We would all like to believe that the best possible evidence informs health policy. Unfortunately, the translation of evidence into policy is not a simple process. So how do we make our research more accessible and useful to policy makers?
This was the dilemma tackled by 25 academic and clinical researchers at a two-day course presented by the Health Services Research Association of Australia and New Zealand (HSRAANZ), the Deeble Institute for Health Policy Research and the Australian Healthcare and Hospitals Association (AHHA) in Sydney on 3 and 4 September, at the The Sydney Policy Lab, curtesy of Sydney Health Partners. Read More
Convenors - Rachael Morton, Associate Professor and Director of health economics at the NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney and Tilley Pain, Principal Research Fellow for allied health professionals at the Townsville Hospital and Health Service and an Adjunct Principal Research Fellow at James Cook University.
(Slides for the Forum are only available to HSRAANZ Members and Forum delegates)
This one-day forum brought together stakeholders with experience in PROMS and PREMs to advance the health services research agenda.
During the morning delegates heard from experts in the field about the application of PROMs and PREMs in government programs, Clinical Practice, General Practice and NGOs and peak consumer bodies.
The afternoon featured short oral presentations in two streams and provided an opportunity to learn about the latest research and leadership in the areas of PROMs and PREMs for quality assurance and benchmarking and PROMs to guide clinical care.
The concluding break-out sessions debated the key challenges and opportunities, and where to from here.
Catherine Katz – Director, Safety and Quality Improvement Systems and Intergovernmental Relations Australian Commission on Safety and Quality in
Healthcare Australian Commission on Safety and Quality in Healthcare
Jean-Frederic Levesque – Chief Executive, NSW Agency for Clinical Innovation
Dominique Cadilhac –Head Translational Public Health and Evaluation Division, Stroke and Ageing Research, School of Clinical Sciences, Monash University
Ian Harris – Professor of Orthopaedic Surgery, UNSW Sydney
Tim Usherwood – Professor of General Practice at the University of Sydney; Honorary Professorial Fellow at the George Institute for Global Health; and Deputy Chair of Western Sydney PHN.
Shilpa Jesudason – Nephrologist, Chair, CNARTS Clinical Research Group and Clinical Director, Kidney Health Australia
This event was held at the National Press Club in Canberra on 1 December. Over 50 delegates from Universities, research centres and Health Departments were in attendance.
The theme for the day was Health Services Research – where to from here? A review of the state and potential of HSR in Australia and New Zealand Full Program
The day commenced with a presentation from Suzanne Robinson of Curtin University and member of the HSRAANZ Executive Committee on the preliminary results of the HSRAANZ commissioned study of the state and potential of Health Services Research in Australia and New Zealand. (Slides) (Please note that the slides contain preliminary data only which could change as the study progresses.)
Suzanne explained that as the the peak body for HSR in Australian and New Zealand the HSRAANZ has a major role in assisting health services researchers and policy makers to meet the challenges facing the health system in the 21st Century. In order to inform the Association's strategy over the next decade we have commissioned a study to provide a clearer picture of the current state of health services research in Australia and New Zealand.
Newcastle University Team
The evaluation team from University of Newcastle team is Dr Elizabeth Fradgley, A/Prof Christine Paul, Prof John Wiggers, Prof Deborah Loxton, Dr Catherine Chojenta, and Dr Melissa Harris. With support from Della Roach, Emma Byrnes, and Annika Ryan.
Prof Jon Karnon President of the HSRAANZ then spoke on the opportunities offered by the MRFF and Mark Booth and Erica Kneipp from the Department of Health responsed on the challenges facing health services and primary health care research and the opportunities offered by the MRFF; research translation centres and emphasis on evidence based policy and greater data availability. (Slides).
The morning concluded with examples of the best and most impactful health services research nominated for the HSRAANZ Impact Award (details attached)
The event concluded with breakout sessions addressing the potential role and approaches to HSR in different healthcare sectors:
A. Data infrastructure
What makes a useful clinical registry?
Need for transparency (quality, standards, integrity)
Clinical Registry – for data linkage; opt out system; other governance issues.
Long term as appropriate.
Regular reviews of minimum data sets.
What are the data linkage priorities?
Going national, linking of hospital collections, MBS and PBS data and national death index are most important
Also cancer, ED, administration, perinatal.
Rationalise governance and ethics.
Is patient reported outcomes data a priority? If so, how could it be supported?
Yes – quality of life
Fit for purpose – generic and disease specific
Clinical care vs research
Utility based measures
Link to clinical registries
What are other data infrastructure priorities?
Linkage of Federal data sets. Health plus
Trusted user model to other data sets and linked data sets.
B. Consumer Engagement
Why engage with them?
Exertise/lived experience/understand patient/community preferences
Should they be renumerated?
Paying can take away altruism.
Alternative is non- monetary gifts.
When should they be involved?
Early in priority setting
KT at start.
