ORCID Profile
0000-0001-9920-4211
Current Organisations
East China Normal University
,
Griffith University
,
Queensland University of Technology
,
University of Sydney
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Publisher: Wiley
Date: 03-06-2021
Abstract: The conversion of rainforests into agriculture resulted in massive changes in species ersity and community structure. Although the conservation of the remaining rainforests is of utmost importance, identifying and creating a bio ersity‐friendly agriculture landscape is vital for preserving bio ersity and their functions. Bio ersity studies in agriculture have often been conducted at low elevations. In this study, we compared the functional ersity (FD), phylogenetic ersity (PD) and community structure of birds along an interacting gradient of land use (protected rainforest, reserve buffer and agriculture) and elevation (low, middle and high) in Sri Lanka. Then, we measured the compositional change by identifying how ecological traits (dietary guild, vertical strata, body mass and dispersal ability) and conservation characteristics (forest dependence and threatened status) responded to land use types. Elevation and land use interacted with each other to shape bird FD. Depending on the elevation, FD in agriculture was either higher or similar to forest. However, PD was similar across all elevation and land use types. Bird community structure in forest was functionally and phylogenetically clustered in comparison to agriculture. Insectivorous birds declined from forest to agriculture, and so did understorey and middle‐storey birds. But frugivorous and canopy birds did not change across land use types, while nectarivores, granivores and carnivores proliferated in agriculture. Forests were dominated by birds with low dispersal abilities, but birds in agriculture had more evenly distributed dispersal abilities. About half of all the in iduals in agriculture were composed of forest species, several of which were threatened. Synthesis and applications . Most farmers in Sri Lanka practice agriculture on small farms ( c . 2 ha) and rely on services (e.g. pest control and pollination) provided by bio ersity for their livelihoods. Our results underline the important role of these heterogeneous agriculture landscapes in maintaining high functional ersity (FD) and harbouring several threatened species. While FD in agriculture was comparatively high, conservation decisions based on land use alone cannot be reliable, because land use effects were elevation dependent. Thus, priority setting exercises aimed at designing optimal agriculture landscapes should consider landscape features, in combination with elevation, to benefit both people and wildlife outside protected areas.
Publisher: Springer Science and Business Media LLC
Date: 09-10-2011
Publisher: BMJ
Date: 2013
Publisher: Wiley
Date: 05-06-2016
DOI: 10.1002/HPM.2301
Abstract: The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and in idual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies shifting of program content focus and details different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd.
Publisher: BMJ
Date: 04-10-2012
DOI: 10.1136/BMJQS-2012-000852
Abstract: To systematically identify and synthesise health service accreditation literature. A systematic identification and narrative synthesis of health service accreditation literature published prior to 2012 were conducted. The search identified 122 empirical studies that examined either the processes or impacts of accreditation programmes. Study components were recorded, including: dates of publication research settings levels of study evidence and quality using established rating frameworks and key results. A content analysis was conducted to determine the frequency of key themes and subthemes examined in the literature and identify knowledge-gaps requiring research attention. The majority of studies (n=67) were published since 2006, occurred in the USA (n=60) and focused on acute care (n=79). Two thematic categories, that is, 'organisational impacts' and 'relationship to quality measures', were addressed 60 or more times in the literature. 'Financial impacts', 'consumer or patient satisfaction' and 'survey and surveyor issues' were each examined fewer than 15 times. The literature is limited in terms of the level of evidence and quality of studies, but highlights potential relationships among accreditation programmes, high quality organisational processes and safe clinical care. Due to the limitations of the literature, it is not prudent to make strong claims about the effectiveness of health service accreditation. Nonetheless, several critical issues and knowledge-gaps were identified that may help stimulate and inform discussion among healthcare stakeholders. Ongoing effort is required to build upon the accreditation evidence-base by using high quality experimental study designs to examine the processes, effectiveness and financial value of accreditation programmes and their critical components in different healthcare domains.
Publisher: BMJ
Date: 2012
Publisher: BMJ
Date: 14-06-2016
DOI: 10.1136/INJURYPREV-2016-041985
Abstract: Knowledge translation and exchange (KTE) can enable evidence-informed road safety policy and practice by reducing the gap between what is known to be effective and what actually occurs. A quality improvement project, undertaken within a government policy frame, was implemented in 2015 to produce an enhanced KTE framework for road safety (the framework). Information was collected from 35 road safety stakeholders in the UK, the Netherlands, Norway and Sweden. Thirteen KTE facilitators were identified that covered research funding and production, the expertise of knowledge users and dissemination practices. The framework was subsequently developed, which separated facilitators seen as essential for a KTE system, from others perceived as aspirational due to their lesser influence and the considerable time and resources required for their implementation. The framework provides a heuristic device to enable policy agencies to holistically assess and improve current KTE systems for road safety, to encourage evidence-informed policy and practice.
