Completed Projects

2014: Dr Wade commenced a PhD. As an infectious diseases physician in Geelong, Dr Amanda Wade saw a need to increase links between the community and hospital to improve hepatitis C care. This formed the basis of Dr Wade’s PhD with the Burnet Institute, which she completed whilst working clinically in blood borne viruses and leading the Barwon Health Liver Clinic. A key aspect of the project was the Prime Study, the world’s first randomised controlled trial that showed people who inject drugs were twice as likely to start direct acting antivirals for hepatitis C when provided in primary care, rather than in standard hospital-based specialist care (Wade, CID, 2020).

2016: A Western Alliance Grant of $85k was awarded to Dr Wade and the local PHN towards ‘Developing a comprehensive Hepatitis C treatment program for Western Victoria’ in which general practitioners were empowered to treat hepatitis C with direct acting antivirals with the support of specialists. The Western Alliance grant was pivotal in enabling Dr Wade to expand her research into the public health arena and engage a critical new team member in infectious disease and public health researcher Dr Christine Roder, who is still a member of the research team today.

2017: Dr Wade presented at the Western Alliance Research Symposium – ‘Outcomes of regional general practitioner prescription of directing-acting antiviral therapy for hepatitis C virus’

2018: Dr Wade and team published their findings (Wade JVH, 2018), an important piece of applied clinical work showcasing an exemplar project enhancing treatment through primary care, with 74 GPs prescribing direct acting antivirals in the first 12 months of the system, with no treatment failure detected. This program paved the way for Western Victoria to be the only Primary Health Network in Australia to reach the 2022 National Strategy treatment target of 65%.

2019: Dr Wade and the Liver Clinic team collaborated with Community Mental Health to establish an interdisciplinary service with the Barwon Health Harm Reduction team that provided hepatitis C care to people who inject drugs attending the needle and syringe program, and who frequently were not engaged in healthcare elsewhere. Harm reduction staff provided testing, and psychiatrists prescribed direct acting antiviral treatment. In this cohort, of which 88% were active injectors, treatment uptake was 62% in those diagnosed with hepatitis C (Roder, JVH, 2021).

2022: Dr Wade was awarded a LiverWell Individual Contribution Award

2022: Dr Wade was awarded a 5 year NHMRC Emerging Leader Investigator Grant to further the work of the Barwon South West hepatitis C elimination team. Dr Wade’s research seeks to accurately characterise the hepatitis C care cascade to identify the priority points of need. This will inform workforce and resource investment to improve diagnosis and treatment rates across the region, and achieve micro-elimination in Barwon South West.

2019: As a junior Speech pathologist at Colac Area Health, Cara participated in the 2019 Allied Health Research Training Program (pre-STaRR) supported by Western Alliance, and pitched an idea to reduce adverse incidents in aged care due to incorrect food and fluid texture prescription

2019-2021: Cara conducted the research at Colac Area Health, supported by Dr Laura Alston (Western Alliance Research Fellow) and Dr Michael Field (Western Alliance Research Translation Coordinator). Based on the research, policy was changed and prescription accuracy improved significantly.

2022: Cara’s research was published in the International Journal of Speech Language Pathology: Hill, C., Clapham, R. P., Buccheri, A., Field, M., Wong Shee, A., & Alston, L. (2022). 

2021 – 2022: Cara completed the STaRR program to further her research skills and set up longer term evaluation and improvement of the research at Colac Area Health, as well as commencing similar work at Barwon Health and Grampians Health. Received STaRR emerging research seed grant ($5000) for Barwon Health project.

2022 – 2023: Cara received two Western Alliance Grants (Emerging Researcher Translation Grant and a Rapid Allied Research Translation Grant) and also a PhD scholarship, which will see her scaling her work into food and fluid texture modification as well as mealtime experience across other Western Alliance Health Services.

Principal Investigator: Dr Laura Alston, Colac Area Health

Collaborating organisations:

Deakin University

The University of Sydney

Description:

This study aimed to gain an understanding of the level of malnutrition risk on the acute ward at Colac Area Health, and to evaluate the accuracy of the current screening program in order to improve malnutrition identification and screening in patients.

Key outcomes:

Across the total sample, 77.0% of patients had high levels of nutrition-related symptoms warranting a need for further assessment by dietitians. Among patients seen by dietitians, 70.4% were diagnosed with malnutrition.

Malnutrition diagnosis by dietitians was associated with being over the age of 65 years, and patients had higher odds of being admitted to a residential aged care facility following discharge.

The diagnosis rate of malnutrition appeared to be high, indicating that rural in-patients may be at a high risk of malnutrition. There was also a high proportion of patients who had documentation in their files that indicated they may have benefited from dietetic assessment and intervention, beyond current resourcing.

Next steps:

Next steps including evaluating the broad range of interventions in terms of benefits to CAH and community. In addition, 

• An intervention to reduce malnutrition prevalence among our patients is in development phase.
• Further research has been conducted to understand the sensitivity and specificity for reviewing patient file data and identifying patients at risk.
• We submitted an MRFF in 2022 to develop a software program to automatically screen files- this is being reviewed and we hope to seek funds to run a pilot study.
• We have also partnered on a successful MRFF led by A/Prof Nicole Kiss to build further on the work at CAH and assist in the development of malnutrition screening tools for cancer patients.

Impacts on health in the region: 

The results of the study led to significant changes to the malnutrition screening program at Colac Area Health, including:

• Significant changes to organisation nutrition policy
• Changes to the management of malnutrition by dietetics, nursing and medical staff
• Additional resourcing from Allied Health Assistants for dietetics.
• Improved screening processes in both the acute ward and residential aged care facility.
• Development of an online education awareness program to educate acute staff of all disciplines on the risks, poor outcomes, screening and treatment for malnutrition
• Improved executive and management awareness of malnutrition.
• This study, in conjunction with a speech pathology project led by the same team also generated foundations for a review of our food service system that has since led to upscaling projects at Grampians Health.
• Megan Green, one of the clinician researchers on the project, won a Rural Victorian Workforce Award for her involvement and was also profiled for International Women’s Day in 2021 (IWD 2021 – Celebrating the Women of Rural Health · RWAV)

Publications:

Alston L, Green M, Versace VL, A Bolton K, Widdicombe K, Buccheri A, Imran D, Allender S, Orellana L, Nichols M. Profiling Malnutrition Prevalence among Australian Rural In-Patients Using a Retrospective Census of Electronic Medical Files over a 12-Month Period. Int J Environ Res Public Health. 2020 Aug 14;17(16):5909. doi: 10.3390/ijerph17165909. PMID: 32824018; PMCID: PMC7459593.

