The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times: A mixed method study.

Objectives: To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED).

Methods: We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report).

The characteristics of a cohort who tamper with prescribed and diverted opioid medications.

Aims: To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®.

Methods: Participants were 606 people from three Australian jurisdictions who reported past month injecting, snorting, chewing or smoking of a pharmaceutical opioid and had engaged in these practices at least monthly in the past 6 months. Baseline interviews were conducted prior to introduction of Reformulated OxyContin® in April 2014.

Methods and predictors of tampering with a tamper-resistant controlled-release oxycodone formulation.

Background: In April 2014, a tamper-resistant controlled-release oxycodone formulation was introduced into the Australian market. This study aimed to identify the level and methods of tampering with reformulated oxycodone, demographic and clinical characteristics of those who reported tampering with reformulated oxycodone, and perceived attractiveness of original and reformulated oxycodone for misuse (via tampering).

Methods: A prospective cohort of 522 people who regularly tampered with pharmaceutical opioids and had tampered with the original oxycodone product in their lifetime completed two interviews before (January-March 2014: Wave 1) and after (May-August 2014: Wave 2) introduction of reformulated oxycodone.

Jurisdictional differences in opioid use, other licit and illicit drug use, and harms associated with substance use among people who tamper with pharmaceutical opioids.

Introduction And Aims: The harms associated with non-medical use of pharmaceutical opioid analgesics are well established; however, less is known about the characteristics and drug-use patterns of the growing and hidden populations of people using pharmaceutical opioids illicitly, including the frequency of pharmaceutical opioid injection. This paper aimed to undertake a detailed examination of jurisdictional differences in patterns of opioid use among a cohort of people who regularly tamper with pharmaceutical opioids in Australia.

Design And Methods: Data were drawn from the National Opioid Medications Abuse Deterrence study.

The impact of clinical leadership on health information technology adoption: systematic review.

Purpose: To conduct a systematic review to examine evidence of associations between clinical leadership and successful information technology (IT) adoption in healthcare organisations.

Methods: We searched Medline, Embase, Cinahl, and Business Source Premier for articles published between January 2000 to May 2013 with keywords and subject terms related to: (1) the setting--healthcare provider organisations; (2) the technology--health information technology; (3) the process--adoption; and (4) the intervention--leadership. We identified 3121 unique citations, of which 32 met our criteria and were included in the review.

Effective notification of important non-urgent radiology results: a qualitative study of challenges and potential solutions.

Introduction: We report on the implementation of a Radiology Notification System (RNS), set up by the medical imaging department of a major Sydney teaching hospital in March 2010. This study aimed to investigate the views of the medical imaging department staff about: (i) the results follow-up problem encountered by the medical imaging department prior to the implementation of the RNS; (ii) what changes occurred following implementation of the RNS; and (iii) suggestions for improving the RNS.

Methods: This is a cross-sectional qualitative study incorporating semi-structured interviews with 16 staff (15 radiologists and 1 clerk) after the implementation of the RNS.

The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature.

Study Objective: We undertake a systematic review of the quantitative literature related to the effect of computerized provider order entry systems in the emergency department (ED).

Methods: We searched MEDLINE, EMBASE, Inspec, CINAHL, and CPOE.org for English-language studies published between January 1990 and May 2011.

Can technology change the work of nurses? Evaluation of a drug monitoring system for ambulatory chronic disease patients.

Objective: To evaluate the impact of an electronic drug monitoring system (eDMS) for ambulatory rheumatology patients on time nurses spent on, and the process of, drug monitoring.

Methods: The study was conducted in the Rheumatology Department of a large metropolitan hospital. The eDMS, a module of the Hospital Clinical Information System (HCIS), was designed to allow electronic ordering and subsequent monitoring of ambulatory patients on long-term, immunosuppressive rheumatology medications.

What do radiology incident reports reveal about in-hospital communication processes and the use of health information technology?

Background: There has been recent rapid growth in the use of medical imaging leading to concerns about an increase in unnecessary investigations, patient exposure to radiation, and incorrect diagnoses. Incident reporting systems provide a portal for staff to catalogue adverse events which occur within a hospital or department. Analysing incident reports can reveal trends and provide guidance for quality improvement efforts.

Use of an electronic drug monitoring system for ambulatory patients with chronic disease: how does it impact on nurses' time spent documenting clinical care?

Medication monitoring of ambulatory rheumatology patients on Disease Modifying Anti-Rheumatic Drugs (DMARDS) is time consuming and complex, with possibilities for error. Electronic systems have the potential to improve the process. The aim of this study was to evaluate the impact of an electronic Drug Monitoring System (eDMS) on the time nurses' spent on clinical documentation associated with monitoring.

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present.

Consumer e-health: an overview of research evidence and implications for future policy.

Consumer e-health is rapidly becoming a fundamental component of healthcare. However, to date only provisional steps have been taken to increase our understanding of how consumers engage with e-health. This study, an interpretive review, assessed the evidence about consumer use of e-health and identified five categories that encompass consumer e-health: (i) peer-to-peer online support groups; (ii) self-management/self-monitoring applications; (iii) decision aids; (iv) the personal health record; and (v) Internet use.