Publisher: Springer Science and Business Media LLC
Date: 20-09-2012
Publisher: Oxford University Press (OUP)
Date: 02-12-2012
Abstract: To evaluate short notice surveys in accreditation programmes. Two trials using short notice surveys were conducted independently: a study of 20 healthcare organizations with the Australian Council on Healthcare Standards (ACHS) and a study of 7 general practices with the Australian General Practice Accreditation Limited (AGPAL). Participating organizations volunteered. ACHS and AGPAL selected 17 and 13 surveyors, respectively, and provided training for them on short notice surveys. Each agency's short notice surveys were an abbreviated version of their current advanced notification surveys. Short notice surveys assessed accreditation programme criteria or indicators that corresponded to the Australian Commission on Safety and Quality in Health Care's priority issues. Fifteen (out of 45) ACHS criteria and 48 (out of 174) AGPAL indicators that aligned to the Commission's criteria were evaluated. Participating organizations were given 2 days notice prior to the short notice surveys. Ratings from the short notice surveys were compared with those from the most recent advanced notification surveys, and statistical tests were performed to detect differences and potential confounding factors. Surveyors and organizational staff completed a post-survey feedback questionnaire which was analysed thematically and by inferential statistics. The short notice survey approach overall produced ratings congruent with the advanced notification survey for both accreditation programmes. However, for both programmes short notice surveys assessed that more organizations would not reach the accreditation threshold as compared with the previous survey. Organizations in both programmes were judged to have achieved less successful performance against clinical standards by the short notice survey than the advanced notification survey. There was support from surveyors and organizational staff for short notice survey to be adopted. However, there were mixed views about the impact of short notice surveys and whether they validated trial participants' continuous improvement efforts. The study demonstrated that short notice surveys are more critical in their assessment of clinical than administrative or corporate items. Short notice surveys, while broadly comparable with existing advanced notification survey practice, produced different accreditation outcomes for a significant proportion of the study organizations. The overall value and worth of short notice surveys remains to be proved.
Publisher: Wiley
Date: 04-11-2022
DOI: 10.1111/BCP.15109
Abstract: To conduct a systematic synthesis of existing evidence reviews on interventions to enhance medication safety in residential aged‐care settings (RACS) to establish and compare their effectiveness. This umbrella review included examination of meta‐analyses, scoping and systematic reviews. Four electronic databases were examined for eligible reviews. Two authors critically appraised those meeting the inclusion criteria using the Joanna Briggs Institute Critical Appraisal Instrument. Fifteen reviews covering 171 unique, primary studies were included. Of the variety of interventions identified in the literature, five main categories of interventions were commonly reported to be effective in promoting medication safety in RACS (medication review, staff education, multidisciplinary team meetings, computerised clinical decision support systems and miscellaneous). Most reviews showed mixed evidence to support intervention effectiveness due to the significant heterogeneity between studies in their sites, s le sizes and intervention periods. In all intervention categories, pharmacists' collaboration was most beneficial, showing definitive evidence for improving medication safety and quality of prescribing in RACS. Eight reviews recommended multicomponent interventions, particularly medication reviews and staff education, but specific details were infrequently provided. Only five reviews presented insights into implementation facilitators and barriers, while the sustainability of interventions was only discussed in one review. There is strong evidence to support the four main categories of interventions identified. However, limited details are available regarding the most appropriate design and implementation of multicomponent interventions and the sustainability of all interventions, thus solid recommendations cannot be made. Future research in this field should focus on producing theoretically informed, methodologically robust, original research, particularly regarding the design, implementation and sustainability of multicomponent interventions, which appears the most promising approach.
Publisher: Elsevier BV
Date: 06-2008
Publisher: Oxford University Press (OUP)
Date: 13-08-2013
Abstract: To identify and analyse research on the use of economic evaluation in health services accreditation. Seven online health and economic databases, and key accreditation agency and health department websites were searched between June and December 2011. The selection criteria were English language and published empirical research studies on the topic of economic evaluation of health service accreditation. No formal economic evaluation of health services accreditation has been carried out to date. Empirical data on costs and benefits were analysed in 6 and 15 studies, respectively. Data extraction Meta-analysis was unsuitable due to output variability. Attributes relating to scalability and independence of outcome data were collected. For the benefit studies, we also assessed the strength of claim that accreditation improved patient safety and quality, and sources of potential bias. The incremental costs ranged from 0.2 to 1.7% of total costs averaged over the accreditation cycle. The benefit studies were inconclusive in terms of showing clear evidence that accreditation improves patient safety and quality of care. The lack of formal economic appraisal makes it difficult to evaluate accreditation in comparison to other methods to improve patient safety and quality of care. The lack of a clear relationship between accreditation and the outcomes measured in the benefit studies makes it difficult to design and conduct such appraisals without a more robust and explicit understanding of the costs and benefits involved.
Publisher: Springer Science and Business Media LLC
Date: 20-11-2015
Publisher: Springer Science and Business Media LLC
Date: 03-08-2011
Abstract: There is little published research investigating sex work in Namibia, particularly in rural areas. Therefore, the aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges. Qualitative interviews were used to better understand the perceptions, experiences and economic considerations of female sex workers in Namibia who were involved in a Behavior Change Communication Program encouraging safer sex practices among high-risk populations in 2006 and 2007. While the Behavior Change Communication Program has made significant strides in educating and empowering young women to negotiate more consistent condom use with sexual partners, the gendered economic inequalities and power imbalances within rural and semi-urban Namibian society that favor men hinder further advancement towards positive behavioral change for HIV prevention and also hinder the development of the loving relationships sought by some sex workers. This study found that sex workers and transactional sex encounters are heterogeneous entities dependent upon the characteristics of the man (known, stranger, wealthy, attractive to the woman) and the woman (in financial need, desiring love). These features all influence condom use. The 3 E's 'education, empowerment and economic independence' are critical factors needed to encourage and facilitate consistent condom use to prevent HIV transmission. Without financial independence and occupational alternatives building on their health education and empowerment, women who engage in sex work-and transactional sex more generally-will remain largely marginalized from Namibian society, and will continue engaging in risky sexual practices that facilitate HIV acquisition and transmission throughout the community.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.HEALTHPOL.2013.09.002
Abstract: Public disclosure is increasingly a requirement of accrediting agencies and governments. There are few published empirical evaluations of disclosure interventions that inform evidence-based implementation or policy. This study investigated the practices associated with the public disclosure of healthcare accreditation information, in addition to multi-stakeholder perceptions of key challenges and opportunities for improvement. We conducted a mixed methods study comprising analysis of disclosure practices by accreditation agencies, and 47 semi-structured in idual or group interviews involving 258 people. Participants were erse stakeholders associated with Australian primary, acute and residential aged care accreditation programmes. Four interrelated issues were identified. First, there was broad agreement that accreditation information should be publicly disclosed, although the three accreditation agencies differed in the information they made public. Second, two implementation issues emerged: the need to educate the community about accreditation information, and the practical question of the detail to be provided. Third, the impact, both positive and negative, of disclosing accreditation information was raised. Fourth, the lack of knowledge about the impact on consumers was discussed. Public disclosure of accreditation information is an idea that has widespread support. However, translating the idea into practice, so as to produce appropriate, meaningful information, is a challenge.
