Researchers do not just “do” science, they must write science as well. It stands to reason, then, that writing science is not only data-based, it is language-based. Good data are not enough – the language you use must ensure clear and persuasive transmission of ideas. This webinar will provide some guidance and strategies for writing effective scientific publications using strong and effective language. We will examine the processes of producing a research article, and will give some thought to how research concepts can be made clear through critical thinking and robust writing skills. We will also think about how to construct an effective article title and abstract.
Dr Liz Tynan is an Associate Professor at the James Cook University (JCU) Graduate Research School in Townsville. She teaches academic writing and critical thinking skills to postgraduate students and has particular responsibility for convening the Skills for International Postgraduates (SKIP) program and the Post-Entry Language Assessment (PELA) program. She also has an adjunct associate professor appointment at the College of Arts, Society and Education. She is a former journalist and journalism academic with a background in both print and electronic media. She is co-author of the Oxford University Press textbooks Media and Journalism: New Approaches to Theory and Practice, and Communication for Business. Her popular history, Atomic Thunder: The Maralinga Story, published by NewSouth, won the Council of Humanities, Arts and Social Sciences (CHASS) Australia Prize for a Book 2017 and the Prime Minister’s Literary Prize (Australian History) 2017.
17 April 2018
Introduction to Health Services Research
Have you ever wanted to learn more about health services research? What is it? Why is it important? What methods are used? Where and when is it conducted? What relevance does it have to policy and practice?
Maybe you are already looking at research questions related to health care cost, quality and service delivery but not identifying it as health services research?
This one-hour webinar, presented by the Executive Committee of the Health Services Research Association of Australia and New Zealand is aimed at people who have heard of health services research, but don't have a clear view of what it is and how it relates to policy and practice.
HSR in practice – Katherine Harding, Allied Health Clinical Research Office at Eastern Health (supported by Tilley Pain & Laura Wilkinson-Meyers)
HSR in hospital policy – Jon Karnon, Health economist, University of Adelaide
HSR in primary care policy – Jackie Cumming, Director of the Health Services Research Centre, Victoria University Wellington
HSR in commissioning in primary care – Suzanne Robinson, discipline leader for Health, Policy and Management, Curtin University
28 March 2018
Why do so many technology projects in healthcare fail? A new framework for studying the non-adoption, abandonment and failure of scale-up, spread and sustainability (NASSS) of health and care technologies.
Trish Greenhalgh Professor of Primary Care Health Sciences and Fellow of Green Templeton College at the University of Oxford.
Please remember to acknowledge and cite Professor Greenhalgh if using these resources.
An apocryphal (but probably not wildly out) statistic suggests that 80% of technology-supported change projects in health and social care fail. We all know that’s because they’re complex. It’s time to unpack what that complexity is all about – because failed technology projects are costly, wasteful and potentially harmful at both a human and a system level.
Many promising technologies are not adopted at all (for example, because of clinician “resistance”) – or they are adopted but quickly abandoned (for example, when it becomes clear that using them creates problems somewhere else in the system). Technologies that are successfully adopted on a small scale (for example, in proof-of-concept demonstration projects – perhaps as part of a randomised controlled trial) may prove difficult or impossible to scale up locally beyond the initial team of enthusiasts, and/or impossible to spread elsewhere (even when the settings appear comparable). Finally, few technology projects are sustained over time in a way that adapts and evolves with a changing context. These five challenges (Non-adoption, Abandonment, and failure of Scale-up, Spread and Sustainability) inspired the development and testing of a framework (NASSS) to explain such phenomena. NASSS is based on the most extensive systematic review ever published on technology adoption in healthcare, plus a large and diverse sample of organisational case studies followed for up to three years. It considers seven domains – the illness or condition, the technology, the value proposition, individual adopters (patients, staff), the adopting organisation(s), the wider system and time. Each domain may be simply (that is, few components, clear categories and predictable), complicated (multiple components and issues), or complex (dynamic, ambiguous, unpredictable).
Complexity in multiple NASSS domains appears strongly predictive of programme failure. Proactive attention to reducing complexity in the different NASSS domains early in the planning stages may reduce the risk of failure (though that hypothesis remains to be tested empirically). The NASSS framework was published in November 2017 and quickly became one of the most downloaded papers ever published in the Journal of Medical Internet Research. Various researchers, design companies, consultancies and policymakers have begun to use it to guide, support and/or evaluate the development, adoption, implementation and scale-up of technology-supported programmes.
This lecture will introduce the NASSS framework, give examples of its application and invite discussion on how it might be used and refined in the future.
Trish Greenhalgh is Professor of Primary Care Health Sciences and Fellow of Green Templeton College at the University of Oxford. She studied Medical, Social and Political Sciences at Cambridge and Clinical Medicine at Oxford before training first as a diabetologist and later as an academic general practitioner. She has a doctorate in diabetes care and an MBA in Higher Education Management. She now leads a programme of research at the interface between the social sciences and medicine, working across primary and secondary care.
Her work seeks to celebrate and retain the traditional and the humanistic aspects of medicine and healthcare while also embracing the unparalleled opportunities of contemporary science and technology to improve health outcomes and relieve suffering. Three particular interests are the health needs and illness narratives of minority and disadvantaged groups; the introduction of technology-based innovations in healthcare; and the complex links (philosophical and empirical) between research, policy and practice.
Trish is the author of over 300 peer-reviewed publications and 16 textbooks. She was awarded the OBE for Services to Medicine by Her Majesty the Queen in 2001 and made a Fellow of the UK Academy of Medical Sciences in 2014. She is also a Fellow of the UK Royal College of Physicians, Royal College of General Practitioners and Faculty of Public Health.
8 December 2017
What role does performance information play in securing improvement in healthcare? A conceptual framework for levers of change.