How should they be involved?
Consumer Health Forum
Panels/ citizens juries.
Facilitate by funding agencies etc.
C. Implementation and improvement in public hospitals
Need junior doctors in research positions. Research needs to be part of their rotation and well resourced.
Need to infiltrate clinical microsystems. Research related to clinical work. Snr Drs need to train juniors.
Need a critical mass of clinical researchers, with collaboration across smaller hospitals.
Need to include nursing and allied health
Need clinician led research and practice based research.
Undertake a survey of what clinicians need – time, funds, mentoring etc.
Simpson Centre clinician led NHMRC program grant.
Clinicians now more involved in health policy and provide a good opportunity to grow HSR.
NIR - put HSR on the agenda; leadership program; Fellowships
Horizons gap – need to predict gaps and have solutions ready.
Joint clinical and academic appointments. Harder in some areas. Senior doctors need training in mentoring. Junior doctors need training in research methods.
D. How to fund research in primary health care?
Should PHNs be allocated research budgets? For what scope and with what support?
They are already overworked so research budgets should be managed by others
But they are well placed to undertake research.
They have great billing data, but limited diagnostic data.
Opportunities – well positioned in rural and urban centres
If not, how else to fund and organise research in PHC?
Universities may have a role working with them.
Consider more joint appointment (academic and PHN-based) health services researchers
Date: 15 March 2016
The College of GPs conducts an annual electronic survey of its members. Nearly 2,500 responses to the 2015 survey were received, giving a response rate of 54% and providing valuable insights into the state of the GP workforce. Results revealed that among currently working respondents, 41% intended to retire in the next 10 years, 56% were aged 50 years or over and 53% were female. Information was also gathered on topics including practice ownership, vacancies, income, working hours, after hours commitments, and how likely members were to recommend a career in general practice. Female respondents earned less than their male colleagues and possible reasons for this difference will be discussed. In addition to the results of the 2015 RNZCGP survey, information from successive Medical Council Workforce Surveys will be presented to illustrate how the age profile of general practitioners became so skewed towards the older age groups and to illustrate the recent increase in the number of younger GPs.
Frances Townsend is a senior policy advisor with the Royal New Zealand College of General Practitioners. She graduated from Otago University with a medical degree in 1983, and went on to train as a general practitioner. She completed a Diploma in Public Health in 2003 and has worked for the Ministry of Health and for the past 10 years the College of General Practitioners on issues including the Health and General Practitioner workforce.
Attahced is a summary of feedback from our latest event which focused on including consumers’ voices in designing, undertaking and translating research. This interactive semi-structured conversational event encouraged exchange between researchers, clinicians, policy makers and consumers about their personal and practical challenges experienced in addressing research-policy-practice gaps.
Transforming Health is intended to bring about a permanent change in systems and the culture of healthcare delivery. The vision is to deliver a quality healthcare system that provides best care, first time, every time. It has six quality principles to transform the system: patient centred, safe, effective, accessible, efficient and equitable.
While the focus is on improving metropolitan hospital services in South Australia, there will be flow-on effects, particularly in primary health care, aged care and country health services. Indeed, there is a commitment to work in partnership with General Practice, Primary Health Care, and the health industry.
As well as ensuring health care professionals are driving the initiative, engagement and consultation with community and consumers has been a significant component of the initiative to date and providing a time and place to contribute your Research Ideas
To support the research process, the Health Services Research Association of Australia and New Zealand (HSRAANZ), Primary Health Care Research & Information Service (PHCRIS), the South Australian Health & Medical Research Institute (SAHMRI) and Cancer Voices convened a Transforming Health Research Workshop. The aim was for researchers, health care professionals and managers, policy makers and consumers advocates to come together to share Research Ideas that could usefully inform the success of Transforming Health. We sought multidisciplinary approaches to cross–fertilise our thinking from the outset and shape how we work together. We asked for bold ideas. Ideas that do more than ‘improve’ but actually inform the implementation, monitor, evaluate and report the impact of ‘Transforming Health’. Research can identify what is working and why, what is not working and why, and any unintended consequences. It can examine what needs to be started, expanded or stopped.
View videos of the presentations.
The symposium held at CHERE’s offices in Ultimo was a huge success with a high calibre researchers and policy makers looking at the latest developments in Australia, New Zealand and internationally in health policy and providing another opportunity for HSRAANZ members to get together and to finish another successful year.Kees Van Gool, Associate Professor, Centre for Health Economics Research and Evaluation kicked of the Symposium with the presentation of a paper looking at the impact of economic crisis on health and health care.