Alston L, Green M, Nichols M, Partridge SR, Buccheri A, Bolton KA, Versace VL, Field M, Launder AJ, Lily A, Allender S, Orellana L. Testing the Accuracy of a Bedside Screening Tool Framework to Clinical Records for Identification of Patients at Risk of Malnutrition in a Rural Setting: An Exploratory Study. Nutrients. 2022 Jan 2;14(1):205. doi: 10.3390/nu14010205. PMID: 35011080; PMCID: PMC8746937.

Investigators: Jaclyn Bishop (Ballarat Heath Service), Raquel Cowan (Barwon Health, Ballarat Heath Service, Deakin University), Dr Thomas Shulz (National Centre for Antimicrobial Stewardship), Mary Smith (DHHS Grampians region)

Affiliation/collaboration: Ballarat Health Service, Barwon Health, Colac Area Health, National Centre for Antimicrobial Stewardship, Victorian Infectious Diseases Service, Deakin University, DHHS Grampians region

This study aims to improve antibiotic prescribing for cellulitis by introducing a set of key actions (known as a bundle of care) that must be completed by hospital staff when treating each and every patient with cellulitis. Cellulitis is a skin infection that is normally treated with antibiotics. If the incorrect antibiotic is chosen or the incorrect dose is prescribed, the infection may not get better. Incorrect use of an antibiotic can lead to it becoming ineffective.

The study’s findings will be used to develop a novel bundle of care that promotes the appropriate prescribing of antibiotics and optimal management of cellulitis.

Investigators: Prof Fergal Grace, Dr Matthew Wallen (Federation University Australia); A/Prof Anna Wong Shee, Dr Luke Evans and Dr Stephen Brown (Ballarat Health Services); Dr Jonathan Rawstorn (Deakin University)

Affiliations/collaboration: Faculty of Health, Federation University Australia; Ballarat Health Services; Institute of Physical Activity and Nutrition, Deakin University. Ballarat Integrated Cancer Centre, Grampians Integrated Cancer Centre, East Grampians Health Service, West Wimmera Health Service, Wimmera Health Care Group, Stawell Regional Health Services

The post-operative period brings significant loss of physical function in cancer patients undergoing surgery. Exercise rehabilitation programs aim to recover cardiorespiratory fitness (CRF) post-operatively. However, pre-operative exercise training (‘prehabilitation’) is a largely untested method to optimise pre-operative CRF gains.

This study will review local practice and analyse current research before undertaking an experimental cancer prehabilitation study with patients in the Grampians region of Victoria.

The study will aid clinical decision-making by identifying candidates who may benefit from prehabilitation. 

Investigators: Prof Richard Osborne, Roy Batterham, Dr Alison Beauchamp, Prof Trish Livingston, Dr Siew Lim and Carol Wildey, Deakin University; Glenn Reeves and Joanne Gell, Grampians Integrated Cancer Services; Andrew Howard, Grampians Pyrenees Primary Care Partnership

A recent needs assessment conducted across the Grampians region found that people in small towns face particular barriers to their participation in care across the cancer journey. This study worked with a range of stakeholders from services and community groups in small towns in the Grampians region to develop strategies to overcome these barriers. The study laid the groundwork for the development of a framework to guide small town service development nationally.

This project is a collaboration of researchers, clinicians and the local communities in participating towns. In addition, the project provides a focal point for new collaborations between researchers at Deakin University and clinician–researchers at Grampians Integrated Cancer Services.

Investigators: Alicia Boyd, Adrian Benson, SJOG; Alasdair Sutherland, South West Healthcare, Stephen Gill, Deakin University

With the projected growth in Total Knee Arthroplasty (TKA) surgery volume forecast over the next 10 years, strategies that contribute to improved post-operative outcomes have the potential to reduce significant burdens on the health care system, whilst positively impacting patients’ quality of life and ability to swiftly return to activities of daily living. 

This study demonstrated that Bioimpedance spectroscopy (BIS) has the potential to be a feasible method to objectively monitor limb swelling after knee replacement in the SJGWH clinical setting, provided care is taken to ensure good quality data is recorded. Wound dressings do not impact BIS results and whole limb swelling can be objectively reported as a personalised change from pre-operative baseline. The associated time implication issues (patient transportation, accurate measuring and patient education) need to be considered to facilitate ease of integration.

The results of this study can directly inform subsequent research, to investigate interaction of clinical outcome and patient reported outcome measures, and the effectiveness of interventions to reduce identifiable, clinically significant, swelling as measured by BIS. Caregiver education to ensure usable quality BIS data and patient education resources are recommended.

Investigators: Jessica Thomson (Seater), Luke Evans, Tracey Duggan, Megan Charity, Rachel Hodges, Anna Wong Shee, Alesha Sayner, Grampians Health Ballarat

Historically, patients undergoing cancer treatment have been advised to rest.  Now the advice is that all people with cancer should avoid inactivity, and return to normal activities as soon as possible following diagnosis.

Grampians Health Exercise Physiologists (EPs) have identified that patients are sedentary for long periods while receiving treatment in the centre. This time could be utilised to increase activity and increase confidence that physical activity is safe to engage in, even with cancer.

This study aimed to determine the feasibility, acceptability and impact of an EP and Nursing collaborative approach to providing low intensity exercise and education to cancer patients during treatment in a large regional health service.

Our findings demonstrate that intra-infusion exercise is safe, feasible and enjoyable for patients attending the CDU for infusion treatment. This allows patients to participate in exercise and engage with an Exercise Physiologist whilst attending the hospital for an existing medical appointment. This is particularly important for patients who travel from outside of Ballarat in the regions for their treatment.

Patients displayed lowered reported levels of fatigue and maintained their overall weekly physical activity during treatment which is contrary to the typical decline in activity levels during anti-cancer treatment.

Principal Investigator:  Prof Anna Peeters, Deakin University

Collaborating organisations:

Kardinia Health provided access to GPs and practice managers to participate in the qualitative study

Western Victoria PHN provided access to primary care data for analysis and contacts with GP clinics around the Western Victorian region for qualitative study recruitment

Description:

As a response to COVID-19, the Federal Government opened up a range of Medicare items for telehealth consultations. This unique situation provided an opportunity to evaluate a model of broad access to telehealth for primary care (care by GPs, pharmacies, allied health practitioners etc).

The Institute for Health Transformation and its partners assessed this change in health care delivery across the key areas requiring evaluation: quality of care, efficiency of service, equity of access, patient outcomes, patient experience, health worker experience, and health costs.