Publisher: IOS Press
Date: 29-06-2023
DOI: 10.3233/SHTI230467
Abstract: The tuberculosis prevention and control model needs to be explored. This study aimed to create a conceptual framework for measuring TB vulnerability to guide the prevention program’s effectiveness. SLR method was employed, resulting in 1.060 articles being analyzed with ACA Leximancer 5.0 and facet analysis. The built framework consists of five components: risk of TB transmission, damage caused by TB, health care facility, the burden of TB, and awareness of TB. Future research is required to explore variables in each component to formulate the degree of TB vulnerability.
Publisher: Wiley
Date: 28-06-2019
DOI: 10.1111/AJR.12525
Abstract: This study examined advance care planning as delivered by general practice registrars and recently fellowed GPs in New South Wales rural settings. The facilitators and barriers to advance care planning uptake in these areas were investigated, as well as the state of general practice training on advance care planning. Qualitative descriptive methodology, involving semi-structured face-to-face and telephone interviews. Primary care. General practice registrars and recently fellowed GPs in New South Wales rural settings. Definition of rural using the Australian Standard Geographical Classification - Remoteness Area. Thirteen participants were included in the study. Thematic analysis of interview transcripts elucidated key issues emerging from participants' accounts. Key barriers included doctor-dependent uptake, demands on doctor's time and the limited relevant resources available. Facilitators recognised were patient control in end-of-life care and long-standing relationships between GPs and their patients. Uptake among patients was low, and minimal training on advance care planning reported. The lack of training opportunities in advance care planning during vocational training, especially when combined with the essential role played by rural GPs in initiating advance care planning and providing end-of-life care, appears to be a major problem that might contribute to poor uptake among patients in rural areas. This study demonstrated, however, the significant benefits that advance care planning could bring in patients living in rural communities if delivered effectively. Given that rural GPs face a number of barriers to providing routine health care, these results highlight an important need to provide GPs and rural communities with support, education, incentive, better administrative tools, options and greater awareness of advance care planning.
Publisher: Emerald
Date: 16-11-2015
DOI: 10.1108/JHOM-02-2015-0034
Abstract: – Health systems are changing at variable rates. Periods of significant change can create new challenges or lify existing barriers to accreditation program credibility and reliability. The purpose of this paper is to examine, during the transition to a new Australian accreditation scheme and standards, challenges to health service accreditation survey reliability, the salience of the issues and strategies to manage threats to survey reliability. – Across 2013-2014, a two-phase, multi-method study was conducted, involving five research activities (two questionnaire surveys and three group discussions). This paper reports data from the transcribed group discussions involving 100 participants, which was subject to content and thematic analysis. Participants were accreditation survey coordinators employed by the Australian Council on Healthcare Standards. – Six significant issues influencing survey reliability were reported: accreditation program governance and philosophy accrediting agency management of the accreditation process, including the program’s framework survey coordinators survey team dynamics in idual surveyors and healthcare organizations’ approach to accreditation. A change in governance arrangements promoted reliability with an independent authority and a new set of standards, endorsed by Federal and State governments. However, potential reliability threats were introduced by having multiple accrediting agencies approved to survey against the new national standards. Challenges that existed prior to the reformed system remain. – Capturing lessons and challenges from healthcare reforms is necessary if improvements are to be realized. The study provides practical and theoretical strategies to promote reliability in accreditation programs.
