ORCID Profile
0000-0002-3401-553X
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Publisher: CSIRO Publishing
Date: 1999
DOI: 10.1071/AH990056A
Abstract: Information technology is believed to be useful for the communication of discharge information between hospitals and community-based health practitioners. At least 20 projects were conducted in Australia between 1993 and 1997 to explore this idea. The value of these projects was at least $618- 000. Despite this level of activity there is no good evidence, either from these projects or the international literature, to suggest that information technology can improve the quality of discharge communications.
Publisher: BMJ
Date: 07-2001
DOI: 10.1136/EMJ.18.4.321
Publisher: CSIRO Publishing
Date: 2001
DOI: 10.1071/AH010066
Abstract: This paper describes a trial of the Canterbury GP After-Hours Service (CGPAHS), a GP staffed after-hours servicewithin the Canterbury Hospital Emergency Department. It was decided not to continue the service beyond the twelve-monthtrial phase because the opportunity cost to do this was greater than existing alternative services.The efficiency of the service might have been improved had greater numbers of patients been referred to it, either fromthe adjacent emergency department or the local community. Reasons why the trial was not able to realise theseefficiencies are explored.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14077
Abstract: This paper describes the development and outcomes from ‘joint working’ between Prince of Wales Hospital and BD (Becton, Dickinson and Company) in Australia. ‘Joint working’ is a term used within the English National Health Service to describe health system and industry partners working together to create novel service models which benefit patients. The joint working process broadened the perspective of both parties through learning from each other and so enhanced the range of tools they each bring to their work. What is known about the topic? Collaboration between industry – specifically the pharmaceutical industry – and English National Health Service providers under the rubric “joint working” has been used successfully to pool skills, experience and/or resources for the joint development and implementation of patient centred projects. This process has required identification of the common interest of both parties and care to ensure the public interest is maintained. What does this paper add? Descriptions of collaboration between public hospital and private industry to deliver improved health outcomes have not been widely published. Joint working has not previously been described in the Australian context. This paper describes an experiment which addresses both of the gaps. What are the implications for practitioners? Opportunities may exist to improve patient outcomes through collaboration between public health providers and industry.
Publisher: BMJ
Date: 02-2018
DOI: 10.1136/BMJOPEN-2017-020235
Abstract: The failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability (2) harness health information technology (IT) to inform and monitor test-result management (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems. This convergent mixed-methods project triangulates three multistage studies at seven adult hospitals and one paediatric hospital in Australia. Study 1 adopts qualitative research approaches including semistructured interviews, focus groups and ethnographic observations to gain a better understanding of test-result communication and management practices in hospitals, and to identify patient-safety risks which require quality-improvement interventions. Study 2 analyses linked sets of routinely collected healthcare data to examine critical test-result thresholds and test-result notification processes. A controlled before-and-after study across three emergency departments will measure the impact of interventions (including the use of IT) developed to improve the safety and quality of test-result communication and management processes. Study 3 adopts a consumer-driven approach, including semistructured interviews, and the convening of consumer-reference groups and community forums. The qualitative data will identify mechanisms to enhance the role of consumers in test-management governance processes, and inform the direction of the research and the interpretation of findings. Ethical approval has been granted by the South Eastern Sydney Local Health District Human Research Ethics Committee and Macquarie University. Findings will be disseminated in academic, industry and consumer journals, newsletters and conferences.
Publisher: CSIRO Publishing
Date: 2001
DOI: 10.1071/AH010080
Abstract: DiNCQUMGP (Divisions National Consortium for the Quality Use of Medicines in General Practice) reports on acollaboration between doctors, pharmaceutical companies, government agencies, and medicine users to managepolypharmacy (prescribing multiple medicines to a patient) amongst older people.We have reported the outcomes of our collaboration (improving the Quality Use of Medicines) elsewhere. Here wediscuss how we worked together, opened up new opportunities, and learned from one another. The first part of thisarticle outlines a constructive new way of thinking about collaborating, that we argue is fundamentally different fromcurrent approaches. The second part describes what we did in the words of those involved.
Publisher: Wiley
Date: 09-2001
DOI: 10.1046/J.1440-1762.2001.00416.X
Abstract: The aim of this study was to describe and evaluate a method of improving the completion of discharge summary information. As a quality assurance activity, a self-carbonating form for both the patient record and discharge letter was introduced to a general practice casualty (GPC) in Sydney, Australia, involving approximately 40 community GPs. Evaluation involved assessment of the change associated with this intervention on a cohort of GPs using logistic regression analysis, clustering at the level of the treating GP. The main outcome measure was completion of a discharge letter to the patient's usual GP. Provision of discharge letters increased from 30% prior to the intervention to 90% following it (P< 0.0005 OR 11.9 95% CI 8.6-16.4). It was concluded that solutions to problems of quality are best developed at the system level. The use of a self-carbonating form to simultaneously generate a discharge letter and the medical record might be used by other similar services with good effect.
