AusHSI Funded Partnership and Implementation Projects

AusHSI managed these funding schemes on behalf of Queensland Health

These grants, available to Queensland-based health service groups, provided support to groups in conducting health services research involving implementation in a real world health service setting. The focus was on providing evidence for health service changes that are both effective and sustainable.

While these funding rounds are no longer available, AusHSI continues to support a variety of projects being undertaken in Queensland Hospital and Health services.

2016 Health Services Research Funding Round Recipients

Implementation Grants

The implementation grants support groups to conduct health services research involving implementation and evaluation in a “real world” health service setting.  The focus of these projects is on providing evidence for health service changes that are both effective and sustainable.  Six groups were interviewed for these grants. The following collaborations were successfully awarded implementation grants:

Associate Professor Anthony Smith, The University of Queensland and Dr Stephen Stathis, Child and Youth Mental Health Service (CYMHS). Building a Virtual Child and Youth Forensic Health Service

This project involves the implementation and evaluation of a novel forensic mental health service for child and youth offenders in Queensland. The Child and Youth Forensic Outreach Service (CYFOS) is part of Queensland Health’s Child and Youth Mental Health Service (CYMHS). The aim of this service is to improve accessibility to forensic mental health services, increase the responsiveness of those services, and increase compliance of the new provisions described in the Mental Health Act. Forensic services include connections with the court or justice system to support youth offenders or those at risk of offending.  A hub and spoke service model will be established – where a CYFOS hub site in Brisbane will provide their outreach services in-person and via video conference to six spoke sites. An economic evaluation and an interpretive evaluation of the implementation process will be carried out, alongside analysis of activity data

Professor Len Gray, The University of Queensland and Veronica Casey, Queensland Health. Evaluation of the implementation of a nursing assessment system for acute care

In collaboration with Metro South Health, the Centre for Research in Geriatric Medicine, The University of Queensland proposes to implement and evaluate a whole of hospital trial of a new nursing assessment system at a 200-bed community hospital in Brisbane (QE11). The interRAI Acute Care system, recently validated in field trials, assesses the functional and psychosocial needs of acute adult inpatients. Using computer algorithms, it generates a suite of applications including diagnostic screeners, risk screeners, scales to measure severity and quality indicators.  These are assembled into a continuously updated assessment summary to guide care planning from the commencement of the hospital stay until discharge.  Evaluation parameters include system acceptability and appropriateness for nursing practice, adoption rates, feasibility and fidelity, a cost comparison between existing and new systems, and sustainability. This system has the potential to dramatically reduce nursing documentation burden and shift the focus of duties to direct patient care.

Dr Adrienne Young, Royal Brisbane and Women’s Hospital and Tracy Comans, Griffith University. Malnutrition Models of Care: realigning resources to reduce low value services to improve nutritional care of acute hospital patients

Malnutrition is a significant problem in the Australian hospital setting, affecting around one third of inpatients and having considerable impacts on patient and health service outcomes. Traditionally, the hospital dietitian role has focused on highly individualised assessment, medical nutrition therapy and monitoring for patients with malnutrition. Recent evidence suggests that taking a systems-level approach may provide a more efficient and effective solution to hospital malnutrition. This is particularly pertinent with increasing patient throughput in Australian hospitals, decreasing lengths of stay, and shifting focus towards outpatient and community models of care.

Consequently, this project aims to develop an evidence based, systematized, interdisciplinary malnutrition program for implementation and evaluation – The SIMPLE Approach. This program will be trialled across six Queensland hospitals within a robust implementation science framework, to evaluate whether The SIMPLE Approach provides a more efficient and effective solution to managing the wicked problem of malnutrition in Queensland hospitals.

Partnership Grants

The partnership grants support the formation of strong partnerships between Queensland-based health service professionals and researchers, to solve health services challenges that emerge from the experiences of healthcare professionals.  Three groups were interviewed in this funding round. Congratulations to the following groups who have been awarded partnership grants.