Key outcomes:

Our project identified clear implications for future roll-out and sustainability of telehealth in rural and regional Victoria. Key findings included:

• The enabling of enhanced efficiencies by telehealth for doctors to see more patients on a daily basis.
• GP identification of telehealth as an important tool for follow-up care and to support continuity of care, especially for patients with chronic disease.
• Improved access to care for busy people with family or working commitments and for vulnerable patients, such as those dealing with family violence or poor mental health.
• The need to establish clear communication lines between policymakers and practices and ensure clarity in guidelines provided to general practice clinics.
• The need for interoperability and a standard platform to perform telehealth activities.
• Substantial use and need of level C (>20 min) telephone consultations. Future changes to MBS items should be made in alignment with evidence and clinical needs.
• The perception by a large majority of survey respondents that overall quality of GP care was unchanged or improved as a result of the introduction of telehealth appointments.
• The need for support of enhanced digital health literacy and technical infrastructure, particularly for older people and priority populations, such as those situated in rural areas.
• The need to establish sustainable funding mechanisms to ensure the viability of telehealth services for health services. This includes ensuring availability and continuity of incentive fees for telehealth services in general practice. 

Impacts on health in the region: 

Our research has played a role in understanding how telehealth services are used in the region and supporting evidence for policy change.

The government recently brought back long telephone consultations for those outside of remote regions or needing COVID-19 antiviral treatment, which our research strongly supports.

This research project encouraged a small upgrade to the Western Victoria PHN database to support better quality and granularity of health data that can be extracted for population health analytic purposes.

The project also helped nurture an early career researcher in the field of digital health and rural health and provided an opportunity for WVPHN staff to develop research skills and publication co-authorship.

Publications:

Use of General Practitioner Telehealth Services During the COVID-19 Pandemic in Regional Victoria, Australia: Retrospective Analysis. Savira F, Orellana L, Hensher M, Gao L, Sanigorski A, Mc Namara K, Versace VL, Szakiel J, Swann J, Manias E, Peeters A. J Med Internet Res. 2023 Feb 7;25:e39384. doi: 10.2196/39384.

Long telephone consultations for GP appointments: evidence versus policy. Savira F, Yuen E, Ugalde A, Graham K, Peeters A. Med J Aust. 2023 Mar 6;218(4):150-152. doi: 10.5694/mja2.51834. Epub 2023 Jan 22.

Perspectives on telehealth implementation in Australia: an exploratory qualitative study with practice managers and general practitioners. Savira F, Orellana L, Hensher M, Gao L, Sanigorski A, Mc Namara K, Versace VL, Szakiel J, Swann J, Manias E, Peeters A. 2024. Manuscript submitted to International Journal of Medical Informatics.

Principal Investigator: Dr Peter Eastman, Barwon Health

Description:

For community palliative care services, the COVID-19 pandemic meant a sudden change away from a predominantly face-to-face model of care to one that incorporates telehealth. 

Understanding how patients and healthcare professionals have experienced telehealth during COVID-19 and how telehealth compares to face-to-face care will be crucial in planning CPC services moving forward.

The aim of this study was to evaluate patient and healthcare professional interactions with telehealth in the context of the sudden changes caused by COVID-19 and investigate preferences around favoured modes of service delivery.

Key outcomes:

The preference of both patient and healthcare professional groups was for a community palliative care service model that combined face-to-face and telehealth consultations. This question has not been asked specifically before and therefore this information is fairly novel. 

Both groups encountered a range of issues when undertaking telehealth consultations. For patients, pre-existing hearing and/or visual impairments and technical and experiential issues when using the technology were the predominant problems. In contrast, healthcare professionals were concerned about the inability to observe visual cues/body language or perform a physical examination and about the potential negative impact this might have on the therapeutic relationship.

Impacts on health in the region:

Identification of issues allowed refinement to be made to the telehealth experience for both palliative care patients and healthcare professionals.  

Overall these findings are important not just for future planning around high value care provision at a loco-regional level but also, potentially, the enhancement of care models for more rural and remote areas where on the ground palliative care services are more limited.

Publications:

Eastman P, Dowd A, White J et al.  Telehealth: rapid adoption in community palliative care due to COVID-19: patient and professional evaluation.  BMJ Supportive and Palliative care.  Epub: doi: 10.1136/bmjspcare-2021-002987

Investigators: Jonathan Rawstorne, Dr Susie Catledge, Dr Sheik Mohammed Shariful Islam, Ralph Maddison (Deakin University), Dr Matthew Wallen (Federation University), Luke Evans (Ballarat Health Service),  John Amarena (Barwon Health), Cathreena Gervis (South West Healthcare), Anne Morrison (South West Healthcare)

Affiliation/collaboration: Barwon Health, Ballarat Health Service, South West Healthcare, Deakin University, Federation University

Exercise-based cardiac rehabilitation (exCR) saves lives but participation in current programmes is very low in regional areas. This project team developed a technology solution that solves key accessibility issues to reach people in almost any location, but the programme is only available in research trials.

The project worked with health providers and people with heart disease to understand how to translate the programme into everyday practice, so more people can experience the life-changing benefits of exCR.

Outputs will be synthesised into a toolkit of pragmatic implementation strategies. The toolkit will be pilot tested in selected sites, refined, and disseminated to stakeholders to facilitate future implementation initiatives. Inclusion of early career and clinical investigators will support capacity development, & cross-institution/cross-sectoral collaboration.

Investigators: Dr Diana Bortoletto, Dr Greg Weeks Dr Adrian Low, Michelle Wilson and Rachel Fyfe, Barwon Health; Dr Kevin McNamara and Dr Vincent Versace, Deakin University; Alice King, Barwon South West Telehealth Program

Medication reviews conducted by hospital pharmacists after patients’ discharge from hospital have been shown to be beneficial to patients, especially for those at risk of medication-related problems. These reviews are generally conducted in the patients’ home or over the telephone.

This study aimed to assess whether using videoconferencing to conduct the medication review is a suitable alternative. Using videoconferencing means that the service can be offered to people who live remotely, which is not the case for reviews in patients’ homes. Participants evaluated the pharmacy service as well as the technology. The pharmacist recorded the changes made to medications and the potential effect this may have had on the participant if the changes had not been made.

The primary objectives of the study included the evaluation of the service across the region, patients’ acceptance and satisfaction with both the pharmacy service and the telehealth technology; the number of pharmacist interventions made and a risk-classification of harm averted, as well as re-admission rates to hospital.

Secondary outcomes included improvements in medication adherence behaviours and collaboration across health care facilities and the care continuum.

Principal Investigator:  Hannah Beks, Deakin Rural Health, Deakin University

Collaborating organisations:

Budja Budja Aboriginal Cooperative as our research partner

Grampians Health, through the contribution of Associate Professor Anna Wong Shee

Description:

To meet the health care needs of Aboriginal and Torres Strait Islander Peoples residing in Djab Wurrung Country (Ararat Rural City and Northern Grampians region, Victoria, Australia) during the COVID-19 pandemic, Budja Budja Aboriginal Cooperative (BBAC) responded rapidly by modifying the delivery of health care services to telehealth (both videoconferencing and phone) consultations to meet physical distancing requirements.