A nurse-assisted screening and referral program for depression among survivors of colorectal cancer: feasibility study.

Objective: To test the feasibility and acceptability of a telephone-based program to screen survivors of colorectal cancer (CRC) for distress, and to refer distressed patients to their treating health service.

Design, Setting And Participants: A prospective, multicentre study involving 59 patients with CRC recruited from six public and private health services in Melbourne, Victoria, from 15 June 2008 to 22 September 2009. Patients who had completed adjuvant chemotherapy for CRC were contacted (7-10 days after recruitment [outcall one] and again 4 weeks later [outcall two]) by the Cancer Council Victoria's helpline nurse, and screened for distress with the Distress and Impact Thermometer (DIT); participants were given tailored information and support and those with distress scores of > or = 5, and impact scores of > or = 4, were referred for follow-up.

Comprehensive medical assessments for monitoring and improving the health of residents in aged care facilities: existing comprehensive medical assessments coverage and trial of a new service model.

Aim: To measure comprehensive medical assessment (CMA) completions among aged care residents in Australia; and to report the outcomes of a CMA service trial.

Methods: A population-based descriptive study of CMA completions using Medicare data; and a qualitative study of an intervention trial carried out at a 115-bed residential aged care facility in Sydney, Australia. Fifty residents participated in the trial; 15 interviews were conducted.

Stepped Skills: A team approach towards communication about sexuality and intimacy in cancer and palliative care.

Background: Cancer often has a profound and enduring impact on sexuality, affecting both patients and their partners. Most healthcare professionals in cancer and palliative care are struggling to address intimate issues with the patients in their care.

Methods: Study 1: An Australian study using semi-structured interviews and documentary data analysis.

Intimacy and sexuality after cancer: a critical review of the literature.

Experiencing a diagnosis of cancer may dramatically alter the way a person feels about themselves, their body, and their significant relationships with others at sexual and intimate levels. The purpose of this article is to provide a critical analysis of the way patient sexuality and intimacy has been constructed throughout cancer and palliative care literature. A critique of 3 well-cited communication frameworks for health professionals: the PLISSIT, ALARM, and BETTER models, will be offered.

Let's talk about sex: risky business for cancer and palliative care clinicians.

Few health professionals feel confident and comfortable when communicating with patients about the sexual and intimate changes that might occur after a diagnosis of cancer. Little research has focused on why health professionals find this type of patient communication so challenging. Drawing on data from a larger study examining issues of intimacy and sexuality from the perspectives of patients and health professionals in cancer and palliative care, this paper will present the health professional perspective.

Issues of intimacy and sexuality in the face of cancer: the patient perspective.

Experiencing a diagnosis of cancer has the potential to dramatically alter the way in which a person experiences intimate and sexual aspects of their lives. This article draws on data from a larger study into issues of intimacy and sexuality from the perspectives of patients and health professionals in cancer and palliative care. A 3-stage reflexive inquiry involved semistructured participant interviews (n = 82), textual analysis of national and international clinical practice guidelines (n = 33), and participant feedback at 15 patient and health professional educational forums.

Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs.

Objective: To explore the ways that patients and health professionals communicate about intimate and sexual changes in cancer and palliative care settings.

Design: A qualitative study using a three-stage reflexive-inquiry approach, with semi-structured, participant interviews (n = 82); textual analysis of national and international cancer and palliative care clinical practice guidelines (n = 33); and participant feedback at 15 educational forums for cancer patients or health professionals.

Setting: A large Australian public teaching hospital between 2002 and 2005.

Constructions of sexuality and intimacy after cancer: patient and health professional perspectives.

With an increasing emphasis on the provision of psychosocial support for patients in cancer and palliative care, an emerging body of literature has highlighted the importance of providing the opportunity for patients to discuss issues of intimacy and sexuality with their health professionals. Very little is known about why health professionals struggle with this level of communication in clinical practice. The aim of this paper is to discuss constructions of intimacy and sexuality in cancer and palliative care from patient and health professional perspectives.

A patient-centred approach to sexuality in the face of life-limiting illness.

Sexuality is intrinsic to a person's sense of self and can be an intimate form of communication that helps relieve suffering and lessens the threat to personhood in the face of life-limiting illness. Health professionals struggle to accept that people with life-limiting illness, especially older people, continue to be sexual beings. People facing life-limiting illness may appreciate the opportunity to discuss issues of sexuality and intimacy with a trusted health professional.

The Breast Cancer Distance Education Program: development and evaluation of a course for specialist breast care nurses.

The Breast Cancer Distance Education Program is the first tertiary-based education program for specialist breast care nurses in Australia. The program covers current treatment options, psychosocial issues, and professional development issues relating to breast cancer nursing. For the first two student intakes (n = 53), precourse, postcourse, and 3-month follow-up surveys were conducted to assess the perceived value of the course, identify any limitations, and note changes in practice that arose.

Intimacy and sexuality for the woman with breast cancer.

Human sexuality is more than sexual function. It is an ever-changing lived experience affecting the manner in which we view ourselves and our bodies. Most health professionals fail to address sexuality in the clinical setting and feel more comfortable focusing on treatment outcomes, such as the management of treatment side effects, than in addressing issues related to sexual behavior.