80 results match your criteria: "NSW Agency for Clinical Innovation[Affiliation]"

Background And Objective: Migrant and refugee women, families, and their children can experience significant language, cultural, and psychosocial barriers to engage with child and family services. Integrated child and family health Hubs are increasingly promoted as a potential solution to address access barriers; however, there is scant literature on how to best implement them with migrant and refugee populations. Our aim was to explore with service providers and consumers the barriers, enablers, and experiences with Hubs and the resulting building blocks required for acceptable Hub implementation for migrant and refugee families.

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Introduction: Patient-reported outcome measures (PROMs) are validated and standardised questionnaires that capture patients' own reports of their symptoms, functioning and well-being. PROMs can facilitate communication between patients and clinicians, reduce symptom burden, enhance quality of life and inform health service re-design. We aim to determine the acceptability of PROMs and the preferred timing of PROM completion in New South Wales (NSW) at the point of care, facilitated by the Health Outcomes and Patient Experiences (HOPE) platform.

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Article Synopsis
  • The study focused on the incidence and characteristics of postinjury multiple organ failure (MOF) in severely injured trauma patients across five trauma centers in New South Wales, Australia.
  • Out of 600 polytrauma patients studied, 23% developed MOF, with the majority showing symptoms by day 3, and no new cases occurring after day 13.
  • Cardiac failure was the most common organ failure observed, with different mortality rates among organ failures, indicating that while MOF is rare in the general population, it is a significant risk in severely injured patients.
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Objective: Determine long-term trends in population-based incidence and outcomes of rib fracture hospitalisations.

Methods: This was a data linkage study of rib fracture cases identified between 2015 and 2022 in New South Wales, Australia. Routinely collected health data were linked between ED, admitted patient and death registry data collection.

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A survey of Australian public opinion on using comorbidity to triage intensive care patients in a pandemic.

Aust Health Rev

August 2024

Intensive Care Unit, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia; and Sydney Medical School - Concord, University of Sydney, Sydney, NSW, Australia.

Article Synopsis
  • The study aimed to assess public perceptions of fairness in intensive care triage methods during a pandemic, focusing on chronic comorbidity factors.
  • A survey conducted with 2000 registered voters evaluated the fairness of triaging based on medical conditions, long-term survival, function, and frailty, alongside preferences for vulnerable individuals and frontline workers.
  • Results revealed that while most respondents found comorbidity-based triage methods fair, a notable minority viewed it as unfair, particularly regarding preferential treatment for vulnerable groups; however, triage for healthcare workers was generally seen as fair.
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Objective: Engagement-capable health organisations recognise that consumer engagement (also known as patient engagement, consumer engagement, patient and public involvement) must occur at every level of the organisation if it is to be meaningful and genuine. Despite this aspiration, health organisations struggle to adopt, implement, and embody consumer engagement capability in a way that has yielded impact. The Partner Ring (PR) is an embedded model for building staff capability for consumer partnerships.

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Moving from participatory approaches incorporating co-design to co-production in health research involves a commitment to full engagement and partnership with people with lived experience through all stages of the research process-start to finish. However, despite the increased enthusiasm and proliferation of research that involves co-production, practice remains challenging, due in part to the lack of consensus on what constitutes co-production, a lack of guidance about the practical steps of applying this approach in respect to diverse research methods from multiple paradigms, and structural barriers within academia research landscape. To navigate the challenges in conducting co-produced research, it has been recommended that attention be paid to focusing and operationalising the underpinning principles and aspirations of co-production research, to aid translation into practice.

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Background: Despite advances in managing secondary health complications after spinal cord injury (SCI), challenges remain in developing targeted community health strategies. In response, the SCI Health Maintenance Tool (SCI-HMT) was developed between 2018 and 2023 in NSW, Australia to support people with SCI and their general practitioners (GPs) to promote better community self-management. Successful implementation of innovations such as the SCI-HMT are determined by a range of contextual factors, including the perspectives of the innovation recipients for whom the innovation is intended to benefit, who are rarely included in the implementation process.

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Background: There is a lack of consumer-friendly tools to empower and support people living with spinal cord injury (SCI) to self-manage complex health needs in community. This article describes the co-design process of the new SCI Health Maintenance Tool (SCI-HMT).

