News

It’s been a rather wet and chilly spring here in Sydney, Australia, but that has not dampened the pace of research progress by the NHMRC Partnership Centre for Health System Sustainability’s (PCHSS’s) investigators. We present some highlights here in this latest edition of our newsletter.

WHAT IS THE PCHSS?

The PCHSS is a $10.75M, five-year collaboration involving 17 lead investigators, 20 expert advisors, and over 40 system implementation partners from around Australia. Our vision is that our research findings significantly influence the development of a more resilient health care system – one that is affordable, cost effective, and delivers improved health outcomes for all Australians.

NEW AWARDS AND RECOGNITION

Congratulations to Professor Rachelle Buchbinder AO on receiving the Best Female Scientist 2022 Award from Research.com. This award is in recognition of Professor Buchbinder’s significant research contribution to the fields of physical therapy, gerontology, and demography. Her most cited works are systematic analyses for Global Burden of Disease studies, and her research has accumulated over 120,000 citations.

Professor Buchbinder also received the 2022 Medal for Excellence in Scientific Research presented by the Council of the Royal Society of Victoria (RSV). The presentation of this medal recognises outstanding leadership in research by scientists within the State of Victoria, Australia and is a testament to Professor Buchbinder’s continued research contribution to evidence-based healthcare. Congratulations Rachelle!

Our heartfelt congratulations also go to Professor Paul Glasziou!

Professor Glasziou AO has been awarded the Vice Chancellor’s Award for Research Excellence at Bond University’s Vice Chancellor’s Research Awards. This award recognises the consistently high-quality of Professor Glasziou’s research in removing barriers to using high quality research in everyday clinical practice, as well as improving the use of non-drug interventions. Congratulations Paul!

Last, but not least, we are pleased to announce that Professor Farah Magrabi was inducted into the International Academy of Health Sciences Informatics in November. Congratulation Farah!

NEW PUBLICATIONS

Since our last newsletter, PCHSS investigators published more than 40 papers, abstracts, reports, and other research works. These and all our papers are available on the Our Publications page on our website.

Notable recent examples of our publications include:

• A paper developing a new methodological framework for describing overdiagnosis for noncancer conditions. The authors highlight the need for frameworks for defining and quantifying overdiagnosis, as it is the most important harm associated with cancer screening programs and is therefore relevant for noncancer diseases. (Bell K, Doust J, Sanders S, Buchbinder R, Glasziou P, Irwig L, Jones M, Moynihan R, Kazda L, Barratt A. A novel methodological framework was described for detecting and quantifying overdiagnosis. Journal of Clinical Epidemiology)
• A scoping review exploring the sustainable performance of healthcare systems, including definitions, measures and challenges. The authors found that definitions for sustainability lacked overarching clarity, and that system fragmentation and an increasingly complex patient population were the main challenges in the field. (Zurynski Y, Herkes-Deane J, Holt J, McPherson E, Lamprell G, Dammery G, Meulenbroeks I, Halim N, Braithwaite J. How can the healthcare system deliver sustainable performance? A scoping review. BMJ Open)

• A new study exploring rates of psychological distress and the use of digital health services during the COVID-19 pandemic. The authors found that the rate of serious psychological distress remained high in 2021 and that these individuals were more likely to access digital mental health services, including telehealth conferencing and telephone or webchat advice services. (Ellis LA, Dammery G, Wells L, Ansell J, Smith CL, Tran Y, Braithwaite J, Zurynski Y. Psychological distress and digital health service use during COVID-19: A national Australian cross-sectional survey. Frontiers in Psychiatry)
• A paper exploring the effectiveness and sustainability of telehealth in primary care after COVID-19. The authors explain that there is continued opportunity for the use of telehealth within primary care settings in Australia, but development of better communication options and ongoing reimbursement of GPs is needed for service viability. (De Guzman KR, Snoswell CL, Smith AC. Telehealth sustainability after COVID-19 – can you see me by video? Australian Health Review)

RECENT CONFERENCES

PCHSS researchers have been busy over the last few months presenting the latest results from our research at national and international conferences.

Here are just a few examples:

Organisational Behaviour in Health Care Conference

From the 12^th to the 14^th of September, PCHSS researchers participated in the 13^th Organisational Behaviour in Health Care (OBHC) Conference at the University of Birmingham, UK. The overarching theme of the conference was evolution and revolution in the organisation of health and care, particularly focusing on the impacts of health system inequalities on patients and healthcare professionals.

