Australian Healthcare Sector Research Articles

An Exploration of Registered Nurses' Experiences Caring for Patients Taking Medicinal Cannabis.

This study aimed to describe nurses' experiences caring for patients who use medicinal cannabis. For the purpose of this study, the term 'medicinal cannabis' is used to describe cannabis-based products that are sourced legally or illegally. Qualitative study using thematic analysis. Eleven registered nurses explored their experiences caring for patients using medicinal cannabis in the Australian healthcare sector. Semistructured interviews were via telephone, Zoom or face to face. Transcribed interview data were analysed using the six phases of thematic analysis. The nurses' experiences of caring for patients who use medicinal cannabis were described in three themes; 'Searching for predictable processes of regulation, access and use of medicinal cannabis', 'One conundrum after another' and 'There is a lot to learn'. Overall, nurses described feeling underprepared to care for patients who use or want to use medicinal cannabis in the Australian healthcare sector. The results indicate that nurses want to have meaningful discussions with patients about the use of medicinal cannabis, yet do not always have the confidence to do so. Nurses sought their own education on how to better support patients. All participants echoed the need for education. The nurse's role in caring for and supporting patients using medicinal cannabis could improve the patient experience. Nurses play an essential role in improving the patient's experience and advocating for those using or wanting to discuss medicinal cannabis as a part of holistic care. Defining the nurse's role in effectively caring for patients can begin by providing evidence-based education to nurses. Including nurses in policy development and beginning to understand the legal and regulatory implications for nurses are important. This is the first study presenting current issues for nurses who care for patients using medicinal cannabis in Australian healthcare systems. COREQ guidelines were adhered to for this study. For this research project on the experiences of registered nurses caring for patients using medicinal cannabis, we did not engage members of the patient population or the general public.

From Dis-empowerment to empowerment: Crafting a healthcare cybersecurity self-assessment

Due to the valuable and sensitive nature of its data, the Australian healthcare sector is increasingly targeted by cyberattacks. Existing cybersecurity evaluation methods often lack the specificity required to address the unique vulnerabilities within this sector, especially in terms of engaging stakeholders and fostering a proactive security culture. These evaluations often overlook psychological empowerment, which enhances individuals’ confidence in managing cybersecurity.This study aims to develop a tailored cybersecurity self-assessment index for the Australian healthcare system. It will focus on enhancing psychological empowerment alongside technical assessments to improve overall sector resilience against cyber threats.Using a design science research approach, the index was developed using expert reviews, online surveys, and in-depth interviews with key stakeholders, including healthcare providers, consumers, and government entities. This iterative process involved identifying gaps in existing cybersecurity measures and designing an index to address technical and human factors.The index’s evaluation through a pilot study revealed that it effectively raised awareness and empowered individuals within the healthcare sector to take ownership of cybersecurity practices. Participants reported increased confidence in managing cybersecurity risks and found the index’s actionable recommendations helpful in improving their security posture. However, challenges related to its applicability across diverse healthcare environments and regulatory constraints were identified.The Australian Healthcare Cybersecurity Self-Assessment Index shows promise as a tool for strengthening cybersecurity in the healthcare sector by integrating psychological empowerment with technical assessments. Further research is needed to refine the tool, incorporate quantitative data, and explore its scalability across different healthcare settings and global applications.

Assessing the Impact of Innovation Processes on Electronic Systems Technology Adoption

Objectives: This study aims to explore the adoption of electronic health records (EHRs) in the Australian private healthcare sector by integrating three prominent innovation models, namely the Technology Acceptance Model (TAM), the Diffusion of Innovation (DOI) model, and the Technology-Organization-Environment (TOE) framework. The objective of the study is to understand how these combined models might better inform the EHR adoption process and identify the key factors influencing successful implementation. Methods/Analysis: An exploratory qualitative research design employing a phenomenological approach was utilized to investigate the research. Data were collected through semi-structured interviews with senior managers at a private hospital in South-East Queensland. Purposive sampling was employed to select participants, ensuring representation from key decision-makers involved in the EHRs planning process. Thematic analysis, guided by the reflexive thematic analysis (RTA) approach of Braun and Clarke, was used to analyze the data and derive insights into the factors influencing EHRs adoption. Findings: Key findings indicate that perceived usefulness and job relevance (from TAM), innovation attributes and communication channels (from DOI), and technological, organizational, and environmental contexts (from TOE) are critical elements for successful EHRs implementation. The study also highlights the importance of user engagement, comprehensive training, leadership support, and financial resources. Novelty/Improvement: This study offers a novel contribution by integrating the TAM, DOI, and TOE models to provide a more holistic understanding of EHRs adoption in the private healthcare sector. It also introduces the concept of time as a critical innovation artefact, highlighting its significance in the adoption process. Doi: 10.28991/ESJ-2024-08-05-02 Full Text: PDF

