Healthcare Transformation​ Research Program

ED ASET Nurse undertaking a Pace-IT telehealth consultation

Our collective purpose is to optimise healthcare experiences and outcomes for individuals, families, communities, and healthcare providers.

Health services are currently fragmented, lacking coordination and integration between providers and across healthcare settings, with insufficient focus on the person at the centre of care. The different health professions and providers often operate in silos. This results in gaps in care, conflicting advice or treatments, duplication of costly services and waste of precious health care resources. These factors can undermine quality of care and negatively impact experiences and outcomes of care, particularly for priority populations.

Despite there being an abundance of research to inform clinical practice (it is estimated that over 1 million articles are published every year in Pub Med), many patients fail to receive evidence-based care. This is commonly referred to the evidence/practice or know-do practice gap - a gap that has been estimated to take 17 years to bridge - that is 17 years from knowledge generation to implementation in practice. And when it does, only a modest 14% of that evidence reportedly reaches the patient. The consequences are that an estimated 30-40% of patients do not currently receive evidence–based care, and 20-25% of care currently delivered is deemed unnecessary and potentially harmful.

In response, we have adopted a whole of system approach rather than focusing on one disease or condition to undertake transformative, person-centred, practice-based research - research that is targeted toward diverse healthcare needs across the lifespan. Research undertaken within our program crosses jurisdictions, disciplines, and geographic boundaries.

Our philosophical approach is first and foremost transdisciplinary. We value the diversity of knowledge (from healthcare consumers, healthcare providers, service managers, academic researchers, and policy makers) to co-create innovative solutions, solutions that can be translated into practice, and that will drive health services transformation. Such an approach will lead to new clinical, academic and industry partnerships, integrated models of care, and ultimately more timely and effective care than that being provided by current health services.

Our program is equally committed to building research capability within the healthcare workforce. Aspiring clinician researchers within our program can access opportunities to build research skills and capabilities, access small “seeding” grants to progress their own practice-based research projects, access career mentoring, and collaborate with academic and other researchers to work on impactful, patient-centred, and cost-effective solutions to “real-world” clinical challenges.

Innovation & Discovery

Our research covers a range of diverse healthcare needs and priority populations. These include maternal and infant health, pain, drug and alcohol, mental health, and older person care.

All projects supported in our program arise from clinical practice, with clinician-driven research more likely to align with the priorities of the health service, and far more likely to be implemented or translated into practice.

The PACE-IT Project

Partnership In Aged Care Emergency with Integrated Technology 

Transfer of people who are residents of residential aged care facilities (RACF) to emergency departments (ED) is common, risky and expensive. Up to 44% of transfers are considered unnecessary and can expose residents to additional investigations and treatments. This can cause additional harm through emotional stress and iatrogenic (illness caused by medical examination or treatment) complications, rather than enhance care.  

The PACE-IT project is an interactive visual telehealth assessment and clinical decision-making model of care (MOC) that is not yet used anywhere in Australia. 

We implemented and evaluated whether the combination of MOC and enhancement of the well-established nurse-led telephone-based aged care emergency (ACE) led to improved communication, ensured the right care was delivered in the right place in a timely way, reduced emergency department (ED) transfers and provided a more integrated and person-centred approach to care for the older resident. 

Our research found a 53% uptake of the PACE-IT model of care and a clinically significant 14% reduction in emergency department (ED) presentations. The initiative is now embedded in routine aged care emergency practices and a reduction in the number of unnecessary ED transfers is the result. 

Resident and staff from RACF taking part in a PACE-IT telehealth consultation with an ED ASET Nurse

PACE-IT Awards

  • Winner of the 2021 HNELHD Integrated Value Based Care Quality Award
  • Current finalist in the 2021 NSW Health Secretary’s Award for Integrated Value Based Care

PACE-IT Publications to date

Tapering and ceasing prescription opioids in chronic non-cancer pain

A co-designed model of care to improve patient outcomes

This research will utilise expertise from patients, specialist clinicians and researchers to develop a healthcare intervention that supports people with chronic non cancer pain to safely transition from long-term prescription opioids to non-pharmacological pain management strategies.

Current evidence suggests that coming off opioids improves treatment outcomes for patients attending specialist pain services. But the logistics of coordinating the specialist multidisciplinary health services needed to support patients to reduce opioids, particularly in the absence of accessible and effective treatment alternatives, can be a barrier to success. 

Our research is much needed, as more than 70% of all opioid-related overdoses involve prescription opioids, which account for 14 emergency department admissions per day, and three deaths every day.

Tapering and ceasing prescription opioids in chronic non-cancer pain

This research will utilise expertise from patients, specialist clinicians and researchers to develop a healthcare intervention that supports people with chronic non-cancer pain to safely transition from long-term prescription opioids to non-pharmacological pain management strategies.

Current evidence suggests that coming off opioids improves treatment outcomes for patients attending specialist pain services. But the logistics of coordinating the specialist multidisciplinary health services needed to support patients to reduce opioids, particularly in the absence of accessible and effective treatment alternatives, can be a barrier to success. 

Our research is much needed, as more than 70% of all opioid-related overdoses involve prescription opioids and accounts for 14 emergency department admissions and three deaths per day.

Embedding Nurse Practitioners in rural and remote emergency departments

Rural and remote emergency departments collectively manage one third of all Australian emergency department presentations yet remain chronically understaffed. Outreach medical services go some way to improving access to emergency care in rural and remote regions, but these often result in delays in care for those presenting with life-threatening conditions or costly inter-hospital transfers for patients with less critical conditions. Without adequate access to timely quality emergency care services, people die from avoidable deaths and these avoidable death rates are proportionally higher in rural and remote areas.

Nurse practitioners are registered nurses, educated at Masters level, who diagnose and treat a range of health conditions, can order and interpret tests, and prescribe necessary and appropriate medications working collaboratively with other health practitioners. This project will assess the effectiveness of embedding a Nurse Practitioner model of care focused on providing safe, equitable and timely service to rural and remote communities accessing emergency care. It is a highly feasible and cost-effective solution that has been shown to be effective in metropolitan settings.

EMDR interventions in a public drug and alcohol service

Approximately 80% of Australians seeking treatment from alcohol and other drug (AOD) services report experiencing trauma, and up to two-thirds have post-traumatic stress disorder. Eye Movement Desensitisation and Reprocessing (EMDR) has an evidence-base in for trauma resolution in general populations.

Evidence exists for its ability to decrease cravings, fears, and depression in those experiencing AOD problems however, a literature gap regarding its implementation and effectiveness exists, particularly in outpatient AOD services.

The project will generate new knowledge by evaluating the implementation of EMDR in a local health district drug and alcohol service, including its acceptability among EMDR-trained clinicians and AOD clients.

Healthcare Transformation Research Program Team 

Executive Leadership Committee

Operations Leadership Committee

Program Members

 

 

Simone Perry
Research Program :
  • Healthcare Transformation​ Research Program
Research Topics :
Effective Health Services, Global Health, Healthy Ageing, Psychology