scholarly journals Exploring the impact of an Aboriginal Health Worker on hospitalised Aboriginal experiences: lessons from cardiology

2009 ◽  
Vol 33 (4) ◽  
pp. 549 ◽  
Author(s):  
Kate P Taylor ◽  
Sandra C Thompson ◽  
Marianne M Wood ◽  
Mohammed Ali ◽  
Lyn Dimer
Keyword(s):  
Health Worker ◽  
Hospital Setting ◽  
Aboriginal Health ◽  
Hospital Staff ◽  
Tertiary Hospital ◽  
Culturally Appropriate Care ◽  
Job Role ◽  
The Impact ◽  
Aboriginal Health Worker

To enhance Aboriginal inpatient care and improve outpatient cardiac rehabilitation utilisation, a tertiary hospital in Western Australia recruited an Aboriginal Health Worker (AHW). Interviews were undertaken with the cardiology AHW, other hospital staff including another AHW, and recent Aboriginal cardiac patients to assess the impact of this position. The impact of the AHW included facilitating culturally appropriate care, bridging communication divides, reducing discharges against medical advice, providing cultural education, increasing inpatient contact time, improving follow-up practices and enhancing patient referral linkages. Challenges included poor job role definition, clinical restrictions and limitations in AHW training for hospital settings. This study demonstrates that AHWs can have significant impacts on Aboriginal cardiac inpatient experiences and outpatient care. Although this study was undertaken in cardiology, the lessons are transferable across the hospital setting.

scholarly journals Strategic information for hospital service planning: a linked data study to inform an urban Aboriginal Health Liaison Officer program in Western Australia

2015 ◽  
Vol 39 (4) ◽  
pp. 429 ◽  
Author(s):  
Judith M. Katzenellenbogen ◽  
Laura J. Miller ◽  
Peter Somerford ◽  
Suzanne McEvoy ◽  
Dawn Bessarab
Keyword(s):  
Western Australia ◽  
Linked Data ◽  
Hospital Admissions ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Tertiary Hospital ◽  
Service Planning ◽  
Liaison Officer ◽  
The Impact

Objectives The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. Methods A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006–11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. Results There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital re-admissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Conclusions Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes. What is known about the topic? The health gap between Aboriginal and non-Aboriginal Australians is well documented. Aboriginal people have significantly higher hospital utilisation rates, as well as higher rates of complications, comorbidities and discharges against medical advice (DAMA). Aboriginal patients receive most of their specialist services in hospital; however, detailed person-based analyses are limited and planning is often based on crude data. What does this paper add? This is the first analysis of linked data focusing on Aboriginal patient flows and volume and 28-day health system outcomes following hospital admission for all causes in a large metropolitan setting. Because the data were linked, admissions belonging to a single episode of care were combined, ensuring that transfers were not counted as re-admissions. Linkage also allowed follow up across time. The results highlight the main disease groups for which Aboriginal patients are admitted, how this varies by age and the high proportion of patients returning to (any) hospital within 28 days, either through EDs or as booked (pre-arranged) admissions. These data aid in the planning of hospital-based Aboriginal health liaison services. What are the implications for practitioners? The paper outlines the complexity with which many Aboriginal patients present to hospital and the risk of DAMA and re-admission. Clinical and organisational strategies can be put in place in hospitals to address these risks and ensure improved continuity of care with community-based primary health services. The Western Australian South Metropolitan Health Service is reviewing these data and will monitor the impact of the hospital-based AHLO program.

Keepin Ya Mob Healthy: Aboriginal Community Participation and Aboriginal Health Worker Training in Victoria

2001 ◽  
Vol 7 (1) ◽  
pp. 116 ◽  
Author(s):  
Karen Adams ◽  
Merilyn Spratling
Keyword(s):  
Training Program ◽  
Health Worker ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Successful Implementation ◽  
Community Consultation ◽  
Worker Training ◽  
Health Worker Training ◽  
Aboriginal Health Worker

This article outlines the development of accredited Aboriginal Health Worker training in Victoria. The processes of community consultation are presented as the primary reason for the successful implementation of the training program in its first year of delivery. The most important community consultation processes involved the active input of Elders and Aboriginal Health Workers. The training was seen as more credible by other Koorie people because of the input of these groups. The supportive role played by both the State and Commonwealth governments as well as industry groups are also explored. The successful implementation of the Aboriginal Health Worker training program demonstrates that Aboriginal people know what is best for them and can effectively initiate, organise and deliver their own culturally appropriate training programs.