The impact of board capital on total value reporting: evidence from the Australian health care sector

PurposeThis study investigates the association between board gender diversity and multiple directorships, two board characteristics representing human, social and relational capital and the extent to which corporate reporting (using the double materiality principle) explains value creation for the organization, environment, society and the economy, which we define as total value reporting.Design/methodology/approachThis study uses a disclosure index developed based on the Integrated Reporting Framework and the Global Reporting Initiative (G4) guidelines to analyze disclosures made using the double materiality principle and reflect the value created by companies. The sample includes corporate reports of 102 Australian Securities Exchange (ASX) companies in the Health Care sector. Ordinary least squares regression analyses test the relationship between board gender diversity and multiple directorships and the quality of total value reporting (and its subcomponents) with appropriate control variables.FindingsFindings reveal that human, social and relational capital formed through multiple directorships and gender-diverse boards is positively related to the quality of total value reporting. Results hold for alternative measures and sensitivity tests of gender diversity and multiple directorships.Practical implicationsOur study reveals that (1) the <IR> Framework, when combined with the GRI Framework, effectively measures connected information quality under a double materiality perspective for total value reporting; (2) enhancing board effectiveness for total value reporting is achievable by increasing female directors and those with multiple directorships; (3) limitations in accessing experienced directors, particularly women, do not disadvantage countries like Australia and (4) directors holding multiple board positions are pivotal in disseminating best practices in corporate governance and reporting across various companies and industries.Social implicationsOur research reveals that gender diversity on corporate boards transcends mere representation, significantly enhancing how firms articulate their value to stakeholders. This finding underscores the urgency for public policies to advocate for increased female board representation. Additionally, our findings indicate that board diversity, encompassing gender, experience, industry background and cultural perspectives, can elevate transparency in reporting, crucial for attracting global investors, particularly in emerging markets.Originality/valueOur study is an early attempt to examine total value reporting – underpinned by double materiality – which reports on how companies create value for themselves, the environment and society. It is one of the first to identify drivers of reporting based on double materiality.

The need for cybersecurity self-evaluation in healthcare

The Australian healthcare sector is a complex mix of government departments, associations, providers, professionals, and consumers. Cybersecurity attacks, which have recently increased, challenge the sector in many ways; however, the best approaches for the sector to manage the threat are unclear. This study will report on a semi-structured focus group conducted with five representatives from the Australian healthcare and computer security sectors. An analysis of this focus group transcript yielded four themes: 1) the challenge of securing the Australian healthcare landscape; 2) the financial challenges of cybersecurity in healthcare; 3) balancing privacy and transparency; 4) education and regulation. The results indicate the need for sector-specific tools to empower the healthcare sector to mitigate cybersecurity threats, most notably using a self-evaluation tool so stakeholders can proactively prepare for incidents. Despite the vast amount of research into cybersecurity, little has been conducted on proactive cybersecurity approaches where security weaknesses are identified weaknesses before they occur.

Economic Evaluation of HLA-B*15:02 Genotyping for Asian Australian Patients With Epilepsy

