered with government and consumers, this study will generate evidence and implement interventions to provide better care for severely injured children and their families
Randomised Trial Of Continuity Of Nursing Care In Vascular Surgery
Funder
National Health and Medical Research Council
Funding Amount
$190,648.00
Summary
Both overseas (Bruni, Hoosier-Paty and Hoffman 1996) and in Australia (Norman, Semmens, Laurence-Brown and Holman, under review), surgeons have become increasingly aware of the need to improve outcomes for patients undergoing arterial surgery for the lower limb. Unlike other areas of health care reform such as cardiac surgery or breast cancer, there is little confidence that the current links between acute facilities, community-based health services and general practice, work optimally together. ....Both overseas (Bruni, Hoosier-Paty and Hoffman 1996) and in Australia (Norman, Semmens, Laurence-Brown and Holman, under review), surgeons have become increasingly aware of the need to improve outcomes for patients undergoing arterial surgery for the lower limb. Unlike other areas of health care reform such as cardiac surgery or breast cancer, there is little confidence that the current links between acute facilities, community-based health services and general practice, work optimally together. Peripheral vascular disease is rarely studied. In NSW, there are about 4200 inpatient episodes for arterial surgery for ischaemia of the lower limb each year (AN-DRG 228 - 232), the majority involving older men. This study brings together a multi-disciplinary team of CIs comprising an academic nurse, two vascular surgeons and an expert in outcomes evaluation to conduct a randomised trial (n-586) of continuity of nursing care for patients admitted for arterial surgery of the lower limb. The intervention is comprised of a 'Patient Stay' Flowchart, continuing postoperative in-patient nursing assessment and staff consultation, Patient Education Discharge Booklet, Patient - Family Care Plan; proactive and reactive telephone follow-up and extensive GP liaison. Blinded outcome evaluation at six and twelve months will compare its differential effectiveness against usual care to which only the Patient Stay' Flowchart has been added. We will generate Level 2 evidence for the effectiveness of continuity of nursing care in improving outcomes for patients undergoing arterial surgery for ischaemia of the lower limb. To our knowledge, this would be the first Australian efficacy trial of its type.Read moreRead less
Coverage with Evidence Development: Application to pharmaceutical reimbursement decisions. Some new medicines produce only a small improvement in health but have considerable costs. When these medicines are trialled on only small numbers of people, uncertainty results about the value of the medicine, which can create problems for decision makers. Funding medicines where there is uncertainty may lead to harm when medicines are later found to be unsafe, or waste millions of dollars when they are ....Coverage with Evidence Development: Application to pharmaceutical reimbursement decisions. Some new medicines produce only a small improvement in health but have considerable costs. When these medicines are trialled on only small numbers of people, uncertainty results about the value of the medicine, which can create problems for decision makers. Funding medicines where there is uncertainty may lead to harm when medicines are later found to be unsafe, or waste millions of dollars when they are overpriced relative to effectiveness. Not funding medicines may disadvantage patients in whom the medicines are effective. Methods to enable access to medicines while reducing uncertainty will offer significant benefit to patients, clinicians and taxpayers. Read moreRead less