Publisher: Springer Science and Business Media LLC
Date: 24-10-2013
Publisher: Springer Science and Business Media LLC
Date: 16-01-2020
DOI: 10.1186/S12913-019-4860-0
Abstract: Assessment of clinical variation has attracted increasing interest in health systems internationally due to growing awareness about better value and appropriate health care as a mechanism for enhancing efficient, effective and timely care. Feedback using administrative databases to provide benchmarking data has been utilised in several countries to explore clinical care variation and to enhance guideline adherent care. Whilst methods for detecting variation are well-established, methods for determining variation that is unwarranted and addressing this are strongly debated. This study aimed to synthesize published evidence of the use of feedback approaches to address unwarranted clinical variation (UCV). A rapid review and narrative evidence synthesis was undertaken as a policy-focused review to understand how feedback approaches have been applied to address UCV specifically. Key words, synonyms and subject headings were used to search the major electronic databases Medline and PubMed between 2000 and 2018. Titles and abstracts of publications were screened by two reviewers and independently checked by a third reviewer. Full text articles were screened against the eligibility criteria. Key findings were extracted and integrated in a narrative synthesis. Feedback approaches that occurred over a duration of 1 month to 9 years to address clinical variation emerged from 27 publications with quantitative (20), theoretical/conceptual/descriptive work (4) and mixed or multi-method studies (3). Approaches ranged from presenting evidence to in iduals, teams and organisations, to providing facilitated tailored feedback supported by a process of ongoing dialogue to enable change. Feedback approaches identified primarily focused on changing clinician decision-making and behaviour. Providing feedback to clinicians was identified, in a range of a settings, as associated with changes in variation such as reducing overuse of tests and treatments, reducing variations in optimal patient clinical outcomes and increasing guideline or protocol adherence. The review findings suggest value in the use of feedback approaches to respond to clinical variation and understand when action is warranted. Evaluation of the effectiveness of particular feedback approaches is now required to determine if there is an optimal approach to create change where needed.
Publisher: Oxford University Press (OUP)
Date: 15-07-2016
Abstract: To examine how consumer engagement (CE) can be promoted through Australian accreditation programmes. A nation-wide qualitative study completed in 2012. All eight Australian States and Territories. Two-hundred and fifty-eight healthcare stakeholders from the acute, primary and aged care sectors. Forty-seven in idual and group interviews were undertaken. Questions elicited views on the dimensions and utility of CE promotion by accreditation programmes. Healthcare stakeholders' views on the dimensions and utility of CE promotion by accreditation programmes. Four mechanisms of CE promotion were identified. Two involved requirements for health service organizations to meet CE-related standards related to consumer experience and satisfaction surveys, and consumer participation in organizational governance processes. Two mechanisms for promoting CE through accreditation processes were also identified, concerning consumer participation in the development and revision of standards, and the implementation of accreditation surveys. Accreditation programmes were viewed as important drivers of CE, yet concerns were raised regarding the organizational investments needed to meet programmes' requirements. Accreditation programmes use erse mechanisms as levers for change to promote CE in healthcare. These mechanisms and their inter-relationships require careful consideration by accreditation agencies and health policymakers to maximize their potential benefits, while maintaining stakeholder engagement in programmes.
Publisher: Oxford University Press (OUP)
Date: 10-2021
Publisher: Africa Health Research Organization
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 23-08-2023
DOI: 10.1186/S12913-023-09892-9
Abstract: In Vietnam and many developing countries, private healthcare is increasingly being leveraged by governments to complement public services and increase health service access and utilisation. Extensive understanding of patterns of utilisation of private over public health services, and the rationale for such consumer decisions, is important to ensure and promote safe, affordable and patient-centred care in the two sectors. Few studies within the Southeast Asian Region have explored how private and public providers interact (via social networks, marketing, and direct contact) with consumers to affect their service choices. This study investigates providers’ views on social factors associated with the use of private over public health services in Vietnam. A thematic analysis was undertaken of 30 semi-structured interviews with experienced health system stakeholders from the Vietnam national assembly, government ministries, private health associations, health economic association, as well as public and private hospitals and clinics. Multiple social factors were found to influence the choice of private over public services, including word-of-mouth, the patient-doctor relationship and relationships between healthcare providers, healthcare staff attitudes and behaviour, and marketing. While private providers maximise their use of these social factors, most public providers seem to ignore or show only limited interest in using marketing and other forms of social interaction to improve services to meet patients’ needs, especially those needs beyond strictly medical intervention. However, private providers faced their own particular challenges related to over-advertisement, over-servicing, excessive focus on patients’ demands rather than medical needs, as well as the significant technical requirements for quality and safety. This study has important implications for policy and practice in Vietnam. First, public providers must embrace social interaction with consumers as an effective strategy to improve their service quality. Second, appropriate regulations of private providers are required to protect patients from unnecessary treatments, costs and potential harm. Finally, the insights from this study have direct relevance to many developing countries facing a similar challenge of appropriately managing the growth of the private health sector.
Publisher: BMJ
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 21-11-2014
Publisher: Wiley
Date: 15-05-2019
DOI: 10.1111/JEP.12930
Abstract: Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and action are largely determined at a systems level currently, and stakeholder engagement in this process is limited. Lack of consensus on an evidence-based definition for UCV remains a substantial barrier to progress in this field.
Publisher: Oxford University Press (OUP)
Date: 24-11-2012
Abstract: To investigate the frequency, style and reliability of newspaper reporting of medication errors. Content analysis of articles discussing medication errors that were published in the 10 most widely read Australian daily newspapers between January 2005 and January 2010. Main outcome measure(s) Newspaper source, article type, article topic, leading news actors, identified causes and solutions of medication errors and cited references. Ninety-two articles included discussion of medication errors, with the one national newspaper, The Australian, the main source of articles (n = 24). News items were the most frequent type of articles (n = 73), with the majority (n = 55) primarily focused on broader hospital problems. Government representatives, advocacy groups, researchers, health service staff and private industry groups were prominent news actors. A shortage of hospital resources was identified as the central cause of medication errors (n = 38), with efficient error reporting systems most frequently identified as a solution (n = 25). Government reports were cited on 39 occasions, with peer-reviewed publications infrequently cited (n = 4). Australian newspaper reporting of medication errors was relatively limited. Given the high prevalence of errors and the potential role consumers can play in identifying and preventing errors, there is a clear argument for increasing public awareness and understanding of issues relating to medication safety. Existing coverage of this issue is unrelated to research evidence. This suggests the need for patient safety researchers and advocacy groups to engage more strongly with the media as a strategy to increase the productive public discourse concerning medication errors and gain support for evidence-based interventions.