The HLA-B*15:02 allele has been associated with an increased risk of carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in specific Asian populations (including Han Chinese, Malaysian, Thai, and Vietnamese individuals). While HLA-B*15:02 genotype testing in Asian populations is recommended by several international prescribing guidelines, it is not subsidized by the Medicare Benefits Schedule in Australia. To evaluate the cost-effectiveness of HLA-B*15:02 genotyping in Asian Australian patients with epilepsy. A model with components of decision analysis and Markov simulation was developed to simulate clinical trajectories of adult Asian Australian patients with newly diagnosed epilepsy being considered for carbamazepine treatment. Cost-effectiveness and cost-utility analyses over a lifetime time horizon were conducted from the perspective of the Australian health care sector. The study was conducted in May 2023 and data analysis was performed from August 2023 to November 2023. No HLA-B*15:02 genotyping and the empirical initiation of treatment with carbamazepine vs HLA-B*15:02 genotyping and the initiation of treatment with valproate in allele carriers. Life-years (LYs), quality-adjusted life-years (QALYs), and costs in 2023 Australian dollars (A$); incremental cost-effectiveness ratios. HLA-B*15:02 screening was associated with an additional mean cost of A$114 (95% CI, -A$83 to A$374; US$76; 95% CI, -US$55 to US$248) and a reduction in 0.0152 LYs (95% CI, 0.0045 to 0.0287 LYs) but improvement by 0.00722 QALYs (95% CI, -0.0247 to -0.01210) compared with no screening, resulting in an incremental cost-effectiveness ratio of A$15 839 per QALY gained (US$10 523 per QALY). Therefore, universal genotyping for Asian Australian individuals was cost-effective compared with current standards of practice at the A$50 000 per QALY willingness-to-pay threshold. Sensitivity analyses demonstrated that the intervention remained cost-effective across a range of costs, utilities, transition probabilities, and willingness-to-pay thresholds. At the A$50 000 per QALY willingness-to-pay threshold, universal screening was the preferred strategy in 88.60% of simulations. The results of this economic evaluation suggest that HLA-B*15:02 screening represents a cost-effective choice for Asian Australian patients with epilepsy who are being considered for treatment with carbamazepine.

The current state of sustainable healthcare in Australia.

ObjectiveTo provide the first document map of sustainability and decarbonisation actions across the Australian healthcare sector, as reported in publicly available documents online, and to identify gaps in actions.MethodsHealthcare providers were identified across all state and territories. Structured Google searches between August and December 2022 were followed by document searches. Updates were undertaken, most recently in December 2023. Targeted documents included position statements, strategies, and reports. Key points from these documents pertaining to sustainability and/or decarbonisation were extracted and descriptively analysed.ResultsA total of 294 documents were included, mostly focused on power generation, transport, building design, and circular procurement/waste pathways. In contrast, relatively few plans for decarbonisation of clinical care were identified (n=42). National and two state governments (New South Wales, Western Australia) have established healthcare sustainability and decarbonisation units, and two further states have publicly committed to doing so (Queensland, Tasmania). However, these documents generally reported separate, siloed actions. While attempts were made to make this review comprehensive, some documents may have been missed or are only available inside an organisation, and new actions will continue to emerge.ConclusionBroad sustainability plans have been developed by many healthcare providers; however, to achieve net zero, decarbonising of clinical practices is also needed, and this is where the least action is currently occurring. To decarbonise clinical care, the sector needs to come together in a more coordinated way.

“It's not a one operation fits all”: A qualitative study exploring fee setting and participation in price transparency initiatives amongst medical specialists in the Australian private healthcare sector

The Australian government, through Medicare, defines the type of medical specialist services it covers and subsidizes, but it does not regulate prices. Specialists in private practice can charge more than the fee listed by Medicare depending on what they feel ‘the market will bear’. This can sometimes result in high and unexpected out-of-pocket (OOP) payments for patients. To reduce pricing uncertainty and ‘bill shock’ faced by consumers, the government introduced a price transparency website in December 2019. It is not clear how effective such a website will be and whether specialists and patients will use it. The aim of this qualitative study was to explore factors influencing how specialists set their fees, and their views on and participation in price transparency initiatives. We conducted 27 semi-structured interviews with surgical specialists. We analysed the data using thematic analysis and responses were mapped to the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behavior model. We identified several patient, specialist and system-level factors influencing fee setting. Patient-level factors included patient characteristics, circumstance, complexity, and assumptions regarding perceived value of care. Specialist-level factors included perceived experience and skills, ethical considerations, and gendered-behavior. System-level factors included the Australian Medical Association recommended price list, practice costs, and supply and demand factors including perceived competition and practice location. Specialists were opposed to price transparency websites and lacked motivation to participate because of the complexity of fee setting, concerns over unintended consequences, and feelings of frustration they were being singled out. If price transparency websites are to be pursued, specialists' lack of motivation to participate needs to be addressed.