Across healthcare systems, there is consensus about the need for independent and impartial assessment of performance. There is less agreement about how the measurement and reporting of performance actually improves healthcare. This webinar will discuss a recently published paper that introduces a conceptual framework that describes ways in which change can be leveraged by healthcare performance information (Levesque and Sutherland, 2017). The framework identifies eight levers for change enabled by performance information, spanning internal and external drivers, and emergent and planned processes: (1) cognitive levers provide awareness and understanding; (2) mimetic levers inform about the performance of others to encourage emulation; (3) supportive levers provide facilitation, implementation tools or models of care to actively support change; (4) formative levers develop capabilities and skills through teaching, mentoring and feedback; (5) normative levers set performance against guidelines, standards, certification and accreditation processes; (6) coercive levers use policies, regulations incentives and disincentives to force change; (7) structural levers modify the physical environment or professional cultures and routines; (8) competitive levers attract patients or funders.
Dr Levesque, Chief Executive of the NSW Agency for Clinical Innovation (ACI).
Dr Jean-Frédéric Levesque joined the NSW Agency for Clinical Innovation (ACI) as Chief Executive in June 2017. Prior to this he was the Chief Executive of the Bureau of Health Information (BHI) from 2013. Dr Levesque has previously held senior positions responsible for publicly reporting information about the Canadian health system. These included the role of Scientific Director, Analyses and Evaluation of Health Systems at the Institut National de Santé Publique du Québec and Deputy Commissioner, Performance Appraisal and Analysis, at the Commissaire a la santé et au bien-etre du Québec. He is currently a member of the Strategic Analytic Advisory Committee of the Canadian Institute of Health Information. Dr Levesque is a Conjoint Professor at the Centre for Primary Health Care and Equity of the University of New South Wales. His research focuses on healthcare performance, particularly in terms of how different models of care impact on patient outcomes and experiences of care, and on the analysis of healthcare reform. In 2011-12, he was a Visiting Academic at the University of Melbourne. He is a Fellow of the Royal College of Physicians of Canada in Preventive Medicine and Public Health and has a Doctorate in Public Health, a Masters in Community Health and a medical degree from the Université de Montréal, Canada.
Kim Sutherland – Acting Chief Executive, Bureau of Health Information
Kim Sutherland joined the Bureau of Health Information in 2010 and was appointed Acting Chief Executive in May 2017. Her substantive position is Senior Director, Performance Measurement and Reporting.
Kim is a health services researcher with experience in performance measurement and reporting, evaluation and assessment of quality, change management in healthcare organisations, and the diffusion of innovations. She has played a central role in the development of performance measurement frameworks in healthcare systems in the United Kingdom and in NSW. She was co-author on a series of reports evaluating the English National Health Service 10-year quality agenda and this work continues to act as the conceptual base for the joint Health Foundation - Nuffield Trust QualityWatch initiative, based in London. Kim currently sits on a healthcare quality indicator technical advisory group of the Organisation for Economic Cooperation and Development.
While at BHI, Kim has led project-based teams to produce over 40 peer reviewed reports that span a range of different patient groups, methodological approaches and organisational contexts to provide a comprehensive picture of performance in the NSW healthcare system.
Kim has a Bachelor of Science degree from the University of Technology, Sydney; a Master of Science from London Hospital Medical College; a Master of Business Administration from Imperial College, London; and a Doctorate from the University of Cambridge.
25 October 2017
"Futile” treatment and why doctors provide it to patients at the end of life: some empirical findings – 25 October
Presentation 1 (Lindy Willmott)
“Futile” treatment and why doctors provide it to patients at the end of life: some empirical findings
Abstract: Over-diagnosis results in treatment that is unnecessary and may be harmful. The “harms of too much medicine” are also contributed to by futile treatment at the end of life. While there is divergence about what the term “futility” means, there is general consensus that futile treatment (however it is defined) is sometimes provided in this setting. To date, there has been very little empirical research as to why doctors sometimes provide treatment knowing that treatment to be medically futile. This presentation reports on the results of 96 semi-structured interviews with doctors from a range of specialties in three Queensland public tertiary hospitals. It explores why doctors sometimes provide treatment they consider to be futile and strategies that they use to avoid providing it.
Presentation 2 (Ben White)
Title: What does “futility” mean? An empirical study of doctors’ perceptions
Abstract: Futile treatment has been identified as a pressing challenge for health professionals and health systems. But what does “futility” mean? While there has been an extensive debate over some decades about conceptual aspects of this term, very little empirical work has been done as to how doctors understand and operationalise the concept of futility. This presentation reports on the results of 96 semi-structured interviews with doctors from a range of specialties in three Queensland public tertiary hospitals. It explores how doctors understand the term “futility” and use it in the clinical setting at the end of life for adult patients. It also considers the processes reported for “diagnosing futility” and when providing treatment, which is otherwise regarded as futile, might still be seen as justifiable. Findings reveal that despite concerns about the term, the concept of “futility” is used in clinical decision-making. There was broad consensus that at the heart of the concept is benefit to the patient, but there was variability as to what constitutes “benefit” and how this was determined by different doctors in different settings. These findings have implications for how and by whom decisions are reached that treatment is no longer worth providing at the end of life.
Lindy Willmott is a Professor with the Faculty of Law at the Queensland University of Technology and a Director of the Australian Centre for Health Law Research at QUT. She researches and publishes extensively in the area of health law, particularly end-of-life issues. She has expertise in socio-legal research and has received funding from the Australian Research Council and the National Health and Medical Research Council to undertake empirical research into various aspects of decision-making at the end of life. Lindy is the author of many text books and is one of the editors of the text ‘Health Law in Australia’, now in its second edition. Lindy was a member of the Queensland Civil and Administrative Tribunal (previously the Guardianship and Administrative Tribunal) for seven years and is currently on the editorial board of the Journal of Medical Ethics.