Publisher: Oxford University Press (OUP)
Date: 11-07-2012
Abstract: To evaluate the effectiveness of utilizing the patient journey survey (PJS) method in healthcare accreditation processes. Randomized trial of the PJS method in parallel with the current accreditation survey (CAS) method of the Australian Council on Healthcare Standards (ACHS). Acute healthcare organizations in Australia. Seventeen organizations, 28 organizational staff, nine surveyors and 38 patients. The results of each surveying method were compared. Participants provided feedback, via 18 interviews and 40 questionnaire surveys, about the benefits and disadvantages of a PJS compared to a CAS. The PJS method is not as comprehensive as the CAS method for accreditation assessment. In matched assessments the majority of items were rated lower by the PJS method than by the CAS. PJSs were shown to be appropriate for assessing mandatory clinical criteria, but were less effective for assessing corporate and support criteria. The two methods erged in their final assessments of which organizations met the accreditation threshold. Participants endorsed the use of PJSs within accreditation processes. The PJS methodology complements but is not a substitute for existing accreditation methods. There is significant stakeholder support for the inclusion of the PJS method within the current accreditation programme.
Publisher: The Sax Institute
Date: 2020
Publisher: Springer Science and Business Media LLC
Date: 30-11-2015
Publisher: Oxford University Press (OUP)
Date: 2023
Abstract: Hospital accreditation is an established quality improvement intervention. Despite a growing body of research, the evidence of effect remains contested. This umbrella review synthesizes reviews that examine the impacts of hospital accreditation with regard to health-care quality, highlighting research trends and knowledge gaps. Terms specific to the population: ‘hospital’ and the intervention: ‘accreditation’ were used to search seven databases: CINAHL (via EBSCOhost), Embase, Medline (via EBSCOhost), PubMed, Scopus, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Institute (JBI) EBP Database (via Ovid). 2545 references were exported to endnote. After completing a systematic screening process and chain-referencing, 33 reviews were included. Following quality assessment and data extraction, key findings were thematically grouped into the seven health-care quality dimensions. Hospital accreditation has a range of associations with health system and organizational outcomes. Effectiveness, efficiency, patient-centredness, and safety were the most researched quality dimensions. Access, equity, and timeliness were examined in only three reviews. Barriers to robust original studies were reported to have impeded conclusive evidence. The body of research was largely atheoretical, incapable of precisely explaining how or why hospital accreditation may actually influence quality improvement. The impact of hospital accreditation remains poorly understood. Future research should control for all possible variables. Research and accreditation program development should integrate concepts of implementation and behavioural science to investigate the mechanisms through which hospital accreditation may enable quality improvement.
Publisher: Deeble Institute for Health Policy Research
Date: 2013
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.PUHE.2011.01.001
Abstract: Despite the acute impact of road trauma involving novice drivers, there have been few efforts to identify the main factors influencing the novice driver policy agenda. Increasing the transparency of such policy dynamics may help inform future novice driver policy agenda-setting processes, as well as those in other public health settings. Forty interviews were conducted between 2007 and 2009 with in iduals involved in novice driver policy debates and processes in four Australian states. An increasing body of positive evaluations from other jurisdictions was seen to provide an initial stimulus for Australian novice driver policy activities. The dissemination of evidence by researchers, lobbying and advocacy by other influential stakeholders, and media reporting of multiple-fatality novice driver crashes were seen as other factors central to policy agenda setting. Australian graduated driver licensing (GDL) policy initiatives may only be acted upon once adequate political support is identified in terms of community demand for action and public acceptance of GDL policy in neighboring states. As such, researcher encouragement of community support for unpopular evidence-based policies during windows of opportunity for policy reform may act as an influential agenda-setting force.
Publisher: BMJ
Date: 05-2021
DOI: 10.1136/BMJOPEN-2021-049873
Abstract: Hospitals commonly examine patient safety culture and other quality indicators to evaluate and improve performance in relation to quality and safety. A growing body of research has separately examined relationships between patient safety culture and patient experience on clinical outcomes and other quality indicators. However, there is a knowledge gap regarding the relationship between these two important domains. This article describes the protocol for a scoping review of published literature examining the relationship between patient safety culture and patient experience in hospital settings. The scoping review will provide an overview of research into the relationship between patient safety culture and patient experience in hospital contexts, map key concepts underpinning these domains and identify research gaps for further study. The scoping review will be conducted using the five stages of Arksey and O’Malley’s framework: identify the research question identify relevant studies study selection chart data and collate, summarise and report the results. The inclusion criteria will be applied using the Population, Concept and Context Framework. Searches will be conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, Scopus and SciELO databases, without applying date range limits. Hand-searching of grey literature will also be performed to find relevant, non-indexed literature. Data will be extracted using a standardised data extraction form developed by the Joanna Briggs Institute. Both descriptive and thematic analyses will be undertaken to scope key concepts within the body of reviewed literature. This type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.