Consensus on Prioritisation of Actions for Reducing the Environmental Impact of a Large Tertiary Hospital: Application of the Nominal Group Technique

Hospitals are the largest greenhouse gas producers within the Australian healthcare sector due to the large amounts of energy, resource utilization, equipment and pharmaceuticals required to deliver care. In order to reduce healthcare emissions, healthcare services must take multiple actions to address the broad range of emissions produced when delivering patient care. The goal of this study was to seek consensus on the priority actions needed to reduce the environmental impact of a tertiary Australian hospital. A nominal group technique was utilized within a multidisciplinary, executive-led environmental sustainability committee to find consensus on the 62 proposed actions to reduce the environmental impact of a tertiary Australian hospital. Thirteen participants joined an online workshop during which an educational presentation was delivered, 62 potential actions were privately ranked according to two domains of 'amenability to change' and 'scale of climate impact' and a moderated group discussion ensued. The group achieved verbal consensus on 16 actions that span staff education, procurement, pharmaceuticals, waste, transport and advocacy on all-electric capital works upgrades. In addition, the individual ratings of potential actions according to each domain were ranked and shared with the group. Despite a large number of actions and varied perspectives within the group, the nominal group technique can be used to focus a hospital leadership group on priority actions to improve environmental sustainability.

Health services in Australia and the impact of antiquated rostering practices on medical scientists: a case for HR analytics and evidenced-based human resource management

PurposeThe purpose of this study is to examine the rostering practices and work experiences of medical scientists at four health services in the Australian public healthcare sector. There are over 16,000 medical scientists (AIHW, 2019) in Australia responsible for carrying out pathology testing to help save the lives of thousands of patients every day. However, there are systemic shortages of medical scientists largely due to erratic rostering practices and workload issues. The purpose of this paper is to integrate evidence-based human resource management (EBHRM), the LAMP model and HR analytics to enhance line manager decision-making on rostering to support the wellbeing of medical scientists.Design/methodology/approachUsing a qualitative methodological approach, the authors conducted 21 semi-structured interviews with managers/directors and nine focus groups with 53 medical scientists, making a total 74 participants from four large public hospitals in Australia.FindingsAcross four health services, manual systems of rostering and management decisions do not meet the requirements of the enterprise agreement (EA) and impact negatively on the wellbeing of medical scientists in pathology services. The authors found no evidence of the systematic approach of the organisations and line managers to implement the LAMP model to understand the root causes of rostering challenges and negative impact on employees. Moreover, there was no evidence of sophisticated use of HR analytics or EBHRM to support line managers' decision-making regarding mitigation of rostering related challenges such as absenteeism and employee turnover.Originality/valueThe authors contribute to HRM theory by integrating EBHRM, the LAMP model (Boudreau and Ramstad, 2007) and HR analytics to inform line management decision-making. The authors advance understandings of how EBHRM incorporating the LAMP model and HR analytics can provide a systematic and robust process for line managers to make informed decisions underpinned by data.

Cost-Utility Analysis of Rituximab vs Mycophenolate Mofetil for the Treatment of Pemphigus Vulgaris

There is an increasing body of literature that supports the use of rituximab as a first-line steroid-sparing agent in pemphigus vulgaris. However, the cost of rituximab is substantial compared with conventional agents, and there are limited health economic data to justify its use. To evaluate the cost-effectiveness of rituximab biosimilars relative to mycophenolate mofetil as a first-line steroid-sparing agent for moderate to severe pemphigus vulgaris. A cost-utility analysis over a 24-month time horizon was conducted from the perspective of the Australian health care sector using a modeled cohort of treatment-naive adult patients with moderate to severe pemphigus vulgaris. A Markov cohort model was constructed to simulate disease progression following first-line treatment with rituximab biosimilars or mycophenolate mofetil. The simulated cohort transitioned between controlled disease, uncontrolled disease, and death. Efficacy and utility data were obtained from available published literature. Cost data were primarily obtained from published government data. One-way and probabilistic sensitivity analyses were performed to assess uncertainty. Primary outcomes were the changes in cost and quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) over the 24 months. Rituximab biosimilars and mycophenolate mofetil. The simulated cohort of treatment-naive patients had a mean age of 50.8 years, a female-to-male ratio of 1.24, and moderate to severe disease as classified by the Harman criteria. First-line rituximab biosimilars were associated with a cost reduction of AU$639 and an improvement of 0.07 QALYs compared with mycophenolate mofetil, resulting in an ICER of -AU$8818/QALY. Rituximab biosimilars were therefore more effective and less costly compared with mycophenolate mofetil. Sensitivity analyses demonstrated that rituximab biosimilars remained cost-effective across a range of values for cost, utility, and transition probability input parameters and willingness-to-pay thresholds. In this cost-utility analysis, rituximab biosimilars were cost-effective compared with mycophenolate mofetil for moderate to severe pemphigus vulgaris. Further investigation into its cost-effectiveness over a longer time horizon is necessary, but the favorable results of this study suggest that the high acquisition costs of rituximab biosimilars may be offset by its effectiveness and provide economic evidence in support of its listing on the Pharmaceutical Benefits Scheme for pemphigus vulgaris.