Abstract: “Health, austerity and economic crises: assessing the short-term impact in OECD countries”
The economic crisis that started in 2008 has had a profound impact on the lives of citizens. Millions of people lost their job, saw their life-savings disappear and experienced prolonged financial hardship. The economic crisis has also led a number of OECD governments to introduce austerity measures to reduce public deficits. The health sector, like many other social welfare programmes, has witnessed extensive spending cuts and has also been the subject of substantial reforms. The combined effects of economic crisis, austerity and reforms have led many OECD health systems into unchartered territory. This paper looks at the impact of economic crisis on health and health care. It summarises findings from the published literature on the effects of economic crisis that took place over the past few decades and also describes recent health policy reforms, focusing on those countries where the economic crisis has hit hardest. Finally, this paper analyses the empirical relationship between unemployment and health care use, quality and health outcomes, using data from OECD Health Statistics. In doing so, it investigates whether the effects of unemployment on health outcomes have been extenuated by austerity measures.
While many of the health reforms undertaken since the start of the economic crisis can make a positive long-term contribution to the health system’s productivity and efficiency, there may also be negative impacts. The short-term effects examined in this paper suggest that austerity measures have had mixed success in protecting patients from reduced health care access, but there remains an important need to actively monitor the wider long-term health impact of the economic crisis.
In her presentation Jackie Cumming, HSRAANZ President and Professor, School of Government, Victoria University of Wellington reviewed developments in the New Zealand health system and reflected on those reforms and the lessons for Australia.
Abstract: “Health System Reforms in New Zealand”
The New Zealand health system went through a series of health reforms during the 1990s and early 2000s, with the overarching organisational arrangements settling by the mid-2000s. Twenty geographically based District Health Boards (DHBs) plan services for their populations, and deliver a wide range of hospital and community services themselves. They work with privately owned primary health care providers to deliver primary health care services organised through Primary Health Organisations (PHOs). During the late 2000s, 80+ PHOs were amalgamated into the 36 that exist today. DHBs also work with not-for-profit providers to deliver some primary health care and community care services (e.g., iwi-based, Māori and Pacific-led primary health care providers, health promotion groups etc.). The most recent changes have involved the establishment of Alliance Leadership Teams (ALTs) where DHBs, PHOs and providers are to work together to plan and deliver services. The main focus is on strengthening primary health care, delivering care closer to home and better integrating services, particularly across primary and secondary health care services. In this talk, Jackie will reflect on these reforms and their effects and discuss key lessons for Australia.
Mark Booth, First Assistant Secretary in the Department of Health provided an update on Commonwealth policy and programs in primary care.
After lunch the 2014 HSRAANZ Best PhD Student Prize was presented to Paul Harris. Paul is a final year PhD student in the Population and Social Health Research Program at Griffith University. Paul won the prize for his paper “The public’s preferences for emergency care alternatives and the influence of the presenting context.” Paul presented his research to the Symposium.
Tony Sherbon, Chief Executive Officer, Independent Hospital Pricing Authority led the afternoon session with a talk on “National Funding Reform: Achieving success with Activity Based Funding.”
Abstract: “National Funding Reform: Achieving success with Activity Based Funding.”
Activity based funding is a funding method in which hospitals are funded on outputs which are categorised, weighted, costed and priced by purchasing organisations. There are a range of categorisation systems available for use by purchasers. Australia uses Australian Revised Diagnosis Related Groups for inpatient service classification and is developing improved systems for categorisation of emergency department services, subacute services, and outpatient services.
In December 2011, Australia established an independent agency to price each service provided by state government hospitals. This in turn determines the amount of federal government funding provided to each state government run local hospital network.
Hospitals can gain a greater understanding of their cost base with activity based funding and can plan their investment in services to fund their services based on the expected price and funding received for those services.
The day closed with Diane Watson, inaugural Chief Executive Officer of the National Health Performance Authority will provide an update on impact of national performance reporting in Australia and abroad.
Abstract “National performance reporting: Progress and impact in Australia and abroad”
Most developed countries have implemented nation-wide, public reporting schemes to monitor and improve health care. In December 2014 it will be two years since the National Health Performance Authority released its first report on the performance of 400 of Australia's largest emergency departments. This presentation will focus on how the Authority uses the "tools of research and knowledge translation" to publish new information in ways that stimulate or accelerate action in local communities to improve health and care. Each of the Authority's reports result in media with audiences of 2,000,000 to 20,000,000 and one of its web based interactive tools has been used by 65,000 people. The presentation will highlight the impact of performance reporting in Australia and abroad. Please visit our new MyHospitals and MyHealthyCommunities websites!
On 29 July 2014 the Association ran an Emerging Research Workshop in Melbourne - hosted by the one of our Corporate Members - the Centre for Health Policy, Melbourne School of Population and Global Health. In the morning four emerging researcher presented their work and received constructive feedback from expert discussants. In the afternoon there was a round table discussion on developing a career in health services research. You can read here a report from Belinda O'Sullivan one of the delegates at the workshop.
While there have been spectacular advances in primary health care research, policy and practice over the past 20 years: from tobacco control, to mental health initiatives and improved cultural understandings of health care, translating evidence-based research to policy and practice can be a long, arduous and uncertain task.
