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Journal of the Australian Healthcare & Hospitals Association
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Australian Health Review

Australian Health Review

Volume 47 Number 1 2023


What is known about this topic? Australian cancer care providers deliver inequitable access and outcomes for First Nations Australians. Systemic and personal racism experienced by First Nations patients are thought to contribute to these inequities. What does this paper add? This paper documents the presence of cancer centre employee racial bias and reiterates the need for further research to document the effect of racism on cancer care outcomes for First Nations patients. What are the implications for practitioners? Healthcare practitioners, similar to other Australians, have implicit bias against First Nations Australians. Previous studies suggest that the presence of bias affects treatment options and outcomes for people of colour. In order to eliminate racism and associated inequities in cancer care services, multi-faceted anti-racism approaches are required.


What is known about the topic? The pandemic has amplified the health needs of Aboriginal and Torres Strait Islander people. What does this paper add? Strategies to enhance person-centred care and access to primary care services are essential to support the wellbeing of Aboriginal communities. The person-centred care (PCC) research that has emerged throughout the pandemic suggests that person-centredness is a priority. What are the implications for practitioners? To continue to support PCC and access, long primary care consultations must be appropriately funded. Future research should focus on the development and evaluation of innovative general practice funding models.

AH21363Attendance at, and experiences of, urban hospital outpatient appointments: informing a new model of care for urban-dwelling Aboriginal and Torres Strait Islander patients

Karen Wynter, Leanne Mullan 0000-0003-0182-2148, Tanya Druce, Gilbert Freeman, Graeme Maguire, Lauren Davidson, Harin Karunajeewa, Shane Crowe and Bodil Rasmussen
pp. 16-25

What is known about the topic? Health outcomes are poorer and burden of disease greater among Aboriginal and Torres Strait Islander people than non-Aboriginal and Torres Strait Islander people. What does this paper add? Compared to non-Aboriginal and Torres Strait Islander people, among Aboriginal and Torres Strait Islander people in urban settings, more outpatient referrals are made, but these referrals are significantly less likely to result in an outpatient clinic booking and attendance. Barriers and enablers to urban-dwelling Aboriginal and Torres Strait Islander people attending outpatient hospital appointments relate to logistical, quality of care and cultural factors. What are the implications for practitioners? Identifying and understanding the barriers and enablers to healthcare access for urban-dwelling Aboriginal and Torres Strait Islander people provides a foundation on which practitioners and organisations can facilitate urban hospital outpatient service development, with the aim to better support healthcare engagement and appointment attendance.


What is known about the topic? Examining research output, effectiveness and acceptability of existing existing parenting and child rearing programs for First Nations parents can inform research priorities and service development.. What does this paper add? Rigorous research to inform the development and evaluation of parenting programs is limited. Strengths-based, community-wide approaches should integrate community identities, expertise and resources, encourage ownership and engagement, and build capacity.. What are the implications for practitioners? Continued efforts are necessary to develop programs uniquely informed by, and tailored to, First Nations parents.

AH22187A culturally safe referral service for at-risk mothers and infants in marginalised, Aboriginal, and Culturally and Linguistically Diverse families

Anna T. Booth 0000-0001-8945-4778, Jennifer E. McIntosh, Lakshmi Sri, Sarah Decrea, Jamie Lee and Claire Ralfs
pp. 58-63

What is known about the topic? Cultural and relational safety are critical in supporting marginalised, Aboriginal and Torres Strait Islander and Culturally and Linguistically Diverse families at risk of statutory systems involvement. What does this paper add? This case study describes an early assessment and referral service for mothers experiencing minority group disadvantage. The service mitigates harms for families that can lead to involvement in child protection systems via a restorative practice approach. What are the implications for practitioners? This service will be of interest to others seeking to improve cultural safety and therapeutic outcomes for diverse and vulnerable families.

AH22192The Commonwealth Criminal Code restricts the use of carriage services to access voluntary assisted dying in Victoria: a perspective

Kate Furness 0000-0002-4176-3050, Jim Howe, Mitchell Chipman, Nirasha Parsotam and Margaret O’Connor 0000-0002-0700-8289
pp. 64-66

What is known about the topic? The Commonwealth Criminal Code Amendment (Suicide Related Material Offences) 2005 (the Code) prohibits Victorian voluntary assisted dying (VAD) trained medical practitioners from using telehealth to conduct their consultations with terminally ill individuals wishing to access VAD. What does this paper add? This paper provides a perspective on the current Code from the viewpoint of the Voluntary Assisted Dying Victoria Board and its secretariat. What are the implications for practitioners? Currently, Victorian VAD trained medical practitioners could be prosecuted for discussing their terminally ill patient’s wishes to seek out VAD using any means of electronic form of communication. This paper urges the federal government to review the Code urgently to allow equitable access to VAD in Victoria.

AH22236Pandemic planning: data, information and evidence

Peter Lewis-Hughes and Peter Brooks 0000-0001-7733-7750
pp. 67-71

What is known about the topic? Much has been reported on the challenges of coronavirus disease 2019 presented to everyone at a global and country level. The pandemic highlighted the often dysfunctional decision making at all levels that impacted on the responses of govenments. What does this paper add? This paper reviews in particular the responses of the Centers for Disease Control and Prevention (CDCs) and ‘maps’ the interjurisdictional pathways that exist or have been proposed in Australia and outlines the opportunity that the new Government has to ensure a proper process of review of these responses. It also provides some suggestions and priorities for consideration in the planning of an Australian CDC as recently canvassed in the discussion paper released by the Department of Health and Ageing. What are the implications for practitioners? An understanding of the complexities of our health ‘governance’ systems and the opportunity to commence a discussion on how we might transform our systems rather than work around the ‘edges’ to ensure we are better prepared for the next pandemic.

