Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better

2020 ◽  
Vol 26 (4) ◽  
pp. 325
Author(s):  
Katarzyna Bolsewicz ◽  
Susan Thomas ◽  
Donna Moore ◽  
Colleen Gately ◽  
Andrew Dixon ◽  
...  

In the Central Coast Local Health District of New South Wales, Australia, childhood immunisation (CI) rates are around 95%, but pockets of underimmunisation exist. Using the World Health Organization’s Tailoring Immunization Programmes, we identified areas of potential low vaccine coverage using Australian Immunisation Register (AIR) data (2016–18) and investigated factors that influence CI. Individual and group interviews with carers, community members and service providers (n=52 participants) were conducted. Data were analysed thematically and the themes presented to stakeholders for feedback before finalisation. During 2018, Umina had 218 children at least 1 month overdue for at least one vaccination. Five themes emerged: (1) broader socioeconomic factors may apply pressures that influence CI; (2) parents largely supported immunisation and knew of its benefits to their children and the community; (3) immunisation service providers are committed, experienced and collaborate with community partners; (4) there is potential to increase access to free immunisation services in Umina; and (5) AIR data and reminder systems could be better used to inform service delivery and prompt parents before immunisations are due. This study identified opportunities to improve CI coverage in Umina and new information useful in developing a tailored immunisation strategy. Awareness of the pressures socioeconomic factors may have on families could help plan and deliver supportive primary health care that includes equitable access to immunisation.

2020 ◽  
Vol 44 (2) ◽  
pp. 205
Author(s):  
Elissa Elvidge ◽  
Yin Paradies ◽  
Rosemary Aldrich ◽  
Carl Holder

ObjectiveThe aim of the present study was to develop a scale to measure cultural safety in hospitals from an Aboriginal patient perspective. MethodsThe Cultural Safety Survey was designed to measure five key characteristics of cultural safety that contribute to positive hospital experiences among Aboriginal hospital patients. Investigators developed a range of different methods to assess the validity and reliability of the scale using a sample of 316 participants who had attended a New South Wales hospital in the past 12 months. Targeted recruitment was conducted at two hospital sites. Opportunistic recruitment took place through a local health district, discharge follow-up service and online via social media. ResultsThe Cultural Safety Survey Scale was a robust measurement tool that demonstrated a high level of content and construct validity. ConclusionThe Cultural Safety Survey Scale could be a useful tool for measuring cultural safety in hospitals from the Aboriginal patient perspective. What is known about the topic?There are increasing calls by governments around the world for health institutions to enhance the cultural safety of their services as one way of removing access barriers and increasing health equity. However, currently there are no critical indicators or systematic methods of measuring cultural safety from the patient perspective. What does this paper add?The cultural safety scale, an Australian first, presents the first empirically validated tool that measures cultural safety from the Aboriginal patient perspective. What are the implications for practitioners?This measurement model will allow hospitals to measure the cultural safety of their services and ascertain whether current efforts aimed to improve cultural safety are resulting in Aboriginal patients reporting more culturally safe experiences. Over time it is hoped that the tool will be used to benchmark performance and eventually be adopted as a performance measure for hospitals across New South Wales.


2015 ◽  
Vol 39 (5) ◽  
pp. 514 ◽  
Author(s):  
Jane Conway ◽  
Sophie Dilworth ◽  
Carolyn Hullick ◽  
Jacqueline Hewitt ◽  
Catherine Turner ◽  
...  

This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person.


2018 ◽  
Vol 27 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Adith Mohan ◽  
Adam Bayes ◽  
Perminder S Sachdev ◽  
Gordon Parker ◽  
Philip B Mitchell

Objective: We examined current pathways of training for junior clinical academic psychiatrists in Australia. An initiative of the School of Psychiatry, University of New South Wales, is described from the perspective of two junior clinical academics. Conclusions: Australia has limited defined clinical academic pathways for psychiatrists when compared internationally. Numerous challenges for junior psychiatrists entering academia include tensions between clinical and academic roles, reduced remuneration, difficulty building a competitive track record and a scarcity of funding. Potential solutions lie with universities and local health districts partnering to fund clinical academic roles and offering flexible entry points across specialty training. Fostering research engagement in junior psychiatrists will develop the next generation of clinical academics with benefit for clinical and academic domains.