The Reducing the Gap Between Research, Policy and Practice Initiative aims to address the challenge of translating research into policy and practice by providing a supportive collegial environment that encourages discussion, the sharing of ideas, information and knowledge, to improve primary health care outcomes.
A joint initiative co-founded by the South Australian Health and Medical Research Institute (SAHMRI), the Health Services Research Association of Australia and New Zealand (HSRAANZ) and the Primary Health Care Research & Information Service (PHCRIS), the first three sessions have been met with enthusiastic responses from researchers, policy makers and research users, and will continue throughout 2014.
Panel 3- Community Perspectives
The inaugural event, held at SAHMRI on the 22nd of May 2014 was facilitated by PHCRIS Director Ellen McIntyre. The panel consisted of three senior South Australian primary health care researchers, Professor Maria Makrides, Professor Justin Beilby, and Professor Judith Dwyer, who all agreed that the most difficult and potentially rewarding aspect of their 20 year research careers has been translating their research to policy.
The reality of this work is that it’s political; there is no way of getting around that. As a researcher who wants to make a difference to policy or practice, you must surround yourself with a good team of people – not just researchers, but policy makers,” said Professor Justin Beilby, Executive Dean of the University of Adelaide’s Faculty of Health Sciences.
Panel discussion one - researchers experiences [Duration 1:29:31]
Panel discussion conclusion - key take home messages [Duration 2.18]
The second panel discussion included the perspectives of policy makers including: Dr David Panter, Chief Executive Officer of Central Adelaide Local Health Network Department of Health South Australia; Christine Morris, a prominent South Australian health promotion consultant and Churchill Fellow; and Jeff Fiebig from the ACH Group. Facilitated by PHCRIS’ Knowledge Exchange Manager, Dr Christina Hagger, Senior Research Fellow, they too spoke of the complexity of working in this space.
“In the case of tobacco the changes to policy didn’t just come from the researchers and the evidence they supplied, the real changes came from the willingness of advocacy groups, politicians and government to support change against all odds,” said Christine Morris.
Panel discussion two - Policy Makers [Duration 1:29:27]
Panel discussion conclusion - key take home messages [Duration 1.54]
The third session in the series, facilitated by Dr Carol Davy, Senior Post Doctoral Fellow, Wardliparingga Aboriginal Research Unit focused on community perspectives. The panel of community advocates included: Ms Stephanie Miller, Executive Director, Health Consumer Alliance of SA Inc; Ms Julie Marker, Acting Chair, Cancer Voices South Australia; and Mr Tim Agius, Director Strategic Development, Maari Ma Health Aboriginal Corporation. Offering insight into the research user's perspective, all panelists called for more integration between consumers, researchers, and policy makers, and respectful research which engages whole communities, not just consumers
"Aboriginal people have been researched to death, but at no time have we been asked what research we would like to be done," said Tim Agius. "Researchers and policy makers need to engage not only with consumers but with communities, from the beginning of a project, not at the end. If you get the process right you’ll get the outcome you’re looking for."
Developing a successful publication track record is an essential part of a successful research career. This workshop held in Auckland on 26 October 2012 gave advice to early career health services researchers on strategies and approaches to get their research published in leading journals. Thanks to the University of Auckland School of Population Health for hosting the event.presentation 1- Chris Carswell, editor of PharmaconoEconomics, Co-Editor of The Patient: Patient-Centered Outcomes Research, Consulting Editor, Applied Health Economics and Health Policy
presentation 2- Tim Tenbensel former Assistant Editor (Health Policy) at Social Science and Medicine
Held - Monday 16th July, 9.00-11.45 am
Royal Adelaide Hospital
This was a half day forum around horizon scanning for health services research and policy. It looked at how the future research needs of policy makers and clinicians can be predicted and addressed? From their personal perspectives an expert panel of health stakeholders was asked to think about and forecast the areas of evidence (general and specific) that people in their position will need to make decisions in 2017. Audience participation was encouraged and audience views on particular issues was sought during and after the presentations.
|Speaker||Link to presentation|
|9.00 am||Welcome||A/Prof Jackie Cumming President, HSRAANZ|
|9.15 am||Panel Member 1 Clinician – Tertiary Setting||Assoc Prof Craig Whitehead Repatriation General Hospital, Adelaide||SA Forum - Whitehead|
Panel Member 2
Clinician – Community Setting
|Dr Helena Williams Executive Clinical Director Southern Adelaide Fleurieu Kangaroo Island Medicare Local (SAFKI)|
|9.45 am||Panel Member 3 Research New Technology||Dr Ian Musgrave Discipline of Pharmacology, University of Adelaide||IFM_HRAANZ_presentation_V2|
|10.00 am||Panel Member 4- Health Service Researcher||Prof Nicholas Graves Professor of Health Economics, Queensland University of Technology||http://prezi.com/wnbpzqrlk_a_/adelaide-hsr/|
|10.15 am||Panel Member 5 – Researcher leader||
Prof Steve Wesseling
Executive Director, South Australian Health and Medical Research Institute
|11 .00am||Open Forum Discussion||Prof Justin Beilby (Facilitator) Exec Dean, Faculty of Health Sciences University of Adelaide|
|11.45 am||Thank You & Close||A/Prof Jackie Cumming President, HSRAANZ|
23 November in Canberra the Association co-hosted with the Centre for Mental Health Research a workshop on successful health grant applications.