The following topics were presented by the PCHSS team:

• People and culture: at the heart of the evolution of learning health systems (Smith CL, Zurynski Y, Dammery G, Meulenbroeks I, Knaggs G, Vedovi A, Warwick M, Ellis LA, Gul H, Braithwaite J.)
• How do we evolve the culture of Australia’s aged care system: A sociological analysis of a Royal Commission’s Final Report (Churruca K, Long JC, Ellis LA, Braithwaite J.)
• Resilience in the face of complexity: An examination of the characteristics of resilience in the implementation of a large-scale community-based mental health intervention (Ellis LA, Zurynski Y, Clay-Williams R, Long JC, Sarkies M, Churruca K, Braithwaite J.)
• Resilient healthcare performance in the real world: revolutionary or evolutionary? (Braithwaite J, Churruca K, Clay-Williams R, Ellis LA, Leask E, Long JC, Sarkies M, Zurynski Y.)
• Fixing the plane while flying: Formative evaluation feedback loops (FEFLs) to orchestrate revolutionary and evolutionary change in dynamic, complex healthcare systems (Braithwaite J, Churruca K, Ellis LA, Long JC, Sarkies M, Zurynski Y, Clay-Williams R.)
• Health workforce planning in Australia: evolution or devolution? (Zurynski Y, Dammery G, Smith CL, Braithwaite J.)

International Society for Quality in Health Care (ISQua) Conference

Over 20 researchers from the Australian Institute of Health Innovation (AIHI) and the PCHSS presented at the ISQua 38^th International Conference 2022, held at the Brisbane Convention and Exhibition Centre from the 17^th to 20^th October. Professors Jeffrey Braithwaite, Rachelle Buchbinder, Anthony Capon, Associate Professor Yvonne Zurynski and Dr K-lynn Smith led a symposium on climate change and health system sustainability. They discussed the impact of climate change on human health and the health systems’ contributions to climate change and presented solutions for reducing the carbon footprint of healthcare.

Another symposium was held to present the findings of the 2021 Voice of the Australian Health Consumer Survey, which collected data from 5100 Australians regarding access and affordability of healthcare during the pandemic. Key findings were discussed including perception and satisfaction with the Australian health system, mental health impacts during COVID-19, patient activation, and the use of telehealth services. The presenters for this workshop were Associate Professor Yvonne Zurynski, Professor Jeffrey Braithwaite, and Dr Louise Ellis.

Other presentations included:

• An evaluation of HeartConnect, an innovative service designed to improve patient access to cardiology services and integrate communication between specialist cardiology services and GPs. It was found that HeartConnect was promising in terms of reducing waiting times, care navigation, and enhancing timely communication. (Zurynski Y, Dammery G, Nalliah C, Willcock S. Heart-connect: Integrating primary care and specialist cardiology for rapid access and better patient and practitioner experiences)
• An exploration of vitamin D testing in Australian children. It was found that although there was a sharp increase in testing over time, the odds of detecting low vitamin D levels have not changed. This highlights the need for education about the Global Consensus Recommendations and better decision-making processes. (Zurynski Y, Munns C, Sezgin G, Georgiou A. Vitamin D pathology testing in Australian children has increased 30-fold since 2003 but the odds of detecting low vitamin D levels remain steady: low value care?)
• An exploration of using a learning health system (LHS) within a university-based general practice. Although challenges to the LHS included COVID-19 and cultural dynamics within the practice, the study indicates that an LHS model can be utilised within a primary care setting. (Dammery G, Lopez F, Mahadeva J, Willcock S. Using an embedded researcher to investigate the learning health system in general practice)
• A scoping review of transition programs for young adults with Type 1 diabetes. It was found that transition programs benefit young adults through increased likelihood of attending appointments, reduced presentations to emergency departments, and reduced diabetes- related stress. (Carrigan A, Meulenbroeks I, Halim N, Zurynski Y. Transition of care for Type 1 diabetes mellitus: A scoping review of the literature)

MEDIA ENGAGEMENTS

Since our last newsletter, there have been more than 20 popular press stories covering PCHSS research.

