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ANNUAL REPORT 2017-18

Bringing healthinnovation to life

CONTENTS

About AusHSI 2

Message from the Academic Director 4

Sustainability 6

Our Offering 6

Engagement 8

Sponsorship 9

HSRAANZ conference 10

Chronic Wounds Solutions Forum 12

Taking Healthcare Home 14

Research Case Studies 15

Research 20

AusHSI’s competitively funded research grants 21

Training 22

Governance 28

Appendix 1: Funded research projects 28

Appendix 2: Publications 28

Contact us 34

AusHSI Annual Report 2017–18

ABOUT AUSHSI

The Australian Centre for Health Services Innovation (AusHSI) was established in 2011 by agreement between Queensland Health, the Royal Brisbane and Women’s Hospital and the Queensland University of Technology. In 2013 The University of Queensland joined as a partner.

AusHSI partners to deliver innovation and improvements for better health services. Combining leading-edge knowledge with hands-on practical experience, AusHSI integrates research findings into policy and practice, and helps make changes that result in greater efficiencies and better patient outcomes.

OUR MISSION

Our mission is to enable our clients to create genuine improvements in the quality and cost effectiveness of health services.

We empower health decision makers to implement and sustain innovations for better health services.

We do this by generating insights from research, translating knowledge into practice, and promoting partnerships between clinicians and academics.

OUR VISION

Bringing health innovation to life

OUR VALUES

Knowledge-based

Build Knowledge – We seek out new information and put knowledge into practice. Our actions are guided by facts. We are independent and always behave with integrity.

Collaborate

Better together – We achieve more when we work together. We build and facilitate strong, diverse partnerships. We are open and inclusive. By sharing expertise, we strengthen capacity and performance

Innovate

Enable breakthrough achievements – We bravely challenge the status quo. We advance new ways for better health services. We pioneer breakthrough ideas.

Efficient

Accomplish more – We seek out smart ways to optimise health benefits. We believe in using resources wisely to accomplish more with less. We are skilled, pragmatic and impartial.

AusHSI Annual Report 2017–18 Page 3

MESSAGE FROM THE ACADEMIC DIRECTOR

A large barrier to innovation in health services is knowledge of how to implement and sustain improvements. In 2017-18 AusHSI delivered a variety of activities that enabled health services to implement and sustain innovations.

Professor Trisha Greenhalgh from the University of Oxford and Dr Roman Kislov from the University of Manchester delivered workshops, and both events were standing room only. Both are leading authorities on the implementation of health care.

In November 2017, AusHSI hosted the successful 10th Health Services and Policy Research Conference on behalf of the Health Services Research Association of Australia and New Zealand (HSRAANZ). Close to 300 policy makers, clinicians and academics took part on the Gold Coast to hear from international keynote speakers, including Dr Roman Kislov. This meeting is the largest concentration of health services academics and health care professionals in Australasia. The program included themed plenary discussions and a diverse program of concurrent sessions. Delegates attended pre-conference workshops, including a sold-out research translation workshop. Early career researchers enjoyed a number of networking and learning experiences and separate streams for indigenous specific research. The feedback we received suggested the meeting strongly helped delegates build capacity and networks in their respective fields.

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Importantly, over the course of 2017-18, AusHSI partnered with a range of organisations to deliver both Government-funded and consultancy research projects. All these projects benefited from AusHSI’s expert guidance and services – founded in the kind of rigorous evidence-based approaches that result in greater efficiencies and improved patient outcomes.

In the past year AusHSI has continued to champion partnerships between researchers, clinicians and policymakers, advancing the field of health services research and encouraging frontline clinical staff to introduce new evidence into practice. We also continued to build strong and diverse partnerships to grow capacity and strengthen health services delivery and performance.

Metro North Hospital and Health Service have partnered with AusHSI for a Graduate Certificate in Health Services Innovation, being delivered for the first time in 2018. This is the first tertiary level qualification aimed specifically at enabling senior clinicians to develop, assess and implement innovations within the healthcare setting. By introducing this qualification, AusHSI provides another guiding pathway to ensure innovation becomes part of our health system for the future.

AusHSI has continued its significant work with Queensland Health’s Integrated Care Innovation Fund (ICIF) Projects, a $35 million state-wide initiative enabling Hospital and Health Services and Primary Health Networks to develop and progress new models of care and innovative approaches to integrated service delivery. AusHSI’s evaluation of the effectiveness of the 23 ICIF-funded projects will help inform HHSs and PHNs across Queensland to deliver new evidence-based practices leading to better outcomes for patients.

AusHSI completed two major research programs: an NHMRC Partnership grant, Researching Effective Approaches to Cleaning in Hospitals (REACH); and the NHMRC Centre of Research Excellence – Reducing Healthcare Associated Infections, which has been running since 2012. The outcomes of these major programs represent a significant contribution to Australia’s knowledge base for patient safety.

We continue to build our track record in large scale competitive health service research, and in June we were awarded – in partnership with the Australian Centre for Health Law Research – a large NHMRC Partnership Grant “Reducing Non-Beneficial Treatment at the End-of-Life”.

As we enter the new financial year we are well positioned to build on this good work for the future, extending partnerships and growing capacity among individuals and organisations to champion health economics and implementation science.

I thank everyone who has contributed to this rewarding journey so far.

Professor Nick Graves AusHSI Academic Director

Page 5AusHSI Annual Report 2017–18

For the past two years AusHSI has focused on moving away from dependence on partner contributions. Over the past 12 months, approximately half of AusHSI’s income came from external grants and consultancy projects.

This transition is still underway and AusHSI will continue to undertake commercial research opportunities, and continue to build our reputation and trust with our health partners.

OUR OFFERING

Through extensive consultation with the health service community, AusHSI has developed a service offering that appeals to potential health service partners, including Hospital and Health Services (HHSs), Primary Health Networks (PHNs) and hospital foundations.

SUSTAINABILITY

Research Funding Allocation and Support

Assist and/ or oversee competitive funding rounds, providing ongoing mentoring and support for clinician researchers thereby building knowledge and strengthening innovation capacity.

Research Prioritisation and Advice

Review and evaluate proposed innovations or trial project outcomes. Recommend projects that offer substantial improvements to health services. Provide advice on research method implementation and evaluation.

Training and Development

Provide a range of training and development options to suit the needs of different health service organisations via practical short courses including knowledge translation, cost-effectiveness, statistics and health economics.

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Implementation of Innovation

Design and facilitate an implementation for a known innovation following a proven framework to ensure successful translation of evidence into practice.

Evaluation of Health Services

Undertake evaluations of health service changes. Demonstrate the variation in costs and health benefits, providing valuable information to inform decision-making.

EvaluationIm

plementationTraining

Prior

itisat

ion

Allocatio

n

& Support


INTERNATIONAL VISITORS

AusHSI hosted two international visitors in the 2017/18 financial year.

Dr Roman Kislov. Seminar 18 October 2017

Distortion of implementation techniques in health care: The case of ‘facilitation’

Dr Roman Kislov is a Senior Research Fellow in the Health Services Research Centre which is part of Alliance Manchester Business School at the University of Manchester. He conducts qualitative research on the processes of knowledge mobilisation, with a particular interest in strategies over time and a multiple case study of research co-production in multi-professional project teams, which are both funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Greater Manchester – a partnership between the University of Manchester and local providers of health services.

Roman will join us at AusHSI again in November 2018 as a visiting fellow to deliver a Knowledge Translation/Implementation workshop.

Professor Trisha Greenhalgh. Seminar 28 March 2018

Why do most technology programmes in healthcare fail? An introduction to the NASSS Framework

Trish Greenhalgh is Professor of Primary Care Health Sciences and Fellow of Green Templeton College at the University of Oxford. She studied Medical, Social and Political Sciences at Cambridge and Clinical Medicine at Oxford before training first as a diabetologist and later as an academic general practitioner. She has a doctorate in diabetes care and an MBA in Higher Education Management. She now leads a programme of research at the interface between the social sciences and medicine, working across primary and secondary care. Her work seeks to celebrate and retain the traditional and the humanistic aspects of medicine and healthcare while also embracing the unparalleled opportunities of contemporary science and technology to improve health outcomes and relieve suffering.