This research evaluated the implementation of telehealth services for Aboriginal and Torres Strait Islander Peoples accessing primary health care services (GP, pharmacy, allied health etc) through BBAC.

Key outcomes:

Telehealth maintained the delivery of primary health care services during COVID-19 and were generally acceptable to Aboriginal clients and health service personnel. Telephone telehealth consultations by Aboriginal and/or Torres Strait Islander clients were utilised more than videoconferencing telehealth consultations.

However, overwhelming preference for face-to-face consultations remained as this was perceived to be more personal, aligned with cultural ways of doing, enabled a thorough clinical assessment, and provided an opportunity for clients to socialise with other members of the community.

Recommendations included:

1. Telehealth services, including both telephone consultation and videoconferencing, should continue to be available as a tool for delivering holistic primary health care services to Aboriginal and Torres Strait Islander Peoples.
2. Support is recommended for Aboriginal and Torres Strait Islander clients to encourage the uptake of videoconferencing as a telehealth platform.
3. For complex clinical presentations and clinical assessments, including an initial patient assessment, an in-person consultation with a health professional is preferred, with videoconferencing as a second option.
4. Telephone consults are recommended as an adjunct to clinical care provided in-person and to follow up established goals of care with clients.

Next steps:

The project was part of a broader research program evaluating service delivery models which was informed by a partnership between Deakin Rural Health and Budja Budja Aboriginal Cooperative.  The partnership is now focused on evaluating student placements undertaken at Budja Budja Aboriginal Cooperative.

Impacts on health in the region: 

Evaluation findings were rapidly disseminated through the Western Victoria Primary Health Network to the Minister for Health and Aged Care and Minister for Indigenous Australians in the context of changes to the MBS telehealth item numbers which saw the removal of telephone MBS item numbers that were frequently utilised by Aboriginal and/or Torres Strait Islander clients of BBAC. Telephone MBS item numbers have since been re-instated and made permanent.

Under-utilisation of the nursing workforce was identified in this study. Subsequently, the project also supported upskilling a Nurse Practitioner in research to undertake a scoping review examining evaluated nurse-led models of care implemented in rural, regional, and remote settings of Australia.

Publications:

Beks, H., Versace, V.L., Mitchell, F., Charles, J.A., Hernan, A., Wong Shee, A., Mc Namara, K.P. Evaluation Report – Telehealth services for Aboriginal and Torres Strait Islander Peoples. August 2021 (for Budja Budja Aboriginal Cooperative)

Beks, H., Versace V. L., Zwolak R., Chatfield T. (2022) Opportunities for further changes to the Medicare Benefits Schedule to support Aboriginal Community Controlled Health Organisations. Australian Health Review 46, 170-172.

Beks, H., Mitchell, F., Charles, J.A., Wong Shee, A., Mc Namara, K.P., Versace, V.L. (2023) Implementation of telehealth primary health care services in a rural Aboriginal Community-Controlled Health Organisation during the COVID-19 pandemic: a mixed-methods study. Rural Remote Health 23 (3), 1-14.

Beks, H., Mc Namara, K.P., Mitchell, F., Charles, J.A., Versace, V.L. (2023) Responsiveness of a rural Aboriginal Community Controlled Health Organisation: A qualitative study. Australian Journal of Rural Health 31 (6), 1214-1228.

Beks, H., Clayden, S., Wong Shee, A., Binder, M.J., O’Keefe, S., Versace, V.L. (2023) Evaluated nurse-led models of care implemented in regional, rural, and remote Australia: A scoping review. Collegian 30 (6), 769-778.

Principal Investigators: 

Hannah Beks, Deakin Rural Health, Deakin University

Vincent Versace, Deakin Rural Health, Deakin University

Collaborating organisations:

Dhauwurd-Wurrung Elderly and Community Health Service (DWECHS): an Aboriginal Community Controlled Health Organisation located on Gunditjmara Country (Portland, VIC)  co-designed the project and all activities

Flinders University supported the scoping review

Warrnambool Clinical School provided support for the project

National Indigenous Knowledges Education Research Innovation (NIKERI) Institute co-designed project and provided cultural guidance

Global Obesity Centre, Institute for Health Transformation co-designed project and led data collection and analysis of yarning luncheons

Description:

The project involved:

1. A scoping review to determine where chronic disease prevention and management programs for Aboriginal and Torres Strait Islander Peoples in Australia have been implemented and evaluated within primary health care, and to identify geographical gaps of implementation and evaluation using the Remoteness Structure.
2. A retrospective clinical audit to quantify chronic disease and risk factor prevalence within a cohort of Aboriginal Peoples in Gunditjmara country.
3. Yarning luncheons using Group Model Building (GMB) to identify the barriers and enablers of chronic disease management forAboriginal Peoples residing in Gunditjmara country to develop community-driven strategies to improve disease prevention and management.
4. A clinical upskilling workshop to Aboriginal Health Workers (AHWs) within the region as a professional development opportunity.

Key outcomes:

1. The scoping review was published in 2019 and identified a need for greater focus on the evaluation of chronic disease programs for Aboriginal people residing in Inner and Outer Regional areas, and Remote areas of Australia.
2. The clinical audit was conducted with ongoing pre-meetings, attendance and talks at DWECHS monthly Community Luncheons incorporating Deakin staff and DWECHS community members.
3. DWECHS community members gathered for ongoing feedback, mapping of data and development of action ideas via the GMB method.
4. A clinical and leadership upskilling workshop was delivered by DWECHS for Aboriginal Health Workers to bring in line with new RACGP and Aged Care standards.

Next steps:

This project demonstrated a process for productive and successful collaboration between Deakin University, Dhauwurd-Wurrung Elderly and Community Health, and the Gunditjmara community in Portland, Victoria.

The project achieved important steps toward community-informed, health service-supported improvements in local chronic disease management and built significant trust and fostered relationships between the parties above. This trust may lead into deeper investigation of implementation within the health service setting, or further engagement of the local community to discuss other health issues.

The processes used here may equally be applied to Indigenous health issues at other levels, such as exploring perceptions of Indigenous health policies among stakeholders.

Impacts on health in the region: 

The upskilling of all relevant staff in the new RACGP and Aged Care standards, Chronic Disease Management plans and team care arrangements have helped ensure that services are delivered within scope of practice and via an interdisciplinary approach.

Strategies developed through the GMB yarning sessions informed DWECHS organisational statement of intent – a requirement of Safer Care Victoria’s Partnering in Healthcare Framework.

Publications:

Beks H, Binder M, Kourbelis C, May N, Clark R, Hudson K, et al. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the primary healthcare setting: a scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports 2018; 16(12): 2268-2278. 