Supporting GPs in the Management of Children and Young People with ADHD Through Project ECHO®: Results from a Self-Efficacy Survey.

Introduction:Attention Deficit Hyperactivity Disorder (ADHD) accounts for a high proportion of paediatric outpatient visits in Australia. Shared care by general practitioners (GPs) would deliver more timely care, closer to home, however GPs indicated the need for interprofessional training support. This study describes the use of Project ECHO®, a guided practice model, to support GPs with ADHD management, by connecting them virtually with an interprofessional team of paediatric specialists using a structured methodology.Methods:A retrospective pre/post-knowledge and self-efficacy survey across twenty-seven aspects of ADHD management was administered, using a seven-point Likert scale.Results:Significant improvement (p < 0.001) in provider self-efficacy was demonstrated across all tested domains.Discussion:Use of the ECHO model™ by an interprofessional team of paediatric specialists achieved an increase in GP knowledge and self-efficacy in the local management of children and young people with complex healthcare needs. Learnings indicate viability to expand the application of the ECHO model™ to address fragmentation for other priority populations across the Australian healthcare and human service sector landscape.Conclusion:Use of the ECHO model™ to support and train GPs was successful. Integration of care was achieved through strengthened partnerships between content and context experts, and the ECHO model™’s case-based learning methodology.

Evaluating an Aboriginal community controlled residential alcohol and other drug services: Use of benchmarking to examine within treatment changes in wellbeing.

Aboriginal Community Controlled Organisations (ACCO) have an important role in the Australian health-care sector. However, there has been a lack of research evaluating ACCOs in the treatment of alcohol and other drug (AOD) use. Using a benchmarking approach, the present study examined within treatment changes on measures of wellbeing for people attending a residential AOD ACCO. The study focused on The Glen, an AOD residential treatment service that is managed by the Ngaimpe Aboriginal Corporation (n=775). The Glen is a male-only service and provides treatment to both Indigenous and non-Indigenous men. The evaluation focused on measures of wellbeing (i.e. symptom distress and quality of life) collected at intake, 30 and 60 days during the person's stay. Comparative benchmarking was conducted with a cohort of men who were attending non-ACCO residential AOD treatment services (n=4457). The Glen participants demonstrated statistically significant improvements on measures of wellbeing. The Glen participants were more likely to complete treatment than participants attending non-ACCO services. Likewise, Indigenous people attending The Glen were more likely to complete treatment (compared to Indigenous people attending non-ACCO services). Rates of reliable and clinically significant change suggested that changes in quality of life were largely equivalent between The Glen and non-ACCO services, while participants attending The Glen tended to demonstrate larger reductions in symptom distress compared to the non-ACCO services. The study provides further support for the important role that ACCOs play in supporting Indigenous people in their recovery.

Effect of barrier related factors on perceived usefulness and ease of use of social media applications in the Australian healthcare sector

Despite the growing popularity of social media internationally, an extant review of the literature revealed a low rate of social media usage among healthcare professionals. While cynicism amongst healthcare professionals might be a reason, there might be other factors that could explain healthcare professionals’ reluctance to use social media in their practices. This research investigated potential barriers that affected healthcare professionals’ behavioural intention to use social media. A cross-sectional survey was randomly administered to 824 healthcare professionals working in Australian healthcare organisations. At the end of data collection, 219 usable responses were collected. Analysis of data via structural equation model (SEM) found that perceived trust, privacy threats, professional boundary, facilitating conditions and self-efficacy significantly influence the notion of perceived usefulness and ease of use. In addition, information quality directly influences health professionals’ perceived ease of utilising social media technology. The result also indicated that gender moderates the relationship between barrier-related factors and perceived usefulness and ease of use. This study’s findings have important implications for healthcare providers and policymakers regarding medical professionals’ perceptions of the potential challenges in using social media as well as developing strategies to counter misinformation against the backdrop of COVID-19.