ENGAGEMENT

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SPONSORSHIP

AusHSI continued to engage with Hospital and Health Services, Primary Health Networks, and divisions and units of the Queensland Department of Health through the organisation and sponsorship of a variety of events relevant to AusHSI’s core values. The following events were supported by AusHSI in the 2017/18 financial year.

My Translation Rules

The My Translation Rules annual awards are designed to reward clinical Dietitians for their translational research efforts. The program runs all year, with training and workshops designed to prepare clinicians to submit an entry for the awards held in November. In 2017, AusHSI sponsored the award, with the recipients receiving attendance at the 3 day AusHSI Knowledge Translation workshop.

Catholic Health Australia Symposium

On 1 June 2018, the Catholic Health Australia (CHA) Research Symposium brought together CHA researchers from across Australia to encourage networking, learning, to celebrate achievements and ongoing initiatives in research, and importantly – to showcase the essential work being done within the Catholic health and aged care sector. AusHSI sponsored CHA’s first Research Shark Tank competition to showcase the innovative research occurring at our hospitals.

ACHSM Breakfast Forum – Launch of the taking healthcare home outcomes paper

On 23 Aug 2017 AusHSI launched the white paper ‘Taking Healthcare Home: Overview of findings and recommendations’. The paper was presented at the Australasian College of Health Services Management (ACHSM) Qld Forum and outlines the key success factors that determine and impede the quality use of healthcare in the home services.

The paper reports the findings of AusHSI’s Taking Healthcare Home Forum held in early 2017. The Forum explored public health policy issues related to healthcare in the home in the Queensland context for three services: hospital in the home; home dialysis; and, home parenteral nutrition.

Based on our findings, AusHSI has recommended a number of practical, insightful ways to improve access to quality at-home care. If followed through, these recommendations will create a professional culture that is familiar with and confident in HITH as a viable alternative to inpatient care.


The 10th Health Services and Policy Research Conference was held 1-3 November 2017 at Surfers Paradise Marriott, Gold Coast, Queensland Australia.

The conference theme was “Shifting priorities: balancing acute and primary care services”.

AusHSI was pleased to be the host of the Health Services Association of Australia and New Zealand bi-annual Conference (HSRAANZ17) attended by close to 300 delegates who gathered to hear from international keynote speakers, including AusHSI visiting fellow Dr Roman Kislov from the University of Manchester.

The Queensland Department of Health Clinical Excellence Division (CED) was the Conference Partner, and AusHSI worked closely with CED marketing to engage with Department of Health Clinicians and decision makers. The program included a stimulating range of five themed plenary discussions and a diverse program of delegate concurrent sessions.

The conference put focus on current and future priorities for resources in acute and primary care, in order to achieve a sustainable and functional system into the future.

Delegates attended pre-conference workshops, including a sold-out research translation workshop, as well as various breakfast sessions, and mingled their way through the two social events. ECR’s were well catered for, with a number of networking and learning experiences on offer, and separate streams of Indigenous sessions which spoke to indigenous specific research themes.

The conference is the preeminent Health Services Research conference in South East Asia, and provided an excellent opportunity to market AusHSI.

The next HSRAANZ conference will be held in Auckland in 2019.

HEALTH SERVICES ASSOCIATION OF AUSTRALIA AND NEW ZEALAND 2017 CONFERENCE

Bottom: Professor Judith Smith – Keynote speaker

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Top: Megan Campbell, AusHSI Centre Manager opened the conference. Bottom: Conference participants

Top: Laura Wilkinson Myer – VP, HSRAANZ Bottom: The Shark Tank panel members


Chronic wounds are a silent epidemic in Australia. They are under-recognised as a public health issue, and their health and economic effects are under-estimated. Evidence-based practice in wound care has consistently been shown to have significant health and economic benefits, yet there are still considerable evidence-practice gaps across Australia. Since 2014 AusHSI has partnered with the Wound Management Innovation Cooperative Research Centre (WMI CRC) in a large-scale health economics collaboration, led by Associate Professor Rosana Pacella.

CHRONIC WOUNDS SOLUTIONS FORUM

Thought leadership forum, August 2017, Metro North HHS

AusHSI held a national forum in August 2017, to discuss the solutions to the many barriers chronic wound sufferers face when attempting to access best-practice care. This forum was hosted by AusHSI, in partnership with Queensland Government, Metro North Hospital and Health Service, Clinical Excellence Division, Brisbane North Primary Health Network and the WMI CRC.

The forum brought together healthcare providers, policy makers, patients, carers and researchers from Queensland and around Australia, and the day-long event encouraged those at the coal face of wound management to share their perspectives and suggestions on what should be done to address the growing epidemic of chronic wounds in Australia.

CHRONIC WOUNDS

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Above: Members of the WMI CRC at the National Forum

In the months following this event, further surveys, discussion and collaboration occurred to collate and refine the hundreds of suggestions into a list of specific recommendations. These recommendations were launched as ‘Solutions to the Chronic Wound Problem in Australia: A Call to Action’ on 15 March 2018, and has garnered widespread interest from those in the wound care industry. Federal Minister for Health, the Hon Greg Hunt MP has referred wound management to the Medicare Benefits Schedule Review Taskforce for consideration.


TAKING HEALTHCARE HOME IDEAS FORUM

The project

Quality home healthcare services have been shown to improve outcomes for patients and their carers, as well as reducing costs and increasing capacity at inpatient hospitals. However, a number of barriers to home healthcare means that eligible patients are not always being readily referred for these services. The project aimed to identify the barriers to referral and to recommend solutions that might improve access to home healthcare.

AusHSI’s role

AusHSI was sponsored by Baxter Healthcare to host an ideas forum. The forum aimed to address the challenges and benefits of enabling at-home care in the context of three services: hospital in the home (HITH), home dialysis, and home parenteral nutrition. It brought together almost 100 leading clinicians, academics, managers and carers to identify the challenges to healthcare at home.

To inform debate on the day, AusHSI produced an issues paper, called “Taking Healthcare Home”. The paper showed that treating acutely ill patients at home, rather than in hospital, could slash treatment costs by up to 50%, reduce mortality rates by 20%, make hospital stays shorter and cut hospital readmission by a quarter.

Outcomes

As a result of the forum, AusHSI produced a paper – Taking Healthcare Home Forum: Overview of findings and recommendations – which outlined how home healthcare services in Queensland tend to be underfunded, outdated and poorly understood. Based on these findings, AusHSI has recommended a number of practical and insightful ways to improve access to quality at-home care. If followed through, AusHSI’s recommendations will create a professional culture that is familiar with and confident in healthcare at home as a viable alternative to inpatient care.

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RESEARCH CASE STUDIES

INVESTMENT AND EVALUATION DECISION MAKING ANALYSIS AND SUPPORT TOOL

The project

The executive team at the Royal Brisbane and Women’s Hospital (RBWH) is committed to allocating funding to health initiatives that provide quality patient outcomes. However, the team faces complex investment decisions with finite resources and limited timeframes. Consequently, they recognised a need to have an evidence-based method of evaluation to help them compare initiatives vying for funding.

AusHSI’s role

RBWH engaged AusHSI to execute their vision for a fast, unbiased and easy-to-use method of evaluation. AusHSI then worked in close consultation with RBWH to develop and test a decision analysis technique that would assess the outcomes of retrospective projects, assess already implemented projects (to support any disinvestment decisions) and compare prospective projects vying for investment moving forward.