Presentations from the event are available below.P
Introduction - Chair Rosalie Viney - Associate Professor of Health Economics, UTS and Deputy Director the Centre for Health Economics Research and Evaluation.
NHMRC Expert – Clive Morris - NHMRC's Head of Research Group
Grant Review Panel Experts – Helen Christensen (Professor and Director of the Centre for Mental Health Research, College of Medicine at The Australian National University Canberra), Paul Dugdale (Director of Chronic Disease Management, Aged Care and Rehabilitation Services, ACT Health (Senior Staff Specialist) and is Associate Professor of Public Health in the ANU Medical School), Davina French (Ageing Research Unit at the ANU)
Successful Applicant –Emily Banks (Scientific Director of the 45 and Up Study, Head of Chronic Disease Epidemiology at the National Centre for Epidemiology and Population Health)
Q and A Session
The government’s recent budget announcement of $1.5 billion in new initiatives to deliver better mental health care is an important initial step towards transformational mental health reform. How can we be sure of the effectiveness of that investment in the prevention, diagnosis and treatment of individuals with or at risk of mental disorders? And what role is there for health services research in informing and influencing how governments and the private sector design, implement and measure programs in mental health?
This seminar, presented by the HSRAANZ and the Centre for Health Policy, Programs and Economics, University of Melbourne showcased how health services research methods are being used to inform mental health policy.
Patrick McGorry, Executive Director of Orygen Youth Health (OYH) - The Contribution of health services research evidnece to national mental health policy
Jane Pirkis, Director, Centre for Health Policy, Programs and Economics, University of Melbourne - Evaluating the Better Access Program
Cathy Mihalopoulos, Senior Research Fellow at the Population Health Strategic Research Centre, Deakin University - Assessing the Cost-Effectiveness of Preventive Interventions for Mental Disorders: Should Australia invest in mental disorder prevention?
Rebecca Reeve, Research Fellow, Centre for Health Economics Research &Evaluation, UTS - The effect of child abuse on long term health and well being: evidence from Australia
Kristy Muir, Associate Dean (Research) of the Faculty of Arts and Social Sciences and Senior Research Fellow with the Social Policy Research Centre at the UNSW - Why measuring mental health outcomes is not enough: lessons from the evaluation of Headspace
Sarah Olesen, Postdoctoral Fellow at the Centre for Mental Health Research at ANU - Self-management of mental health in Australia: Who, how many, and relationships with formal health service use.
The slides from this successful workshop on the secrets to a successful health services research grant application are now available.
This workshop which was attended by over 30 delegates focused on NHMRC project grants and featured a panel of experts including a senior NHMRC representative, successful applicants, and grant review panel experts, who reflected on common pitfalls and the secrets of success, the key elements of a strong grant application, tips and techniques for successful grant writing, and ways to improve writing discipline.
Some of the question tackled in the Q and A session included:
• What makes different types of research (behavioral group, secondary data analysis/trial groups) fundable?
• Do projects proposing a trial of an intervention need to have an economic evaluation component and how should it be included?
• Should you bother to submit an application if you have only just completed your PhD and only have one publication?
• What should you do when you have a researcher who is essential to your research project but does not have a good track record?
• How do you decide who should be a CI and an AI and who should be the CIA?
Introduction Chair – Rosalie Viney (Rosalie Viney)
NHMRC Expert – Elim Papadakis (no slides)
Grant Review Panel Experts – Louisa Jorm , Marion Haas (Slides) and Sally Redman Successful Applicants – Annie McCluskey and Sallie Pearson
The Association ran a Seminar at Melbourne University on the 4th September 2009. This seminar discussed the different methodologies used to elicit citizen’s preference for treatment and services and their place in health services research.
Held on 21 May 2015 - Victoria University, Wellington
Performance targets have been a cornerstone of New Zealand’s health policy since 2009. They are set to become more deeply entrenched in our publicly-funded health system through the formulation and implementation of IPIF (Integrated Performance and Incentive Framework). For advocates of this approach, health targets provide a way to prioritise attention, enhance accountability and stimulate health service improvement. Critics of targets and performance management focus on potential downsides including target-induced myopia, the prospect that health services will ‘hit the target but miss the point’, and unnecessarily distort the work of those providing health services.
