Impact of a standardised rapid response system on clinical outcomes of female patients: an interrupted time series approach.

Background: This study aimed to assess the impact of a standardised rapid response systems (the Between the Flags (BTF)) implemented across New South Wales (NSW), Australia, among female patients.

Methods: We conducted an interrupted time series (2007-2013) population-based linkage study including 5 114 170 female patient (≥18 years old) admissions in all 232 public hospitals in NSW. We studied changes in levels and trends of patient outcomes after BTF implementation among four age groups of female patients.

The effectiveness of a standardised rapid response system on the reduction of cardiopulmonary arrests and other adverse events among emergency surgical admissions.

Aim: A standardised rapid response system (RRS), called the "Between-the-Flags" (BTF) program, was implemented across a large health jurisdiction in Australia in 2010. The impact of RRS on emergency surgical admissions is unknown.

Methods: We linked the NSW Admitted Patient Data Collection (APDC) and the NSW Registry of Births, Deaths, and Marriages.

Hospital variability of postoperative sepsis and sepsis-related mortality after elective coronary artery bypass grafting surgery.

Purpose: Hospital variability of postoperative sepsis and sepsis-related mortality after elective CABG surgery was not known in Australia.

Material And Methods: Population-based analysis of all elective patients who underwent CABG surgery in public and private hospitals between 2007 and 2014 using linked data from the state-wide Admitted Patient Data Collection and the NSW Registry of Births, Deaths, and Marriages.

Results: We identified 18,928 (9464 pairs) matched patients who had elective CABG surgery in public hospitals (n = 9) and private hospitals (n = 13) during the study period.

Socio-demographic disparities in the utilisation of general practice services for Australian children - Results from a nationally representative longitudinal study.

Objective: This study aimed to investigate the pattern of general practice services utilization for Australian children and to examine socio-demographic disparities in general practitioner (GP) visits.

Methods: We used the linked data from the nationally representative Longitudinal Study of Australian Children (LSAC) and the Medicare Australia claims data record. We used survey negative binomial and logistic regression to examine the socio-demographic factors associated with the utilisation of general practice services.

The impact of post-operative sepsis on mortality after hospital discharge among elective surgical patients: a population-based cohort study.

Background: Our aim in the present study was to assess the mortality impact of hospital-acquired post-operative sepsis up to 1 year after hospital discharge among adult non-short-stay elective surgical patients.

Methods: We conducted a population-based, retrospective cohort study of all elective surgical patients admitted to 82 public acute hospitals between 1 January 2007 and 31 December 2012 in New South Wales, Australia. All adult elective surgical admission patients who stayed in hospital for ≥4 days and survived to discharge after post-operative sepsis were identified using the Admitted Patient Data Collection records linked with the Registry of Births, Deaths, and Marriages.

Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

Background: Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia.

Methods: A population-based study using all admitted patients (aged 18-90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002-2009.

Impact of a standardized rapid response system on outcomes in a large healthcare jurisdiction.

Aim: To assess the impact of a standardized rapid response system (RRS) implemented across a large health care jurisdiction on reducing serious adverse events, hospital mortality and unexpected deaths.

Method: We conducted an interrupted time series (2007-2013) population-based study in the state of New South Wales (NSW), Australia to evaluate the impact of introducing a statewide standardized RRS (the between-the-flags [BTF] system) which employed a five-component intervention strategy. We studied 9,799,081 admissions in all 232 public hospitals in NSW.

Incidence and mortality of postoperative sepsis in New South Wales, Australia, 2002-2009.

Objective: To describe the incidence and mortality of postoperative sepsis in New South Wales, Australia.

Design, Setting And Participants: A retrospective study of adult elective surgical admissions (n = 229 918) in 82 public acute care hospitals in NSW, 2002-2009.

Main Outcome Measures: Changes in the incidence rate of post-operative sepsis and sepsis-related mortality.

Delayed Emergency Team Calls and Associated Hospital Mortality: A Multicenter Study.

Objective: We tested the hypothesis that responses to physiologic deterioration in hospital ward patients delayed by more than 15 minutes are associated with increased mortality.

Design, Setting, And Participants: We used data from a 23-hospital cluster randomized trial (January 2004 to December 2004) of implementation of rapid response teams (intervention) versus standard practice with conventional cardiac arrest team-based responses to emergencies (control). We examined emergency calls in all hospitals.

Geographic variation of failure-to-rescue in public acute hospitals in New South Wales, Australia.

Despite the wide acceptance of Failure-to-Rescue (FTR) as a patient safety indicator (defined as the deaths among surgical patients with treatable complications), no study has explored the geographic variation of FTR in a large health jurisdiction. Our study aimed to explore the spatiotemporal variations of FTR rates across New South Wales (NSW), Australia. We conducted a population-based study using all admitted surgical patients in public acute hospitals during 2002-2009 in NSW, Australia.

Rate of venous thromboembolism among surgical patients in Australian hospitals: a multicentre retrospective cohort study.

Objectives: Despite the burden of venous thromboembolism (VTE) among surgical patients on health systems in Australia, data on VTE incidence and its variation within Australia are lacking. We aim to explore VTE and subsequent mortality rates, trends and variations across Australian acute public hospitals.

Setting: A large retrospective cohort study using all elective surgical patients in 82 acute public hospitals during 2002-2009 in New South Wales, Australia.