Lake Mungo

1985 ◽  
Vol 13 (2) ◽  
pp. 27-31 ◽  
Author(s):  
Barry Wright
Keyword(s):  
Everyday Life ◽  
Health Worker ◽  
Aboriginal People ◽  
New South ◽  
New South Wales ◽  
Aboriginal Health ◽  
Aboriginal Child ◽  
South Wales ◽  
A Site ◽  
Aboriginal Health Worker

Lake Mungo, in New South Wales, is the home of the first known people in this country. Here, the oldest known evidence of Aboriginal people in Australia has been found. Because of its importance, it is a site which everyone should know about. To give us a feeling for Lake Mungo, Billy Reid, the illustrator of The Aboriginal Health Worker and The Aboriginal Child at School, came with me on a trip. We travelled west to the Darling River (whose Aboriginal name is Calewatta), and then south-east to Lake Mungo itself. Billy made wonderful drawings to represent the deeds and everyday life of those people. This can be reconstructed from the fossil evidence found at Lake Mungo. He has also drawn some scenes of life along the banks of the Calewatta - the river which is Billy’s own home. He hails from Bourke.

Aboriginal health worker screening for sexually transmissible infections and blood-borne viruses in a rural Australian juvenile correctional facility

Sexual Health ◽  
2010 ◽  
Vol 7 (1) ◽  
pp. 44 ◽  
Author(s):  
David J. Templeton ◽  
Beverley A. Tyson ◽  
Joel P. Meharg ◽  
Katalin E. Habgood ◽  
Patricia M. Bullen ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Worker ◽  
Screening Program ◽  
Correctional Facility ◽  
Aboriginal Health ◽  
Juvenile Detention ◽  
Newly Diagnosed ◽  
Substantial Impact ◽  
Sexually Transmissible Infections ◽  
Aboriginal Health Worker

Introduction: In Australia, Aboriginal youth are disproportionately represented in juvenile detention centres. We assessed the prevalence of sexually transmissible infections (STIs) and blood-borne viruses (BBVs) identified by an Aboriginal Health Worker (AHW)-led screening program delivered to male detainees of a rural juvenile detention centre. Methods: A retrospective review of first screening visit data was performed. Demographic and behavioural data were collected and the prevalence of STI/BBV was assessed. Results: Over a 4-year period to November 2004, 101 screens on new medium-to-long-term detainees were performed. The median age of participants was 17 years (range 14–20) and 87% were Aboriginal. Most reported multiple lifetime sexual partners (mean 14, range 0–60) and a minority had used a condom for the last episode of vaginal intercourse. Injecting drug use and non-professional tattoos or piercings were both reported by over one-third of participants, with over 80% reporting previous incarceration. One-quarter of those screened were newly diagnosed with one or more STI/BBV. The most common infection identified was urethral chlamydia (prevalence 16.3%, 95% confidence interval 10.0–25.5%), although the prevalence of newly diagnosed syphilis, hepatitis B and hepatitis C were each over 5%. Many participants remained susceptible to hepatitis B. Conclusion: An AHW-led STI/BBV screening program identified a large number of asymptomatic and previously undiagnosed infections in this group of young male detainees. Such an education and screening program using skilled Aboriginal staff not affiliated with the correctional system could have a substantial impact on the prevalence of STI/BBV among juvenile detainees.

scholarly journals Pharmacotherapeutic follow-up in a respiratory intensive care unit: description and analysis of results

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Ana Carolina de Souza e Silva ◽  
Domingos Sávio de Carvalho Sousa ◽  
Eunice Bobô de Carvalho Perraud ◽  
Fátima Rosane de Almeida Oliveira ◽  
Bruna Cristina Cardoso Martins
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Pharmacist ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Respiratory Intensive Care Unit ◽  
The Impact

ABSTRACT Objective: To describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit. Methods: A descriptive and cross-sectional study carried out from August to October 2016. The data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System. Results: Forty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%). Conclusion: Pharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.