Here is a sampling of news stories from the past few months:

• Great health system, but I can’t afford it (Zurynski Y, Braithwaite J, Wells L, MJA Insight+, 16 May 2022)
• Not in the script: doctors turn to parkrun and social activities to treat chronic conditions (Wells L, Zurynski Y, The Guardian, 29 May 2022)
• Flu may be back, but COVID is far from over. How do they compare? (Glasziou P, The Conversation, 4 July 2022))
• We have the best of health care services, but are patients finding care they need? (Braithwaite J, Mirage News, 5 July 2022)
• No hologram doctors any time soon: future of AI in healthcare (Coiera E, Mirage News, 23 July 2022)
• Changing the law to shield kids from e-cigarette advertising on social media (Hendrie D, UWA News, 28 July 2022)
• First of its kind study to assess the impact of AI on clinical decision-making (Magrabi F, Digital Health CRC, 6 September 2022)
• Actor Ryan Reynolds has urged 45 year olds to screen for bowel cancer. But the case for screening in your 40s isn’t clear cut (Glasziou P, Yahoo News, 21 September 2022)
• Grants awarded to help deliver better outcomes for older people (Westbrook J, Australian Ageing Agenda, 29 September 2022)
• Some GPs just keep their heads above water. Other doctors’ businesses are more profitable than law firms (Scott A, The Conversation, 12 October 2022)

OTHER NEWS

Professor Jeffrey Braithwaite, Associate Professor Yvonne Zurynski, and Dr K-lynn Smith are editing a Routledge ‘Handbook on Climate Change and Health System Sustainability’. The Handbook will contain over 40 chapters from internationally renowned authors addressing topics including the impact of climate change on mental health, how to reduce health systems’ carbon footprint, and how a OneHealth perspective can improve our environment and our health. The book will be published in late 2023.

NEW LEVERAGED FUNDING

PCHSS’ researchers won $26,379,171 in new funding and contracts in the past year.

Examples of some of the new projects include:

• Professor Johanna Westbrook and colleagues’ grant to investigate “Transforming residential aged care through evidence-based informatics.” This research will be conducted in partnership with BESTMED, Aged Care Industry Information Technology Council, Aged Care Quality and Safety Commission, Consumers Health Forum of Australia, Southern Cross Care and Bupa Aged Care.
• Professor Jeffrey Braithwaite and colleagues grant from the HCF Research Foundation to investigate the implementation of evidence and consensus-based perioperative care pathways in private, academic health sciences centres.
• Medibank Private awarded a grant to Professor Jonathan Karnon and colleagues to conduct an implementation study on using patient-reported outcomes measures for quality improvement in elective surgery.
• Professor Paul Glasziou and colleagues received funding the NSW Agency for Clinical Innovation (ACI) to investigate a structured implementation approach to reduce unwarranted clinical variations.

PAST EVENTS

On the 14^th October, PCHSS hosted an event on ‘Creating Integrated, Safe Healthcare Systems: Lessons from around the World’. Distinguished speakers Professor Sir Liam Donaldson (Integrated Care Board (North-East and North Cumbria), UK), Dr Ezequiel García Elorrio (Institute for Clinical Effectiveness and Health Policy (IECS)), Professor Johanna Westbrook (PCHSS and AIHI) and Associate Professor Yvonne Zurynski (PCHSS and AIHI) presented perspectives from their countries on what is needed to improve healthcare systems. The speakers were then joined by Professor Nick Goodwin (University of Newcastle), Adjunct Associate Professor J.R. Baker (PCCS), Dr Christian von Plessen (Centre universitaire de médecine Générale et santé publique) and Associate Professor Robyn Clay-Williams (AIHI) in lively and wide-ranging panel discussions with the audience.

The AIHI and PCHSS team also hosted several global researchers on the 25^th October for an event titled, ‘Quality of care in the 2020s: International perspectives’. Presentations focused on perspectives of quality and safety within international health systems, with special presenters including Professor Boel Andersson Gäre (Professor of Quality Improvement and Leadership at Jönköping University, Sweden), Professor Siri Wiig (Centre Director at SHARE – Centre for Resilience in Healthcare, Norway) and Professor Holger Pfaff (Director of the Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Germany).

Follow us on Twitter @PCHSS_AIHI for notifications of upcoming events and registration links.

Videos of other past events are available on our YouTube Channel.