Professor Ben White is a Director of the Australian Centre for Health Law Research in the Faculty of Law at the Queensland University of Technology (QUT). Ben graduated with first class Honours and a University Medal in Law from QUT and then completed a DPhil at Oxford University on a Rhodes Scholarship. Before joining the Law Faculty, he worked as an associate at the Supreme Court and at Legal Aid Queensland. Between 2005 and 2007, Ben was appointed as the full-time Commissioner of the Queensland Law Reform Commission where he had carriage of the Guardianship Review on behalf of the Commission. He also served as a part-time Commissioner between 2007 and 2010. Ben’s area of research focus is end of life decision-making and he is undertaking a number of Australian Research Council funded studies examining law at the end of life. He is currently a committee member of the Australasian Association of Bioethics and Health Law and an editor of ‘Health Law in Australia’ (2nd ed, 2014, Thomson).
18 July 2017
An introduction to the GRADE approach in systematic reviews and guideline development
A/Professor Zachary Munn Director Transfer Science, Joanna Briggs Institute and Director JBI Adelaide GRADE Center
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of grading systems commonly used in health care. The working group has developed a common, sensible and transparent approach to grading quality (or certainty) of evidence and strength of recommendations. Many international organizations have provided input into the development of the GRADE approach which is now considered the standard in guideline development. This short webinar will provide an introduction to the GRADE approach in systematic reviews, health technology assessment and in developing trustworthy clinical guidelines.
A/Professor Zachary Munn is an advocate for evidence-based healthcare and for ensuring patients receive the best care possible based on the best available evidence. He is the director of the Transfer Science program of the Joanna Briggs Institute and is the Director of the JBI Adelaide GRADE Center, the first in Australia. In this role he leads the development and coordination of the Institute’s educational courses, the development of systematic review and implementation software tools, and the promotion and publication of the collaboration’s methodologies. A/Prof Munn is the current Chair of the international JBI Scientific Committee and has been involved in the conduct of dozens of systematic reviews, clinical guidelines, evidence implementation and health services research projects.
13 June 2017
Conclusions versus Decisions in Quantitative Research
Abstract: Drawing insights from the works of brilliant statisticians, such as Fisher, Neyman, Pearson, Lindley, Birnbaum, Pratt, Raiffa, Good and Tukey, this webinar presents the fundamental issues related to the debate regarding the distinction between conclusions and decisions in quantitative research. The webinar discusses ideas and implications relevant to health researchers, practitioners and policy-makers (no mathematical formulas are presented). ‘Decisions’ and ‘conclusions’ are defined, and their meanings and implications for quantitative research are discussed. Significance testing, hypotheses testing and confidence intervals are examined from the ‘conclusions versus decisions’ perspective. Examples are discussed and suggestions for best practice in quantitative research are proposed.
Dr Catalin Tufanaru: Dr Catalin Tufanaru MD, MPH, MClinSci, PhD, is a Research Associate at the Joanna Briggs Institute (JBI), Faculty of Health and Medical Sciences, University of Adelaide, Australia. Catalin is involved in teaching research methodology and statistics in a graduate program at University of Adelaide, the Master of Clinical Science in Evidence Based Health Care. He is an Associate Investigator at NHMRC Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), and a Research Affiliate at The Critical and Ethical Mental Health (CEMH) Research Group, the Robinson Research Institute, the University of Adelaide. Catalin is involved in the RIAT (Restoring Invisible and Abandoned Trials) initiative, and he is one of the co-authors of the RIAT re-analysis of Study 329. He is the author of five books on topics such as health promotion and health education, social marketing, health policy analysis, systematic reviews of economic evidence, and statistics for systematic reviews. Catalin is an accredited JBI Comprehensive Systematic Review trainer and a peer reviewer for the JBI Database of Systematic Reviews and Implementation Reports. Recent seminars presented by Catalin include ‘Statistical Misconceptions in Evidence-based Medicine’ (Aged and Extended Care Services Research Seminar, Basil Hetzel Institute, Adelaide, April 2017) and ‘Beyond hypothesis and significance testing in health research’ (Transdisciplinary Measurement and Evaluation Research Group, University of Adelaide, May 2017).
23 May 2017
Weekend allied health services in rehabilitation
Abstract: This webinar will present research on provision of additional weekend rehabilitation services. A series of preliminary studies including systematic reviews, a national survey of practice, and a pilot study were conducted prior to completion of a large randomised controlled trial of rehabilitation inpatients allocated to either a 6-day rehabilitation service (Monday to Saturday) or to standard care (5-day rehabilitation service Monday to Friday). The results demonstrated that compared to standard care inpatients allocated to receive the weekend service had a reduced length of hospital stay with greater likelihood of achieving clinically important improvements in functional independence and health-related quality of life during the admission. From the economic perspective this was likely to be a cost effective intervention. The body of research provides high quality evidence that providing additional allied health rehabilitation services can help patients get better quicker and is likely cost effective from a health service perspective. The next challenge in this research is to explore how best to facilitate transfer of this knowledge into practice.
Nicholas Taylor: Nick Taylor is Professor of Allied Health, a joint position between La Trobe University and Eastern Health. He leads the Allied Health Clinical Research office at Eastern Health. The focus of Nick’s research is on improving rehabilitation outcomes, both in the effectiveness of specific interventions and in the way services are delivered. He has more than 200 peer-reviewed journal publications.
Natasha Brusco: Tash Brusco is the Chief Physiotherapist at Cabrini Health. She completed a PhD in 2015 that involved a fully-powered randomised controlled trial in the inpatient rehabilitation setting examining weekend services with a cost effectiveness economic evaluation. Tash’s PhD thesis was recognised for its outstanding merit at La Trobe University by being awarded the Nancy Millis Medal for excellence. Tash has multiple additional roles at Cabrini Health including Research Fellow and the Manager of Education and Quality for Allied Health and Ambulatory Services. In addition, she is an Adjunct Senior Lecturer and Honorary Researcher at La Trobe University for the School of Allied Health.