Publisher: BMJ
Date: 10-2012
Publisher: Wiley
Date: 22-03-2019
DOI: 10.1002/HPM.2768
Abstract: The local-level impacts of decentralizing national health systems are significant yet infrequently examined. This review aims to assess whether localized health services delivery in Indonesia, which commenced a health system decentralization process in 2001, achieved its objectives or could be enhanced. A systematic review was undertaken to collate published evidence regarding this topic and synthesize key findings holistically using the six building blocks framework of the World Health Organization (WHO) to categorize health system performance. Four research databases were searched in 2016 for relevant evidence published between 2001 and 2015. The inclusion criteria were relevance to the topic of decentralization impacts at the district level, original research, and published in English. Included articles were appraised for quality using a standardized tool, with key findings synthesized using the WHO building blocks. Twenty-nine articles met the inclusion criteria and categorized under the WHO building blocks categories. The findings highlight problematic impacts of decentralization related to three building blocks: service delivery, health financing, and workforce. In the 15 years of post-decentralization in Indonesia, the service delivery, health workforce, and health financing blocks should be prioritized for further research and policy evaluation to improve the overall health system performance at the district level.
Publisher: American Public Health Association
Date: 11-2010
Abstract: Young drivers are overrepresented in road trauma and vehicle-related deaths, and there is substantial evidence for the effectiveness of graduated driver licensing (GDL) policies that minimize young drivers’ exposure to high-risk driving situations. However, it is unclear what role research plays in the process of making GDL policies. To understand how research is utilized in this context, we interviewed influential GDL policy actors in Australia and the United States. We found that GDL policy actors generally believed that research evidence informed GDL policy development, but they also believed that research was used to justify politically determined policy positions that were not based on evidence. Further efforts, including more effective research dissemination strategies, are required to increase research utilization in policy.
Publisher: Research Square Platform LLC
Date: 12-10-2023
Publisher: Oxford University Press (OUP)
Date: 30-10-2012
Abstract: The study aim was twofold: to investigate and describe the organizational attributes of accreditation programmes in low- and middle-income countries (LMICs) to determine how or to what extent these differ from those in higher-income countries (HICs) and to identify contextual factors that sustain or are barriers to their survival. Web-based questionnaire survey. National healthcare accreditation providers and those offering international services. In total, 44 accreditation agencies completed the survey. Income distinctions, accreditation programme features, organizational attributes and cross-national ergence. Accreditation programmes of LMICs exhibit similar characteristics to those of HICs. The consistent model of accreditation worldwide, centres on promoting improvements, applying standards and providing feedback. Where they do differ, the ergence is over specialized features rather than the general logic. LMICs were less likely than HICs to include an evaluation component to programmes, more likely to have certification processes for trainee surveyors and more likely to make decisions on the accreditation status based on a formulaic, mathematically oriented approach. Accreditation programme sustainability, irrespective of country characteristics, is influenced by ongoing policy support from government, a sufficient large healthcare market size, stable programme funding, erse incentives to encourage participation in accreditation by Health Care Organizations as well as the continual refinement and improvement in accreditation agency operations and programme delivery. Understanding the similarities, differences and factors that sustain accreditation programmes in LMICs, and HICs, can be applied to benefit programmes around the world. A flourishing accreditation programme is one element of the institutional basis for high-quality health care.
Publisher: Wiley
Date: 29-03-2023
DOI: 10.1111/ELE.14203
Abstract: Research on island species–area relationships (ISAR) has expanded to incorporate functional (IFDAR) and phylogenetic (IPDAR) ersity. However, relative to the ISAR, we know little about IFDARs and IPDARs, and lack synthetic global analyses of variation in form of these three categories of island ersity–area relationship (IDAR). Here, we undertake the first comparative evaluation of IDARs at the global scale using 51 avian archipelagic data sets representing true and habitat islands. Using null models, we explore how richness‐corrected functional and phylogenetic ersity scale with island area. We also provide the largest global assessment of the impacts of species introductions and extinctions on the IDAR. Results show that increasing richness with area is the primary driver of the (non‐richness corrected) IPDAR and IFDAR for many data sets. However, for several archipelagos, richness‐corrected functional and phylogenetic ersity changes linearly with island area, suggesting that the dominant community assembly processes shift along the island area gradient. We also find that archipelagos with the steepest ISARs exhibit the biggest differences in slope between IDARs, indicating increased functional and phylogenetic redundancy on larger islands in these archipelagos. In several cases introduced species seem to have ‘re‐calibrated’ the IDARs such that they resemble the historic period prior to recent extinctions.
Publisher: EDP Sciences
Date: 2022
DOI: 10.1051/BIOCONF/20225400013
Abstract: The COVID-19 pandemic has affected many ways of life, especially among people who experience the infection. The pandemic negatively affected the physical, social, and psychological functioning of in iduals and societies, worldwide. This study aimed to evaluate the extent to which key factors may influence the QoL of people with COVID-19 in Semarang, Indonesia. The online cross-sectional study recruited 107 participants. Adults (≥ 17 years of age) with positive COVID-19 infection history were targeted. Quality of life was measured with the WHOQOL-BREF questionnaire. The questions explain how respondents attribute to each aspect of their life and how problematic or satisfactory they perceive them for their overall quality of life. Results showed that the highest mean score was found for the social domain (14.112.89), and the lowest mean score was observed for the environment domain (13.272.01). The presence of comorbidities had a statistically significant difference in the environment domain (p-value:0.006). During the COVID-19 pandemic, people had less satisfaction with their environment. The presence of anxiety often promotes changes in the perception of QoL for all domains among respondents (p-value: .0001). Investing such resources in these groups may be an efficient option to maximize positive public health impacts in this resource-poor environment.
