CENTRE FOR HEALTH SERVICES RESEARCH

1

Quality of Life, Wellbeing and Outcomes Following Intensive Care Admission.

Monitoring the quality of life, well being and outcomes of patients following admission to Blacktown ICU and to identify patients “at risk” of health deterioration and predictors of poor health outcome after discharge from ICU

M Piza

Dr Graham Reece

Blacktown ICU

The Literature Reviews, Methodology & Tools and Ethics Committee all finalized.

Data Collection in progress

Preliminary analysis currently in progress

Report 05/1

2

Cerebral Angiograms Outcomes Review

Complications rates for cerebral angiograms performed at Westmead Hospital with recommendations for t prospective monitoring and related quality improvement activities.

Y Guo

M.Piza

G.Rubin

Radiology staff

•  Grand Rounds in August 2004

•  Poster Canberra August 2004

•  Oral presentation September 2004

•  Review from Prof Dorsch Jan. 05

•  Paper is in preparation

3

Pathology Utilisation Review

Investigate of the appropriateness of pathology tests ordered across WSAHS and conducted by ICPMR

(June 2003 to Feb 2004 inclusive)

D Campbell ,

E Lai

A collaborative project with WSAHS ICPMR.

•  Preliminary report sent to ICPMR April 04

•  Met with ICPMR July 04 to discuss next steps. Agreed that ICPMR would arrange joint presentation to ACE meeting. As of 8 Nov. 04 awaiting confirmation of meeting details from ICPMR

4

MAA Whiplash Health Outcomes Project

Long- and short-term health outcomes of patients with whiplash injury who seek compensation from the Motor Accidents Authority.

Stage 1 of this longitudinal project commenced in 2000.

D Sindhusake

W Schofield

G Rubin

Trudy Rebbeck

Ian Cameron

Price Waterhouse Coopers

•  Three papers submitted and awaiting results – rejected.

•  Stage 3 data collection begins July 04 and received Aug 04

•  Two papers comparing health outcomes before and after legislation are in preparation

5

Mortality of Patients During Admission and After Discharge from Westmead Hospital

AIMS to relate demographics, morbidity and treatment measures to survival.

G Rubin

W Schofield

YY Lai

•  Ethics approval from NSW Health received August 2004, data expected by end 08/2004

•  Data screened, linked by end 12/2004

•  1 st draft report due 28/ 2/2004

•  Analyses and draft reports will continue throughout 2005

6

Operations at Westmead for Neck of Femur Fracture (NOF) Progress

Time from admission to surgery & outcomes. The former from the surgical cancellations data file,

pending availability of NSW Mortality data

W Schofield

Orthopaedics staff

•  Analysis completed.

•  Progress report concluded

•  Priority for analysis when mortality data available Jan 2005 (see above)

7.

Evaluation of availability and use of clinical policies

Availability and use of clinical policies in departments in Westmead Hospital .

B Adelstein,

G Rubin

TO BE DONE Departments in which study to be done to be chosen, and discussions with them held.

Progress report 30 th June . ?????

8

Surveillance on patients admitted to WMH with multiple complex conditions

A cross sectional study of WMH patients on one day who require treatment for multiple chronic conditions

D Campbell

G Rubin

W Schofield

B Marrozeky

D Mitchell

•  Mar 04 case studies presented to Division of Medicine

•  May 04 survey instrument developed

•  Ward survey undertaken 6 July 04, complex patients reviewed 8 July 04

•  Results fed back to Div Med meeting 21 July 04, sub-group established to develop recommendations

•  Report from sub-committee submitted to Div. Med. in Nov. 04. Further action deferred until Feb. 05

10

E Check (Evidence Check)

A consultancy for the NSW Institute for Health Research to develop a mechanism to reach agreement between policy makers and researchers for required evidence

G Rubin

D Campbell

GRIPP Committee, Institute for Health Research

•  Semi structured interviews with policy makers and researchers conducted Jun-Aug

•  Report and commissioning documents developed Aug 04

•  Draft reports submitted 17 Aug, 27 Aug

•  Final report submitted 2 Sep 04

•  GRIPP meeting 13 Sep 04 . Feedback received.

•  Documents and process to be trialled March 05.

11

Modelling factors associated with trends in cardiovascular mortality in WSAHS

A study to apply a UK model explaining factors associated with the decline in CVD mortality to WSAHS and examine investment of CVD resources

D Campbell

D Sindhusake

G Rubin

S Capewell

•  IMPACT model received Jul 04

•  Initial scoping of model Aug-Oct 04

•  Identify and obtain data for NSW model Nov 04-Jan 05

•  Develop model and identify resources devoted to CHD treatment and prevention Feb-April 05

•  An application for NHMRC project grant being developed.

12

Patient Satisfaction

To Pilot the ideal ward questionnaire with a sample of patients to test the instrument

WN Schofield

Dr Paul Harnett

D Campbell

E Lai

•  Received ethics clearance for second round of data collection July 04

•  Data collection analysis Sep 2004)

•  Analysis Sep/Oct 2004 )

Postponed due to CCC evaluation

13

Clinician attitudes to use of guidelines at WMH

Identifying potential barriers to use of clinical practice guidelines at WMH

Y Guo

G Rubin

B Adelstein,

A project in collaboration with streams

•  Proposal and questionnaire June 04

•  Data collection, data analysis and report March 2005

14.

Business process reengineering in radiology

To transform the journey for patients presenting to radiology department

G Weerakkody

A collaborative project with Dept of Radiology and University of Western Sydney (School of IT)

•  Draft report on Nov 2004

15.

Measure the accuracy of diagnosis for CT scans vs clinical examination for abdominal pain at WMH

To determine the effectiveness of CT scans for diagnosing abdominal conditions Clincaps:

M Piza

Emergency department and Radiology

M. Portia-Anthony

Yang Yi Ong

•  0405 Prepare database-done

•  Preliminary analysis (MP) Concluded

•  Final analysis (MP) Jun 2005

•  Draft report Dec 2005

•  Poster completed.

16

Uptake of Evidence Based Practice: Availability of CPG.

To describe the availability of clinical practice guidelines in each stream/department in WSAHS.

To identify the strategies available to implement the translation of evidence to practice, to reinforce and sustain the EBP in each department.

Y Guo

G Rubin

B Adelstein

Clinical operations unit

Clinical Streams

•  Proposal and questionnaire finished Aug 04

•  Awaiting feedback from Dr Baker

•  Pilot Oct 04 in dept. of WCH

•  Document review to be discussed in Jan. 05

17

Analysis and reporting of speech pathology Therapy Outcome Measure data

To analyse Therapy Outcome Measure data, and develop a system for ongoing analysis of outcome data, from speech pathology clients at Blacktown Mt Druitt CHC

D Campbell

Angela O'Sullivan (Senior Speech Pathologist, Blacktown Mt Druitt CHC)

•  Background scoping Jun-Jul 04

•  First meeting with AO'S 3 Aug 04

•  Draft database development Aug-Sep 04

•  Second meeting with AO's 13 Oct. 04

•  Database finalised and data entry completed Dec. 04

18.

Acute condition deterioration project

(PACE)

To audit all cases who's vital signs deteriorated unexpectedly during a 3 month period.

(Jan-March 05)

Inform on time of patient's deterioration to respond to treatment and transfer

M. Piza

B. Adelstein

ICU

•  Proposal finalised

•  Data collection in progress

•  Report end of May 05.