In this environment, it is crucial to understand how regimes of targets and performance management are actually implemented, given the potential for substantial benefits and the substantial risks. Our presentation is based on extensive research into the implementation of two health targets that were in place between 2009 and 2012: shorter stays in emergency departments, and immunisation coverage of two-year-olds. We will address:
•What type of activities and initiatives had the most impact on target implementation?
•What was the balance of positive and negative consequences for each of these targets?
In answering these questions, we can begin to identify the key features of health targets that generate positive consequences, and those that are likely to lead to problems. In doing so, we aim to highlight the key factors that need to be considered by those designing regimes of performance management.
Tim Tenbensel is the Head of the Health Systems Section in the School of Population Health, University of Auckland, where he lectures in health policy and public management. His research has focused on the implementation of health policy initiatives, including health targets, Better Sooner More Convenient primary care initiatives, and the introduction of the DHB system in the early 2000s.
Esther Willing (Ngati Toarangatira) is a lecturer in Māri Health and Policy, based at Te Kupenga Hauora Māri, University of Auckland. She recently completed her PhD on the implementation on the immunisation target for two year olds. She also has extensive experience in health services evaluation over a ten year period. She has a particular interest in the potential of health targets to address health inequalities.
10 December 2012
Presenter: Mark Booth. First Assistant Secretary, Primary and Ambulatory Care Division, Department of Health and Ageing.
Abstract: Over the past 20 years, Mark has been involved in primary health care reform in the United Kingdom, New Zealand and Australia. This presentation provides an over view of health reform from working as a researcher, a health policy maker and senior health advisor in the UK and New Zealand, a Commonwealth Fund Harkness Fellow in the US, and more recently as part of the Senior Executive of the Commonwealth Department of Health and Ageing.
Biography: Mark has a background as a health economist, working in health policy areas in the UK and New Zealand. He joined the Department of Health and Ageing in 2010, undertaking several Branch Head roles including responsibility for the development and implementation of the Medicare Locals initiative. Mark is First Assistant Secretary of the Primary and Ambulatory Care Division which aims to provide Australians with access to high quality, cost-effective, evidence-based primary care which coordinates with other types of care such as aged care services and hospital specialists.
Mark was a 2006–07 Commonwealth Fund Harkness Fellow in Health Care Policy.
On 28 November Joshua M Wiener, Ph.D., Distinguished Fellow and Program Director for Aging, Disability and Long-Term Care at RTI International gave a lecture examining the major changes and the options for future reform in delivery, quality assurance and financing of long-term care.
Joshua M. Wiener, Ph.D, is a Distinguished Fellow and Program Director for Aging, Disability and Long-Term Care at RTI International. He is the author or editor of eight books and over 200 journal articles, reports and monographs on health care for older people, people with disabilities, quality assurance, residential care facilities, long-term services and supports, international health care systems, Medicaid, health reform, health care rationing, and maternal and child health.
You can view the full presentation at http://www.youtube.com/watch?v=AAp-OtEly2k&feature=player_detailpage
The slides from this lecture presented by Dr Sherbon on 16 October 2012 are now available - SLIDES
The Independent Hospital Pricing Authority (IHPA) commenced operations in December 2011 and is charged with the responsibility of introducing some key elements of activity based funding for public hospitals in Australia. The Commonwealth legislation that created the IHPA was based on the National Health Reform Agreement signed by all first ministers in August 2011.
In June 2012, IHPA published its Pricing Framework and the National Efficient Price for the 2012/13 financial year which will provide a firm basis for hospital managers to plan for the uncapped introduction of activity based Commonwealth funding from 1 July 2014. Commonwealth payments to Local Hospital Networks will be based on this National Efficient Price from 1 July 2012 although a guarantee of funding will apply at jurisdictional level for the 2012/13 and 2013/14 financial years which are transitionary years under the Agreement.
IHPA has also drafted criteria that will be used to determine which public hospitals are activity base funded and which will be block funded. This has important implications for all small hospitals in Australia.
IHPA is also responsible for designing and implementing new activity based funding systems for mental health, subacute care and teaching, training and research in all Australian public hospitals and has commenced work on these issues.
Before taking up the position of Acting Chief Executive Officer in the Independent Hospital Pricing Authority in September 2011, Dr Tony Sherbon had 21 years experience in clinical and administrative management within the NSW, ACT and South Australian health systems.
Dr Sherbon is currently working on the establishment of the Independent Hospital Pricing Authority agreed at the Council of Australian Governments meetings held in April 2010 and February 2011.
Dr Sherbon previously oversaw the design and implementation of the SA Government’s Health Care Plan in his previous role as Chief Executive of SA Health.
Dr Sherbon has previously chaired the Australian Health Ministers Advisory Council, and has previously been a Board member of the South Australian Health and Medical Research Institute, National E-Health Transition Authority and Health Workforce Australia.
