Ann M Dadich

Using visual analytics to improve hospital scheduling and patient flow

The increasing demand for hospital emergency services has important implications for the allocation of limited public resources and the management of healthcare services. Although reform is an oft-cited way to improve the healthcare system, it has a limited ability to readily address this increasing demand. This paper presents an innovative approach to identify and translate feasible solutions to improve the efficiency of hospitals. Premised on visual analytics, the paper describes the way a software program was used to represent sonography department processes within a virtual environment. The processes were represented by collecting and assembling information about room capacity, room use, patient-scheduling practices, staff capacity, and equipment availability. The resulting model helped to identify areas for improvement and simulate viable options to improve these areas. This was associated with two clear benefits - it allowed solutions to be considered without making changes to the physical environment, and it provided a way to clearly demonstrate to staff the relationship between process change and improved efficiency. The paper concludes with directions for future research.

Competing voices : marketing and counter-marketing alcohol on Twitter

Excessive alcohol consumption constitutes a global health problem, and despite increasing efforts to promote safe drinking, spending on alcohol advertising far outweighs spending on safe-drinking messages. Twitter represents a new channel for social marketing, but its use to promote safe drinking has not been examined. In this study, six Twitter accounts maintained by advocates of safe drinking and/or abstinence were compared with six accounts maintained by alcohol companies using a mixed-method design. The Twitter accounts of alcohol companies were followed by more people, and their tweets were more likely to use interactive features such as hashtags, to be forwarded to others, and to be associated with positive stimuli, suggesting greater interactivity and influence than prohealth Twitter messages. The results suggest social marketers may benefit from adopting the practices of for-profit marketers to increase the visibility of, engagement with, and influence of their tweets.

‘I didn’t like just sittin’ around all day’: facilitating social and community participation among people with mental illness and high levels of psychiatric disability

People with mental illness can be profoundly disabled and at risk of social exclusion. Transitional models of supported housing have limited effectiveness in improving community participation. Stable, individualised psychosocial housing support programmes have been found to assist in improving mental health and decreasing hospitalisations, but little is understood about whether or how these programmes facilitate social and community participation. This article argues that, if certain supports are available, supported housing models can assist people with high levels of psychiatric disability to participate meaningfully in the community. To make this case, the article uses findings of a longitudinal evaluation of a supported housing model in Australia: the Housing and Accommodation Support Initiative Stage One (HASI). HASI is a partnership between the New South Wales Government Departments of Health and Housing and non-government organisations. It is a coordinated approach that provides clients with housing and community-based clinical support, as well as support with daily living skills and community participation. An analysis of questionnaire, database, interview and clinical data is used to demonstrate how HASI contributes to increased social and community participation. The article concludes with policy implications for supported housing models that aim to facilitate meaningful community participation for people with mental illness.

Tricks of the Trade in Community Mental Health Research: Working With Mental Health Services and Clients

The complexities of research in the community mental health sector are seldom acknowledged in existing literature; this article attempts to address this void. It presents the methodological challenges experienced in the longitudinal evaluation of the Housing and Accommodation Support Initiative—a program that supports people with chronic mental illness toward long-term recovery. The evaluation provides a case study for understanding methodological problems in community mental health research, which include working with organizations that experience high staff turnover; staff members who have large caseloads; and clients who have chronic mental illness. Although not applicable to all research designs, the suggested strategies highlight the importance of innovation, flexibility, and balance between research theory and practical limitations when conducting community mental health research.

Healthcare reform: implications for knowledge translation in primary care

BackgroundThe primary care sector represents the linchpin of many health systems. However, the translation of evidence-based practices into patient care can be difficult, particularly during healthcare reform. This can have significant implications for patients, their communities, and the public purse. This is aptly demonstrated in the area of sexual health. The aim of this paper is to determine what works to facilitate evidence-based sexual healthcare within the primary care sector.Methods431 clinicians (214 general practitioners and 217 practice nurses) in New South Wales, Australia, were surveyed about their awareness, their use, the perceived impact, and the factors that hindered the use of six resources to promote sexual healthcare. Descriptive statistics were calculated from the responses to the closed survey items, while responses to open-ended item were thematically analyzed.ResultsAll six resources were reported to improve the delivery of evidence-based sexual healthcare. Two resources – both double-sided A4-placards – had the greatest reach and use. Barriers that hindered resource-use included limited time, limited perceived need, and limited access to, or familiarity with the resources. Furthermore, the reorganization of the primary care sector and the removal of particular medical benefits scheme items may have hampered clinician capacity to translate evidence-based practices into patient care.ConclusionsFindings reveal: (1) the translation of evidence-based practices into patient care is viable despite reform; (2) the potential value of a multi-modal approach; (3) the dissemination of relatively inexpensive resources might influence clinical practices; and (4) reforms to governance and/or funding arrangements may widen the void between evidence-based practices and patient care.