Publisher: MDPI AG
Date: 11-2022
DOI: 10.3390/PATHOGENS11111279
Abstract: The microbiome has been implicated in the development of metabolic conditions which occur at high rates in people with schizophrenia and related psychoses. This exploratory proof-of-concept study aimed to: (i) characterize the gut microbiota in antipsychotic naïve or quasi-naïve people with first-episode psychosis, and people with established schizophrenia receiving clozapine therapy (ii) test for microbiome changes following a lifestyle intervention which included diet and exercise education and physical activity. Participants were recruited from the Eastern Suburbs Mental Health Service, Sydney, Australia. Anthropometric, lifestyle and gut microbiota data were collected at baseline and following a 12-week lifestyle intervention. Stool s les underwent 16S rRNA sequencing to analyse microbiota ersity and composition. Seventeen people with established schizophrenia and five people with first-episode psychosis were recruited and matched with 22 age-sex, BMI and ethnicity matched controls from a concurrent study for baseline comparisons. There was no difference in α- ersity between groups at baseline, but microbial composition differed by 21 taxa between the established schizophrenia group and controls. In people with established illness pre-post comparison of α- ersity showed significant increases after the 12-week lifestyle intervention. This pilot study adds to the current literature that detail compositional differences in the gut microbiota of people with schizophrenia compared to those without mental illness and suggests that lifestyle interventions may increase gut microbial ersity in patients with established illness. These results show that microbiome studies are feasible in patients with established schizophrenia and larger studies are warranted to validate microbial signatures and understand the relevance of lifestyle change in the development of metabolic conditions in this population.
Publisher: CSIRO Publishing
Date: 2000
DOI: 10.1071/AH000132
Abstract: Effective and integrated primary health care services are seen world wide as the lynch pin of an equitable,efficient and high quality health care. Health services dominated by specialist care suffer either fromuncontainable costs (USA with 14% of GDP) or poor quality care (Russia and other former members of theSoviet bloc). Ierachi et al. (2000) argue that Australia should take the retrograde step of endorsing a servicewhich aims to "provide rapid, high quality and continuously accessible unscheduled care, for conditions coveringthe full spectrum of acute illness and injury" (emphasis added). They aim to provide care "for conditions", notfor people. General practice provides care for people, not just diseases or injuries.
Publisher: CSIRO Publishing
Date: 1997
DOI: 10.1071/AH970100
Abstract: The Balmain Hospital General Practice Casualty is a unique casualty style service,staffed and run by local general practitioners. It is a joint initiative of the CentralSydney Area Health Service and the Division of General Practice, Central SydneyArea, and is jointly funded by the Area Health Service and the Commonwealth.The casemix seen and type of services provided suggest that the service is intermediatebetween that provided by general practitioners and that provided by emergencydepartments. The service is well accepted by patients and local general practitioners.A number of benefits are seen by both service providers and users in terms ofcontinuity of care and increased general practitioner skills.
Publisher: CSIRO Publishing
Date: 2003
DOI: 10.1071/AH030026B
Abstract: Objective:To describe and compare the pattern of morbidity in a general practice casualty with primary care patients inemergency departments (EDs).Setting and subjects:Patients presenting to a general practice casualty and primary care patients in two EDs in Sydney, NSW.Results:The pattern of morbidity in the general practice casualty was similar to that among ambulatory patients in EDs.Conclusion:Opportunities may exist to substitute care between casualty services provided by GPs and those provided in EDs.
Publisher: CSIRO Publishing
Date: 2002
DOI: 10.1071/AH020095
Abstract: This paper describes HealthConnect, an after-hours telephone triage and advice service which operated for 15 months in 2000 and 2001. We describe the service, discuss utilisation and implementation issues, and conclude with a description of the key lessons learned from the trial. The service received over of 12000 calls, of which over half were for information rather than immediately seeking care.Continuing marketing appears to be required in order to ensure ongoing demand for services of this kind. Qualityassurance is essential to ensure that an optimal service is provided, and staff recruitment and training are critical tothis. A national standardised approach to services of this kind is desirable to provide a consistent service to consumers and realise economies of scale.
Publisher: Elsevier BV
Date: 06-1994
Publisher: Wiley
Date: 12-1998
DOI: 10.1046/J.1440-1762.1998.00281.X
Abstract: The objective of this study was to assess the quality of communications between hospitals and general practitioners (GPs). The proportion of medical records in which the patient's general practitioner (GP) was identified, the accuracy of medications recorded in the discharge summary, the proportion of GPs who received discharge summaries, and the timeliness of receipt of discharge summaries were all evaluated. Discussions were held with all stakeholders, the literature was reviewed and GPs were surveyed to identify potential measures of quality. These were then trialled to assess their utility and practicability. Timeliness, issues that required follow-up and treatment provided in hospital were of greatest importance to general practitioners. The GP's name was recorded in 88% of audited records. Few inaccuracies were detected in the medications recorded in the discharge summaries, and GPs received 77% of discharge summaries. Methods similar to those used in this study might be broadly applied to improve the quality of discharge communication throughout Australia.
Publisher: AMPCo
Date: 11-2012
DOI: 10.5694/MJA12.11329
Publisher: CSIRO Publishing
Date: 1998
DOI: 10.1071/AH980238
Abstract: Hand washing remains an important preventative method for making thetransmission of nosocomial infections redundant. Despite awareness by health workersof the practices required and of the legislation governing hand washing, the studyreported here found that compliance to these procedures was quite poor. The resultsof two surveys distributed to health workers and direct observation by clinical staffin an aged care hospital found that 45percent of health workers did not wash their handsand 24 percent did not change their gloves between patient consultation. Methods forincreasing effective hand washing in clinical settings must be identified if hygienicpractice is to be improved.
Location: Germany
No related grants have been discovered for Patrick Bolton.