ABSTRACT: The popularity, use and practice of complementary and integrative medicine (CAM) raises a number of core public health/health services research issues with reference to effectiveness, patient-practitioner communication, professional role and inter-professional relations amongst others. Unfortunately such topics remain largely under-researched. In order to improve health, well-being and health care for all and to help expand the broad evidence-base around CAM it is essential that a critical and rigorous program of public health and health services research be promoted and undertaken in this area. In response, the Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM) [an international network with headquarters based at the University of Technology Sydney] conducts and promotes rigorous, critical public health and health services research examining traditional, complementary and integrative health care.
NORPHCAM currently leads a number of mixed-method, national projects both completed and in progress exploring health economics, rural health, women's health and the CAM/conventional care interface (funded by NHMRC, ARC and PHCRED in excess of $6M). Drawing upon recent and ongoing fieldwork this presentation will illuminate how a public health and health service research program is essential to understanding and exploring the role of CAM in contemporary health care and in addressing the research capacity building challenges facing the field.
BIOGRAPHY: Jon is an NHMRC Career Development Fellow and Professor of Public Health in the Faculty of Nursing, Midwifery and Health at UTS. Jon also holds a number of international positions including Visiting Professor of Health Services Research (Complementary and Integrative Health Care) at the London South Bank University, UK. He is also Executive Director of the Network of Researchers in the Public Health of Complementary and Alternative Medicine, NORPHCAM– an international network with over 200 members promoting and conducting rigorous public health and health services research examining the practice and use of complementary and alternative medicine (CAM), traditional medicine and integrative health care. Jon has been leading a national team of researchers examining CAM use and provision for women’s health in Australia. Drawing upon data from the Australian Longitudinal Study on Women’s Health, this ground-breaking work constitutes the largest longitudinal analysis of CAM use in the world to date, n=>40,000 women.
Jon is Associate Editor of three international peer-reviewed CAM journals, Complementary Therapies in Medicine (opens an external site), BMC Complementary and Alternative Medicine and the Journal of Acupuncture and Meridian Studies (opens an external site), and Regional Editor for the European Journal of Integrative Medicine. Jon has produced over 155 peer reviewed academic publications since 2000 and has edited/co-edited 6 international research books including Editor-in-Chief of the first International Reader in Traditional, Complementary and Integrative Medicine (Palgrave MacMillan, 2012).
Jon has extensive training in qualitative health research methods, health social science and mixed-method design. He currently leads (CIA) 6 national & international CAM projects (ARC and NHMRC-funded) and has been researching numerous aspects of CAM and conventional primary health care for over 10 years attracting in excess of AUD$5.5M in external funding since 2007.
ABSTRACT: Due to the considerable investment in trials of healthcare interventions and in evidence syntheses, we have increasingly good evidence about best practice. However, much is wasted because research evidence and guideline recommendations are not implemented effectively. The result is that good quality health care and best health outcomes may not be achieved.
Interventions to improve delivery of evidence-based health care have achieved modest and variable success. Improving implementation depends on changing the behaviour of health professionals and others, but behavioural science is seldom used to inform interventions to improve practice.Three problems in taking healthcare interventions from trial to practice will be addressed, illustrated by research from behavioural science:
BIOGRAPHY: Professor Michie undertook her undergraduate and postgraduate training in experimental and developmental psychology at the University of Oxford and her clinical psychology training at the Institute of Psychiatry, University of London. Professor Michie is a chartered clinical and health psychologist, Fellow of the Academy of Social Sciences, the European Health Psychology Society and the British Psychological Society.
Professor Michie leads UCL’s Health Psychology Research Group, studying behaviour change in relation to health: how to understand it theoretically and how to design more effective interventions. Her work develops methods to advance the study of behaviour change e.g. developing taxonomies of behaviour change techniques to specify the content of interventions, applying theory to synthesising evidence in systematic reviews. This is conducted in the domains of professional practice and implementation (e.g. behavioural support for smoking cessation, hand hygiene), and preventive behaviours amongst patients and the general population (e.g. physical activity and healthy eating, vaccination uptake). She is co-author of a comprehensive model of behaviour change (the Behaviour Change Wheel) and contributed to the 2011 House of Lords Science and Technology Enquiry into Behaviour Change.
Professor Michie is co-director of the UK’s National Health Service’s Centre for Smoking Cessation and Training and Chair of the Behaviour and Communication group of the UK Government’s Scientific Pandemic Influenza Advisory Group on which she serves. She was a consultant to the Department of Health advising on public health policy and practice, 2004-2010 and is currently a member of the Public Health Interventions Advisory Committee of NICE (National Institute of Clinical and Health Excellence), and of its Implementation Strategy Group. Professor Michie is on several international advisory boards, including Knowledge Translation Canada and the Implementation Research Institute, USA.
