Guardianship in hospitals: a collaborative pilot project.

Objectives This paper describes the development, implementation and preliminary results of a collaborative pilot project aimed at reducing the time hospital-based patients with cognitive impairments spend waiting for the allocation of legally appointed Advocate Guardian decision makers from the Office of the Public Advocate (OPA). The aim of the study was to investigate the effect of increased availability of public advocate guardians on guardian allocation waits, patient discharge outcomes and healthcare system demand. Methods A multi-institutional pilot program created a dedicated hospital guardian team within OPA, funded by the health networks, to reduce the time to guardian allocation for patients within each network.

IMPACT: Investigating the impact of Models of Practice for Allied health Care in subacuTe settings. A protocol for a quasi-experimental mixed methods study of cost effectiveness and outcomes for patients exposed to different models of allied health care.

Introduction: This protocol considers three allied health staffing models across public health subacute hospitals. This quasi-experimental mixed-methods study, including qualitative process evaluation, aims to evaluate the impact of additional allied health services in subacute care, in rehabilitation and geriatric evaluation management settings, on patient, health service and societal outcomes.

Methods And Analysis: This health services research will analyse outcomes of patients exposed to different allied health models of care at three health services.

Complex patients: social workers' perceptions of complexity in health and rehabilitation services.

We report on a qualitative study exploring health social workers' understanding of complexity in relation to inpatients in subacute wards at three sites across a large health network in Melbourne, Australia. Findings indicate that social workers' understanding of complexity refers to five interrelated themes: multiple competing demands; uncertainty; patient and family characteristics; pending breakdown; systems challenges. Social workers with less practice experience report that complex clients present more challenges than do social workers with greater experience.