Publisher: Australasian College of Health Service Management
Date: 02-08-2023
DOI: 10.24083/APJHM.V18I2.2347
Abstract: Objectives: Private Equity (PE) involvement in healthcare has been evident in the United States (US) for some time, with questionable benefits reported. There are significant differences in funding, health insurance and regulation in the US, when compared to Australia and New Zealand (NZ), so it is not clear whether existing US research can be generalised to these settings. This study aims to examine published information regarding PE involvement in the private-for-profit (PFP) healthcare sector in Australia and NZ, including evidence of PE shareholdings and its impacts. Design: This scoping review considers academic and grey literature, including academic research and commentary papers, media reports, corporate reports, PFP healthcare websites and government submissions. Main Outcome & Results: Thirty three relevant sources were identified, but no specific information on the impacts of PE investment were discovered. The academic papers highlight an ongoing debate (but limited research evidence) about PFP healthcare, including the quality of clinical care, practice consolidation and a downward trend on clinician ownership. The grey literature offered more information on PE investment and growth of the PFP sector, but limited detail about shareholdings. Conclusion: With little research on PE investment in Australia and NZ, it is difficult to know if continued PE growth will have a positive or negative affect on operational performance and outcomes, such as clinician engagement and clinical care. The authors conclude that there is a shifting landscape of PFP healthcare in Australia and NZ, to less clinician and greater PE ownership. Given the reports of negative impacts of PE involvement in the US, these trends pose significant immediate and long-term implications. This paper sets the agenda for further research to explore the organisational and system-level impacts of PE growth in Australia and NZ.
Publisher: Research Square Platform LLC
Date: 16-10-2023
Publisher: BMJ
Date: 2018
Publisher: Oxford University Press (OUP)
Date: 10-02-2014
Abstract: Multi-Stakeholder Health Services Research Collaborations (M-SHSRCs) are increasingly pursued internationally to undertake complex implementation research that aims to directly improve the organisation and delivery of health care. Yet the empirical evidence supporting M-SHSRCs' capacity to achieve such goals is limited, and significant impediments to effective implementation are identified in the literature. This dichotomy raises the question, 'is it worth engaging in M-SHSRCs?' In this paper, we contribute to the narrative evidence-base by outlining key issues emerging from our substantial collaborative experience in Australia. Key benefits, challenges and mechanisms that may enable effective implementation of M-SHSRCs in other contexts are highlighted. We conclude that M-SHSRCs are worthwhile and succeed through significant financial, temporal and emotional investments.
Publisher: SAGE Publications
Date: 24-03-2022
Abstract: Assessment processes applied within some health service accreditation programs have been criticised at times for being inaccurate, inconsistent or inefficient. Such criticism has inspired the development of innovative assessment methods. The Australian Commission on Safety and Quality in Health Care considered the use of three such methods: short-notice or unannounced methods patient journey or tracer methods and attestation by governing bodies. A systematic search and synthesis of published peer-reviewed and grey literature associated with these methods. The published literature demonstrates that the likely benefits of these three assessment methods warrant further evaluation, real-world trials and stakeholder consultation to determine the most appropriate models to introduce into national accreditation programs. The subsequent introduction of models of short-notice assessments and attestation by governing bodies into the Australian Health Service Safety and Quality Accreditation Scheme in January 2019 demonstrates how the findings presented in this article influenced the national change in assessment practice, providing an ex le of evidence-informed accreditation development.
Publisher: School of Public Health and Community Medicine, University of New South Wales
Date: 2015
Publisher: Springer Science and Business Media LLC
Date: 30-01-2023
DOI: 10.1038/S41559-022-01973-Y
Abstract: Edge effects often exacerbate the negative effects of habitat loss on bio ersity. In forested ecosystems, however, many pollinators actually prefer open sunny conditions created by edge disturbances. We tested the hypothesis that forest edges have a positive buffering effect on plant-pollinator interaction networks in the face of declining forest area. In a fragmented land-bridge island system, we recorded ~20,000 plant-pollinator interactions on 41 islands over 3 yr. We show that plant richness and floral resources decline with decreasing forest area at both interior and edge sites, but edges maintain 10-fold higher pollinator abundance and richness regardless of area loss. Edge networks contain highly specialized species, with higher nestedness and lower modularity than interior networks, maintaining high robustness to extinction following area loss while forest interior networks collapse. Anthropogenic forest edges benefit community ersity and network robustness to extinction in the absence of natural gap-phase dynamics in small degraded forest remnants.
Publisher: Wiley
Date: 04-11-2015
DOI: 10.1111/HEX.12300
Publisher: Wiley
Date: 23-07-2023
DOI: 10.1002/HPM.3689
Abstract: The private sector's contribution to Universal health coverage (UHC) has been increasingly recognised by policymakers in low‐ and middle‐income countries. This study aimed to identify service‐provider and consumer‐level factors affecting choice of private over public health services in Vietnam. A concurrent mixed‐method design was adopted. A quantitative phase explored consumers' health service choice by analysing data from a random national s le of 10,354 in iduals aged 16 and over. The qualitative phase investigated how private and public providers organise their services to influence consumer choices by conducting interviews with policymakers, hospital and clinic managers, and health practitioners. The combined results demonstrate that at the in idual level, absence of any type of health insurance was the factor most closely associated with the use of private services. Private health services were more likely to be used by people from ethnic majority groups compared to ethnic minorities (odds ratio [OR]: 1.6, 95% CI: 1.4–2.0), and by people living in urban compared to rural areas (OR: 1.1, 95% CI: 1.0–1.3). The service providers suggested that consumers opted for private services that were perceived to have poorer quality in the public sector, such as counselling, physical therapy and rehabilitative care. Additional motivational factors include the private sector's more flexible working hours, shorter waiting times, flexible pricing of services, personalised care and better staff behaviour. The findings can inform national health system planning and coordination activities in Vietnam and other countries that aim to harness the attributes of both the public and private sectors to achieve UHC.