18 May 2017
The Harkness Fellowships in Health Care Policy and Practice
Robin Osborn (Vice President and Director, The Commonwealth Fund) will discuss how the Fellowship works, the program throughout the year, and eligibility.
Jane Hall (Director of Strategy, Centre for Health Economics and Research Evaluation, University of Technology Sydney) will speak about the Fellowship and its relevance to Australian applicants.
Robyn Whittaker (2010-11 New Zealand Harkness Fellow) will discuss her Harkness Fellowship experience, her project, and how the Harkness Fellowship changed her life, personally and professionally.
The Harkness Fellowships in Health Care Policy and Practice provide a unique opportunity for mid-career professionals—academic researchers, government policymakers, clinical leaders, hospital and insurance managers, and journalists—from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, and the United Kingdom—to spend up to 12 months in the United States working with leading experts to study health care delivery reforms and critical issues on the health policy agenda in both the U.S. and their home countries. The Commonwealth Fund brings together the full class of Fellows through the year to participate in a series of high level policy briefings and leadership seminars with health care leaders.
The deadline for receipt of applications from Australia and New Zealand is September 5, 2017.
Learn more about the Fellowship:
Please feel free to contact Robin Osborn (Director of the Harkness Fellowships in Health Care Policy and Practice) at firstname.lastname@example.org with any additional questions about eligibility, the project, or the application process.
27 April 2017
Bleeding hearts, profiteers or both? Understanding doctors' fees in an unregulated market.
Associate Professor Kees van Gool, Deputy Director of the Centre for Health Economics Research and Evaluation, University of Technology Sydney.
“[The Government] has no authority to control the amount doctors charge for their services as this would amount to civil conscription. Doctors are free to determine their own value of the health service they provide.” The Australian Department of Health and Ageing, 2009
This presentation focuses on the degree to which doctors use their freedom to set and differentiate their fees to different patients. In the context of the Australian health care system, fees have a direct bearing on the out-of-pocket costs faced by patients. The first part of this seminar shows that in an unregulated fee-setting environment, general practitioners (GPs) and specialists discriminate their fees on the basis of patients’ income status. The second part focuses on the impact of the 2004 Strengthening Medicare reforms. Whilst these reforms have been widely credited with increasing levels of bulk-billing among GPs, our findings suggest that there is considerable variation in GP responses to the reforms. As a result, the OOP costs incurred by different population groups have changed substantially, with direct implications on the barriers to access of GP care. Understanding the degree of fee variation among doctors is an important issue in terms of understanding the potential variable impact that a policy change may have.
Associate Professor Kees van Gool is a health economist and has extensive experience in international, national and regional health policy research. He is the Deputy Director of the Centre for Health Economics Research and Evaluation, based at the University of Technology Sydney. He leads a team of researchers working on the financing and economics of the Australian Health Care system, including a special focus on primary care. Kees was a lead investigator in two independent reviews of the Extended Medicare Safety Net conducted for the Department of Health and has been a chief investigator on a number of competitive grants. He has worked extensively on cancer care, screening, cystic fibrosis and policy evaluation. In 2011 he completed his PhD at the University of Technology Sydney, looking at the out-of-pocket costs faced by patients under Australia’s Medicare system. Kees has previously worked at the Department of Health, NSW Health and the OECD where he led a project on international policy analysis on cardiovascular disease care and outcomes.
29 March 2017
HSRAANZ Webinar Series – Needs must: Changing the focus of workforce planning models
Abstract: Health Care Planning has largely been based on applying anticipated population demographic change to existing levels of workforce supply (or service utilisation) with no attention given to changing patterns of health care need within populations. In this session a new approach to health workforce planning is presented that accommodates changes in population needs, changes in the services planned to address needs and changes in the way those services are to be delivered. The approach provides an important input to policies aimed at addressing the continuing rapid increases in the costs of publicly funded health care systems and answering claims that such systems are no longer sustainable.
Bio: Stephen Birch is a Professor in The Centre for Health Economics and Policy Analysis at McMaster University in Canada and in the Centre for Health Economics at the University of Manchester. He also is Adjunct Professor at the University of Technology Sydney, Australia and a former visiting professor at the University of Cape Town, South Africa. He is senior scientist at the WHO Collaborating Centre on Health Workforce Planning at Dalhousie University, Canada and a former member of the UK Department of Health’s Centre for Workforce Intelligence. He has served as a consultant with WHO and the World Bank as well as many national and provincial health departments on health workforce planning. His main research interests are in the economics of health care systems with particular emphasis on equity, resource allocation and planning and well as alternative delivery models. He has over 250 publications in peer reviewed journals and was ranked equal first in Canada in the 2012 World Bank publication on the quantity and impact of health economics research. He was Senior Editor for Social Science and Medicine from 1997-2012 and currently serves on editorial boards of several multidisciplinary scientific journals. He has served on various public boards including the Local Health Integration Network and the District Health Council in Hamilton Ontario, the Health Professions Regulatory Council in Ontario and the Community Health Council in York, UK.
22 February 2017
HSRAANZ Webinar Series – Understanding the potential of telehealth for people in remote locations
The use of telehealth to support patients living in remote areas is gaining much interest in the Australian health sector. In the right circumstances, telehealth can save people having to travel extensive distances to access specialist health services. This is especially important for people living in rural and remote areas of the country, and for people who have difficulty travelling away from home. This presentation will give an overview of a range of telehealth projects led by the University of Queensland’s Centre for Online Health (COH). Over time, most projects have been successfully translated from a research idea into routine service delivery in Queensland. Critical steps in establishing these projects will be discussed, as well as key research findings, challenges and lessons learnt.