Beks H, Binder MJ, Kourbelis C, Ewing G, Charles J, Paradies Y, et al. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the Australian primary health care setting: a systematic scoping review. BMC Public Health 2019; 19(1): 1115. 

Beks H, Amos T, Bell J, Ryan J, Hayward J, Brown A, Mckenzie C, Allen B, Ewing G, Hudson K, Clark R, Morphett B, Allender S, Creighton D, Johnstone M, Versace VL.  Participatory research with a rural Aboriginal Community Controlled Health Organisation: lessons learned using the CONSIDER statement. Rural and Remote Health 2022; 22: 6740. https://doi.org/10.22605/RRH6740

Investigators: Susan Brumby, Dale Ford, Lorraine Hedley, Western District Health Service; Muhammad Aziz Rahman, Wendy Cross, Federation University; Grace Sousa, South West Healthcare; Louise Greenstock, Western Alliance

This research study assessed psychological distress, anxiety and coping strategies from two regional screening sites:
1. A drive-through screening clinic based at Western District Health Service, Hamilton and
2. A Respiratory Assessment Clinic with prior phone screening at South West Healthcare.

People that had pre-existing mental health issues, co-morbidities, smoked, and consumed alcohol were identified as high-risk groups for psychological wellbeing in regional Victoria during the COVID-19 pandemic.

Conversely, being female, aged over 60 years and living alone was not associated with increased stress, fear or lower resilience unlike previous studies. Specific interventions to support the mental wellbeing of these vulnerable populations along with engaging healthcare providers should be considered.

Investigators: Jayde Cesarec, Elyse Baker, Jamie Swann, Western Victoria Primary Health Network (WVPHN)

The coronavirus pandemic led to an increase in mental illness. We identified adult males as a key group at risk of mental illness due to the consequences of the coronavirus pandemic

This project sought to determine the extent to which Covid-19 affected help seeking behaviours for mental health-related concerns throughout western Victoria. We also investigated if recent suicide rates, intentional self-harm hospitalisations, self-reported mental illness, and jobseeker payments are associated with the number of GP (General Practice) visits to identify local areas where additional mental health support may be needed.

The grant allowed us to take a “deep dive” into a known issue and will have some impact on the design of mental health services going forward. There is also the potential to workshop the results with our Practice Facilitators (our “front line” staff who provide direct support to general practice) to understand whether the learnings can be integrating into any quality improvement activities currently being supported by WVPHN.

As a further benefit, discussions around the strengths and limitations of practice data raised during this project have enhanced our understanding of the practice data and will positively impact projects going forward.

Principal Investigator: Prof Anna Peeters, Deakin University

The primary aim of this study was to co-create and test interventions that will improve experience and outcomes for Victorian regional and rural mental health consumers. The utility of new systems-based approaches was explored in the co-creation of mental healthcare system solutions in the Barwon-Southwest region.

The measurable direct impact of this study’s findings on patient care and mental health and well-being is rooted in the application of the co-designed Group Model Building (GMB) approach.

Based on prior research evidence and funded by the Western Alliance Flagship Research Program, this project aimed to bring about substantial improvements in acute-care mental health outcomes for consumers in the Barwon-Southwest Victoria Region.

While the two-year duration of the project allowed us to make substantial progress, it’s important to acknowledge that the transformation of healthcare systems and the improvement of mental health outcomes are long-term undertakings.

Our work has laid a solid foundation, providing valuable insights, initial co-designed interventions, and a collaborative platform for stakeholders. Recognising the scope and complexity of this issue, we view this project as a critical first step toward achieving lasting improvements in mental health care. Moving forward, we will continue to build on outcomes from this project and remain committed to continued collaboration, innovation, and iterative improvements as we work to drive positive change in the region’s mental health services.

Principal Investigator:  Dr Andrea Hernan, Deakin Rural Health, Deakin University

Collaborating organisations:

Primary care practices who participated in the study:

• Active Health Portland
• Hamilton Medical Group
• Robinson Street Medical Clinic
• Terang Medical Clinic
• Timboon Clinic
• Warrnambool Medical Clinic

Description:

Capturing patient feedback about factors that contribute to safety incidents and using it for safety improvement work in primary care is a developing and novel field of research.

This research explored the feasibility of using a patient feedback tool to help design a safety improvement intervention in primary care settings in south west Victoria.

Patients provided feedback on the safety of the care they received to inform the development and implementation of interventions to improve the safety of care provided to all patients in participating primary care practices. 

Key outcomes:

The findings indicate that using patient feedback on a safety intervention in primary care was feasible, and is suited to scaling-up to a larger effectiveness trial and extending further into policy and practice.

This finding complements existing safety improvement strategies and activities, and integrates into current patient feedback service requirements for Australian primary care.

A theoretical model was developed which encompassed multiple mediating factors grouped under three meta-level findings; practice readiness, utilisation of problem solving skills and agency. Developing a programme theory for this intervention was essential to understanding the complexities of primary care practice and to identifying the essential components for implementation on a larger scale.

Next steps:

Further research will assess the effect of the intervention on safety incident reduction. Principal researcher, Dr Andrea Hernan, received a Deakin University Dean’s Postdoctoral Research Fellowship to extend this work in a large randomised controlled trial with 16 general practices throughout Australia.

Impacts on health in the region: 

In addition to informing development of primary care resources and publications i.e. patient involvement in safety manuals, this research had additional health impacts:

• General practice staff were upskilled in quality and safety improvement.
• The process of collecting patient feedback was found by patients and staff as an acceptable measure for safety.
• Measurable and sustained changes to systems for safety, were developed, such as increased access to care and improved patient information accuracy.
• The patient feedback tool has been translated on an international scale into several different languages (German, French, Mandarin, Turkish) and implemented in some overseas primary care practices.

Publications:

Investigating the feasibility of a patient feedback tool to improve safety in Australian primary care: a study protocol. Hernan A, Kloot K, Giles S, Beks H, Mc Namara K, Binder M, Versace V. BMJ Open. DOI: http://dx. doi. org/ 10. 1136/ bmjopen-2018- 027327.

Patient feedback for safety improvement in primary care: Results from a feasibility study. Hernan A, Giles S, Beks H, Mc Namara K, Kloot K, Binder M, Versace V. BMJ Open. DOI: doi:10.1136/bmjopen-2020-037887

Nature and type of patient-reported safety incidents in primary care: cross-sectional survey of patients from Australia and England. Hernan AL, Giles SJ, Carson-Stevens A, Morgan M, Lewis P, Hind J, Versace V. BMJ Open. 2021 Apr 29;11(4):e042551. doi: 10.1136/bmjopen-2020-042551. 

Theorizing factors mediating with the implementation of a patient feedback on safety intervention implemented in the primary care setting. H Beks, AL Hernan, S Giles, M Malakellis, KP Mc Namara, VL Versace. Qualitative health research 31 (12), 2260-2273.

