Australian Journal of Rural Health最新文献

{"title":"Continuing professional development training needs of allied health professionals in regional and rural Victoria","authors":"Michael Pang BPhysio,&nbsp;Alesha Sayner MPhysio,&nbsp;Kylie McKenzie PhD","doi":"10.1111/ajr.13141","DOIUrl":"10.1111/ajr.13141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of the study was to identify continuing professional development (CPD) needs of allied health professionals (AHP) in regional and rural Victoria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study was an online cross-sectional design conducted between December 2022 and February 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings and Participants</h3>\u0000 \u0000 <p>AHPs employed at a large multi-site regional public health service providing acute, subacute, community and outpatient care in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>The online questionnaire included four sections investigating satisfaction of CPD, prioritised topics for CPD, preference for CPD sourcing and perceived capabilities in delivering education. To investigate prioritised topics of CPD, a tool was adapted from the Hennessy Hicks Training Needs Analysis questionnaire to align with allied health (AH) career pathways. For organisational alignment, a second questionnaire was sent to AH managers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 17% (53/316 AHPs) from members of 10 AH professions. The median years of clinical experience for participants was between 2 and 5 years. Participants with 6–10 years of clinical experience reported the lowest level of satisfaction. Research and education were identified as areas of highest training need. Self-perceived competence in education delivery was proportionately lower in areas of assessment, developing digital learning and constructive alignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CPD needs for AHPs in a regional and rural health service were shown to vary by career stage and weighted towards developing research and education delivery capabilities. Findings from this study may support public health sector and policy investment in CPD opportunities to support horizontal career progression opportunities, a balance of internal and externally sourced professional development and strategic investment in education delivery capabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"763-773"},"PeriodicalIF":1.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustaining multidisciplinary teams in rural and remote primary care","authors":"Geoff Argus BSc (Hons), MPysch (Clin), GCert Public Health, MAPS, FCCLP, GAICD","doi":"10.1111/ajr.13144","DOIUrl":"10.1111/ajr.13144","url":null,"abstract":"&lt;p&gt;The health system in rural and remote Australia has been under significant strain for decades with rural and remote Australians continuing to face barriers in accessing and utilising appropriate primary health care due to a range of factors including geographic spread, low population density, infrastructure limitations and higher costs of delivering healthcare.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The global shortage of health care workers since the COVID-19 pandemic will likely further exacerbate the long-standing challenges for rural and remote Australian communities in attracting and retaining a suitably trained multidisciplinary primary care workforce with the appropriate mix of required skills.&lt;/p&gt;&lt;p&gt;Whilst the concept of multidisciplinary health care teams is well-established, there have been renewed calls for the implementation of sustainable multidisciplinary team-based models of primary care service delivery in rural and remote communities. There are several bodies of work in recent times that point towards the importance of needs-based multidisciplinary health workforce planning for effective and sustainable rural and remote primary care in Australia.&lt;/p&gt;&lt;p&gt;In 2023, the Office of the National Rural Health Commissioner released the &lt;i&gt;Ngayubah Gadan Consensus Statement: Rural and Remote Multidisciplinary Health Teams&lt;/i&gt;,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; which identifies key contextual areas for successful implementation and sustainability: Policy and Funding Context, Organisational Context, Multidisciplinary Team Context and Person and Community Context. The statement provides a framework for contextual considerations in the implementation and sustainability of multidisciplinary primary health care teams in rural and remote Australia. It makes clear that place-based solutions are required where service models are co-designed with the community to meet the specific ongoing health needs of the community.&lt;/p&gt;&lt;p&gt;The Innovative Models of Care (IMOC) Program administered by the Australia Department of Health and Aged Care&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; is attempting to address these issues by funding trials of multidisciplinary primary care models in rural and remote locations. This is an important initiative to showcase successful examples of rural and remote multidisciplinary models of primary care and determine the elements of success and challenge. A diversity of models and locations have thus far been funded, and it will be valuable to see over time a robust evaluation of these projects to inform future primary care reform.&lt;/p&gt;&lt;p&gt;The findings and outcomes of the &lt;i&gt;Unleashing the Potential of our Health Workforce—Scope of Practice Review&lt;/i&gt;&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; will be important in informing the future of rural and remote primary care. Identifying the appropriate mix of skills and capabilities of multidisciplinary primary care teams and clinicians working at their full scope of practice has been identified in the review. It is heartening to see the sugges","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 3","pages":"606-607"},"PeriodicalIF":1.