The impact of knowledge, attitudes and beliefs on the engagement of primary and community-based healthcare professionals in cancer care: a literature review

Abstract Background: Primary health services are well placed to reinforce prevention, early intervention, and connected care. Despite this important role, primary care providers (PCPs) have a limited capacity to meet the varied needs of people with cancer and their carers – furthermore, the reasons for this largely remain unexplored. Scope: To identify: (1) the knowledge, attitudes, and beliefs held by health professionals and patients that can influence the engagement of PCPs with the early detection of cancer and follow-up care; (2) evidence that attitudes and beliefs can be modified with measureable impact on the engagement of PCPs with cancer care; and (3) potential targets for intervention. This was achieved through a review of English publications from 2000 onwards, sourced from six academic databases and complemented with a search for grey literature. Findings: A total of 4212 articles were reviewed to identify studies conducted in the UK, Canada, Holland (or The Netherlands), Australia, or New Zealand given the comparable role of PCPs. Several factors hinder PCP participation in cancer care, all of which are related to knowledge, attitudes, and beliefs. Patients and specialists are uncertain about the role that primary care could play and whether their primary care team has the necessary expertise. PCPs have varied opinions about the ideal content of follow-up programs. Study limitations include: the absence of well accepted definitions of key terms; the indexing systems used by databases to code publications, which may have obscured all relevant publications; the paucity of robust research; and possible researcher bias which was minimized through independent review by trained reviewers and the implementation of rigorous inter-rater reliability measures. Conclusions: Knowledge, attitudes, and beliefs influence PCP engagement in cancer care. It is important to develop shared understandings of these terms because the knowledge, attitudes, and beliefs of PCPs, specialists, patients, and their families can influence the effectiveness of treatment plans.

How can non-clinical case management complement clinical support for people with chronic mental illness residing in the community?

The recovery of people with chronic mental illness who reside in the community requires integrated support services. Yet evidence of poor collaboration in the mental health system abounds and there is little understanding of how non-clinical case managers can work effectively with clinical services. This article analyses an example from the mental health Housing and Accommodation Support Initiative in Australia. Using interviews (42 consumers, family members and mental health workers) and consumer care plans (20), the article explores how clinical and non-clinical case managers worked together in consumer care planning and examines the perceived influence of support. The research found they worked effectively in care planning when the planning was consumer-driven; there was active participation from consumers, non-clinical and clinical case managers; and when planning was treated as a process, with incremental goals, reflective practice, as well as shared understanding and commitment to the collaboration.

From bench to bedside: Methods that help clinicians use evidence-based practice

Abstract Despite the increasing number of evidence-based practices and the significant use of public resources towards these, clinicians and practitioners do not consistently use evidence available to them. This paper examines methods that help clinicians and practitioners adopt evidence-based practices. A review was done of 69 systematic reviews, meta-analyses and literature reviews. Several methods can change the knowledge and skill base of professionals, and, to a lesser extent, patient health outcomes; namely, educational interventions; electronic methods; credible and skilled leadership; feedback; discussion; financial incentives; guidelines; portfolios; simulations; and visits from trained individuals. While robust evidence is lacking, effective interventions are likely to be multimodal; address the needs of the target group; be well-planned; be intensive; encourage active participation; be relevant to the clinical context; and provide opportunities for ongoing professional development. The dissemin...

Finding brilliance using positive organizational scholarship in healthcare.

PURPOSE Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the brilliant is as important as conventional approaches that focus on the negative, the problems, and the failures. POSH offers different opportunities to learn from and build resilient cultures of safety, innovation, and change. It is not separate from tried and tested approaches to health service improvement--but rather, it approaches this improvement differently. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH POSH, appreciative inquiry (AI) and reflective practice were used to inform an exploratory investigation of what is good, excellent, or brilliant health service management. FINDINGS The researchers identified new characteristics of good healthcare and what it might take to have brilliant health service management, elucidated and refined POSH, and identified research opportunities that hold potential value for consumers, practitioners, and policymakers. RESEARCH LIMITATIONS/IMPLICATIONS The secondary data used in this study offered limited contextual information. PRACTICAL IMPLICATIONS This approach is a platform from which to: identify, investigate, and learn about brilliant health service management; and inform theory and practice. SOCIAL IMPLICATIONS POSH can help to reveal what consumers and practitioners value about health services and how they prefer to engage with these services. ORIGINALITY/VALUE Using POSH, this paper examines what consumers and practitioners value about health services; it also illustrates how brilliance can be theorized into health service management research and practice.

Health LEADS Australia and implications for medical leadership

Purpose – The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services. Design/methodology/approach – The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated. Findings – For the well-bein...