Outcomes

AusHSI created a multi-criteria decision analysis tool that applies a number of facts and figures from each project to assess criteria including financial impact, effect on hospital capacity, patient outcomes, risk and safety. The range of outcomes are scored and can then be visually presented within the tool, making each project comparable. It has allowed the executive team to:

• compare multiple projects using multiple criteria simultaneously• quickly and easily identify the projects with the highest and

lowest value• make explicit and transparent decisions when allocating or

withdrawing project funding

AusHSI continues to support RBWH in implementing this method, with tests currently underway to review how results from the tool compare with the original way of making funding decisions.

MODELLING THE DEMAND FOR ENDOSCOPY SERVICES

The project

In 2016, Queensland Health (QH) identified an increasing pressure on public endoscopy services, driven by population growth and ageing. QH recognised a need to predict the demand for future services and identify solutions that might stem the increase in wait list times.

AusHSI’s role

QH engaged AusHSI to conduct an analysis of its endoscopy system, forecast the impacts of future endoscopic demand and identify ways to reduce wait list times.

Focusing on Metro North Hospital and Health Service (MNHHS) and Metro South Hospital and Health Service (MSHHS), AusHSI created a model of Queensland’s endoscopy system that captured the pathways that patients experience. The model was tailored to reproduce general wait list sizes, times, and other related statistics. AusHSI used the model to test possible changes to endoscopy services, focussing on the effect additional procedures had on wait list sizes and times but also looking at future costs and patient outcomes under a range of plausible scenarios.

Outcomes

The modelling showed that by achieving a minimum number of additional procedures, QH could expect to see an increase in patient quality of life as well as manage wait list times in the future. It demonstrated that additional procedures would be a valuable and cost-effective investment in terms of health outcomes.

AusHSI’s findings and recommendations contributed to the planning of Queensland Health’s Endoscopy Action Plan which will invest $160 million over four years to deliver more services and improve access across the Queensland Health system.


INTEGRATED CARE INNOVATION FUND

Evaluation of Health Service, Implementation of Innovation Training and Development

Queensland Health’s $35 million Integrated Care Innovation Fund (ICIF) is a state wide initiative enabling Hospital and Health Services and Primary Health Networks across Queensland to develop and progress new models of care and innovative approaches to integrated service delivery.

AusHSI is delivering health services evaluation and study design to assess the quality and effectiveness of initiatives funded by ICIF. As part of the project, AusHSI will also build skills with short courses in a number of key areas: cost effectiveness, statistical analysis and implementation science.

The ICIF represents a $35m investment from the Queensland Government – the largest single investment in integrated care initiatives in Queensland, and one of the largest of its kind in Australia.

AusHSI’s evaluation of the effectiveness of 20 ICIF-funded projects will help inform HHSs and PHNs across Queensland to deliver new evidence-based practices leading to better outcomes for patients. This significant program will span over two years, with an expected completion date of 2019.

Some key project in the ICIF include:

Metro North Hospital and Health Service

Queensland Civil and Administrative Tribunal (QCAT) Guardianship Process Initiative

The goal of the initiative is to reduce waiting times from application to hearing date through staffing enhancements, process improvement and funding of additional hospital-based hearing days.

The initiative puts patients at the centre of decision-making by increasing access to guardianship tribunal services and promotes strong and respectful relationships through streamlined inter-agency communications and pathways.

Torres and Cape Hospital and Health Service

Integrated Oral Health in Remote Primary Care Locations

In Queensland’s isolated regional areas, provision of routine health services such as dental clinics is challenging. With the support of the Integrated Care Innovation Fund, the introduction of tele-dentistry in prevention and early identification of dental disease is a novel and inclusive way of providing care. Sustainable dental care to remote populations is vital to reduce the oral health disease burden in these communities.

RESEARCH CASE STUDIES

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Children’s Health Queensland Hospital and Health Service

Attention Deficit Hyperactivity Disorder (ADHD) Project ECHO™ Model

GP-led services are more accessible to patients and deliver holistic care to the entire family. Funded by the Integrated Care Innovation Fund, Children’s Health Queensland (CHQ) will use ECHO™ telementoring to train, support and collaborate with GPs in the community. The Project ECHO™ Model facilitates training GPs to provide care that would otherwise require specialist hospital outpatient care.

Darling Downs Hospital and Health Service

Floresco Centre Mental Health Integrated Care and Innovation

With funding from the Integrated Care Innovation Fund, Toowoomba’s Floresco Centre is providing an innovative service for adults experiencing mental health illness who require integrated care in the community.

The project’s goals are to improve quality of life and health outcomes, reduce unnecessary admissions and inpatient stays in the public mental health system, enhance integrated care, and improve social participation. The innovative service delivery model is recovery-oriented, and uses an evidence-based approach with consistent outcome measures for initial assessment, ongoing measurement and evaluation.

Sunshine Coast Hospital and Health Service

Regional Hepatology Partnership

Hepatitis C contributes to a significant burden of disease in Queensland, affecting almost 50,000 people across the state. Recent advances in treatment mean that many patients living with the disease now have a cure. Identification of liver conditions is usually conducted through primary care, but for segments of the population with access inequities, the health system needs to be proactive and dynamic in its care delivery to prevent disease progression and higher costs down the line.

With the support of the ICIF and the national government, the Regional Hepatology Partnership (RHP) project has made this treatment more accessible. The partnership seeks out undiagnosed liver disease in regional Sunshine Coast populations, where patients may not otherwise be able to access the care they need.


CHILDREN’S HOSPITAL FOUNDATION – HEALTH SERVICES RESEARCH

Research Funding Allocation and Support Training and Development

To facilitate value-based healthcare delivery, the Children’s Hospital Foundation offers funding for health services research projects that directly align with Children’s Health Queensland Hospital and Health Services’ (CHQHHS) strategic imperatives.

The Children’s Hospital Foundation invited AusHSI to provide expert advice in the administration of the 2017 funding round and throughout its review period. AusHSI’s role was to help identify the applications that best aligned with CHQHHS’ strategic priorities, i.e. those which offered the most significant and best value improvements to children’s health outcomes. Panellists looked for applications that focused on measuring health outcomes, improving healthcare delivery, and ensuring systems and processes are effective and efficient in improving value for patients.

AusHSI worked closely with the Children’s Hospital Foundation and CHQHHS executives and service leads to develop the Health Services Research stimulus grant scheme for the Children’s Hospital Foundation round and strengthen partnerships between researchers and clinicians. AusHSI’s role in reviewing research proposals and assisting with funding allocation included the following responsibilities:

• Working with the CHF to develop shared funding guidelines and selection criteria

• Responding to questions regarding applications, providing methodological feedback

• Providing expert members for the funding round’s Research Advisory Committee (RAC)

• Reviewing all applications to ensure minimum standards of novelty, rigour of methods

• Providing feedback suitable to deliver directly to applicants

• Participating in shortlisting discussions, and interviewing shortlisted applicants

• Providing follow-up feedback to applicants.

During the four-week application period, candidates had the opportunity to send a short project synopsis to an AusHSI implementation scientist who advised on the project’s alignment with health services research. This helped ensure that only eligible projects were submitted. Feedback was also given on projects deemed unsuitable or not ready for funding, to enable the applicant to either rework their application or to apply to a more suitable scheme.

RESEARCH CASE STUDIESRESEARCH CASE STUDIES

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Ongoing research support

The Children’s Hospital Foundation funded four Project Grants in the health services research field. During the 12 month project period, grant recipients receive AusHSI assistance in the form of implementation and health economics evaluation services, support services and mentoring, thereby building knowledge and strengthening capacity for innovation.

Training

On the 12th March 2018, prior to the 2018 Health Services Research and Woolworths Nutrition Health services Research Grant rounds opening, Professor Nick Graves ran a 1 day Grant Writing Workshop for Children’s Health Queensland Hospital and Health Services staff and eligible applicants.