Publisher: IEEE
Date: 17-09-2022
Publisher: Wiley
Date: 25-01-2016
DOI: 10.1111/JEP.12512
Abstract: Accrediting health care organizations against standards is a recognized safety and quality intervention. The credibility of an accreditation programme relies on surveying reliability. We investigated accreditation survey coordinators' perceptions of reliability issues and their continued relevancy, during a period of national accreditation reform. In 2013 and 2014, questionnaire surveys were developed using survey coordinators' feedback of their experiences and concerns regarding the accreditation process. Each year, a purpose-designed questionnaire survey was administered during the accrediting agency survey coordinator training days. Participants reported that survey reliability was informed by five categories of issues: the management of the accreditation process, including standards and health care organizational issues surveyor workforce management survey coordinator role survey team and in idual surveyors. A new accreditation system and programme did not alter the factors reported to shape survey reliability. However, across the reform period, there was a noted change within each category of the specific issues that were of concern. Furthermore, consensus between coordinators that existed in 2013 appears to have diminished in 2014. Across all categories, in 2014 there was greater ersity of opinion than in 2013. The known challenges to the reliability of an accreditation programme retained their potency and relevancy during a period of reform. The ersity of opinion identified across the coordinator workforce could potentially place the credibility and reliability of the new scheme at risk. The study highlights that reliability of an accreditation scheme is an ongoing achievement, not a one-off attainment.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.JHQR.2019.08.008
Abstract: Accreditation programs have a crucial role in improving the safety and effectiveness of hospital services. Many factors contribute to achieve accreditation goals. This study evaluated the national Iranian hospital accreditation program from the view of hospital managers in Iran. The study was conducted in 2015 using a validated questionnaire designed to collect feedback concerning accreditation processes and impacts. In total, 547 managers were surveyed using a stratified random s ling method. A 5-degree scale Likert from totally disagree=1 to totally agree=5 has been used for the evaluation. Descriptive and inferential statistics were used to analyze the data. Approximately half of hospital managers were satisfied with the accreditation standards and surveying methods. The reason for their dissatisfaction was the high number of measures (2.38). The main challenges to the accreditation method were reported inadequate surveyor training (2.94) their satisfaction with the infrastructure was low because of a lack of hospital resources. Nonetheless, the accreditation program was perceived as being successful in improving patient safety (3.80), patient compliance (3.72), and error reduction (3.53). An effective accreditation program requires reducing the number of standards and making them clearer as well as the infrastructure for the implementation of accreditation such as sufficient and sustainable funds, enough human resources and equipment should be provided. Appropriate surveyors should be selected and trained professionally to ensure inter-rater reliability among them.
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.AAP.2010.02.005
Abstract: The overrepresentation of young drivers in road trauma statistics produces significant media interest. Graduated licensing restrictions involving night-time curfews and restrictions on passenger numbers are prominent topics within media coverage. This was particularly apparent in Australia between January 2004 and July 2008, when various models of either restriction were introduced in four states. Australian newspaper and Sydney free-to-air television coverage during the peak period were analysed to identify the framing strategies used by news actors supporting or opposing these policies. Fifteen frames were identified. These predominantly assessed the proposed restrictions in terms of their need, evidence base, practicality and the degree to which they were consonant with 'commonsense' perceptions and had community support. While expert road injury reduction news actors primarily emphasised their moral imperative and likely effectiveness, opponents stressed their impracticality and proposed alternative solutions. Research evidence is only one component of information presented as policy-relevant in policy discourse conducted in news media. Policy reform advocates using the media to advocate for evidence-based policies in road injury prevention need to appreciate that evidence is not the only currency exchanged in such debates and should study opponents' rhetoric in order to anticipate and counteract the framing strategies being used.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.COLEGN.2014.09.005
Abstract: Effective nursing leadership is necessary for the delivery of safe, high quality healthcare. Yet experience and research tells us that nursing leaders are commonly unprepared for their roles. Take The Lead (TTL), a large-scale, multifaceted professional development program was initiated in New South Wales, Australia, to strengthen the capacity of Nursing/Midwifery Unit Managers (N/MUMs). The aim of this study was to examine the effects of TTL on job performance, nursing leadership and patient experience. Nursing/Midwifery Unit Managers (n = 30) and managers of N/MUMs (n = 30) who had completed the TTL program were interviewed between August and December 2010. The semi-structured interviews included a combination of open-ended questions and questions that required respondents to rate statements using a Likert scale. Data from the open-ended questions were thematically analysed to identify and categorise key concepts. The responses to the Likert items were analysed via descriptive statistics. Nursing/Midwifery Unit Managers' participation in TTL engendered improvements in job performance and leadership skills, as well as some improvement in patients' experiences of care. The program facilitated role clarification and helped foster peer-support and learning networks, which were perceived to provide ongoing professional and personal benefits to participants. Our study revealed a consensus about the beneficial outcomes of TTL among those involved with the program. It supports the significant and ongoing value of widely implemented, multifaceted nursing leadership development programs and demonstrates that participants value their informal interactions as highly as they do the formal content. These findings have implications for delivery mode of similar professional development programs.
No related grants have been discovered for Reece Hinchcliff.