Professor Louise Cullen, Royal Brisbane and Women’s Hospital and Professor Nicholas Graves, Queensland University of Technology. The impact of ImpACT: A protocol to improve emergency chest pain assessment

The Improved Assessment of Chest pain Trial (ImpACT) Protocol is an approach for risk stratification of emergency patients, enabling safe targeted appropriate strategies and resource use in the assessment of patients with possible acute coronary syndromes (ACS). It identifies patients who can safely undergo accelerated care, and a proportion in who further testing for coronary ischemia beyond ECGs and troponin testing is not required.

A 2006 report by the Australian Institute of Health and Welfare identified that Aboriginal and Torres Strait Islander (ATSI) people had a three-fold increase in the rate of major coronary events compared to other Australians. Of particular concern was the observation that rates were 7-9 times higher in patients under the age of 45 years. Consequently, risk stratification models utilising age as a factor independent of ethnic status may not accurately identify patients as low risk of ACS.

Professor Matthew Brown, Metro South Health Service and Professor Nicholas Graves, Queensland University of Technology. How will the inclusion of novel information about gene mutations in patients being treated for leukaemia impact on clinical care, costs and health outcomes.

Leukaemia is a form of blood cancer where genetics plays a significant role in patient prognosis.  Improvements in genome sequencing technology have advanced our knowledge of leukaemia, however, the integration of these findings into clinical practice is yet to be fully realised.

This project will evaluate how the inclusion of novel information on gene mutations will impact on clinical care, costs and health outcomes for patients being treated for leukaemia.  As part of a partnership between QUT and Metro South Hospital and Health Service, Whole Exome Sequencing will be introduced to identify a larger proportion of the mutations involved, which will then be used to inform personalised treatment decisions.

The results of this work will inform decision makers about the cost-effectiveness of adopting Whole Exome Sequencing into clinical practice, and its impact on the utilisation of health services.

Implementation projects funded by AusHSI in the previous round:

Evaluating the implementation of a Kidney Supportive Care Program into a Hospital and Health Service

The last year of a patient’s life consumes more health resources than any other period, with health needs the greatest in groups with high burden of disease, such as end-stage kidney disease.

This project is evaluating the innovative person-centred Kidney Supportive Care Program (KSCp) in Metro North Hospital and Health Service. It aims to show that systemising a multidisciplinary collaborative approach based on international kidney and palliative care evidence sustains independent living, expands resilience for complex health decision-making and provides care that meets patients’ disease experience in addition to timely symptom control. The impact of these changes will deliver greater patient and health service outcomes in a highly vulnerable patient group.

Early detection of deterioration in elderly residents (EDDIE): Implementing a hospital avoidance initiative

Existing models of care in residential aged care facilities (RACF) are not equipped to identify and manage the sub-acute needs of residents.

This study is evaluating the implementation of a hospital avoidance (HA) program, assessing the costs of the program and developing a robust protocol to support adoption of the HA program in other RACFs.

The program was developed, implemented and pilot tested at a regional RACF. The HA program focused on a proactive clinical care model with the provision of equipment, education and a suite of decision support tools to assist nursing staff in detecting and responding early to the deteriorating resident – ultimately enabling residents to remain at home, and reducing unnecessary emergency department presentations.

The PARiHS framework (Promoting Action on Research Implementation in Health Services) is now being used to inform knowledge translation of the HA program at a subsequent regional RACF.

Implementing economic modelling to improve service planning in Specialist Orthopaedic and Neurosurgical Outpatient services

Many people suffer musculoskeletal problems like back pain, neck pain and knee arthritis and need to seek specialist care at public hospitals. Demand is much higher than services can currently provide, resulting in long waits.

This project uses a computer model to predict the demand for orthopaedic and neurosurgical outpatient services and how it can be most efficiently managed. This is done by creating a computer-generated population, sending them through different pathways of care and counting how long they will have to wait.

The project is working out the best way of managing the demand by modelling different mixes of traditional specialist-led and physiotherapy-led services to meet the needs of patients across three health service regions.

The results will allow related health services to understand demand and plan the most efficient combination of services to provide in the future.