Cardiopulmonary arrest and mortality trends, and their association with rapid response system expansion.

Objectives: To understand the changes in the population incidence of inhospital cardiopulmonary arrest (IHCA) and mortality associated with the introduction of rapid response systems (RRSs).

Design, Setting And Participants: Population-based study of 9 221 138 hospital admissions in 82 public acute hospitals in New South Wales, using data linked to a death registry, from 1 Jan 2002 to 31 Dec 2009.

Main Outcome Measures: Changes in IHCA, IHCA-related mortality, hospital mortality and proportion of IHCA patients surviving to hospital discharge.

The impact of implementing a rapid response system: a comparison of cardiopulmonary arrests and mortality among four teaching hospitals in Australia.

Aims: To compare clinical outcomes between a teaching hospital with a mature rapid response system (RRS), with three similar teaching hospitals without a RRS in Sydney, Australia.

Methods: For the period 2002-2009, we compared a teaching hospital with a mature RRS, with three similar teaching hospitals without a RRS. Two non-RRS hospitals began implementing the system in 2009 and a third in January 2010.

Trends and variations in the rates of hospital complications, failure-to-rescue and 30-day mortality in surgical patients in New South Wales, Australia, 2002-2009.

Background: Despite the increased acceptance of failure-to-rescue (FTR) as an important patient safety indicator (defined as the percentage of deaths among surgical patients with treatable complications), there has not been any large epidemiological study reporting FTR in an Australian setting nor any evaluation on its suitability as a performance indicator.

Methods: We conducted a population-based study on elective surgical patients from 82 public acute hospitals in New South Wales, Australia between 2002 and 2009, exploring the trends and variations in rates of hospital complications, FTR and 30-day mortality. We used Poisson regression models to derive relative risk ratios (RRs) after adjusting for a range of patient and hospital characteristics.

A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting.

Background: Despite growing interest and urges by leading experts for the routine collection of patient reported outcome (PRO) measures in all general care patients, and in particular cancer patients, there has not been an updated comprehensive review of the evidence regarding the impact of adopting such a strategy on patients, service providers and organisations in an oncologic setting.

Methods: Based on a critical analysis of the three most recent systematic reviews, the current systematic review developed a six-method strategy in searching and reviewing the most relevant quantitative studies between January 2000 and October 2011 using a set of pre-determined inclusion criteria and theory-based outcome indicators. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to rate the quality and importance of the identified publications, and the synthesis of the evidence was conducted.

Effective discharge planning - timely assignment of an estimated date of discharge.

Objective: To examine the implementation of estimated date of discharge (EDD) for planned admissions and admissions via the emergency department, to assess the variance between EDD and the actual date of discharge (ADD), and to explore the determinants of delayed discharge in a tertiary referral centre, Sydney, Australia.

Methods: Primary data from a convenience sample of 1958 admissions for allocation of EDDs were linked with administrative data. The window for assigning EDDs for planned admissions was 24h, for admissions via the emergency department it was 48h.

Have the health gaps between Indigenous and non-Indigenous Australian children changed over time? Results from an Australian National Representative Longitudinal Study.

The purpose of this study was to evaluate the changes of health gaps between Indigenous and non-Indigenous children over time and to explore critical factors that contribute to the changes. We employed data consisting of two cohorts of Australian children: infant (0/1 year) and children (4/5 years) that are part of the Longitudinal Study of Australian Children. Health outcomes were measured by physical outcome index (POI) and parent-rated health during 2004, 2006 and 2008.

Ethnic and Indigenous access to early childhood healthcare services in Australia: parents' perceived unmet needs and related barriers.

Objective: To evaluate the parents' perceived unmet needs in early childhood healthcare services among Indigenous, non-English-speaking background (NESB) and English-speaking background (ESB) children and the related barriers.

Method: Data was from the Longitudinal Study of Australian Children (LSAC). Rao-Scott chi-square was used to examine the level of parents' perceived unmet needs in three ethnic groups in early childhood healthcare services over a 12 month period.

The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in Australia.

Objective: To examine the differences in health services utilisation and the associated risk factors between Indigenous and non-Indigenous infants at a national level in Australia.

Methods: We analysed data from a national representative longitudinal study, the Longitudinal Study for Australian Children (LSAC) starting in 2004. We used survey logistic regression and survey multiple linear regression to examine the factors associated with health services utilisation.

Health services utilisation disparities between English speaking and non-English speaking background Australian infants.

Background: To examine the differences in health services utilisation and the associated risk factors between infants from non-English speaking background (NESB) and English speaking background (ESB) within Australia.

Methods: We analysed data from a national representative longitudinal study, the Longitudinal Study of Australian Children (LSAC) which started in 2004. We used survey logistic regression coupled with survey multiple linear regression to examine the factors associated with health services utilisation.

Discharge delay in acute care: reasons and determinants of delay in general ward patients.

To identify the reasons and determinants of discharge delay in acute care patients, information associated with delayed discharge was extracted from the medical record of 1958 patients in a tertiary referral hospital in New South Wales. A logistic regression model was used to examine the association between demographic factors and reasons for discharge delay. Delayed discharge was most commonly associated with the patient's medical conditions, delayed health care or medical consultation, delayed diagnostic services and delayed allied health services.