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Farm to bedside: Collaboration with local farmers to supply rural Australian hospital food","authors":"Joshua G. Kovoor,&nbsp;Brandon Stretton,&nbsp;Luke Spajic,&nbsp;Genevieve Moseley,&nbsp;Harry Brown,&nbsp;Silas D. Nann,&nbsp;Alasdair Leslie,&nbsp;Aashray K. Gupta,&nbsp;Ammar Zaka,&nbsp;Yuchen Luo,&nbsp;Samuel Gluck,&nbsp;Matthew Marshall-Webb,&nbsp;Stephen Bacchi","doi":"10.1111/ajr.13142","DOIUrl":"10.1111/ajr.13142","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"847-849"},"PeriodicalIF":1.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does on-site computed tomography matter? A cross-sectional study of stroke patients’ door-to-scan-time in rural hospitals","authors":"Nicholas Arnold GradDip,&nbsp;Kathryn Gough BMSc,&nbsp;Anthony Patsalou MD,&nbsp;Brendan Carrigan MBBS,&nbsp;William MacAskill PhD","doi":"10.1111/ajr.13140","DOIUrl":"10.1111/ajr.13140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Many rural Australian hospitals lack on-site computed tomography (CT). These hospitals often refer patients to local off-site private radiology clinics or to central hospitals, challenging the achievement of time-sensitive scans. For stroke patients, timely access to CT affects treatment options. This study questions whether on-site CT matters in rural hospitals by investigating stroke patients’ door-to-scan-time (DTST) and CT scan sequence referrals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective chart audit was completed across four rural hospitals; two with on-site CT and two without. Adult emergency stroke presentations were randomly sampled. Comparisons between on-site and off-site CT hospitals were made for DTST and CT sequence referrals using Mann–Whitney U-tests and Fisher's exact tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 120 charts were audited (on-site CT, <i>n</i> = 60; off-site CT, <i>n</i> = 60). DTST was longer for off-site vs. on-site CT hospitals (median = 4.30 h vs. median = 0.70 h; <i>U</i> = 338, <i>p</i> &lt; 0.001) regardless of whether presentations occurred in business hours or out of hours (<i>p</i> &lt; 0.001). Off-site CT hospitals ordered less CT angiography or perfusion scanning (32% vs. 85%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Off-site CT hospital patients had longer DTST and received less angiography or perfusion scanning. These findings suggest that on-site CT matters to rural stroke patients by improving equitable access to CT and appropriate scan referrals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"834-839"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural and remote pharmacists’ perspectives of grey nomads with diabetes travelling in Australia","authors":"Anita De Bellis PhD,&nbsp;Christine McCloud PhD,&nbsp;Jane Giles CDE,&nbsp;Marc Apollloni Grad Dip Comm Prac Pharm,&nbsp;Wendy Abigail PhD,&nbsp;Pauline Hill PhD","doi":"10.1111/ajr.13139","DOIUrl":"10.1111/ajr.13139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the research was to explore rural and remote pharmacists’ experiences of encountering grey nomads with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative Interpretive Description design was used to explore and capture the experiences of rural and remote pharmacists interacting with grey nomads who had diabetes. Data from the interviews were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The Pharmacy Guild of Australia was approached and through their membership rural and remote pharmacists were invited to participate in the research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nine rural and remote pharmacists who had encounters and provided services to grey nomads with diabetes responded to be interviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysed findings established four major themes including: the influence of rural and remote locations on services; common problems encountered by the pharmacists; preparation for travel by grey nomads with diabetes; and pharmacists’ preparedness to support grey nomads with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study identified that pharmacists needed remuneration for services provided to grey nomads with diabetes. Also, further development of the My Health record and telehealth to include pharmacists would be advantageous for grey nomads who have diabetes. Pharmacists stated there was a need for further education and a continuing professional development module specifically designed for pharmacists on diabetes self-management that moved beyond medications. A pre-travel checklist for grey nomads with diabetes travelling in rural and remote Australia would benefit all stakeholders through better preparation of travellers with diabetes to self-manage, thereby reducing the demand for health services including pharmacies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"740-749"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiarrhythmic preferences and outcomes post DC cardioversion for atrial fibrillation, an Australian rural perspective","authors":"Martin Thomas MD,&nbsp;James Elhindi BSc,&nbsp;Kanishka Kamaladasa FRACP,&nbsp;Tilak Sirisena FRACP","doi":"10.1111/ajr.13138","DOIUrl":"10.1111/ajr.13138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Direct current cardioversion (DCCV) remains one of the recommended management strategies for symptomatic atrial fibrillation (AF). Antiarrhythmic drugs (AAD) are prescribed post procedure to maintain sinus rhythm (SR). Limited literature exists on the AAD prescribing practices and their efficacy, post-DCCV in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The primary aim was to determine the preferred AAD post-DCCV and the factors affecting AAD prescribing practices. The secondary aim was to assess the efficacy of the AAD in maintaining SR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A retrospective observational audit of patients with non-valvular AF who underwent successful elective DCCV for symptomatic AF, during 2015–2020 at a regional hospital in New South Wales (NSW) (Dubbo Base Hospital). Patients were followed up for a duration of 12 months post-DCCV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>233 patients underwent successful DCCV during the study duration. Amiodarone was the preferred AAD of choice post-DCCV followed by sotalol and flecainide, respectively (36.5% vs. 27.8% vs. 1.3%). 35.2% patients were not prescribed AAD. Amiodarone and sotalol had similar but modest efficacies and neither were superior to no AAD, in maintaining SR 12 months post-DCCV (AF recurrence rate 61.5% vs. 68.2% vs. 71.6% respectively, <i>p = 0.37</i>). Antecedent cerebrovascular accident (CVA), pulmonary disease, smoking, prior treatment with digoxin, diuretics and left ventricular (LV) dysfunction were factors that influenced AAD prescribing practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study demonstrates equal efficacies of amiodarone, sotalol and no AAD in maintaining SR 12 months post-DCCV. Prescribing practices post-DCCV at Dubbo Base Hospital differ from observed national trends and guidelines. AAD prescription requires a multifaceted approach with a key consideration to prioritise safety over efficacy, being mindful of challenges in delivering optimal healthcare in a rural setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"750-762"},"PeriodicalIF":1.9,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building the workforce of tomorrow: The weighting of rural exposure in standardised curriculum vitae scoring criteria for entrance into Australian specialty training programs","authors":"Thomas Muecke,&nbsp;Stephen Bacchi MBBS, PhD,&nbsp;Robert Casson MBBS, PhD,&nbsp;Weng Onn Chan MBBS","doi":"10.1111/ajr.13131","DOIUrl":"10.1111/ajr.13131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the weighting of rural exposure within publicly available standardised curriculum vitae (CV) scoring criteria for trainee medical officer's applying into medical and surgical specialty training programs in Australia and New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods/Design</h3>\u0000 \u0000 <p>An observational analysis of rural exposure point allocations within publicly available standardised CV scoring criteria for entrance into specialty training programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>All Australian and New Zealand medical and surgical specialties training programs outlined by the Australian Health Practitioner Regulation Agency (AHPRA) who publish publicly available standardised CV scoring criteria for entrance into specialty training were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 14 specialty training programs that publish publicly available standardised CV scoring criteria, 8/14 allocate points towards rural exposure. While the allocation of points within this scoring domain varies between the eight training programs, the mean weighting of rural exposure is 13.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The relative weighting of rural exposure varies between the eight specialty training programs who include rural exposure as a CV scoring criteria. The deliberate and strategic construction of CV scoring criteria and inclusion of rural exposure points is important to continue developing the Australian rural specialist workforce. Future development of standardised CV scoring criteria should continue to consider point allocation towards rural exposure and related activities to ensure that the requirements of rural Australian healthcare needs are met across medical and surgical specialties.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"827-833"},"PeriodicalIF":1.9,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparedness and training needs of a regional public mental health service to support people with intellectual disability","authors":"Jo Spong PhD,&nbsp;Teresa Iacono PhD,&nbsp;Janelle Weise PhD,&nbsp;Julian Trollor MD,&nbsp;Lisa Spong MMHN,&nbsp;Tim Lenten MNSc","doi":"10.1111/ajr.13130","DOIUrl":"10.1111/ajr.13130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the preparedness and training needs of a regional public mental health workforce to support people with intellectual disability and mental ill health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and Participants</h3>\u0000 \u0000 <p>Staff from a regional public mental health service in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A mixed-methods design comprised a survey, interviews and a focus group to collect data about staff attitudes, confidence, education and professional development regarding supporting people with intellectual disability and mental ill health. Descriptive and thematic analyses were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 31 survey respondents, seven interviews and one focus group were analysed. Survey descriptive analyses showed participants believed treating people with intellectual disability was part of their role but reported areas of low confidence along with insufficient education and training in intellectual disability mental health. Thematic analyses from interviews showed that