Held on Wednesday, 18 April 2012, 1.00 – 2.30 pm, Victoria University of Wellington, Professor Sir Mansel Aylward, Inaugural International Visiting Chair, Ko Awatea Centre for Health System Innovation and Improvement, Counties Manukau District Health Board, gave a talk about “The Pursuit of Happiness and Wellbeing: A Forlorn Hope?” and the work he has been doing at Ko Awatea – a centre designed to bring together thinking, innovation and action.
Sir Mansel is recognised internationally for his considerable contribution and ongoing involvement in health systems improvement, advice on policy and implementation, especially on work and health. He is the first-ever Chair of the Bevan Commission in Wales, which brings together a group of international experts to give expert advice to the Minster for Health and Social Services to help ensure that increasingly Wales can draw on best practice from across the world while remaining true to the principles of the NHS as established by Anuerin Bevan. He is current Chair of Public Health Wales, a new unified NHS Trust responsible for the delivery of public health services at national, local and community level in Wales. He is also Director of the Centre for Psychosocial and Disability Research at Cardiff University which offers a unique opportunity to extend knowledge and understanding of the psychosocial, economic and cultural factors that influence health, illness, recovery, rehabilitation and reintegration. Sir Mansel was Chair of the Wales Centre for Health, an Assembly Government Sponsored Body established to be the ‘hub of connected organisations’ and to communicate better health messages to the people of Wales. He was also former Chief Medical Advisor and Chief Scientist to the UK Department for Work and Pensions.
He is a physician and specialist in rheumatology and rehabilitation, therapeutics and clinical pharmacology; a visiting Professor at several universities in Europe and North America and a consultant to the United States Social Security Administration and Department of Labour. He led the Corporate Medical Group on the UK Government's Welfare Reform initiatives and made a major contribution in establishing the new postgraduate diploma for doctors in Disability Assessment Medicine. He was closely involved in developing the UK’s successful “Pathways to Work” initiatives and a framework for Vocational Rehabilitation. He is keenly interested in addressing the health, work and social issues relevant to morbidity, mortality, work, economic inactivity and social exclusion in the South Wales Valleys where he was born and brought up. His interests are in rheumatology and rehabilitation, health and productivity, psychosocial illnesses, health inequalities, chronic fatigue syndromes and back pain disability. He has published widely in these various areas.
Dr Boult gave a public lecture at the Health Services Research Centre, School of Government, Victoria University, Wellington in 3 April 2012.
Dr Boult described and led a discussion of the creation and evaluation of the “Guided Care” model of health care for people with multiple chronic conditions. Guided Care is a, team-based model of primary care in which a registered nurse, co-located in a primary care practice, partners with 2-5 physicians to provide comprehensive, coordinated, patient-centered care to 50-60 patients. These services include comprehensive assessment, care planning, transitional care, proactive patient monitoring, care coordination, self-management support, caregiver support, and facilitation of access to community-based services.
A 3-year, multi-site, cluster-randomized controlled trial showed that Guided Care significantly improved:
Guided Care also produced modest reductions in re-admissions to hospitals, skilled nursing facilities and home health care, especially in well-integrated systems of care. Practices can adopt Guided Care fairly easily because technical assistance is available: a practical implementation manual; on-line courses for physicians, practice administrators and nurses; and a patient orientation booklet.
The seminar included a conversation between the speaker and the audience about the application of lessons from the Guided Care project to health care in New Zealand.
Dr Boult holds joint appointments on the faculties of the Johns Hopkins University Schools of Medicine and Nursing. He is a teacher, a researcher and a board-certified physician in Family Medicine and Geriatrics. He has extensive experience in developing, testing, evaluating, and diffusing new models of health care for older persons with chronic conditions.
Professor Judith Hibbard Senior Researcher and Professor ,University of Oregon, 23 March 2011
In this presentation I will review the evidence about what patient and consumer activation entails, how it is measured, and what we have learned about patients at different levels of activation. I will elaborate on the research that indicates that activation levels are predictive of health behaviors, health status, health care utilization and costs. Further, I will review the strategies that have been shown to be effective in increasing activation in patients. Finally, I will discuss how the research results are informing approaches for improving care.
Judith Hibbard is a Senior Researcher and Professor at the University of Oregon. Over the last 28 years she has focused her research on consumer choices and behavior in health care. She has a particular interest in testing approaches that give patients more knowledge and control over their health and health care. Her studies examine such topics as: how consumers understand and use health care information, how health literacy affects choices, enrollee behavior within consumer driven health plans, and assessments of patient and consumer activation She is the lead author of the Patient Activation Measure (PAM). Prof. Hibbard advises many health care organizations, foundations, and initiatives. She has served on several advisory panels and commissions, including the National Advisory Counsel for AHRQ, the National Health Care Quality Forum, United Health Group Physician Advisory Panel, and a National Advisory Council for the Robert Wood Johnson Foundation. Prof. Hibbard holds a masters degree in Public Health from UCLA and her doctoral degree is from the School of Public Health at the University of California at Berkeley.