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"The only thing we know about the future is that it will be different"
Peter Drucker

 

Choosing Wisely together: Physio & OT

Researchers from John Hopkins Hospital (US) recognised that neurology patients were often receiving physical and occupational therapy when they had no physical impairments. A multidisciplinary team introduced a multifaceted intervention which led to improvements in the delivery of allied health rehabilitation services to acute neurology inpatients. The intervention also increased the frequency of rehabilitation treatment for patients with the highest functional impairment, thereby ensuring that appropriate services were being delivered based on patient needs.

Source: The Neurohospitalist 2017; online first 12 September
Full text available for Austin & MHW Heidelberg staff via document delivery

Further reading
Frailty Intervention Therapy Team (FITT): A step in the right direction - Integration of early interdisciplinary assessment in the emergency department
This conference abstract outlines how one hospital implemented a Frail Intervention Therapy Team (FITT) to respond to the needs of all frail elderly patients attending the emergency department (ED). Comprising staff from physiotherapy, occupational therapy, social work, dietetics, speech therapy and pharmacy, the team aimed to identify and rapidly assess 100% of frail patients aged 75years+ who presented to ED during core hours. This early intervention and multidisciplinary team approach improved patient flow in ED and reduced length of stay for admitted patients. 
Source: International Journal of Integrated Care 2017; 17(5): A420  

 

Disinvestment in low-value care

The ever-increasing strain on health budgets means that efforts towards disinvestment in low-value care and the promotion of high-value care is "essential if Australia wants to continue to have a world-class healthcare system." In a recent Issues Brief, the Deeble Institute makes six recommendations to promote disinvestment in low-value healthcare in Australia. These include: expanding the scope of the Medical Services Advisory Committee and Pharmaceutical Benefits Advisory Committee; improving the collection of patient reported outcomes data; using the services of the AIHW (Australian Institute of Health and Welfare) to ensure data sharing across health providers; provision of better information for consumer decision-making; promotion and investment in high-value care by private health insurers; and using an outcomes-based funding model.

Source: Deeble Issues Brief No. 23, 2017 

 

Pregnancy complications – improving care delivery

Complications in early pregnancy include miscarriage, recurrent miscarriage or ectopic pregnancy. Previous research has focused primarily on diagnostic tests and therapeutic management, with little research addressing the aspects of care that are valued by women or their partners. This systematic review identified 24 valued aspects of care covering the eight dimensions of patient-centred care. The authors found four key targets for improvement of care delivery including: "understandable information provision about the etiology of pregnancy; staff discussing patients' distress; informing patients of pregnancy loss in the presence of a friend or partner; and staff performing follow-up phone calls to support their patients after a miscarriage".

Source: Human Reproduction Update 2017; online first: 11 October

 

Safety considerations in cancer rehabilitation

Due to the medically complex nature of cancer treatment, it is important for providers of rehabilitation services to have a broad knowledge of cancer progression and common treatment side effects. This report provides a focused review of safety considerations for rehabilitation interventions across all aspects of cancer care. The evidence for any contraindications is presented so providers can create a safe care plan. 

Source: PM & R 2017; 9(9S2):S415-S428

 

Can a mobile app improve your sleep?

Statistics indicate that sleep disorders and insufficient or irregular sleep are a significant public health problem and increase the risk for obesity, poor cardiovascular health and diabetes. "Mobile health (mHealth) is increasingly being used as a practical intervention tool in medicine and public health" and this systematic review examines the effectiveness of mobile technology interventions for improving sleep quality. The review discusses the use of mobile phone apps as well as conventional mobile phone support via calls or text messages. Researchers found evidence that mobile phones can be a feasible and usable tool to improve both sleep disorders and sleep quality.

Source: JMIR mHealth and uHealth 2017; 5(9): e131

Interested in clinical apps? Check out our apps guide

 

Procedural simulation – tips for educators

Procedural simulation (PS) is any simulation activity which uses various teaching tools to enable acquisition of competencies for a particular procedure (for example airway management or neuraxial block). To help healthcare educators include PS in training programs, researchers from Canada have developed 12 evidence based practical tips.