AusHSI also held three drop-in clinics during the grant rounds. Potential applicants were invited to attend a consultancy session with AusHSI research academics. Clinicians were able to pitch their ideas one-on-one to the AusHSI academics who provided immediate advice as to the suitability of the project for the scheme as well as advice on project design and methods to those that met the eligibility criteria.

“ The skills that AusHSI has been able to provide have added a lot of value to our Health Services Research funding scheme. Taking a collaborative approach to identifying, funding and supporting health services research has given the Children’s Hospital Foundation confidence that the projects and researchers they are funding will impact health outcomes for Queensland children and families and will build research capacity over time”.

Damon Mudge, former Chief Operating Officer, at Children’s Hospital Foundation


GOVERNMENT FUNDED RESEARCH

As an internationally leading research body, our team works on a number of NHMRC funded research grants. In the 2017/18 financial year, two of these projects concluded, with the award of another project commencing in the 2018/19 financial year.

REDUCING NON-BENEFICIAL TREATMENT AT THE END-OF-LIFE 2018-2020

The NHMRC has recently awarded an Australian-first collaboration between AusHSI and QUT’s Australian Centre for Health Law Research (ACHLR), the University of New South Wales, University of Adelaide and the University of Queensland. A Partnership Grant on reducing non-beneficial treatment at the end of life will commence in the 2018/19 financial year.

RESEARCHING EFFECTIVE APPROACHES TO CLEANING IN HOSPITALS (REACH) 2014-2018

The REACH Project is investigating the effectiveness of an evidence based cleaning intervention in 11 major hospitals nationwide. In 2016-2017, each of these hospitals received tailored training and support from the study team to implement and evaluate the intervention.

The project is led by academic team members from AusHSI in partnership with Wesley Medical Research, with academic partners from University of Western Australia, Avondale College, Australian Catholic University and eight national industry, professional and policy partners.

It builds on the work of AusHSI grant recipient and PhD student Michelle Allen, who conducted a pilot project of the cleaning bundle at Logan Hospital in 2014.

Findings from the pilot study have been used to refine the design of a cleaning bundle and the implementation strategies for the REACH trial, ensuring the intervention is acceptable to hospital staff, has outcomes that can be reliably measured, and is feasible to implement.

THE CENTRE OF RESEARCH EXCELLENCE – REDUCING HEALTHCARE ASSOCIATED INFECTIONS 2012-2017

The Centre of Research Excellence in Reducing Healthcare Associated Infections (CRE-RHAI) is an NHMRC funded research collaboration focused on developing and investigating innovative and cost-effective strategies to reduce the incidence of healthcare associated infections in Australia.

Led by AusHSI it brought together a diverse group of experts from clinical and academic. The new knowledge generated by the CRE-RHAI will have a direct impact on decisions about infection control at both a clinical and policy level, with the major output of the research being information about the cost-effectiveness of infection control programs and the translation into health services.

AUSHSI FUNDED RESEARCHSince 2012 AusHSI has held 13 funding rounds, awarding 6 implementation grants, 29 stimulus grants, 22 postgraduate scholarships and 3 partnership grants, totalling $2,995,256 in funding.

See appendix 1 for a list of all AusHSI funded research to date, including a link of where to find outcome details from completed projects.

RESEARCH

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AUSHSI’S COMPETITIVELY FUNDED RESEARCH GRANTS

Grants administered by QUT

Grant Title Funding Source AusHSI researchers involved

Centre of Research Excellence in Reducing Healthcare Associated Infections

NHMRC Centre of Research Excellence Grant 1030103

Prof Nicholas Graves, Dr Lisa Hall, Dr Kate Halton, Emily Bailey

Researching Effective Approaches to Cleaner Hospitals (The REACH Trial)

NHMRC Partnership Grant – industry partner Wesley Research Institute

Prof Nicholas Graves, Prof Adrian Barnett, Dr Lisa Hall, Dr Kate Halton, Dr Katie Page, Alison

Farrington

Building capacity for health services research in Australia

NHMRC Research Fellowship GNT1059565

Prof Nick Graves

Meta-research: Using research to increase the value of health and medical research

NHMRC Research Fellowship GNT1117784

Prof Adrian Barnett

Reducing Non-Beneficial Treatment at the End of Life

NHMRC Partnership grant GNT1151923. Funding partners are Metro North Hospital and Health Service and Gold Coast Health

Professor Nick Graves Professor Adrian Barnett

Dr Xing Lee Alison Farrington

Validation and valuation of a new cardiovascular specific multi-attribute utility instrument; assisting resource allocation decisions in heart disease

Australian Heart Foundation Postdoctoral Fellowship Award 101949

Dr Sanjeewa Kularatna

Australian Perioperative Nurses' Utilisation of Evidence-Based Practice Standards

Australian College of Perioperative Nurses

Dr Sonya Osborne

Examining the impact of an extended Paediatric Trauma Support Service

Children’s Hospital Foundation, administered by UQ

Dr Sonya Osborne

Dr Sanjeewa Kularatna

Finding cost-effective management practices in cardiovascular disease

IHBI Early Career Research Award Dr Sanjeewa Kularatna

Using big data to manage Australia’s blood supply during flu season

IHBI Early Career Research Award Dr Nicole White

Utilising junior medical staff at triage to improve Emergency Department Outcomes

IHBI Early Career Research Award Dr David Brain

Establishing a method for the routine collection of patient reported outcome measures in maternity services

IHBI Early Career Research Award Dr Sanjeewa Kularatna (Mentor to grant recipient,

Dr Elizabeth Martin)

Exploring the development of an overarching evaluation framework to robustly evaluate healthcare interventions

QUT Strategic Links fund Dr David Brain, Dr Sanjeewa Kularatna, Prof Nick Graves

(Mentor)


In 2017/18 AusHSI continued to deliver training through the successful short course series. This model sees training delivered in cost-effectiveness and statistics to up to 30 health professionals, health services researchers, or research students on each occasion.

STATISTICS

Professor Adrian Barnett ran a one-day statistics refresher course for people who have had some practical experience with statistics or some undergraduate statistics training. The course focuses on simple study designs and some common mistakes, with a range of practical exercises throughout the day.

This popular basic refresher course was held on the 29 November 2017 and 18 June 2018. This course was also delivered on-site at West Moreton Hospital and Health Services on the 21st May 2018 as an introduction to statistics in healthcare.

HEALTH CONSUMERS QUEENSLAND

On the 8th February 2018, AusHSI hosted Jo Smethurst from Health Consumers Queensland to facilitate a half day training course titled ‘consumer engagement for better research outcomes: the fundamentals of consumer partnership’. This workshop aimed to increase participants’ knowledge and skills to establish effective consumer partnerships and collaboration through the research cycle.

TRAINING

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KNOWLEDGE TRANSLATION AND IMPLEMENTATION

AusHSI, in partnership with The University of Adelaide and Metro North Hospital and Health Service, ran a three-day course on Knowledge Translation and Implementation. This course was designed for academic and clinician researchers who want to make their work more accessible and useful to other researchers, policy makers, and practitioners.

The Knowledge Translation Course was not held in the 2017/18 financial year due to the teaching commitments of the Graduate Certificate. It is scheduled for November 2018 in Adelaide, with a one-day workshop to be facilitated by visiting fellows Dr Roman Kislov and Professor Ian Graham to be held at QUT in late 2018.

COST-EFFECTIVENESS

The Economics 3-day Short Course series developed by Professor Nick Graves and presented by Professor Graves and other senior AusHSI researchers remains very popular, being offered 3 times in the 2017/18 financial year onsite at Kelvin Grove and once at West Moreton Hospital and Health Services.


On behalf of QUT, and in collaboration with Metro North Hospital and Health Services, AusHSI has led development of a new Graduate Certificate in Health Science (Health Services Innovation major). The collaboration and new qualification aligns with the MNHHS Research Strategy by increasing the capacity of MNHHS staff in implementation science, cost-effectiveness and health service evaluation.