Cost-effectiveness of professional-mode flash glucose monitoring in general practice among adults with type 2 diabetes: Evidence from the GP-OSMOTIC trial.

To assess the cost-effectiveness of professional-mode flash glucose monitoring in adults with type 2 diabetes in general practice compared with usual clinical care. An economic evaluation was conducted as a component of the GP-OSMOTIC trial, a pragmatic multicentre 12-month randomised controlled trial enrolling 299 adults with type 2 diabetes in Victoria, Australia. The economic evaluation was conducted from an Australian healthcare sector perspective with a lifetime horizon. Health-related quality of life (EQ-5D) and total healthcare costs were compared between the intervention and the usual care group within the trial period. The 'UKPDS Outcomes Model 2' was used to simulate post-trial lifetime costs, life expectancy and quality-adjusted life years (QALYs). No significant difference in health-related quality of life and costs was found between the two groups within the trial period. Professional-mode flash glucose monitoring yielded greater QALYs (0.03 [95% CI: 0.02, 0.04]) and a higher cost (A$3807 [95% CI: 3604, 4007]) compared with usual clinical care using a lifetime horizon under the trial-based monitoring frequency, considered not cost-effective (incremental cost-effectiveness ratio=A$120,228). The intervention becomes cost-effective if sensor price is reduced to lower than 50%, or monitoring frequency is decreased to once per year while maintaining the same treatment effect on HbA1c . Including professional-mode flash glucose monitoring every 3months as part of a management plan for people with type 2 diabetes in general practice is not cost-effective, but could be if the sensor price or monitoring frequency can be reduced.

Health library spaces and the COVID-19 pandemic: insights from the Australian healthcare sector

In response to the COVID-19 pandemic and subsequent stay at home orders, libraries in health services across Australia moved to virtual service models with limited or unstaffed physical libraries. This article considers the impact of the pandemic on physical library space in clinical environments. To investigate, seven interviews were conducted with library leaders from the Australian health care sector at the end of the momentous year of 2020 – as the country caught its breath following the initial waves of the virus.

Management practices impacting on the rostering of medical scientists in the Australian healthcare sector

PurposeThis study examines the management rostering systems that inform the ways medical scientists are allocated their work in the public healthcare sector in Australia. Promoting the contributions of medical scientists should be a priority given the important roles they are performing in relation to COVID-19 and the demand for medical testing doubling their workloads (COVID-19 National Incident Room Surveillance Team, 2020). This study examines the impact of work on medical scientists and rostering in a context of uncertain work conditions, budget restraints and technological change that ultimately affect the quality of patient care. This study utilises the Job-Demands-Resources theoretical framework (JD-R) to examine the various job demands on medical scientists and the resources available to them.Design/methodology/approachUsing a qualitative methodological approach, this study conducted 23 semi-structured interviews with managers and trade union officials and 9 focus groups with 53 medical scientists, making a total 76 participants from four large public hospitals.FindingsDue to increasing demands for pathology services, this study demonstrates that a lack of job resources, staff shortages, poor rostering practices such as increased workloads that lead to absenteeism, often illegible handwritten changes to rosters and ineffectual management lead to detrimental consequences for medical scientists’ job stress and well-being. Moreover, medical science work is hidden and not fully understood and often not respected by other clinicians, hospital management or the public. These factors have contributed to medical scientists’ lack of control over their work and causes job stress and burnout. Despite this, medical scientists use their personal resources to buffer the effects of excessive workloads and deliver high quality of patient care.Originality/valueFindings suggest that developing mechanisms to promote sustainable employment practices for medical scientists are critical for the escalating demands in pathology.