Associate Professor Anthony Smith
Dr Anthony Smith is an Associate Professor and Director of the University of Queensland’s Centre for Online Health. He also has an Adjunct Professor appointment at the University of Southern Denmark's Centre of Innovative Medical Technology. Dr Smith has more than 16 years of research experience based on investigations of new telehealth applications for the benefit of clinicians and patients in regional and remote areas of Queensland. In 2013, Anthony began a role as chief investigator for the NHMRC Centre of Research Excellence (CRE) in Telehealth, where he leads two major themes of work involving telehealth applications in small remote communities and Indigenous communities. Anthony is the scientific committee chair for the International Conference on Successes and Failures in Telehealth (SFT); and past-President of the Australasian Telehealth Society (ATHS). His frequent work in rural and remote areas of Queensland provides him ample motivation for healthcare innovation and use of telehealth – with the ultimate aim of giving people living in underserved locations, convenient and fairer access to specialist healthcare.
Centre for Online Health: https://coh.centre.uq.edu.au/
Centre of Research Excellence in Telehealth: http://www.cretelehealth.org.au/
Successes and Failures in Telehealth Conference: http://www.sftconference.com
Australasian Telehealth Society: http://www.aths.org.au/
Associate Professor Anthony Smith: http://researchers.uq.edu.au/researcher/1081
19 October 2016
Developing primary care that is fit for the future: cross-country comparisons
Across nations, there appears to be consensus about the vital importance of strong and comprehensive primary care provision to enable effective prevention, treatment and management of long-term conditions, and a responsive and accessible service for people requiring episodic advice and care. The Commonwealth Fund, World Health Organisation, and European Commission have all underlined the policy importance of primary care in recent publications.
What is less clear however is how primary care should adapt and change to meet this challenge, and what health systems need to do to enable this. In many countries where primary care is based on general practice or family medicine as the core provision, there is considerable current focus on the ‘primary health care home’ model, as evidenced in New Zealand, Australia and the UK among others.
In this webinar, Professor Judith Smith will draw on her extensive research and policy experience of primary care in the UK, New Zealand and Australia to examine the opportunities and risks of developing new models of primary care that are fit for the future. She will draw out cross-country comparisons and learning, and identify the particular challenges that need to be addressed (and researched) if current policy ambitions for primary care are to be realised.
Professor Judith Smith BA MBA PhD
Director, Health Services Management Centre, University of Birmingham
Judith is a widely published health services researcher and policy analyst. She took up post as Director of the Health Services Management Centre (HSMC) and Professor of Health Policy and Management at the University of Birmingham on 1 June 2015. This followed six years spent as Director of Policy at the Nuffield Trust, an independent charitable research foundation in London. Judith’s main research interests are: health commissioning and purchasing; the organisation and management of primary care; long-term conditions and integrated care; the evaluation of health care organisation; and health care management and culture.
Earlier in her career, Judith spent 12 years at HSMC, holding the positions of Senior Lecturer, Director of Research, and Academic Director of the NHS Management Training Scheme. From 2007 to 2009, Judith was based in New Zealand as a Visiting Senior Research Fellow at the Victoria University of Wellington and working as an advisor to the New Zealand Ministry of Health.
Judith is a Non-Executive Director of the Birmingham Children’s Hospital NHS Foundation Trust, Honorary Professor at the London School of Hygiene and Tropical Medicine, and a member of the board of the UK Health Services Research Network. Judith’s other roles have included being an expert advisor on NHS organisation and commissioning, and policy assessor to the Mid Staffordshire NHS Foundation Trust Public Inquiry; chair of the Royal Pharmaceutical Society’s Commission on future models of care; and a member of the board of the European Health Management Association.
28 September 2016
Choosing Wisely – where we came from, where we are going and why we need you.
Please do not replicate or circulate any slides without the permission of the author
Choosing Wisely Australia aims to improve the quality of healthcare through bringing to light tests, treatments, and procedures where evidence shows they provide no benefit or, in some cases, lead to harm. Led by Australia’s medical and allied health colleges, societies and associations and facilitated by NPS MedicineWise, Choosing Wisely Australia challenges the way we think about healthcare, questioning the notion 'more is always better'. Unnecessary practices are a diversion away from effective care. They often lead to more frequent and invasive investigations that can expose the consumer to undue risk of harm, emotional stress, or financial cost. To date 19 colleges, societies and associations have come together to develop lists of recommendations: "Tests, treatments and procedures to question."
This webinar will be jointly presented by Dr Robyn Lindner from NPS MedicineWise and Professor Adam Elshaug who is a member of the Choosing Wisely Advisory Group. They will outline the road travelled thus far in facilitating the roll out Choosing Wisely Australia: the challenges, successes and lessons learned.
They will highlight case studies of where Choosing Wisely recommendations are being implemented at the clinical coalface; discuss where to from here; and how the campaign fits with the international Choosing Wisely movement (with over a dozen countries now participating). Lastly, they will draw attention to how members of the health services and policy research community can become engaged with the campaign through design, implementation and evaluation.
Dr Robyn Lindner
Dr Robyn Lindner is Client Relationships Manager at NPS MedicineWise - an independent not for profit organisation that develops programs for both health professionals and consumers to support quality use of medicines and health technologies including diagnostics. As part of this role, Robyn has recently led the implementation of a new healthcare initiative to Australia called Choosing Wisely. This initiative seeks to start a conversation about appropriate healthcare in Australia by challenging the notion that more is always better when it comes to healthcare.
Professor Adam Elshaug
Adam Elshaug is Professor of Health Policy, HCF Research Foundation Professorial Research Fellow, and Co-Director of the Menzies Centre for Health Policy (MCHP) at The University of Sydney. He also Heads the Value in Health Care Division within MCHP, is Senior Fellow with the Lown Institute in Boston, a ministerial appointee to the Medicare Benefits Schedule (MBS) Review Taskforce, a member of the Choosing Wisely Australia advisory group, the Choosing Wisely International Planning Committee, the ACSQHC's Atlas of Healthcare Variation Advisory Group, and an elected Member of the Executive Committee of the Health Services Research Association of Australia and New Zealand (HSRAANZ). He is a Chief Investigator within the Wiser Healthcare Collaborative: http://wiserhealthcare.org.au/ and his work in the area of low-value care has resulted in first-author publications in journals such as the NEJM, BMJ, JAMA, and MJA among others.