The Graduate Certificate is an Australian-first, aiming to refocus health services towards innovation and value-based care. Students will complete two core units focused on implementation science and cost-effectiveness analysis for decision-making. Students will also select two elective units to complete the Graduate Certificate. Elective units are Health Planning and Evaluation, Health Policy in a Global Context and an independent project where students can apply their new knowledge to change and introduce innovations within their health service.

2018 MNHHS Graduate Certificate Cohort

GRADUATE CERTIFICATE IN HEALTH SERVICES INNOVATION

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Professor Jeff Rowland

“ The Implementation Science Unit of the AusHSI Graduate Certificate in Health Services Innovation is helping me get evidence-based innovation off the ground. It is confirming and broadening my knowledge and providing different implementation frameworks to develop the right contextual approach.”

Professor Rowland is undertaking a project addressing falls treatment in patients presenting to the Emergency Department. People fall for many different reasons. Some falls or unexplained fainting are harmless while others may be serious. However, many people who arrive at the Emergency Department are admitted unnecessarily when their condition could be managed appropriately at local community level.

Professor Rowland from The Prince Charles Hospital is part of a project designed to ensure that the hospital process is patient-centred, that people are not put through unnecessary delays or stays in hospital, and healthcare resources are used appropriately.

At the same time as running the project, Professor Rowland is enrolled in Australian Centre for Health Services Innovation’s Graduate Certificate in Health Services Innovation. The first unit of the course is Implementation Science, and the training is helping him to apply more rigorous methodology to his research. It is:

• Providing theory to confirm the knowledge he has gained through practical experience

• Broadening the scope of his knowledge • Integrating newer concepts around knowledge translation

into the research plan • Enabling deeper understanding of the project’s context

The possible outcomes for this project include fewer people in Emergency being admitted to hospital, fewer inappropriate investigations into falls and less wastage of patients’ and clinicians’ time – in short a more efficient and effective use of hospital resources and a more streamlined process for patients.


Leah Thompson

“ I have found the Australian Centre for Health Services Innovation Graduate Certificate in Health Services Innovation very useful in terms of building on my project implementation and evaluation skills. For example, at the end of the course I know I have the skills to effectively plan, implement and evaluate the outcomes of the App myself and have some new understanding about the potential return on investment and economic value- and that’s a portion of the project that I would previously have had to outsource. I have experienced lots of additional benefits from partnering with AusHSI on this course, in particular, the networking with my Metro North colleagues.”

Leah Thompson is an Occupational Therapist and Manager of Research & Quality (IMS) at The Prince Charles Hospital. Leah has long been involved with projects and research into facilitating change and leadership and today she is developing an App to help the health system record, track and report sub-specialist’s consultations for inpatients.

In the current health system, it is hard for medical sub-specialists to track their referrals and this can make it hard for them to bill accurately for their inpatient consultation services. This lack of overview leads to resourcing inefficiencies and private health billing that can be left in arrears.

Leah discovered the Graduate Certificate in Health Services Innovation course with the help of colleagues and thought it would help increase her skill-set and professional network as well as helping her to develop the Consultation App.

One of the most useful things the course has taught Leah is that that implementation is a process within itself – and successful and sustained implementation requires a considerable time investment and planning. In her professional role, Leah has learnt to build time for project implementation and not underestimate the investment that meaningful context and stakeholder analysis can mean to the success of a project.

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Arthur Kadhani

“ The Implementation Science Unit of the Australian Centre for Health Services Innovation Graduate Certificate in Health Services Innovation has provided a framework that is remarkably applicable to any environment or any scope. It is a really effective program that helps you target the right people with the right information to save the whole health system time and resources.”

Arthur Kadhani is trialing a new model of care to improve interdisciplinary communication in clinical practice at the Redcliffe Hospital Emergency Department. He is also concurrently a student of AusHSI’s Graduate Certificate in Health Services Innovation, the first post graduate qualification in Queensland teaching implementation science to practicing clinicians.

Arthur has been a mental health nurse for some time and his project aims to improve the treatment of mental health patients arriving in the Emergency Department. It aims to improve the communication between the different health care disciplines by whom the patient will be seen and so the timeliness and quality of their treatment overall.

Arthur is introducing a daily interdisciplinary meeting to assess incoming patients and together prioritise their various needs, thereby smoothing the patients’ journey within the health service. His proposed meeting format, in the round, would ensure different health disciplines supported each other to provide coordinated care.

Arthur’s mental health executive recommended he study the new AusHSI Graduate Certificate in Health Services Innovation for the benefit of his research into this project. The Implementation Science Unit will allow him to:

1. Choose an implementation science framework to design and refine the project

2. Increase his skills and knowledge base3. Better communicate the project to the hospital and explain

the efficiencies generated4. Improve the potential for his project being adopted hospital

wide and/or accepted as a trial new practice for Emergency Departments across QLD

5. Accelerate adoption of the new model of care6. Improve patient health outcomes as a result of the project

Arthur will first pilot his new model of care on the morning shift at Redcliffe Hospital Emergency Department and, if successful, will scale up the intervention to other shifts.


MANAGEMENT COMMITTEE

Accountability for the implementation and management of AusHSI is shared by the Partners through the forum of the Management Committee.

The Management Committee is accountable for the financial management of AusHSI and regularly reviews income and expenditure.

In 2017/18 the Management Committee members were:

Ross Young Queensland University (Chair) of Technology

Gerald Holtmann University of Queensland

Nick Graves AusHSI Academic Director

Will Parsonage AusHSI Clinical Director

Megan Campbell AusHSI Centre Manager

Merrilyn Banks Royal Brisbane and Women’s Hospital

Amanda Dines Royal Brisbane and Women’s Hospital

Jane Partridge Department of Health

Karen Thompson Department of Health

Patsy Yates Queensland University of Technology

The AusHSI Management Committee met three times in 2017/18

• Monday 21 August 2017

• Tuesday 14 November 2017

• Tuesday 22 May 2018

Appendix 1: Funded research projects

Due to the length of this appendix, full details including project summaries and updates on projects are available on the AusHSI website: http://www.aushsi.org.au/wp-content/uploads/2017/08/Appendix-1-AusHSI- Funded-Research.pdf

Appendix 2: Publications

2017/18 Publications arising from AusHSI funded research

1. Bell, J.J., A. Young, J. Hill, M. Banks, T. Comans, R. Barnes, and H.H. Keller. Rationale and developmental methodology for the SIMPLE approach: A Systematised, Interdisciplinary Malnutrition Pathway for impLementation and Evaluation in hospitals. Nutr Diet, 2018. 75(2): p. 226-234.

2. Lum, E.P.M., K. Page, J.A. Whitty, J. Doust, and N. Graves. Antibiotic prescribing in primary healthcare: Dominant factors and trade-offs in decision-making. Infection, Disease and Health, 2018. 23(2): p. 74-86.

3. Ryan, B., R. C Franklin, F. Burkle, E. Smith, P. Aitken, K. Watt, and P. A Leggat. The Role of Environmental Health in Understanding and Mitigating Postdisaster Noncommunicable Diseases: The Critical Need for Improved Interdisciplinary Solutions. Vol. 80. 2017.

GOVERNANCE APPENDICES

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http://www.aushsi.org.au/wp-content/uploads/2017/08/Appendix-1-AusHSI-Funded-Research.pdf



2017/18 Publications from AusHSI directors and staff

1. Allen, M., L. Hall, K. Halton, and N. Graves, Improving hospital environmental hygiene with the use of a targeted multi-modal bundle strategy. Infection, Disease and Health, 2018. 23(2): p. 107-13.

2. Barnett, A., Missing the point: are journals using the ideal number of decimal places? [version 2; referees: 1 approved, 1 approved with reservations]. F1000Research, 2018. 7(450).

3. Barnett, A., P. Clarke, C. Vaquette, and N. Graves, Using democracy to award research funding: an observational study. Research Integrity and Peer Review, 2017. 2: p. 16.