Investigators: Dr Amanda Wade, Prof Eugene Athan, Dr Greg Weeks, Margaret Wardrop and Christine Roder, Barwon Health; Prof Margaret Hellard, Burnet Institute; Dr Mark Davies, Western Victoria Primary Health Network; Angus McCormack, Deakin Medical School

More than 230,000 Australians are infected with hepatitis C virus (HCV). The majority remains untreated because therapy is toxic, often unsuccessful and accessible only through specialist doctors. Untreated HCV can lead to liver cancer and death.

New, direct-acting antiviral (DAA) treatment for HCV became available in March 2016. DAA treatment is highly effective and well tolerated. Australia is now in the position to eliminate HCV; the key is to increase access to treatment.

This study aimed to increase access to treatment in western Victoria by developing a program that facilitates DAA prescribing in general practice and provides a clear referral network.

This important piece of applied clinical work showcased an exemplar project enhancing treatment through primary care, with 74 GPs prescribing direct acting antivirals in the first 12 months of the system, with no treatment failure detected.

This program paved the way for Western Victoria to be the only Primary Health Network in Australia to reach the 2022 National Strategy treatment target of 65%.

Antimicrobial stewardship in general practice

Investigators: Prof Eugene Athan and Alicia Neels, Barwon Health

Antimicrobial resistance is a global crisis threatening the benefits of many contemporary medical advancements, including chemotherapy, transplantation and prosthetic joint replacement. Prudent use of antibiotic medicines will slow down or possibly halt emerging resistance.

This study was the first of its kind to prospectively measure the effect of education and training on the prescribing behaviour of general practitioners (GPs) in Australia. There is evidence of inappropriate, excessive and prolonged antibiotic prescribing, which is increasing the risk of antibiotic resistance and adverse effects such as antibiotic-related diarrhoea.

 

Led by Professor John Toumbourou, colleagues and collaborators, this project took a systems-wide approach to reducing harms associated with alcohol and other drug use. Communities across the western region of Victoria partnered with experts at Deakin University in a range of interventions designed to reduce harmful alcohol and drug use. The project continued successful interventions that have reduced alcohol supply to adolescents and reduced adolescent alcohol consumption.

 

Principal Investigator: Dr Michael Field, Colac Area Health & Western Alliance

Collaborating organisations:

• Study investigators: Deakin University & Monash University
• Participating health service sites:  East Grampians Health Service, Mildura Base Hospital, Barwon Health, Ballarat Health Services, Royal Flying Doctor Service Victoria, West Gippsland Healthcare Group, Gippsland Lakes Complete Health, Gippsland Southern Health Service

Description: 

This study investigated the impact of COVID-19 on the wellbeing of staff at Victorian regional & rural health services. 

The study had four phases (health service stakeholder consultation, anonymous staff wellbeing surveys, COVID-19 cases & restrictions data collection, staff interviews) and a final report of results and recommendations for optimising staff wellbeing to be provided to health service leadership.

Key outcomes:

The following study tasks were completed: co-design with health service stakeholders, completion of data, data analysis and drafting of study results in abstract and publication format. Findings included:

• Community support has the potential to positively influence rural health staff wellbeing, and as such, community engagement should be a feature of health service wellbeing strategies.
• Four major themes of factors, both within and external to the health service environment, influenced the wellbeing of rural health service staff during the pandemic: rural community relations; the nature of the health workplace; self-care & supportive networks; and public health measures.
• The following groups of participants experienced poorer wellbeing scores during COVID-19: Staff with less than 5 years tenure at health services, part time employees, and staff whose duties were changed during COVID-19.

Next steps:

A staff wellbeing committee has been established at lead site Colac Area Health. A number of recommendations from the CReW study have been implemented by the committee, with very good response from staff. It is planned to work with other participating health services who may wish to implement study recommendations at their health services.

A follow-up study, CReW-Ace (COVID-19 and Regional & Rural Health Staff Wellbeing: Accessibility of Support Services), has received funding is currently collecting data from participating health services across regional Victoria.

Finally, the CReW study is exploring collaborating with other studies investigating COVID-19 related issues, including conducting a comparison of rural vs. metropolitan outcomes.

Impacts on health in the region: 

The CReW Study has had a direct impact on staff wellbeing at the lead health service through using the study results to inform policy decision by a committee focussed on staff wellbeing.

The study has also had a significant impact of building research capability in the region through employment of a research assistant who has subsequently secured an ongoing research position, and through establishing a strong network of health services and academic organisations in rural & regional Victoria.

Publications: 

Field M, Buccheri A, King O, Bishop J, Wong Shee A, Imran D, Jacobs J, Versace V, Isaacs A, Sutton K, Sourlos N, Murphy F, Kennelly M, Wood E, Alston L. Rural health service leaders co-design state-wide research addressing an emerging health issue: A case report. Aust J Rural Health. 2022 Dec;30(6):884-890. doi: 10.1111/ajr.12915. Epub 2022 Aug 17. PMID: 35975966.

King O, Buccheri A, Isaacs A, Bishop J, Alston L, Versace V, Wong Shee A, Sourlos N, Imran D, Jacobs J, Murphy F, Kennelly M, Field M, “The Community, the Workplace, and Public Health Measures: A Qualitative Study of Factors that Impacted the Wellbeing of Rural Health Service Staff in Victoria, Australia, during the COVID-19 Pandemic”, Health & Social Care in the Community, vol. 2023, Article ID 5556980, 12 pages, 2023. https://doi.org/10.1155/2023/5556980

Investigators: A/Professor Anna Wong Shee (Ballarat Health Service/Deakin University), Dr Renee Clapham, Dr John Aitken (Ballarat Health Service), Dr Anna Ugalde, Dr Jaithri Ananthapavan, Kevin McNamara (Deakin University)

Affiliation/collaboration: Ballarat Health Service, Western Victoria PHN, East Grampians Health Service, Wimmera Health Service, Ballarat Community Health, Rural Northwest Health, Stawell Regional Health, Deakin University

In health service research, it is vital that we address questions that are important to patients and that the research meets a health service need or gap in the evidence.

This project brought together consumers, who can identify areas for improvement based on their experiences, allied health professionals, who understand the public health system, and academics, with research expertise, to identify and prioritise research needs for allied health practice in the Grampians region.

Investigators: Prof Gerard Gill, Prof Daryl Pedler and Dr Bernard Shui, Deakin University; Dr Blake Peck and Andrew Smith, Federation University Australia; Linda Govan, Australian Primary Healthcare Nurses Association; Dr Denise Ruth, General Practitioner, Geelong; Dr Jane Opie, Western Victoria Primary Health Network

Studies reveal an older general practitioner (GP) population in western Victoria. The Western Victoria Primary Health Network (PHN) demonstrates a similar proportion of older Practice Nurses (PNs) approaching retirement. Recruiting and retaining PNs is a priority as nurses provide primary health care vital to improving health outcomes for people living in rural communities. There is limited research identifying the education needs of PNs specific to this region.