23 July 2016
HSRAANZ Webinar Series - Strategies to implement evidence: audit and feedback
Evidence-based healthcare relies on the use of the best available evidence in healthcare. This often requires a change in the way care is delivered, and change can be difficult. This presentation described methods for evidence implementation, with a focus on audit and feedback as a mechanism to change and improve practice. Specifically, this presentation will discussed:
- An introduction to evidence-based healthcare
- Current barriers to evidence-based healthcare
- An introduction to evidence implementation and strategies for implementation
- An introduction to audit and feedback projects including real world examples
Associate Professor Zachary Munn is the director of the Transfer Science program of the Joanna Briggs Institute: leading the development and coordination of the Institute’s educational courses, the development of systematic review and implementation software tools, and, the promotion and publication of the collaboration’s methodologies. He is the convener of two methodology committees focusing on grading evidence and systematic reviews of prevalence and incidence data. Dr. Munn is the current Chair of the international JBI Scientific Committee. Dr Munn has been involved in the conduct of dozens of systematic reviews and evidence implementation projects. Dr. Munn is a member of the GRADE working group, the Guidelines International Network tech working group, and a member of the Guidelines International Network Australia and New Zealand steering group.
The Joanna Briggs Institute (JBI) is the international not-for-profit, research and development centre within the Faculty of Health Sciences at the University of Adelaide, South Australia.
23 June 2016
HSRAANZ Webinar Series – panel on commissioning health care in Australia – reflecting on Primary Health Networks.
Health systems are challenged by pressures of increased demand and rising costs. The rise in complex chronic conditions means that the current system design that stems from an era when communicable disease was more prevalent than chronic is struggling to meet the changing health needs of the population. As governments look to ways to reform health systems we have seen an interest in the role of commissioning as a mechanism through which to reform many different aspects of public services. Primary Health Networks (PHN) have been charged with commissioning primary care services in Australia. The essence of commissioning is to take a stewardship role with a focus on providing vision and direction for the health system, collecting and using intelligence, and exerting influence - through regulation and other means.
As PHNs reach their first birthday it’s timely to take stock of how commissioning is developing both nationally and internationally. This webinar will incorporate research, policy and practice perspectives on the development and implementation of commissioning in Australia.
The panel session focused on broad areas relating to the following:
- The current understanding of commissioning, and what it should achieve in PHN localities;
- The challenges and opportunities of the commissioning process in Australia;
- Concepts and elements of successful commissioning;
- How are PHN commissioners working with wider stakeholder groups?
Helen Dickinson, Associate Professor of Public Governance at the School of Social and Political Sciences, University of Melbourne
Helen’s expertise is in public services, particularly in relation to topics such as governance, leadership, commissioning and priority setting and decision-making. Helen has published sixteen books and over fifty peer-reviewed journal articles on these topics and is also a frequent commentator within the mainstream media. She is co-editor of the Journal of Health, Organization and Management and Australian Journal of Public Administration. In 2015 Helen was made a Victorian Fellow of the Institute of Public Administration Australia and she has worked with a range of different levels of government, community organisations and private organisations in Australia, UK, New Zealand and Europe on research and consultancy programmes.
Learne Durrington Chief Executive WA Primary Health Alliance
With more than 25 years’ experience in the management of government and not-for-profit organisations, Learne Durrington has a reputation for driving innovation within and across the health and social care sectors. Learne is passionate about achieving a connected and accessible health system that is patient and outcome focused.
As the CEO of WA Primary Health Alliance, Learne is leading the establishment of strategic alliances and partnerships across WA to support systemic change within the primary healthcare system. Learne leads with the principle that good health outcomes can only be achieved through the combined effort of all levels of government, clinical and social care services together with private and public organisations.
Starting her career as a social worker, Learne has a MBA and is an Associate Professor of Health Sciences at Curtin University, a Fellow of the Australian College of Health Services Management and GAICD.
Suzanne Robinson, Associate Professor and Theme Leader for Health Systems and Health Economics, Curtin University
Suzanne is Theme Leader for the Health Systems and Health Economics group at Curtin University and an Honorary Senior Research Fellow at the University of Birmingham, UK. Suzanne has been involved in leading health systems and health economics projects that have had major impact on government reform initiatives. Suzanne also leads international research on decision making and priority setting in health, this work involves a number of aspects around population health planning and resource allocation. Suzanne has worked with a number of Australian and UK organisations around commissioning and procurement of health and social care services. This work involves both research and educational programmes, including the development and delivery of the first UK Masters programme in commissioning health services, this was delivered by the University of Birmingham. She was recently awarded the Australasian College of Health Services Management award for innovation and excellence for her work in health systems research and capacity building.
Jason Trethowan, Chief Executive Officer, Western Victoria Primary Health Network Ltd.
Jason Trethowan was appointed CEO of Western Victoria Primary Health Network in June 2015, with the organisation established on 1 July 2015.
Previously, Jason was the CEO of Barwon Medicare Local and held this position from 2011. Jason led the organisation, collaborating closely with local community and health industry partners to strengthen the primary care system. Prior to Barwon Medical Local Jason was the CEO of Geelong Practitioner's Association from 2007 – 2011 where he led the establishment of Australia's leading headspace site (Barwon) from May 2007 and led the advocacy for and establishment of a $7M GP Super Clinic which opened in August 2010.
Jason's experience includes partnerships, business operations, health system innovation and corporate governance. He holds a Master's Degree in Business Administration (MBA), Graduate Certificate in Health Informatics and a Bachelor of Health Information Management. Jason is currently a Board Member of the G21 Geelong Region Alliance, a council member of the Australian Health and Hospital Association and also a Steering
26 May 2016
HSRAANZ Webinar - Obesity and General Practice
This webinar jointly presented by Prof Jon Karnon and Jodi Gray (University of Adelaide) and Mark Harris (University of New South Wales) addressed: the issues around the management of obesity in primary care; what referral options are needed and the role that local health authorities and PHNs can play in developing these; and an opportunity to express an interest in involvement in further research in this area.