4. Barnett, A., S. Glisson, and S. Gallo, Do funding applications where peer reviewers disagree have higher citations? A cross-sectional study [version 1; referees: awaiting peer review]. F1000Research, 2018. 7(1030).

5. Barnett, A.G., I. Stewart, A. Beevers, J.F. Fraser, and D. Platts, Thermal clothing to reduce heart failure morbidity during winter: a randomised controlled trial. BMJ Open, 2017. 7(10).

6. Barnett, A.G., P. Zardo, and N. Graves, Randomly auditing research labs could be an affordable way to improve research quality: A simulation study. PLoS ONE, 2018. 13(4).

7. Barnsbee, L., A.G. Barnett, K. Halton, and S. Nghiem, Chapter 24 – Cost-effectiveness A2 – Gregory, Shaun D, in Mechanical Circulatory and Respiratory Support, M.C. Stevens and J.F. Fraser, Editors. 2018, Academic Press. p. 749-772.

8. Bellapart, J., K. Cuthbertson, K. Dunster, S. Diab, D.G. Platts, O.C. Raffel, L. Gabrielian, A. Barnett, J. Paratz, R. Boots, and J.F. Fraser, Cerebral Microcirculation and Histological Mapping After Severe Head Injury: A Contusion and Acceleration Experimental Model. Front Neurol, 2018. 9: p. 277.

9. Blythe, R., D. Cook, and N. Graves, Scepticaemia: The impact on the health system and patients of delaying new treatments with uncertain evidence; a case study of the sepsis bundle [version 1; referees: awaiting peer review]. Vol. 7. 2018.

10. Brain, D., Managing the disconnect between scientific discovery and its translation into practice. Med J Aust, 2018. 209(1): p. 13.

11. Brain, D., L. Yakob, A. Barnett, T. Riley, A. Clements, K. Halton, and N. Graves, Economic evaluation of interventions designed to reduce Clostridium difficile infection. PLoS ONE, 2018. 13(1).

12. Brain, D.C., A.G. Barnett, L. Yakob, A. Clements, T.V. Riley, K. Halton, and N. Graves, Reducing length of stay to improve Clostridium difficile-related health outcomes. Infection, Disease and Health, 2018. 23(2): p. 87-92.

13. Burns, C.L., S. Kularatna, E.C. Ward, A.J. Hill, J. Byrnes, and L.M. Kenny, Cost analysis of a speech pathology synchronous telepractice service for patients with head and neck cancer. Head & Neck, 2017. 39(12): p. 2470-80.

14. Cabilan, C.J., K. Vallmuur, R. Eley, C. Judge, S. Cochrane, C. Reed, J. Riordan, K. Roberts, O. Thom, and G. Wood, Impact of ladder-related falls on the emergency department and recommendations for ladder safety. Emerg Med Australas, 2018. 30(1): p. 95-102.

15. Carlton, E.W., J.W. Pickering, J. Greenslade, L. Cullen, M. Than, J. Kendall, R. Body, W.A. Parsonage, A. Khattab, and K. Greaves, Assessment of the 2016 National Institute for Health and Care Excellence high-sensitivity troponin rule-out strategy. Heart, 2017.

16. Carter, H.E., S. Winch, A.G. Barnett, M. Parker, C. Gallois, L. Willmott, B.P. White, M.A. Patton, L. Burridge, G. Salkield, E. Close, L. Callaway, and N. Graves, Incidence, duration and cost of futile treatment in end-of-life hospital admissions to three Australian public-sector tertiary hospitals: a retrospective multicentre cohort study. BMJ Open, 2017. 7(10).

17. Cheng, Q., M. Gibb, N. Graves, K. Finlayson, and R.E. Pacella, Cost-effectiveness analysis of guideline-based optimal care for venous leg ulcers in Australia. BMC Health Services Research, 2018. 18(1).

18. Cheng, Q., N. Graves, and R.E. Pacella, Economic Evaluations of Guideline-Based Care for Chronic Wounds: a Systematic Review. Appl Health Econ Health Policy, 2018: p. 1-19.

19. Cheng, Q., P. Lazzarini, M. Gibb, P. Derhy, E. Kinner, E. Burn, N. Graves, and R.E. Norman, A cost-effectiveness analysis of optimal care of diabetic foot ulcers in Australia. International Wound Journal 2017. 14(4): p. 616-628.


20. Comans, T.A., K.H. Nguyen, B. Mulhern, M. Corlis, L. Li, A. Welch, S.E. Kurrle, D. Rowen, W. Moyle, S. Kularatna, and J. Ratcliffe, Developing a dementia-specific preference--based quality of life measure (AD-5D) in Australia: a valuation study protocol. BMJ Open, 2018. 8(1): p. e018996.

21. Coveney, J., D.L. Herbert, K. Hill, K.E. Mow, N. Graves, and A. Barnett, ‘Are you siding with a personality or the grant proposal?’: observations on how peer review panels function. Res Integr Peer Rev, 2017. 2: p. 19.

22. Cullen, L., J.H. Greenslade, T. Hawkins, C. Hammett, S. O’Kane, K. Ryan, K. Parker, J. Schluter, E. Dalton, A.F. Brown, M. Than, W.F. Peacock, A. Jaffe, P.K. O’Rourke, and W.A. Parsonage, Improved Assessment of Chest pain Trial (IMPACT): assessing patients with possible acute coronary syndromes. Med J Aust, 2017. 207(5): p. 195-200.

23. Dhanani, J.A., A.G. Barnett, J. Lipman, and M.C. Reade, Strategies to reduce inappropriate laboratory blood test orders in intensive care are effective and safe: a before-and-after quality improvement study. Anaesth Intensive Care, 2018. 46(3): p. 313-320.

24. Dhanani, J.A., P. Tang, S.C. Wallis, S.L. Parker, P. Pandey, J.F. Fraser, J. Cohen, A. Barnett, J.R. Roberts, and H.K. Chan, Characterisation of 40mg/ml and 100mg/ml tobramycin formulations for aerosol therapy with adult mechanical ventilation. Pulm Pharmacol Ther, 2018. 50: p. 93-99.

25. Fanning, J.P., L.E. See Hoe, M.R. Passmore, A.G. Barnett, B.E. Rolfe, J.E. Millar, A.J. Wesley, J. Suen, and J.F. Fraser, Differential immunological profiles herald magnetic resonance imaging-defined perioperative cerebral infarction. Ther Adv Neurol Disord, 2018. 11: p. 1756286418759493.

26. Fox, A., G. Gardner, and S. Osborne, Nursing service innovation: A case study examining emergency nurse practitioner service sustainability. Journal of Advanced Nursing, 2017. 74: p. 454-64.

27. Fox, A., G. Gardner, and S. Osborne, Nursing service innovation: A case study examining emergency nurse practitioner service sustainability. Journal of Advanced Nursing, 2018. 74(2): p. 454-464.

28. Frakking, T.T., J. Waugh, H.-J. Teoh, D. Shelton, S. Moloney, D. Ward, M. David, M. Barber, H. Carter, S. Mickan, and K. Weir, Integrated children’s clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition: a multi-centre randomised controlled trial study protocol. BMC Pediatrics, 2018. 18(1): p. 72.

29. Frossard, L.A., D. Berg, G. Merlo, T. Quincey, and B. Burkett, Cost Comparison of Socket-Suspended and Bone-Anchored Transfemoral Prostheses. Journal of Prosthetics and Orthotics, 2017. 29(4).

30. Frossard, L.A., G. Merlo, B. Burkett, T. Quincey, and D. Berg, Cost-effectiveness of bone-anchored prostheses using osseointegrated fixation: Myth or reality? Prosthet Orthot Int, 2017: p. 309364617740239.

31. Graves, N., The Centre of Research Excellence in Reducing Healthcare Associated Infections. Infection, Disease and Health, 2018. In press.