Surge capacity for critical care specialised allied health professionals in Australia during COVID-19

Significant investment in planning and training has occurred across the Australian healthcare sector in response to the COVID-19 pandemic, with a primary focus on the medical and nursing workforce. We provide a short summary of a recently published article titled “Surge capacity of Australian intensive care units associated with COVID-19 admissions” in the Medical Journal of Australia and, importantly, highlight a knowledge gap regarding critical care specialised allied health professional (AHP) workforce planning in Australia. The unique skill set provided by critical care specialised AHPs contributes to patient recovery long after the patient leaves the intensive care unit, with management targeted at reducing disability and improving function, activities of daily living, and quality of life. Allied health workforce planning and preparation during COVID-19 must be considered when planning comprehensive and evidence-based patient care. The work by Litton et al. has highlighted the significant lack of available data in relation to staffing of critical care specialised AHPs in Australia, and this needs to be urgently addressed.

Caring for the carers in a public health district: A well-being initiative to support healthcare professionals.

To assess the impact of the proactive organisational resource allocation in terms of a 6-week well-being initiative to support public healthcare professionals' workplace engagement, well-being and job satisfaction. Burnout of healthcare professionals can be a major cost to the Australian economy and public healthcare sector. According to the social exchange theory, when healthcare professionals perceive that their organisation proactively allocates resources to caring for its employees, then they are more likely to reciprocate and become more engaged in their work roles. The study used a pre- and postsurvey of healthcare professionals who participated in the well-being initiative. Between February-June 2019, 172 healthcare professionals were surveyed before and after a well-being initiative. The survey included questions on workplace engagement, workplace well-being and job satisfaction. Paired t tests were used to determine whether the difference between before and after averages was significant. The TREND statement was used to ensure the quality reporting of this study. The well-being initiative had a positive impact on the healthcare professionals involved in the initiative. Nursing staff benefitted the most from the well-being initiative, while the full-time staff members and highly experienced demonstrated an increase in engagement. Well-being initiatives can be a targeted strategy to help alleviate burnout amongst healthcare professionals and build a mutually beneficial relationship between management and employees. This study shows how implementing a staff well-being initiative increases workplace engagement, which benefits both the individual and the organisation.

The Cost-Effectiveness of an Internet Intervention to Facilitate Mental Health Help-Seeking by Young Adults: Randomized Controlled Trial.

BackgroundLittle empirical evidence is available to support the effectiveness and cost-effectiveness of internet interventions to increase help-seeking behavior for mental health in young adults.ObjectiveThe aim of this study was to evaluate the cost-effectiveness of a Web-based mental health help-seeking navigation tool (Link) in comparison with usual help-seeking strategies.MethodsA cost-utility analysis alongside the main randomized trial of Link was conducted from the Australian health care sector perspective. Young adults aged 18 to 25 years were randomized to the Link intervention (n=205) or usual care (n=208) with 1- and 3-month follow-ups. The primary outcome of this study was quality-adjusted life years (QALYs) measured by the assessment of quality of life–4D. Costs were calculated based on the self-reported resource use questionnaire and were reported in 2015 Australian dollars. Primary analyses were conducted as intention-to-treat and reported as incremental cost-effectiveness ratios. Completer analyses were conducted in a sensitivity analysis.ResultsSignificantly more QALYs were gained in the intervention group than the control group (0.15 vs 0.14; P<.001). The intervention was associated with significantly lower health professional consultation costs at 1-month follow-up (mean costs Aus $98 vs Aus $162; P<.05). Costs of hospital services were lower at 3 months in the intervention arm (mean costs Aus $47 vs Aus $101); however, there was insufficient sample size to detect a significant difference between the groups. There were no statistically significant differences in the total costs between the 2 arms. Relative to the control group, those who received the intervention experienced 0.01 more QALYs (0.00-0.02) and had lower total health sector costs of Aus −$81 (Aus −$348 to Aus $186) over 3 months. The intervention was found to be more effective and less costly compared with usual help-seeking strategies. The intervention was 100% likely to be cost-effective below a willingness-to-pay value-for-money threshold of Aus $28,033 per QALY. Results were robust in the sensitivity analysis.ConclusionsOur study found that the online youth mental health help-seeking Web service is a cost-effective intervention for young people aged 18 to 25 years compared with usual search strategies. Further research is required to confirm these results.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12614001223628; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=366731