AH22248Evaluating an implementation of the Australian National Guidelines for the On-Screen Display of Discharge Summaries

Masarrat Mahera, Hamish Rodda, Nick Monypenny and Paul Wembridge

pp. 535-544

What is known about the topic? Electronic discharge summaries (eDS) are critical for ensuring safe transfer of care. The National Guidelines for On-Screen Presentation of Discharge Summaries provide a framework for pertinent information to be included in an eDS. What does this paper add? This paper describes an effective improvement strategy that increased inclusion of pertinent information in eDS, in particular, principle diagnosis and alerts. What are the implications for practitioners? The eDS software used for this intervention is in common use at Australian hospitals, therefore, this work might be suitable for adoption at other health services.

What is known about the topic? Patient-oriented studies of telehealth models of care typically report high levels of patient satisfaction however are often small in sample size and geographically limited. What does this paper add? This large-scale telehealth patient survey compares rural and urban respondents and find similar rates of satisfaction. What are the implications for practitioners? Clinicians delivering services to patients through telehealth models of care can be confident that in a developed nation such as Australia, the quality of a patient’s telehealth experience does not appear to vary depending on where the patient lives.

AH23108Establishment of the first Australian public and health-professional palliative care advice service: exploring caller needs and gaps in care

David J. T. Marco , Esther McMillan-Drendel, Jennifer A. M. Philip , Theresa Williamson and Brian Le

pp. 569-573

What is known about the topic? Ongoing challenges exist in developing sustainable service models to meet the increasing palliative care needs of patients at home, especially in regional and rural communities. What does this paper add? The first 1000 calls to the newly established Palliative Care Advice Service (PCAS) showed high uptake by local and regional communities seeking support with symptom management, availability of local support services, and medication advice. What are the implications for practitioners? PCAS provides a high-impact, low-cost solution that is accessible to regional families and healthcare professionals.

What is known about the topic? Approaches used in Australian acute care facilities to address the end-of-life actions in the National Safety and Quality Health Services Standards (2nd edn), and the associated barriers and enablers, are poorly understood. What does this paper add? Greater confidence exists around processes over measuring outcomes for all six actions. Significant gaps and uncertainties exist around addressing Actions 5.15, 5.19 and 5.20. What are the implications for practitioners? Clinicians require greater resources, support, guidance, and system-level approaches to enable high quality end-of-life care.

AH23101Government-supported clinical knowledge and information resource portals are key to ensuring quality, safe health care and evidence-based practice – the Australian context

Gemma Siemensma , Alice Anderson and Cassandra Gorton

pp. 596-601

What is known about the topic? Little is known about government-supported clinical knowledge and information resource portals within Australia as each health department implements these separately. What does this paper add? This paper explores how reliable evidence is facilitated in Australia’s public health system and how the application of evidence-based practice underpins the safety and efficiency of the Australian healthcare system and keeps patients at the centre of care. What are the implications for practitioners? Without access to a breadth of evidence-based resources, clinicians will be limited in their ability to perform their roles, and this will adversely impact the cost and quality of health care for Australians.

What is known about the topic? If newly admitted patients cannot be accommodated on their treating team’s 'home ward', they may be sent to another ward as an ‘outlier’, or their care may be handed over to the team on whose home ward they are located. What does this paper add? Our retrospective analysis found that handovers within the first 24 h of admission are associated with longer than expected length of stay. What are the implications for practitioners? Early handovers of care are detrimental for individual patients and for hospital bed management, and continuity of care should be prioritised early in a patient’s hospital journey.

What is known about the topic? For patients with cancer living in regional areas, the financial burden of travel and accommodation can be a major challenge in accessing cancer care. What does this paper add? This study investigated whether the provision of additional financial assistance to patients living in regional areas influenced their decision to participate in a cancer related clinical trial; half of participants indicated that it did. What are the implications for practitioners? The provision of financial assistance to patients living in regional areas has the potential to reduce inequities in cancer clinical trial participation and improve cancer outcomes.

What is known about the topic? The use of lung ultrasound (LUS) is emerging as an important tool in respiratory care. However there is a paucity of evidence published on the practicalities of implementing physiotherapy-led LUS in Australia. What does this paper add? The use of LUS in respiratory physiotherapy is an exciting area of growth. This paper describes the experience and practicalities of implementing physiotherapy-led LUS from a regional hospital perspective. This paper allows insight into the processes required and recommended for physiotherapists who are considering implementing physiotherapy-led LUS.

What is known about this topic? Early rehabilitation is recommended for hospitalised patients with certain diagnoses, but it is unclear whether it can be integrated more widely to benefit patients with varied conditions. What does this paper add? In a pragmatic cohort of hospitalised patients with high rehabilitation needs, those who received in-reach rehabilitation were twice as likely to be discharged home from acute care compared to waitlist controls. What are the implications for practitioners? In-reach rehabilitation is feasible to implement for patients with heterogeneous diagnoses and is effective. Wider access to these teams may help improve patient flow in acute care settings.

What is known about the topic? Anaphylaxis is a rare but inherent risk of treatments and investigational agents. What does this paper add? Using a recent coronial finding in Victoria, this letter explores clinical governance responsibilities of health services and private providers of radiology services with respect to anaphylaxis recognition and management. What are the implications for practitioners? There is a strong case for health service and corporate governance teams (for stand-alone clinics) to ensure that all staff have recent, adequate training to recognise and initiate treatment of anaphylaxis. Reliance on an ambulance response is not enough.