2019 ◽  
Vol 25 (4) ◽  
pp. 310
Author(s):  
Susan Thomas ◽  
Helen Higgins ◽  
Julie Leask ◽  
Lisa Menning ◽  
Katrine Habersaat ◽  
...  

The World Health Organization’s Tailoring Immunization Programmes approach was used to develop a new strategy to increase child vaccination coverage in a disadvantaged community in New South Wales, Australia, including reminders, outreach and home visiting. After 18 months, the strategy hasn’t been fully implemented. A process evaluation was conducted to identify barriers and facilitators for research translation. Participants included child health nurses, Population Health staff, managers and general practitioners. The Capability–Opportunity–Motivation model of behaviour change (COM-B) was used to develop questions. Twenty-four participants took part in three focus groups and four interviews. Five themes emerged: (i) designing and adopting new ways of working is time-consuming and requires new skills, new ways of thinking and changes in service delivery; (ii) genuine engagement and interaction across fields and institutions helps build capacity and strengthen motivation; (iii) implementation of a new strategy requires clarity; who’s doing what, when and how?; (iv) it is important not to lose sight of research findings related to the needs of disadvantaged families; and (v) trust in the process and perseverance are fundamental. There was strong motivation and opportunity for change, but a need to enhance service capability. Areas requiring support and resources were identified.


Author(s):  
E. Saurman ◽  
D. Perkins ◽  
D. Lyle ◽  
M. Patfield ◽  
R. Roberts

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Trevena ◽  
E Munn ◽  
L King ◽  
M Thomas ◽  
L Shepherd ◽  
...  

Abstract Issue Obesity and its determinants are risk factors for most leading causes of chronic diseases. In New South Wales (NSW), Australia, 1 in 2 adults and more than 1 in 5 children are above a healthy weight. As a key symbolic part of a suite of health eating policies, the NSW Ministry of Health implemented a Healthy Food and Drink in NSW Health facilities for Staff and Visitors Framework (Framework) across 18 Local Health Districts (LHDs). Many countries are grappling to understand the effectiveness of obesity prevention policies. Description 2: This policy evaluation synthesised evaluation study findings and internal records to assess the effectiveness of the Framework in achieving implementation targets: a) the removal of sugar-sweetened drinks (SSDs) from sale (Dec 2017), b) implementation of 12 food-based practices (Dec 2018). Results The overall implementation package was appropriate for the large, geographically dispersed, decentralised health system (160 health facilities; 927 food outlets;76 retailers) and variable retail arrangements. The Ministry provided LHDs with overall direction, phasing, and monitoring; the LHDs had local leadership, governance, cross-functional support and autonomy to implement in a way to suit them. Accountability and pace of implementation was driven most notably by monitoring and reporting using an electronic tool (PHIMS-N), and a 'network of practice' that was pivotal to problem solving. SSDs were removed from 96% (n = 606) of applicable food outlets; overall average achievement of all practices was high at 82% (22.4 SD). Nine in 10 (92%) consumers support the Framework, and retailers are accepting of its targets. Lessons: This was the right policy at the right time, with well-orchestrated implementation. Annual monitoring and reporting enabled by PHIMS-N is unique in this type of policy implementation and essential for tracking progress, informing decision making, and ensuring accountability. Key messages Implementation of the Framework has resulted in the removal of SSDs from sale, increased availability of healthier foods and decreased unhealthy foods as measured by 12 food-based practices. The Framework is feasible and effective in influencing retail practices in health facilities, has high consumer support for its goals, and overall acceptability and adoption amongst retailers.


1995 ◽  
Vol 1 (1) ◽  
pp. 94
Author(s):  
Joy Northey

Lake Cargelligo is a small, isolated rural community in the centre of New South Wales with a population of 2000, of these 60% live in the town. The project to build a gymnasium was the result of a combined approach to improve the health and fitness of the community by hospital and community health staff and by the community at large. It was the outcome of a series of innovative approaches to addressing local health issues.


Respirology ◽  
2017 ◽  
Vol 22 (5) ◽  
pp. 978-985 ◽  
Author(s):  
Anthony Linton ◽  
Matthew Soeberg ◽  
Richard Broome ◽  
Steven Kao ◽  
Nico van Zandwijk

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