Source: Medical Teacher 2017; online first 24 October

 

Did you know?

Did you know there is an online Transplant Library?
The Transplant Library
(available under Evidence summaries on the Library website and Hub page) provides access to high quality, evidence-based information on all of aspects of solid organ transplantation. The Transplant Library includes all randomized controlled trials from the earliest record, including congress abstracts and ongoing trials, plus systematic reviews and clinical practice guidelines.
RCTs published from 2004 have been given a methodological quality rating and selected trials have been reviewed by internationally recognised experts, including specialist surgical staff from Austin Health

Do you know about the Health Translations Directory? 
The Health Translations Directory aims to improve the health of people from culturally and linguistically diverse backgrounds by providing health professionals and community members with reliable, accurate, and up to date health information in many different languages. Resources are provided by government departments, peak health bodies, hospitals and community health groups.

Further information for Austin staff can also be found on the Hub - Language Services page.

 

Austin Health Research Online - recent submissions

Untapped potential in Australian hospitals for organ donation after circulatory death
Rakhra SS, Opdam HI, Gladkis L, et al. Medical Journal of Australia 2017; 207(7): 294-301

A novel framework for automated, intelligent extraction and analysis of online support group discussions for cancer related outcomes
Ranasinghe W, Bandaragoda T, De Silva D, et al. BJU International 2017; 120(Supp 3): 59-61

Obesity-related CKD: when kidneys get the munchies
Mount PF, Juncos LA, Journal of the American Society of Nephrology 2017; online first: 20 October

Inhibiting system xC− and glutathione biosynthesis – a potential Achilles' heel in mutant-p53 cancers
Clemons NJ, Liu DS, Duong CP, et al. Molecular & Cellular Oncology 2017; 4(5): e1344757

Activity and safety of AZD3759 in EGFR-mutant non-small-cell lung cancer with CNS metastases (BLOOM): a phase 1, open-label, dose-escalation and dose-expansion study
Ahn MJ, Kim DW, Chul Cho B, et al. Lancet Respiratory Medicine 2017; online first: 19 October

See more at AHRO, Austin Health Research Online

 

eBooks Spotlight

Sleep medicine / edited by Darren R Mansfield – IP Communications, 2017.
This book provides an overview of the essential concepts and principles of sleep medicine. It covers the physiology of sleep, the range of sleep disorders and their impact on health and human functioning. 

Neonatal cardiology / Michael Artman, Lynn Mahony & David F. Teitel – 3rd ed. McGraw Hill Education, 2017.  
Provides paediatric cardiologists, neonatologists, and obstetricians with a guide to the differential diagnosis of cardiovascular disturbances and their management in newborn infants.

Talley & O’Connor’s clinical examination : a systematic guide to physical diagnosis / Nicholas J Talley & Simon O’Connor – 8th ed., Elsevier, 2018. 
This new edition in two volumes provides a patient centred, evidence based approach to clinical examination. Volume one focuses on history taking and clinical examination while volume two focuses on medical specialities.

 

Journals Spotlight

American Journal of Preventive Medicine

Australian Social Work

Endocrine Reviews

Epilepsy & Behavior

Gastric Cancer

Journal of Immigrant and Minority Health

Journal of the American College of Cardiology (JACC)

Paediatrics and Child Health

Pigment Cell & Melanoma Research

Psychoneuroendocrinology

Seminars in Liver Disease

Looking for the latest journal issues?
All our journal titles with electronic access are available via the Journal List
(outside the Austin Health network use your Library barcode no. & PIN for access)

If you require an article from a journal that is not in the Journal List, please use our online document delivery form.

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The Austin Health Sciences Library accepts no liability for the information or advice provided by external links. Links are provided on the basis that readers make their own decisions about the accuracy, currency and reliability of the information contained therein. Any opinions expressed are not necessarily those of Austin Health.