32. Greenslade, J., E. Cho, C. Van Hise, T. Hawkins, W. Parsonage, J. Ungerer, J. Tate, C. Pretorius, M. Than, and L. Cullen, Evaluating Rapid Rule-out of Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay at Presentation. Clin Chem, 2018. 64(5): p. 820-829.

33. Greenslade, J.H., T. Adikari, C. Mueller, Y. Sandoval, T. Nestelberger, W. Parsonage, T. Hawkins, and L. Cullen, Characteristics and occurrence of type 2 myocardial infarction in emergency department patients: a prospective study. Emerg Med J, 2017.

34. Greenslade, J.H., T. Adikari, C. Mueller, Y. Sandoval, T. Nestelberger, W. Parsonage, T. Hawkins, and L. Cullen, Characteristics and occurrence of type 2 myocardial infarction in emergency department patients: a prospective study. Emerg Med J, 2018. 35(3): p. 169-175.

35. Greenslade, J.H., E.W. Carlton, C. Van Hise, E. Cho, T. Hawkins, W.A. Parsonage, J. Tate, J. Ungerer, and L. Cullen, Diagnostic Accuracy of a New High-Sensitivity Troponin I Assay and Five Accelerated Diagnostic Pathways for Ruling Out Acute Myocardial Infarction and Acute Coronary Syndrome. Ann Emerg Med, 2018. 71(4): p. 439-451 e3.

36. Greenslade, J.H., K. Chung, W.A. Parsonage, T. Hawkins, M. Than, J.W. Pickering, and L. Cullen, Modification of the Thrombolysis in Myocardial Infarction risk score for patients presenting with chest pain to the emergency department. Emerg Med Australas, 2018. 30(1): p. 47-54.

37. Greenslade, J.H., T. Hawkins, W. Parsonage, and L. Cullen, Panic Disorder in Patients Presenting to the Emergency Department With Chest Pain: Prevalence and Presenting Symptoms. Heart Lung Circ, 2017. 26(12): p. 1310-1316.

38. Greenslade, J.H., R. Nayer, W. Parsonage, S. Doig, J. Young, J.W. Pickering, M. Than, C. Hammett, and L. Cullen, Validating the Manchester Acute Coronary Syndromes (MACS) and Troponin-only Manchester Acute Coronary Syndromes (T-MACS) rules for the prediction of acute myocardial infarction in patients presenting to the emergency department with chest pain. Emerg Med J, 2017. 34(8): p. 517-523.

39. Hettiarachchi, R.M., S. Kularatna, M.J. Downes, J. Byrnes, J. Kroon, R. Lalloo, N.W. Johnson, and P.A. Scuffham, The cost-effectiveness of oral health interventions: A systematic review of cost-utility analyses. Community Dentistry and Oral Epidemiology, 2017. 00: p. 1-13.

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40. Hettiarachchi, R.M., S. Kularatna, M.J. Downes, J. Byrnes, J. Kroon, R. Lalloo, N.W. Johnson, and P.A. Scuffham, The cost-effectiveness of oral health interventions: A systematic review of cost-utility analyses. Community Dent Oral Epidemiol, 2018. 46(2): p. 118-124.

41. Hutton, D.W., S.L. Krein, S. Saint, N. Graves, A. Kolli, R. Lynem, and L. Mody, Economic Evaluation of a Catheter-Associated Urinary Tract Infection Prevention Program in Nursing Homes. Journal of the American Geriatrics Society, 2018. 66(4): p. 742-47.

42. Jayasinghe, R.M., J. Perera, V. Jayasinghe, I.P. Thilakumara, S. Rasnayaka, M.H.M. Shiraz, I. Ranabahu, and S. Kularatna, Awareness, attitudes, need and demand on replacement of missing teeth among a group of partially dentate patients attending a University Dental Hospital. BMC Research Notes, 2017. 10(1): p. 334.

43. Knibbs, L.D., C.P. Coorey, M.J. Bechle, J.D. Marshall, M.G. Hewson, B. Jalaludin, G.G. Morgan, and A.G. Barnett, Long-term nitrogen dioxide exposure assessment using back-extrapolation of satellite-based land-use regression models for Australia. Environ Res, 2018. 163: p. 16-25.

44. Kularatna, S., J. Byrnes, Y.K. Chan, C.F. Ski, M. Carrington, D. Thompson, S. Stewart, and P.A. Scuffham, Comparison of the EQ-5D-3L and the SF-6D (SF-12) contemporaneous utility scores in patients with cardiovascular disease. Quality of Life Research, 2017.

45. Le Grande, M., C.F. Ski, D.R. Thompson, P. Scuffham, S. Kularatna, A.C. Jackson, and A. Brown, Social and emotional wellbeing assessment instruments for use with Indigenous Australians: A critical review. Social Science & Medicine, 2017. 187: p. 164-173.

46. Lee, X.J., M. Hainy, J.P. McKeone, C.C. Drovandi, and A.N. Pettitt, ABC model selection for spatial extremes models applied to South Australian maximum temperature data. Computational Statistics & Data Analysis, 2018. 128: p. 128-144.

47. Lee, X.J., A.N. Pettitt, and S.J. Dancer, Quantifying the relative effect of environmental contamination on surgical ward MRSA incidence: An exploratory analysis. Infection, Disease & Health, 2018.

48. Levada, L. and S. Osborne, Skin preparation of the patient – more than skin deep. ACORN: The Journal of Perioperative Nursing in Australia, 2017. 30(2): p. 57.

49. Luangasanatip, N., M. Hongsuwan, Y. Lubell, D. Limmathurotsakul, P. Srisamang, N.P.J. Day, N. Graves, and B.S. Cooper, Cost-effectiveness of interventions to improve hand hygiene in healthcare workers in middle-income hospital settings: a model-based analysis. Journal of Hospital Infection, 2018.

50. Lum, E.P.M., K. Page, L. Nissen, J. Doust, and N. Graves, Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice. BMC Public Health, 2017. 17(1): p. 799.

51. Manoukian, S., S. Stewart, S. Dancer, N. Graves, H. Mason, A. McFarland, C. Robertson, and J. Reilly, Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology. Journal of Hospital Infection, 2018.

52. Martin, E., M. Beckmann, L. Barnsbee, K. Halton, K. Merollini, and N. Graves, Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: A systematic review of reviews and meta-analyses. BJOG: An International Journal of Obstetrics and Gynaecology, 2018. 125(8): p. 956-64.

53. McCreanor, V., N. Graves, A. Barnett, W. Parsonage, and G. Merlo, A systematic review and critical analysis of cost-effectiveness studies for coronary artery disease treatment [version 1; referees: 1 approved]. Vol. 7. 2018.

54. McCreanor, V., N. Graves, A. Barnett, W. Parsonage, and G. Merlo, A systematic review and critical analysis of cost-effectiveness studies for coronary artery disease treatment [version 2; referees: 2 approved]. F1000Research, 2018. 7(77).

55. Meloncelli, N., A. Barnett, F. Pelly, and S. de Jersey, Diagnosis and management practices for gestational diabetes mellitus in Australia: Cross-sectional survey of the multidisciplinary team. Aust N Z J Obstet Gynaecol, 2018.

56. Mitchell, B.G., A. Farrington, M. Allen, A. Gardner, L. Hall, A.G. Barnett, K. Halton, K. Page, S.J. Dancer, T.V. Riley, C.A. Gericke, D.L. Paterson, and N. Graves, Variation in hospital cleaning practice and process in Australian hospitals: A structured mapping exercise. Infection, Disease and Health, 2017. 22(4): p. 195-202.

57. Mitchell, B.G., O. Fasugba, A. Gardner, J. Koerner, P. Collignon, A.C. Cheng, N. Graves, P. Morey, and V. Gregory, Reducing catheter-associated urinary tract infections in hospitals: study protocol for a multi-site randomised controlled study. BMJ Open, 2017. 7(11): p. e018871.