The Aboriginal health worker

2006 ◽  
Vol 184 (10) ◽  
pp. 529-530 ◽  
Author(s):  
Melvina Mitchell ◽  
Lynette M Hussey
Keyword(s):  
Health Worker ◽  
Aboriginal Health ◽  
Aboriginal Health Worker

Feasibility of collaborative precision medicine oncology between academic- and community-based hospitals.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18015-e18015
Author(s):  
Lorna Rodriguez-Rodriguez ◽  
Mark Krasna ◽  
Kim M. Hirshfield ◽  
Veronica Rojas ◽  
Gregory Riedlinger ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Community Hospital ◽  
Treatment Options ◽  
Cohort Analysis ◽  
Hospital Setting ◽  
Tumor Board ◽  
Health Staff ◽  
Study Enrollment ◽  
The Impact

e18015 Background: The Rutgers Cancer Institute of New Jersey (CINJ) is conducting an ongoing, prospective, observational clinical trial that is evaluating use of comprehensive genomic profiling (CGP) and molecular tumor board (MTB) review to assist in caring for patients with rare or refractory cancers. As part of this precision medicine approach to cancer care, CINJ has formed a partnership with community hospitals (Meridian Health) to enroll patients in this study, and to actively participate in MTB meetings. The purpose of this cohort analysis is to evaluate the feasibility of using CGP to identify clinically-relevant genomic alterations as an aid to guiding point-of-care management in a community hospital setting. Methods: Meridian Health staff was trained in patient selection, enrollment, and follow-up. CGP was performed by Foundation Medicine, Inc. The patient case’s clinical history, pathology, and CGP results were presented at an MTB meeting. The enrolling physicians (n = 11) were invited to attend the MTB in person or through web-accessible video conferencing. A letter listing MTB consensus recommendations on potential treatment options was sent to the referring physician, and patient follow-up was scheduled at regular intervals. Results: 35 patients were enrolled by Meridian Health. Gyn and GI cancers were the most common types at enrollment (each 26%, 9 out of 35), followed by breast cancer (20%, 7 out of 35). At study enrollment, the mean KPS was 91%, and 23 patients (66%) had stage IV disease. The median duration between study enrollment and MTB presentation was 44 days. 3 patients were excluded because of deteriorated clinical status at the time of the MTB. MTB-based treatment options were implemented in 9 of 32 patients (28%). This result is similar to those reported in published analyses of patients enrolled at CINJ. Conclusions: Collaborations between an academic cancer center and a community hospital is a feasible approach to facilitating access to precision medicine for cancer patients treated in the community. A larger cohort is needed to determine the impact on patient’s outcomes.

scholarly journals Exploring the Impact of Obesity on Health Care Resources and Coding in the Acute Hospital Setting: A Feasibility Study

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 459
Author(s):  
Winnie S. Y. Tan ◽  
Adrienne M. Young ◽  
Alexandra L. Di Bella ◽  
Tracy Comans ◽  
Merrilyn Banks
Keyword(s):  
Health Care ◽  
Hospital Care ◽  
Demographic Data ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Anthropometric Measurements ◽  
Participant Recruitment ◽  
Orthopaedic Ward ◽  
The Impact ◽  
Care Costs

Obesity is costly, yet there have been few attempts to estimate the actual costs of providing hospital care to the obese inpatient. This study aimed to test the feasibility of measuring obesity-related health care costs and accuracy of coding data for acute inpatients. A prospective observational study was conducted over three weeks in June 2018 in a single orthopaedic ward of a metropolitan tertiary hospital in Queensland, Australia. Demographic data, anthropometric measurements, clinical characteristics, cost of hospital encounter and coding data were collected. Complete demographic, anthropometric and clinical data were collected for all 18 participants. Hospital costing reports and coding data were not available within the study timeframe. Participant recruitment and data collection were resource-intensive, with mobility assistance required to obtain anthropometric measurements in more than half of the participants. Greater staff time and costs were seen in participants with obesity compared to those without obesity (obesity: body mass index ≥ 30), though large standard deviations indicate wide variance. Data collected suggest that obesity-related cost and resource use amongst acute inpatients require further exploration. This study provides recommendations for protocol refinement to improve the accuracy of data collected for future studies measuring the actual cost of providing hospital care to obese inpatients.

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