underpinning confidence, education and training were the themes (1) need for flexibility, such as having more time and (2) solutions but with challenges, such as limited opportunity to upskill and availability of experts. A need for collaborative problem-solving where staff share skills and information to work towards person-centred solutions was a key theme from the focus group analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Professional development in intellectual disability mental health is required for the regional public mental health workforce but needs to account for the challenges experienced and reflect how teams function. Exploration of described preparedness offered a possible learning approach informed by workforce members. Collaborative learning approaches to supporting people with intellectual disability and mental ill health are suggested.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"724-739"},"PeriodicalIF":1.9,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of technology and connectivity issues in general practices in rural New South Wales and their impact on staff capability to perform their job","authors":"Margot Leeson-Smith B.HSc,&nbsp;Louise Geddes PhD,&nbsp;Heath Johnson B.Communication (Hons),&nbsp;Sabrina Pit PhD,&nbsp;Robyn Ramsden PhD","doi":"10.1111/ajr.13129","DOIUrl":"10.1111/ajr.13129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify the technology and connectivity issues in rural and remote general practices, and the factors independently associated with these issues that negatively impact staff's capability to perform their job.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An annual cross-sectional survey of rural and remote general practice managers. Dependent variables included demographic data, practice size, geographic location, connection type and frequency of connectivity issues. Descriptive statistics are presented, and bivariate logistic regression was undertaken to determine factors independently associated with connectivity issues that negatively impact staff's capability to perform their job.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred sixty-eight general practice managers from rural and remote New South Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of respondents (87%, <i>n</i> = 146) indicated that technology and connectivity issues had impacted staff's capability to perform their job. Internet problems were the most frequently reported issue (36%, <i>n</i> = 61). In bivariate analysis, practices that had a total clinical staff headcount between 5 and 7 (OR 0.27; 95% CI 0.10–0.67; <i>p</i> = 0.005) or between 8 and 11 (OR 0.39; 95% CI 0.16–0.95; <i>p</i> = 0.038) were significantly less likely to report technology and connectivity issues that negatively impact staff's capability to perform their job, compared with practices with a total clinical headcount of less than five.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Technology and connectivity issues persist in rural and remote general practices. This is the first study to demonstrate that technology and connectivity issues impact on rural staff's capability to perform their job. Furthermore, smaller practices face more technology and connectivity issues that negatively impact staff's capability to do their job than larger practices. Further research is required to find solutions to address these challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"715-723"},"PeriodicalIF":1.9,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a day-stay joint replacement pathway in an Australian regional public hospital: A descriptive study","authors":"Amanda Tutty BASc (Physio)(Hons),&nbsp;Sam Martin FRACS (Orth),&nbsp;Corey Scholes PhD,&nbsp;Michel Genon FRACS (Orth),&nbsp;Jane Linton BASc (Physio),&nbsp;Simon Davidson BPhys (Hons),&nbsp;Christopher Williams PhD","doi":"10.1111/ajr.13127","DOIUrl":"10.1111/ajr.13127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the implementation, feasibility and safety of a day-stay joint replacement pathway in a regional public hospital in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Over a 12-month pilot period, a prospective descriptive analysis of consecutive patients undergoing total knee and hip arthroplasty was conducted. The number of eligible day-stay patients, proportion of successful same-day discharges and reasons for same-day failure to discharge were recorded. Outcome measures captured for all joint replacements across this period included length of stay (LoS), patient reported outcomes, complications and patient satisfaction. The implementation pathway as well as patient and staff identified success factors derived from interviews were outlined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-one/246 (17%) patients booked for joint replacement surgery were eligible for day-stay and 21/41 (51%) achieved a successful same-day discharge. Unsuccessful same-day discharges were due to time of surgery too late in the day (7/20), no longer meeting same-day discharge criteria (11/20) and declined discharge same-day (2/20). Over the implementation period 65% (162/246) of all patients were discharged with a LoS of 2 days or less. Patient satisfaction for the day-stay pathway was high. Complication rates and patient-reported outcomes were equivalent across LoS groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The day-stay joint replacement surgery pathway was feasible to implement, safe and acceptable to patients. Day-stay pathways have potential patient and system-level efficiency benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"32 4","pages":"703-714"},"PeriodicalIF":1.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}