This study engaged with PNs, GPs and consumers to explore the role of PNs and their education needs, with the aim of improving nurse-led models of care in western Victoria. 

Investigators: Prof Penny Paliadelis, Federation University Australia; Denielle Beardmore and Kristee Winters, Ballarat Health Services

 The interprofessional graduate program (IPGP) for graduates with a double degree in paramedicine and nursing was the first program of its kinds to be conducted jointly by a public hospital and ambulance service in Victoria.

The workforce structures in health and, in particular of both of these professions, does not always facilitate a smooth transition for the early entry worker with a double degree to work across both professions at the same time. Ballarat Health Services, in partnership with Ambulance Victoria, created and implemented an innovative transition program to address these issues and provide graduates with a supportive framework. However, it is unclear whether this transition program has assisted the graduates in finding employment in their chosen professions within the region.

To date, it has not been identified whether double degrees in health disciplines such as nursing and midwifery, or nursing and paramedicine serve the needs of regional and rural communities, and there is little evidence of the experiences of graduates in transitioning into the rural workforce in either profession. This study aimed to evaluate the employment outcomes and participant experiences of the first cohorts of the IPGP program, based at Ballarat Health Services. 

The findings may assist health education providers and services to create a curriculum that prepares double-degree graduates for rural practice and, ultimately, benefits the health workforce in western Victoria.

Led by Professor Steven Allender, colleagues and collaborators in western Victoria, this project took a systems approach to reducing obesity.

Communities of the Great South Coast of Victoria partnered with obesity experts at Deakin University to deliver sustained change in the weight status of children. They sought to change the ways in which families, communities and organisations do things, so that healthy weight is the norm rather than the exception. Obesity is a national priority as well as a local one: in parts of the Great South Coast, up to 48 per cent of children have been measured as overweight or obese.

Investigators: Suzie Rayner, Elle Lee, Hayden Richards, Barwon Health; Georgie Lee, Deakin University; Andrew Rixon,  Griffith University

Leadership in Emergency Medicine is essential to the basic functioning of any emergency department. Leadership skills are required across a range of circumstances by both emergency doctors and senior nurses. Despite its importance, there is limited research describing and evaluating leadership in an emergency department setting.

This project aimed to understand the perception and experience of leadership by doctors and senior nurses working in an emergency department, and to explore the skills required to perform effectively in a leadership role.

The improvement in understanding and thus training for leadership, particularly day to day on the floor will improve departmental efficiency and patient outcomes.

Validity of a body-worn alarm system for the effective management of enuresis in children: A study in western Victoria

Investigators: Dr Blake Peck (Federation University Australia); Bronwyn Peck, Dr Rosemarie Shea and Dr Mark Nethercote (Ballarat Health Services); Shirley Whitaker, Andrea Green, Kerrie Svedas and Stacey Dubberley (Grampians Regional Continence Service); Erica Pearce (Barwon Health); Sarah Schuhmann (Colac Area Health)

Affiliation/collaboration: Federation University Australia, Ballarat Health Services, Grampians Regional Continence Service, Barwon Health, Colac Area Health, Deakin University

Bedwetting is a major concern for children in Australia. Currently, the most widely used system for managing this issue is the bell-pad alarm system. This alarm is expensive and children often have to wait for long periods before they can get access. However, there is an alternative device that is cheaper and therefore more readily accessible for children and families. This project will consider how well this alternative device compares to the bell-pad for treating bedwetting in children.

This study aimed to evaluate the effectiveness of the body-worn alarm system, as an alternative to the current therapy (bell-pad device) for the treatment of enuresis across the region of western Victoria, and included an economic evaluation to assess its cost-effectiveness for both families and the health services.

Investigators: Dr Natasha Frawley, Dr Anna Wong Shee, Carolyn Robertson, Anne Marie McKenzie and Julie Lodge, Ballarat Health Services; Dr Catherine Nagle and Dr Vincent Versace, Deakin University; Allison Schotton, Maryborough District Health Service; Kerry Sturmfels, East Grampians Health Service

Teenage pregnancy is associated with high rates of maternal and neonatal death, and medical complications. Australia has the sixth-highest rate of teenage pregnancy in the developed countries, with the highest rates occurring in non-urban areas.

There is a lack of evidence for best-practice management of teenage pregnancy. This study involved a systematic review of the literature, scope best-practice models of care and seek to understand the experiences of teenagers giving birth in rural and regional areas.

The project’s outcome will inform development of evidence-based guidelines for best-practice management of teenage pregnancy in rural and regional areas.

Investigators: Prof Steven Allender, Dr Lynne Millar, A/Prof Andrew Bell, Prof Marjorie Moodie, Prof Robert Carter and Prof Boyd Swinburn, Deakin University

Partnering institutions: Deakin University, Western District Health Service, Southern Grampians and Glenelg Primary Care Partnership, Department of Health and Human Services for the State of Victoria, Southern Grampians Shire Council, Glenelg Shire Council, Barwon Health, Portland District Health, Colac Area Health and Western Alliance

It is hypothesised that a systems intervention for childhood obesity will be effective in its impact, efficient in its implementation, scalable in its delivery and sustainable in its longevity.

This 5-year study, supported by the NHMRC, Western Alliance and other regional partners, is testing effectiveness using a range of individual anthropometry and behavioural measures and community measures of capacity, system and environment change. The study is assessing efficiency, affordability and economic impact in the economic component. The stepped-wedge design allows for the testing of scalability (increasing participating communities) and sustainability (dose response of time exposed within trial compared to external comparator).

Investigators: Judith Russell, Ballarat Health Services; Rosemary King, Federation University of Australia; Karla Elliott, Monash University; Jaclyn Bishop, Western Alliance 

Babies born between 36 and 38 completed weeks of pregnancy are more likely to have difficulties establishing breastfeeding and to return to hospital in the first two weeks for feeding problems. There is a lack of knowledge about whether or not pregnant women in the Western Region of Victoria are made aware of these possible difficulties when early planned birth is suggested by their doctor.

This project aimed to understand the experiences and perceptions of women when receiving information and obstetric doctors when providing information about potential breastfeeding challenges if early planned birth is being considered.           

The study found that there is very limited information provided to pregnant women and their partners about the challenges of breastfeeding a late preterm or early term infant when early planned birth was being considered. Information and discussion was limited due to the focus on the medical and obstetric issues requiring planned early birth, and a lack of midwifery contact for women in high risk care pathways.