AH22228Adapting the ‘First 2000 Days maternal and child healthcare framework’ in the aftermath of the COVID-19 pandemic: ensuring equity in the new world

Antonio Mendoza Diaz 0000-0003-1646-7601, Ron Brooker 0000-0002-8737-2506, Sara Cibralic, Elisabeth Murphy, Sue Woolfenden and Valsamma Eapen 0000-0001-6296-8306
pp. 72-76

What is known about the topic? The ‘First 2000 Days’ policy is publicly available, it represents an important effort to highlight the importance of the first 5 years of life for a child’s development. This policy and others like it have been broadly adopted around Australia. What does this paper add? This paper is a constructive critique of the policy that suggests greater responsiveness, integration, sustainability and equity. What are the implications for practitioners? This paper helps us understand how best to shape early childhood health services so they can be most effective.


What is known about the topic? Ambulatory Care Sensitive Conditions (ACSCs) relate to conditions or diagnoses that in the paediatric context are frequently mediated by common viral illness. What does this paper add? A reduction in the numbers of presentations and admissions with paediatric ACSCs was seen during the public health measures implemented to reduce the transmission of COVID-19 in Victoria, Australia. What are the implications for practitioners? These data can assist development of healthcare policy to allow healthcare resources to be prioritised for patients in whom viral transmission is not relevant.


What is known about this topic? COVID-19 has resulted in significant pressures on critical care beds and tertiary hospital operating space. What does this paper add? Repurposing an elective surgical centre to provide emergency surgical services increased tertiary hospital surge capacity. What are the implications for practitioners? Satellite sites should be included in surge capacity plans in infectious disease epidemics and disasters. This case report details our strategies to reconfigure our elective surgical centre to an emergency service.

AH22037Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia – a qualitative study

Lillian Smyth 0000-0003-2679-2969, Suzannah Roushdy, Jerusha Jeyasingham, Joshua Whitbread, Peta O’Brien, Charles Lloyd, Christian J. Lueck, Carolyn A. Hawkins, Graham Reynolds and Diana Perriman
pp. 92-99

What is known about the topic? Clinician and patient experiences of telehealth use have already been documented in contexts where both clinician and patient have opted-in to that process. What does this paper add? The paper adds data on clinician experience across a range of specialities, from a context (pandemic public-heath measures) where the choice element was reduced for both patient and clinician. What are the implications for practitioners? The data speak to the generalisability of existing evidence, but also provide practical considerations in planning for the inclusion of telehealth for specialist health services in the Australian context.


What is known about the topic? The COVID-19 pandemic has had a significant impact on healthcare usage and access. What does this paper add? This paper identifies the impact of access to health care during the COVID-19 pandemic on vulnerable subgroups within middle-aged and older Australians, including those with chronic and mental health issues. Telehealth is an acceptable way to facilitate access to services for these groups. What are the implications for practitioners? Practitioners are strategically positioned to provide alternatives to face-to-face visits during times of limited access and identify those who are in most need of additional care by way of telehealth intervention.

AH22142COVID-19 vaccine hesitancy, acceptance and informational needs in an Australian cancer population: a cross-sectional survey

Brighid Scanlon, David Wyld, Paul Firman, Midori Nakagaki, Jo Durham, Glen Kennedy, Paul Moran, Michael Smith and Nicole Gavin
pp. 110-118

What is known about topic? People with cancer are a COVID-19 vaccine priority group, as they are at increased risk of morbidity and mortality from this disease. There is currently a dearth of information regarding COVID-19 vaccine hesitancy, acceptance, or informational needs for this population. What does this paper add? This paper has shown that although vaccine refusal rates were low in this population, feelings of hesitancy remained. Women, those in younger age categories, those with previous vaccine hesitancy and those who felt they had not received adequate information had stronger vaccine hesitancy and higher refusal rates. What are the implications for practitioners? There is a need for tailored information and open communication regarding COVID-19 vaccines and people with cancer. There is an opportunity to build upon established relationships of trust between cancer patients and their clinicians.


What is known about the topic? The real-world effectiveness of coronavirus vaccination program in preventing COVID-19 hospitalisation is 43–86% but this does not include regional programs and health services. What does this paper add? Individual absolute risk reduction for vaccinated local people was modest, but the overall local program effectiveness was substantial in preventing hospitalisations after removal of border quarantine. What are the implications for practitioners? Maintaining coronavirus vaccination programs in rural and regional areas is highly effective in preventing hospitalisations from COVID-19 after quarantine-based public health measures are removed.

AH22110Worsening general health and psychosocial wellbeing of Australian hospital allied health practitioners during the COVID-19 pandemic

Danielle Hitch 0000-0003-2798-2246, Sarah Booth, Karen Wynter, Catherine M. Said 0000-0002-8773-9750, Kimberley Haines, Bodil Rasmussen 0000-0002-6789-8260 and Sara Holton 0000-0001-9294-7872
pp. 124-130

What is known about the topic? Many cross-sectional studies report poor psychosocial wellbeing during the COVID-19 pandemic. What does this paper add? Here we provide evidence about the long-term and declining general and psychological health status of Australian allied health practitioners during the COVID-19 pandemic. What are the implications for practitioners? The psychological wellbeing of allied health practitioners has declined as the COVID-19 pandemic continues. There is an urgent need for initiatives targeting allied health practitioners that support their wellbeing and ongoing ability to provide high quality patient care.

Committee on Publication Ethics

Announcement

An English Language Editing Service is available for authors submitting to Australian Health Review.

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