Managing obesity is a major and increasing challenge for the Australian Health System. While GPs have an important role in the assessment and management of obesity and its complications, the intensity of support required for most obese patients to achieve and maintain weight loss is much higher than the amount of support it is possible to provide in routine practice.
Despite this GPs have limited referral options and relatively few patients are referred for more intensive behavioural or surgical interventions. There are a range of patient, practitioner and system factors that influence GPs decision to refer patients for weight management support, some of which can be addressed to improve referral.
One alternative to external referral is for patients to be offered more intensive, structured programs within general practice by practice nurses. This has a number of advantages but requires training, quality control and adequate funding to ensure that it is effective and sustainable.
Webinar participants will obtain:
- An understanding of the issues around the management of obesity in primary care
- A clearer view of what referral options are needed and the role that local health authorities and PHNs could play in developing these
- An opportunity to express interest in involvement in further research in this area.
COMPaRE-PHC is a Centre for Research Excellence involving Universities and collaborating organisations across three states. The Centre is focused on conducting and translating research on weight management and obesity prevention into primary health care. This webinar will present some of the findings from the Centre’s research on the pathways for the management of obesity in primary care.
Or go to https://youtu.be/1mLLUIhy8l8
10 May 2016
HSRAANZ Webinar "Improving health systems - the role of design thinking and operations research
Health systems and services are under stress. In Australia, the health budget continues to receive the attention of politicians and media on a regular basis. Politicians seem to want their cake and eat it too – to spend less, but have better outcomes delivered for patients and the community. In such an environment, the only thing that is certain is that change will occur. How can health care managers and clinicians seek to improve the services they run, while improving the bottom-line. The methods being employed in other industries have a lot to offer. We believe that design thinking – a way of achieving the goals of systems thinking – combined with appropriate methods from operations research has a lot to offer when change is required – it can help achieve both improved services and better outcomes.
This webinar provided attendees with an understanding of what operations research and design thinking are, and how they can be used in the health care setting. The need to properly understand the nature of the change and ways of facilitating this was also be discussed.
This webinar was be presented by Dr Mark Mackay (Flinders University); Mr Keith Stockman (Monash Health) and Professor Robert Adams (The Queen Elizabeth Hospital and University of Adelaide).
25 December 2016
HSRAANZ Webinar – “Priority setting and resource allocation in health care: lessons learned and future steps”
Craig Mitton, Professor and Senior Scientist, Centre for Clinical Epidemiology & Evaluation, School of Public Health, University of British Columbia.
Abstract - Health organizations the world-over must allocate resources within a limited funding envelope. Recently, decision makers have come under even greater pressure as year-over-year growth in budgets has decreased and organizations have entered into a period of serious fiscal constraint. The objective of this talk is to present a set of methods that have been used many times over across Canada and elsewhere to assist decision makers in addressing financial challenges while remaining true to their goals of population health and quality patient care. In addition to outlining latest methods and innovations, several case studies from Canada will be discussed including solutions to key challenges. Areas of potential future research will also be presented.
Bio - Craig Mitton is a Senior Scientist at the Centre for Clinical Epidemiology and Evaluation and a Professor in the School of Population and Public Health in the Faculty of Medicine at the University of British Columbia. Within the School Craig is Head of the Health Services and Policy Division and is the Director of the Master of Health Administration program. The focus of his research is in the application of health economics to impact real-world decision making in health organizations. He has published a book entitled the ‘Priority setting toolkit: a guide to the use of economics in health care decision-making’ and has authored over 120 peer reviewed publications. http://spph.ubc.ca/person/craig-mitton
16 November 2015
What Keeps You Strong? Contributing to a Research Program Aimed at Supporting the Wellbeing of Older Aboriginal and Torres Strait Islander Peoples
Dr Carol Davy, Senior Research Fellow, South Australian Health and Medical Research Institute
Despite poorer health status and higher levels of socio-economic disadvantage, statistics show that on average, older Aboriginal and Torres Strait Islander peoples are less likely to use aged care services, in comparison to their non-Indigenous counterparts. Improving understandings of Aboriginal and Torres Strait Islander peoples’ cultures and the factors that support concepts of wellbeing is likely to support greater engagement with such services. The aim of this research program is to develop a model of care which will assist primary healthcare and aged care services to support the wellbeing of older Aboriginal and Torres Strait Islander peoples. The program began with a large systematic literature review which identified interventions and strategies that have or could improve the wellbeing of older Indigenous peoples internationally. The results of this review suggested that Indigenous identity was central to wellbeing for many Indigenous peoples. Crucial to maintaining Indigenous identity was a sense of independence, whereby older Indigenous people are able to contribute to and remain active members of their community. As physical independence often diminishes with age, having the support of culturally safe primary healthcare and aged care services that understand the importance of maintaining an Indigenous identity and also cater for the particular needs of Indigenous peoples was also found to be important. Given the number of Indigenous peoples who have been impacted by assimilation policies, services that also support Indigenous peoples to reconnect with their culture, community and family may be particularly crucial.
Carol Davy has had over 12 years’ experience in using both qualitative and quantitative methods to better understand the health needs of particular populations. Carol’s PhD completed in 2009 utilised a social psychology methodology to better understand the role that belief systems such as the biomedical model, Indigenous knowledge and religion played in informing and guiding primary health care service provision and utilisation. Currently, Carol is working on a number of programs related to primary and aged care services at Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute. As Senior Research Fellow, Carol is helping to lead the work conducted by the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) and “What Keeps You Strong” a program of work which aims to support the wellbeing of older Aboriginal and Torres Strait Islander peoples. She is also involved in a study which developed a Wellbeing Framework for use in primary healthcare services and has developed a suite of master classes which aim to strengthen the research capacity of staff working in the Aboriginal healthcare sector. Carol is a recipient of the 2015 Health Services Research and Policy Fellowship. Prior to completing her PhD, Carol worked closely with the Papua New Guinea Institute of Medical Research on a variety of projects, including developing and managing a study which aimed to measure both the patient and health systems costs of treating malaria, in addition to the potential savings which may be recognized if a preventative malaria program was implemented. Dr Carol Davy has also worked at the University of Adelaide where she was an investigator on the Middle East Area of Operations Health Studies, and senior researcher responsible for the Middle East Area of Operations Prospective Study.