Methods: Co-design of the SCI-HMT using a mixed-methods approach included a rapid review, e-Delphi surveys with range of multidisciplinary health care professionals ( = 62), interviews of participants with SCI ( = 18) and general practitioners ( = 4), focus groups ( = 3 with 7, 4, and 4 participants with SCI, respectively), design workshops with stakeholders ( = 11, 8), and end-user testing ( = 41).

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Integrated Text Messaging (ITM) for people attending cardiac and pulmonary rehabilitation: A multicentre randomised controlled trial.

Ann Phys Rehabil Med

April 2024

Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Cardiology, Concord Repatriation General Hospital, Sydney Local Health District, NSW, Australia.

Background: People living with cardiac and respiratory disease require improved post-hospital support that is readily available and efficient.

Objectives: To 1) test the effectiveness of an automated, semi-personalised text message support program on clinical and lifestyle outcomes amongst people attending cardiac and pulmonary rehabilitation. Also, 2) to evaluate the program's acceptability and utility using patient-reported outcome and experience measures.

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Background: Unwarranted clinical variation in hospital care includes the underuse, overuse, or misuse of services. Audit and feedback is a common strategy to reduce unwarranted variation, but its effectiveness varies widely across contexts. We aimed to identify implementation strategies, mechanisms, and contextual circumstances contributing to the impact of audit and feedback on unwarranted clinical variation.

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Background: Stroke management in rural areas is more variable and there is less access to reperfusion therapies, when compared with metropolitan areas. Delays in treatment contribute to worse patient outcomes. To improve stroke management in rural areas, health districts are implementing telestroke networks.

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Prehospital times and outcomes of patients transported using an ambulance trauma transport protocol: A data linkage analysis from New South Wales Australia.

Injury

October 2023

NSW Institute for Trauma and Injury Management (ITIM), NSW Agency for Clinical Innovation (ACI), Australia; South Western Sydney Clinical School, University of New South Wales, Australia. Electronic address:

Introduction: Prehospital trauma systems are designed to ensure optimal survival from critical injuries by triaging and transporting such patients to the most appropriate hospital in a timely manner.

Objectives: We sought to evaluate whether prehospital time and location (metropolitan versus non-metropolitan) were associated with 30-day mortality in a cohort of patients transported by road ambulance using a trauma transport protocol.

Methods: Data linkage analysis of routinely collected ambulance and hospital data across all public hospitals in New South Wales (NSW).

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Introduction: Emergency department (ED) care must adapt to meet current and future demands. In Australia, ED quality measures (eg, prolonged length of stay, re-presentations or patient experience) are worse for older adults with multiple comorbidities, people who have a disability, those who present with a mental health condition, Indigenous Australians, and those with a culturally and linguistically diverse (CALD) background. Strengthened ED performance relies on understanding the social and systemic barriers and preferences for care of these different cohorts, and identifying viable solutions that may result in sustained improvement by service providers.

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Incorporating a polygenic risk score-triaged coronary calcium score into cardiovascular disease examinations to identify subclinical coronary artery disease (ESCALATE): Protocol for a prospective, nonrandomized implementation trial.

Am Heart J

October 2023

Faculty of Medicine & Health, University of Sydney, Camperdown, NSW, Australia; Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia. Electronic address:

Background: Identifying and targeting established modifiable risk factors has been a successful strategy for reducing the burden of coronary artery disease (CAD) at the population-level. However, up to 1-in-4 patients who present with ST elevation myocardial infarction do so in the absence of such risk factors. Polygenic risk scores (PRS) have demonstrated an ability to improve risk prediction models independent of traditional risk factors and self-reported family history, but a pathway for implementation has yet to be clearly identified.

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Article Synopsis
  • Large hospitals can improve patient care by working together and supporting each other when making changes.
  • Not all strategies work the same for every hospital, so it’s important to find the best ways to collaborate.
  • The study found six key principles to help hospitals work better together, like having regular meetings, building good relationships, and getting support from management.
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Introduction: Prehospital triage and transport protocols are critical components of the trauma systems. Still, there have been limited studies evaluating the performance of trauma protocols in New South Wales, such as the NSW ambulance major Trauma transport protocol (T1).

Objectives: Determine the performance of a major trauma transport protocol in a cohort of ambulance road transports METHODS: A data-linkage study using routine ambulance and hospital datasets across New South Wales Australia.

