What is known about the topic? The did not wait (DNW) group of patients are typically younger, present during evening or night hours, and cite long wait times as the primary reason for leaving. On review of these studies, they are all single centre studies. What does this paper add? Our study analysed state-wide linked data and showed that rising ED patient volumes significantly increased the likelihood of not waiting. Those in the highest patient volume quintile were 3.5 times more likely not to wait, with younger age (15–24 year group) being 6.1 times and lower triage category 5 being 13.3 times more likely not to wait. What are the implications for practitioners? Targeted interventions addressing ED flow and outpatient access to treatment may reduce DNW rates, particularly for younger, lower-acuity patients.

What is known about the topic? The harmful use of alcohol is a major contributor to the global burden of disease, disabilities and deaths. People arriving at emergency departments with alcohol-related harm have a different demographic profile, clinical characteristics and outcomes compared with other emergency department presentations. What does this paper add? Medication, pathology and radiology are commonly required for people presenting to emergency departments with alcohol-related harm. Nearly two-thirds arrive by ambulance and arrive after hours (between 6 pm and 6 am). What are the implications for practitioners? People arriving at the emergency department with alcohol-related harm require significant resourcing.

What is known about the topic? Before the introduction of the National Mutual Acceptance scheme, overly bureaucratic research ethics and governance processes hindered Australasian maternity outcomes surveillance, and recent evidence from other disciplines suggests that multi-centre research remains obstructed by costly and inefficient governance processes. What does this paper add? Our research demonstrates: complex, repetitive and inconsistent research governance processes impede statewide review of severe acute maternal morbidity. What are the implications for practitioners? Overregulation of low- and negligible-risk research is costly and limits investigation and prevention of life-threatening obstetric conditions.

What is known about the topic? Intravenous medications have multiple steps required to safely prepare and administer. Succinct, clear instructions can be difficult to find and may be prone to error. What does this paper add? This paper reports on the establishment of a hospital clinical pharmacist-led group to develop and maintain intravenous medication guidelines on preparation, administration and relevant information to clinicians. Each guideline is regularly reviewed and improved based on end-user feedback. What are the implications for clinicians? Clinicians have access to clear, accurate guidelines tailored to the needs of the hospital that can be accessed quickly.

Online short summary

What is known about the topic? Value-based health care (VBHC) is now enmeshed within Australian healthcare conversations as well as implementation strategies. What does this paper add? This paper explores the barriers and opportunities for VBHC and compares the differing paradigms of VBHC and health economics. What are the implications for practitioners? o harmonise the two, and realise VBHCs potential, we must bridge existing misalignments, experiment with hybrid models that integrate VBHC’s focus on outcomes with health economic principles to ensure care is not just high value at the bedside, but also fair and efficient at the population level.

What is known about the topic? Current health policy emphasises value-based care: efficient, outcome-driven models that aim to improve quality and reduce cost. Emerging research shows value frameworks often prioritise clinical metrics and provider performance over patient-defined experience or meaning. What does this paper add? It argues that meaning — not just measurable value — must be foregrounded in healthcare policy. The commentary explores how policies assumed universal access but often reinforce inequity, eroding trust and excluding marginalised voices. It makes the case for treating lived experience as foundational, not optional, and for structuring policy around real-world meaning, not just metrics. What are the implications for practitioners? Practitioners should embed consumer voice early and consistently, across service design, evaluation, and funding decisions, to ensure equity and trust. They should invest time and resources in engaging voices often excluded by assumptions of universality (such as people with disability, chronic illness or low income). And they should recognise that access, dignity, and visibility must precede ‘value’ if equitable care is the goal.

What is known about the topic? The overwhelming majority of inpatient procedures in Australia are performed under no- or known-gap arrangements, but there is a suggestion that this is associated with ‘booking fees.’ What does this paper add? The arrangements that private health insurers impose on specialists mean that real fees for procedures have fallen dramatically while costs of providing care have increased. What are the implications for practitioners? At a time when private health insurers are making record profits a rethink of no- and known-gap arrangements – which constitute price caps – must occur urgently.

What is known about the topic? A reflection of the effectiveness of national health funding reforms, the challenges faced by such reforms, and considerations required to move to a value-based healthcare agenda. What does this paper add? This reflection examines Australia’s 2010 national health reforms, particularly the pursuit of technical efficiency and the unintended perverse incentives it has generated. It explores the key actors across the health system and how their influence can inadvertently shape a value-based agenda in ways that diverge from the original reform objectives. What are the implications for practitioners? It provides an opportunity to reflect that the lens that we use will impact the outcome, and that various lenses and perspectives exist when pursuing a value based health agenda. It provides insights that can improve policy to deliver effective reforms in the future.

What is known about the topic? Values-based healthcare is a driver of patient outcomes within the constraints of a challenging resource poor health care environment. What does this paper add? and what are the implications for practitioners? This paper suggests that in addition to the robust integration of ethical principles into clinical practice, an effective complaints resolution mechanism enhances the compassion and patient centredness of health care and provides a more sustainable basis for value-based healthcare into the future.

What is already known about the topic? There is no agreed-upon tool, process, or method to guide mental health nurses (MHNs) in assessing and documenting a patient’s mental state. What this paper adds? The study demonstrated that the implementation of a standardised instrument can significantly improve documentation of patient mental state. What are the implications for practitioners? A benefit of the tool is to provide a standardised template to: facilitate improved documentation of interactions and recognise change or deterioration in mental state; facilitate improved communication between health disciplines working on the treating team; enable MHNs to articulate and document complex and sometimes confusing content elicited from patient engagement and interactions; and set an agreed minimum standard for documentation.

What is known about the topic? Very little is known about the weighting of extracurricular involvement within standardised curriculum vitae scoring criteria across the Australian medical and surgical specialty training programs. What does this paper add? This paper highlights the limited and varied weighting of extracurricular activities between training programs, specifically in comparison with academic domains. What are the implications for practitioners? Specialty training programs should continue to consider the importance assigned to extracurricular involvement, and junior medical officers should consider whether their time and effort is best spent securing curriculum vitae points from an academic domain.

What is known about this topic? Regulation has a significant impact on registered health professions. This means that the design, governance, proportionality and scope of professional regulation are the focus of significant reform in many countries. What does the paper add? A unique, longitudinal view of the development and maturation of a national health practitioner regulatory system, which is multi-professional in its scope, is provided. What are the implications for practitioners? An understanding of the genesis, design and achievements of the National Registration and Accreditation Scheme and the challenges shaping future reform of regulation, reflecting wider changes in the health system, are conveyed.

What is known about the topic? Triptans effectively treat migraines when taken early. Timely access is paramount, and downscheduling in February 2021 allowed over-the-counter (OTC) triptan supply in Australia. What does this paper add? This study shows that subsidised triptan dispensing rates slowed after downscheduling, suggesting a shift to OTC access. It also estimates cost impacts for general and concessional patients. What are the implications for practitioners? OTC access may benefit patients needing immediate treatment without a prescription. However, for those with frequent migraines, subsidised prescriptions, especially for concessional patients, remain more affordable and appropriate for ongoing management. Triptans are available OTC at a reduced price (but for fewer tablets). Downscheduling of triptans has reduced the rate of PBS subsidised dispensings. Patients with acute migraines benefit from OTC triptan access. Downscheduling has the potential to lower costs for the government.