13 October 2015
Academic-health service partnerships as a translational strategy: panacea or placebo?
Gill Harvey, Professorial Research Fellow, School of Nursing, The University of Adelaide
The challenges of translating research evidence into policy and practice are well recognised. One strategy that is increasingly pursued as a possible solution is the creation of formal collaborations between universities and health care organisations, premised on the belief that closer working between the producers and users of research evidence will help to overcome the barriers to translation.
In this seminar, I will explore the growing focus on these types of partnerships and examine emerging evidence about whether and how they actually work. This will include drawing on my experience of working within and evaluating the Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) in the English National Health Service.
Gill Harvey is based in the School of Nursing at the University of Adelaide. She came to the university in October 2013 whilst on a two year sabbatical from her post as Professor of Health Management at Manchester Business School (MBS) in the UK. In November 2014, she took up a 4 year contract as a High Cite Professorial Research Fellow in Adelaide. Gill has a professional background in nursing; previous posts in the UK include working as the Director of the Royal College of Nursing’s Quality Improvement Programme and Director of the National Institute for Health and Care Excellence (NICE) National Collaborating Centre for Nursing and Supportive Care, with a remit to develop clinical guidelines for the National Health Service (NHS). Her teaching and research interests are in the field of quality improvement, knowledge translation and mobilisation in health care.
Policy Based barriers and enablers to high quality health care provision in aged care settings
Dr Amee Morgans, Senior Research Fellow | RDNS Institute.
There are a range of federal and state government interface challenges which determine referral pathways and barriers between aged care and health care, which are summarised in Figure 1. There is an aged care/health care industry mutual misunderstanding about responsibilities for management of health care of aged care recipients, and current health service models are built on these assumptions, often to the disadvantage of the individual seeking services.
Critical to the success of the system delivering care to those who are most in need are the inter-sectoral relationships that can drive change and implementation from both health and aged care industry perspectives. The importance of peak bodies in driving inter-sector partnerships and communication is evident and the timing to commence these activities opportune.
Dr Morgans has extensive experience in management of teams responsible for strategic cross-divisional and multi-organisation project management, government policy analysis and research impact evaluation. Dr Morgans specialises in the design and delivery of projects which create real impact and innovative research that translates into operational, system and policy level change via evidence based industry level advocacy.
11 May 2015
"Why hospital standardised mortality ratios should be avoided"
Nick Black, Professor of Health Services Research, London School of Hygiene and Tropical Medicine
SLIDES - Click Here
RECORDING- Click Here
There is a pressing need to assess the quality of hospitals. Many countries have chosen to use hospital-wide mortality ratios, which have the attraction of simplicity and providing a single measure. But these measures are misleading for five key reasons, all of which will be discussed. Despite criticisms by leading health services researchers in the USA, Canada, UK and Australia over the past two decades, the use of this approach persists. And their use can have harmful consequences for patients, clinicians and managers.
So if politicians and the public insist on deaths in hospital being used to improve the quality of hospitals, how might this be done better? An approach based on in-depth case record review being adopted in several countries will be explored together with rigorous methods for assessing the quality of hospital care.
Biography : Nick Black
After qualifying in medicine from Birmingham University in 1974, he worked in NHS hospitals before joining Save the Children Fund to run a child health programme in Nepal. He then underwent post-graduate training at Oxford, including a doctorate on reasons for the epidemic in surgery for glue ear, before spending three years as a lecturer at the Open University writing a distance-learning course 'Health and Disease' with a biologist, sociologist and economist.
In 1985 he moved to the LSHTM and was promoted to a Chair in Health Services Research in 1995. His main research interests are the use of clinical databases for evaluation and audit of health services (particularly in the field of surgery and critical care), patient-reported outcomes, non-randomised methods of evaluation and, recently, dementia care. He is a trustee of the Intensive Care National Audit & Research Centre.
In 1996, together with Nick Mays, he founded the Journal of Health Services Research & Policy, which they continue to edit and, in 2005, was elected Chair of the newly created UK HSR Network. In 2006 he published Walking London’s Medical History (new edition 2012) to raise public understanding of health services and health care policy through seven walks through London plus a tour of north and east Kent. Since 2007 he has chaired the National Advisory Group for Clinical Audit & Enquiries which advises NHS England. He is also a member of several advisory groups on quality assessment for the DH, NHSE, CQC and QualityWatch.
Social media for health services research: what works and what doesn’t? TWITTER.
Presenter: Melissa Sweet
Melissa Sweet is an independent journalist who specialises in covering public health, and is the author/co-author of several health-related books. She founded the public health blog Croakey, and is an active blogger and tweeter. She is currently undertaking a PhD at Canberra University, which will produce a long-form work of journalism about Aboriginal and Torres Strait Islander health and history, as well as a decolonising methodology for journalism practice. Twitter is a critical part of her PhD, and has also been useful in helping to transform her journalistic practice. She has an adjunct position as Senior Lecturer in the Sydney School of Public Health at the University of Sydney, and chairs the Public Interest Journalism Foundation based at the Centre for Advancing Journalism at the University of Melbourne.
A recording of this Webinar is available at:
Video 1 http://youtu.be/OJD96GCWjdE
Video 2 http://youtu.be/t62nXu-1xcQ
Useful Twitter Links/Resources