58. Mitchell, B.G., N. White, A. Farrington, M. Allen, K. Page, A. Gardner, K. Halton, T.V. Riley, C.A. Gericke, D.L. Paterson, N. Graves, and L. Hall, Changes in knowledge and attitudes of hospital environmental services staff: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study. Am J Infect Control, 2018.

59. Mitchell, B.G., A. Williams, Z. Wong, and J. O’Connor, Assessing a temporary isolation room from an infection control perspective: A discussion paper. Infection, Disease and Health, 2017. 22(3): p. 129-135.


60. Munday, J., S. Osborne, and P. Yates, Intrathecal Morphine-Related Perioperative Hypothermia in Women Undergoing Cesarean Delivery: A Retrospective Case-Control Study. J Perianesth Nurs, 2018. 33(1): p. 3-12.

61. Munday, J., S. Osborne, P. Yates, D. Sturgess, L. Jones, and E. Gosden, In Response. Anesth Analg, 2018.

62. Nanda, G., K. Vallmuur, and M. Lehto, Improving autocoding performance of rare categories in injury classification: Is more training data or filtering the solution? Accid Anal Prev, 2018. 110: p. 115-127.

63. Nghiem, S., N. Graves, A. Barnett, and C. Haden, Cost-effectiveness of national health insurance programs in high-income countries: A systematic review. PLoS ONE, 2017. 12(12).

64. Nghiem, S., N. Graves, A. Barnett, and C. Haden, Correction: Cost-effectiveness of national health insurance programs in high-income countries: A systematic review. PLoS One, 2018. 13(1): p. e0191989.

65. Nghiem, S., X.B. Vu, and A. Barnett, Trends and determinants of weight gains among OECD countries: an ecological study. Public Health, 2018. 159: p. 31-39.

66. Nghiem, S.H. and L.B. Connelly, Convergence and determinants of health expenditures in OECD countries. Health Economics Review, 2017. 7(1): p. 29.

67. Nguyen, T.P.T. and S.H. Nghiem, The effects of competition on efficiency: The vietnamese banking industry experience. The Singapore Economic Review, 2017. 0(0): p. 1-30.

68. Nickels, M.R., L.M. Aitken, J. Walsham, A.G. Barnett, and S.M. McPhail, Critical Care Cycling Study (CYCLIST) trial protocol: a randomised controlled trial of usual care plus additional in-bed cycling sessions versus usual care in the critically ill. BMJ Open, 2017. 7(10): p. e017393.

69. Pacella, R.E., R. Tulleners, Q. Cheng, E. Burkett, H. Edwards, S. Yelland, D. Brain, J. Bingley, P.A. Lazzarini, J. Warnock, L. Barnsbee, T. Pacella, K. Clark, M. Smith, A. Iddir, I. Griffiths, G. Sussman, J. van Netten, M. Gibb, J. Gordon, G. Harvey, D. Hickling, X.J. Lee, B. Ploderer, A. Vallejo, S. Whalley, and N. Graves, Solutions to the Chronic Wounds Problem in Australia: A Call to Action. . Wound Practice & Research: Journal of the Australian Wound Management Association, 2018. 26(2): p. 84-98.

70. Parsonage, W., Cardiac disease in pregnancy, in Examination Obstetrics and Gynaecology, G.J.a.F. M., Editor. 2017, Elsevier.

71. Parsonage, W.A., T. Milburn, S. Ashover, W. Skoien, J.H. Greenslade, L. McCormack, and L. Cullen, Implementing change: evaluating the Accelerated Chest pain Risk Evaluation (ACRE) project. Med J Aust, 2017. 207(5): p. 201-205.

72. Parsonage, W.A. and L. Ruane, Cardiac Troponin and Exercise; Still Much to Learn. Heart Lung Circ, 2017. 26(7): p. 645-647.

73. Pham, T.D., S. Nghiem, and L. Dwyer, The economic impacts of a changing visa fee for Chinese tourists to Australia. Tourism Economics, 2017. 0(0): p. 1354816617726204.

74. Pickering, J.W., D. Flaws, S.W. Smith, J. Greenslade, L. Cullen, W. Parsonage, E. Carlton, A. Mark Richards, R. Troughton, C. Pemberton, P.M. George, and M.P. Than, A Risk Assessment Score and Initial High-sensitivity Troponin Combine to Identify Low Risk of Acute Myocardial Infarction in the Emergency Department. Acad Emerg Med, 2018. 25(4): p. 434-443.

75. Rowell, D., S. Nghiem, S. Ramagopalan, and U.-C. Meier, Seasonal temperature is associated with Parkinson’s disease prescriptions: an ecological study. International Journal of Biometeorology, 2017.

76. Rowhani-Farid, A. and A. Barnett, Badges for sharing data and code at Biostatistics: an observational study [version 1; referees: 1 approved, 1 approved with reservations]. F1000. Vol. 7. 2018.

77. Ruane, L., H.G. J, W. Parsonage, T. Hawkins, C. Hammett, C.S. Lam, T. Knowlman, S. Doig, and L. Cullen, Differences in Presentation, Management and Outcomes in Women and Men Presenting to an Emergency Department With Possible Cardiac Chest Pain. Heart Lung Circ, 2017. 26(12): p. 1282-1290.

78. Sheng, R., S. Zhong, A.G. Barnett, B.J. Weiner, J. Xu, H. Li, G. Xu, T. He, and C. Huang, Effect of traffic legislation on road traffic deaths in Ningbo, China. Ann Epidemiol, 2018.

79. Than, M.P., S.J. Aldous, R.W. Troughton, C.J. Pemberton, A.M. Richards, C.M.A. Frampton, C.M. Florkowski, P.M. George, S. Bailey, J.M. Young, L. Cullen, J.H. Greenslade, W.A. Parsonage, B.M. Everett, W.F. Peacock, A.S. Jaffe, and J.W. Pickering, Detectable High-Sensitivity Cardiac Troponin within the Population Reference Interval Conveys High 5-Year Cardiovascular Risk: An Observational Study. Clin Chem, 2018.

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80. Than, M.P., J.W. Pickering, J.M. Dryden, S.J. Lord, S.A. Aitken, S.J. Aldous, K.E. Allan, M.W. Ardagh, J.W.N. Bonning, R. Callender, L.R.E. Chapman, J.P. Christiansen, A.P.J. Cromhout, L. Cullen, J.M. Deely, G.P. Devlin, K.A. Ferrier, C.M. Florkowski, C.M.A. Frampton, P.M. George, G.J. Hamilton, A.S. Jaffe, A.J. Kerr, G.L. Larkin, R.M. Makower, T.J.E. Matthews, W.A. Parsonage, W.F. Peacock, B.F. Peckler, N.C. van Pelt, L. Poynton, A.M. Richards, A.G. Scott, M.B. Simmonds, D. Smyth, O.P. Thomas, A.C.Y. To, S.A. Du Toit, R.W. Troughton, K.M. Yates, and I.C.-A.I. Group, ICare-ACS (Improving Care Processes for Patients With Suspected Acute Coronary Syndrome): A Study of Cross-System Implementation of a National Clinical Pathway. Circulation, 2018. 137(4): p. 354-363.

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Contact us

Location Institute for Health and Biomedical Innovation Queensland University of Technology 60 Musk Avenue Kelvin Grove QLD 4059

Email: [email protected]

Web: www.aushsi.org.au

Twitter: @aushsi

Mail: c/- IHBI, QUT, 60 Musk Avenue, Kelvin Grove QLD 4059

Authors

Megan Campbell Centre Manager

Joanne Preston Senior Project Officer

All AusHSI staff contributed to the final version of this report in July/August 2018

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Partners

AusHSI’s partners are The Queensland Government, The Royal Brisbane and Women’s Hospital, Queensland University of Technology, and The University of Queensland.

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