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The COVID-19 pandemic has seen an increase in rapidly disseminated scientific evidence and highlighted that traditional evidence synthesis methods, such as time and resource intensive systematic reviews, may not be successful in responding to rapidly evolving policy and practice needs. In New South Wales (NSW) Australia, the Critical Intelligence Unit (CIU) was established early in the pandemic and acted as an intermediary organisation. It brought together clinical, analytical, research, organisational and policy experts to provide timely and considered advice to decision-makers.

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Introduction: Poor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) was developed and piloted.

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Lung Support Service: Implementation of a Nationwide Text Message Support Program for People with Chronic Respiratory Disease during the COVID-19 Pandemic.

Int J Environ Res Public Health

December 2022

Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia.

Article Synopsis
  • The COVID-19 pandemic led to the closure of in-person pulmonary rehabilitation programs in Australia, prompting the evaluation of a six-month text message support program aimed at helping individuals manage their health remotely.
  • The study used the RE-AIM framework to assess the program’s reach, effectiveness, adoption, implementation, and maintenance, with findings indicating a positive reception among participants regarding the clarity and helpfulness of the messages.
  • Results showed a 36.4% enrollment rate with high satisfaction levels (e.g., 98.5% found messages easy to understand), a 92.2% retention rate, and cost-effectiveness, indicating the program's potential as a viable alternative to traditional rehabilitation methods.
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Falls from ladders in New South Wales: A data-linkage study.

Injury

February 2023

NSW Institute for Trauma and Injury Management (ITIM), NSW Agency for Clinical Innovation (ACI), 1 Reserve Road, St Leonards, NSW, 2065, Australia; Sydney Medical School, the University of Sydney, Australia.

Introduction: Fall from ladders is increasingly identified as a significant cause of injury and mortality, yet large-scale research into ladder fall outcomes and trends is limited.

Objectives: To explore the nature and severity of injuries resulting from ladder falls and to determine predictors of Injury Severity Score (ISS) and 6-month mortality.

Methods: Data were obtained from the New South Wales (NSW) Trauma Registry, Admitted Patient Data Collection and Registry of Births, Deaths, and Marriages on patients aged 15 and over who had major trauma from a ladder fall and were admitted to hospital between January 1st, 2012, and July 31st, 2019.

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Article Synopsis
  • - The study analyzed crash risk differences between young drivers born in Asia and those born in Australia using data from a large cohort of 20,806 drivers over a 13-year period.
  • - Initially, Asian-born drivers had crash risks that were less than half of their Australian-born peers, but this risk increased steadily over time, eventually becoming similar to that of Australian-born drivers.
  • - The findings suggest that as young Asian-born drivers acculturate and adopt local driving behaviors, their crash risk changes, which should be taken into account for future road safety initiatives.
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Impact of comorbidities on survival following major injury across different types of road users.

Injury

October 2022

The George Institute for Global Health, University of New South Wales, Level 5, 1 King St, Newtown, NSW 2042, Australia.

Background: While comorbidities and types of road users are known to influence survival in people hospitalised with injury, few studies have examined the association between comorbidities and survival in people injured in road traffic crashes. Further, few studies have examined outcomes across different types of road users with different types of pre-existing comorbidities. This study aims to examine differences in survival within 30 days of admission among different road user types with and without different pre-existing comorbidities.

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Objectives: This study aimed to describe mental health emergency department (ED) presentations among young people aged 8-26 years in New South Wales, Australia, and to identify key characteristics associated with higher risk of ED mental health re-presentation.

Design, Setting And Participants: Retrospective analysis of linked ED data records for mental health presentations between 1 January 2015 and 30 June 2018.

Main Outcome Measures: The main outcome was the total number of mental health ED re-presentations within 1 year, following initial presentation.

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Developing a greater understanding of the social and environmental factors that are related to differential outcomes for individuals who experience persistent pain and disability is important for achieving health equity. In this study, we aimed to develop insights into the role of the social determinants of health (SDH) in care experiences and health status for socio-economically disadvantaged adults who experience persistent low back pain or persistent pain following spinal cord injury. Our objectives were to investigate 1) relationships between the SDH and health outcomes, 2) care experiences, and 3) perceived barriers and facilitators to optimal pain care.

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