Women felt unprepared for these challenges and expressed that they felt a loss of control, sadness, disappointment and uncertainty about what to expect. Women stated that they would have felt more prepared if they had received information about what to expect prior to giving birth.

Doctors stated that they would like more education about this issue, more resources to provide to women and the ability to refer women to a midwife or lactation consultant for further discussion if needed.

The application of knowledge gained from this study to the specific context of Western Regional maternity services will include recommendations for enhanced midwifery contact with women in high risk care pathways who have increased risk of early birth, consumer information and decision-making guidelines around early planned birth. These tools have the potential to impact behaviours and attitudes, and improve patient care, patient experiences and health outcomes for women and their infants.

Investigators: Angela Holmes, Ellen Kelsey, Kathryn McLeod, Barwon Health

This project initially began with a project looking into the rates of urinary retention post administration of intravesical (into the bladder) of botox toxin (aim to paralyse the bladder for patients with overactive bladder symptoms). This study showed that patients with prior pelvic surgery were more likely to have rates of retention in our retrospective study set.

This project then developed into a second stage, where we were looking into different administration paradigms for intravesical botox. We have subsequently completed and published a scoping review to critically appraise evidence regarding different surgical administration techniques

We hope that these studies will help inform changed consent pathways for patients receiving botox to the bladder post pelvic surgery as these patients may be at a higher rate of retention. We also hope to influence changing administration paradigms for intravesical botox with the scoping review.

Investigators: Bronwyn Roberts, Katherine Armstrong and Tatum Pretorius, Western District Health Service; Hannah Beks and Dr Kara Holloway, Deakin University; Dr Alison Kennedy, National Centre for Farmer Health

Falls in aged care continue to be problematic and often result in injury. Hourly ‘staff rounding’ of aged-care residents at high risk of falls (to observe and intervene if necessary), has been shown to be effective in reducing the incidence falls and relate injury.

This study aimed to examine whether staff rounding on a 20-minute basis can further reduce falls and minimise falls-related injury. This project is a collaboration of nursing and allied health clinicians in aged care at 6 sites of Western District Health Service and Deakin University.

Led by Professor Julie Pasco, colleagues and collaborators across the region, this project aimed to establish the extent and influence of ageing on disease and injury in western Victoria. The project collected new data and drew on existing information collected by various agencies to provide a detailed snapshot of the health and safety of people living in the region and its relationship to age.

This information is required to identify gaps and plan changes to services and infrastructure to better serve the community. The global burden of chronic disease is growing and is expected to escalate because of the expanding and ageing population.

In western Victoria, the burden of chronic disease and its consequent effect on physical disability, psychological distress, dementia and mortality is set to grow in accordance with this trend. The region also has pockets of older populations that are more remote and isolated, particularly those living on farms.

Investigators: Jake Romein, Gabrielle Hutchins, Jaclyn Bishop, Ella Ottrey, East Grampians Health Service; Scott Talpey, Federation University

This two phase study involved conducting focus groups (phase 1) involving older adults over 60yr of age and a 6 week pilot study (Phase 2) of the desired modified sports program.

The focus groups were designed to gain a greater understanding of what the community desires in regards to a modified sports program (sport, time, day, frequency, duration, location, expectations, etc.). Phase 2 involved implementing a six week program based off of the results from phase 1. Social connection and physical activity levels were tracked over the duration using surveys.

This information will then be assimilated to provide guidelines for community uptake of a modified sport program.

We were able to engage with local council and facilities to enable the longevity of this program, ran by the community in the community. Retention levels have been consistent thus far and we are hoping that the program continues to grow in numbers.

The anticipated effects are for older people to remain more physically active and engage in sustainable, enjoyable and social exercise.

We are planning to develop a modified sports program toolkit to help facilitate other regional areas to adopt an adaptation of the program in their own local area.

Investigators: A/Prof Tim Baker and Kate Kloot, South West Healthcare and Centre for Rural Emergency Medicine, Deakin University

Very little data is collected and collated from Victoria’s 45 small rural hospital-based emergency care facilities, despite the fact that their patients share a common patient identification number across the hospitals. They simply report one figure – the total number of patients they see each year. Those figures show these facilities manage approximately 140,000 emergency presentations annually – 8 per cent of all emergency presentations in Victoria, including critically ill and injured patients.

Currently it is not possible to determine details of these presentations, such as patient demographics, triage category, details of arrival and departure, and diagnosis data. This reduces the ability to examine how rural emergency care is shared, the types of patient presentations and needs of the region or, with linkage to other health databases, to evaluate how a change in clinical or procedural practice in one organisation might benefit or harm another.

This project aimed to develop a comprehensive and ongoing emergency care database in south-west Victoria by collating data where it is not collated, and linking currently unlinked data. Data was collected from all rural hospitals in south-west Victoria. This scalable project will consider extension of data collection to 14 hospitals in the Grampians sub-region, and potential further.

The project’s outcomes provide for both clinical service delivery and research benefits. Small hospitals will gain a new source of information to guide service delivery, while researchers will benefit by gaining access to data. Rural communities requiring emergency care will benefit from both.

The project’s outputs will be development of a working emergency care database for the south-west sub-region’s hospitals and a ready source of data for research, publication in academic journals and conference presentations.

Investigators: Prof Daryl Pedler, Meg Murray and Jessica Beattie, Deakin University; Prof Belinda Gabbe, Monash University, A/Prof Susan Brumby, National Centre for Farmer Health

Farms are known to be dangerous sites for both work and leisure activities, but few studies have explored in detail the effects of farm-related injury.

This study measured the social, mental and physical effects of farm-based major trauma. The aim was to provide a realistic insight into the barriers that prevent farmers from returning to a pre-injury lifestyle and to identify interventions that may assist in promoting a return to their pre-injury work role. This project is a collaboration of researchers and clinicians from Deakin University, Monash University and the National Centre for Farmer Health.

Investigators: Prof David M Ashley, A/Prof Charlie Corke and Dr Violet Mukaro, Barwon Health; Dr Renee Otmar, Western Alliance

Funded by the Department of Health, this project  used a simple, easy-to-use questionnaire to demonstrate the efficacy of engaging cancer patients in documenting their treatment priorities and goals. Data from the study will provide strong evidence to support widespread introduction of the tool into clinical practice. By evaluating the perspectives of both patients and clinicians, the study will be able to assess resistance, and the nature of that resistance, that might impede the integration of the questionnaire into clinical practice.

Led by Dr John Rolley, this pilot project developed and tested a Practice Nurse-led clinic to assess the cardiovascular risk of otherwise healthy patients attending a general practitioner (GP) practice located in the Great South Coast Medicare Local region. Practices identified for this project are located within high-risk areas for cardiovascular disease. The project duration was 8 months, commencing in mid-2014.