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NOTICE:
Welcome to our Spring issue
As we wrap up this edition of Hospital + Healthcare, preparations are in full swing for Australia’s major infection prevention and control conference ACIPC 2024. Over the last few years, the landscape of infection prevention and control has changed significantly.
The rise in antimicrobial resistance and growing zoonotic threats leading to novel infections has made it critical to develop tools and techniques to prevent, minimise and control risks.
In this edition’s lead article Francette Geraghty-Dusan, a senior One Health — a framework that recognises the interlinkages between human, animal and environmental health — practitioner provides insights on impactful things we can do, alongside immunisation, to reduce risks. Geraghty-Dusan is one of the key speakers at the ACIPC 2024 conference to be held from 17–20 November at the Melbourne Convention and Exhibition Centre and online.
The conference, themed ‘Succession, sustainability, and the advancement of infection prevention and control’, features a range of speakers including: Michael Borg, Head, Department of Infection Prevention & Control, Mater Dei Hospital, Malta; Glenn Browning, Director, Asia-Pacific Centre for Animal Health; Bronwyn King AO, Founder, Director and
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CEO, Tobacco Free Portfolios; Heather Gilmartin, Health Services Researcher, Implementation Scientist, Denver/Seattle Centre of Innovation, Rocky Mountain Regional Veteran Health Administration Medical Centre; Jessica Dangles, Executive Director, Certification Board of Infection Control and Epidemiology, and many more. If the topic is of interest and you haven’t registered already, this information-packed event might be worth attending.
As usual, IPC is not the only topic covered in the edition — we have articles and insights on healthcare innovation, leadership from St Vincent’s Health Network Sydney CEO Anna McFadgen, strategies to tackle clinician burnout, pain management, treating knee osteoarthritis, opioid use, diabetes care and more.
Mansi Gandhi Editor, H+H hh@wfmedia.com.au
We welcome articles and research reports from health professionals across Australia for review for the quarterly print publication and our daily web page. If you have a story you think would be of interest, please send an email to
There’s more to decontamination than just disinfection…
Disinfection is often the main focus in medical device reprocessing, but is only one step of the decontamination procedure. A successful reprocessing cycle is the sum of its parts — if one stage is compromised, the outcome is compromised. While many providers feel they are responsible for just the disinfection step, their success is dependent on ensuring other factors are completed.
Cleaning
It is commonly accepted that cleaning is the most important step for medical device reprocessing. If a device is improperly cleaned, most disinfectants are unable to perform effectively with the challenge of contamination, and the cycle will be compromised. Under the Australian Standard AS:5369, cleaning agents are regulated by the TGA, and must be included on the ARTG. Standard soaps or detergents mixed with water do not meet the requirement.
It is important that cleaning products are compatible not only with the medical device materials, but also with the method of disinfection. Within Australia, a commonly seen wipe used for cleaning and disinfection of medical devices prior to HLD states on the pack “Not to be used on invasive medical devices” and that it should not be combined with other disinfectants. There have been documented cases of devices being damaged by using a wipe followed by a disinfectant — both were compatible with the materials in isolation, but not combination.
Your medical device manufacturer or disinfection provider should be able to inform you of not only which products are compatible, but also have the appropriate regulatory approvals. Is your cleaning agent on the ARTG for that intended purpose?
Disinfection
Disinfection is only as effective as the user. Machine-based disinfection systems provide
a confirmation that a cycle was completed under specific parameters, but often do not recognise basic features that may impact disinfection – such as incorrect device placement. Machines can also be variable in terms of cycle times and delivery. Manual systems rely on the user, but users are trained to recognise and decontaminate, and adjust behaviours to requirements. While machines can feel convenient, nothing replaces the focus of an individual.
Rinsing
The Australian Standard states to rinse medical devices in line with the disinfectant provider’s IFU. Many disinfection technologies do not require rinsing, as they leave no residue, or residue is proven to be negligible. If a device is rinsed, AS:5369 provides guidance on rinse water quality, with detailed feature for compliance.
Traceability
Traceability records for devices that undergo HLD are required to ensure tracking between patients. These records include details of the individual device, the date and time of reprocessing, means of reprocessing and the person who completed it. Other factors required by the disinfectant manufacturer can also be recorded. While traceability has been completed manually in the past, digital traceability is becoming more common,
and often contains in-built features such as training or process challenges.
Storage
AS:5369 states that semi-critical devices should be stored to prevent environmental contamination in a designated storage area. Storage systems are designated as an accessory to reusable medical device and must be entered on the ARTG. Many facilities use commercially available plastic bags to store devices, but this does not meet requirements. Additionally, a number of device companies also supply covers for storage, but most have not been validated as suitable for purpose and are not found on the ARTG. Can you claim your cover is compliant?
Tristel provides a stable of products to ensure devices are entirely reprocessed in line with requirements. While many practitioners are familiar with Tristel’s Trio50 for total, validated decontamination of devices, other products are available to fill the gaps left behind in existing practices. Tristel Clean is a dedicated medical device cleaning agent that can be used as a standalone product, or prior to machine-based or manual disinfection. Tristel 3T is a complete digital traceability system that provides guidance to the user and confirms product use. Finally, Tristel Protect is a portable transport and storage system that has been validated to keep devices contamination-free for up to 72 hours.
Tackling
zoonotic threats
Amy
Sarcevic
Icover
n the fight against infectious disease, prevention is always better than cure. But are our current prevention strategies enough, or do we need to look beyond measures such as immunisation and the use of aseptic technique?
Proponents of One Health — a framework that recognises the interlinkages between human, animal and environmental health — believe so. They argue that, while clinical measures are important, they are only one small piece of a much bigger puzzle.
“We tend to think vaccines are the gold standard when it comes to infectious disease prevention. And yes, they are very important,” said One Health expert Francette Geraghty-Dusan*
“But actually, if you dig deeper — and roam into other disciplines — there are other impactful things we can do alongside immunisation. Things which actually reduce the likelihood of organisms transferring to humans in the first place.”
Animal health management impacts human health
Indeed, a recent work by Australian scientists, featured in the journal Nature, revealed how dwindling bat food reservoirs, caused by deforestation and climate change, are forcing bats to disperse more widely into agricultural and urban areas in search of food. Here, when stressed, they excrete Hendra virus, infecting horses, who in turn spread it to humans.
“People often feed horses underneath the shade of fruiting trees, where they are exposed to bat urine and saliva on dropped fruit. The horses get sick, and without appropriate IPC, exposed horse owners and veterinary workers can get infected with this deadly virus.
“A One Health approach would say, ‘yes, let’s immunise, but let’s also do more to protect bat food reservoirs, so they are less susceptible to ongoing climate variation, and spend more time in areas which are less populated’. This gets to the real heart of the issue,” Geraghty-Dusan said.
Safeguarding wildlife and wilderness areas can also prevent the emergence of other infective organisms. Scientists already know that SARS had its origins in bats, and was transmitted through civet cats in wildlife markets. Similarly, a genetic sequencing study in 2023 showed that SARS-CoV-2 — the pathogen responsible for COVID-19 — likely had animal origins.
“Public health emergencies often come from the disruption of the environment and inappropriate animal use. And tackling this is far more impactful than a purely clinical approach like a human immunisation program,” Geraghty-Dusan said.
Environmental management impacts human health
The spread of antibiotic-resistant genes (ARGs) through wastewater is an example of how the environment can impact human health in the realm of infection prevention and control (IPC).
In some countries, agricultural animals are fed antibiotics for weight gain, and their ARGs can migrate to humans via water bodies in turn, fuelling antibiotic resistance.
This huge global problem was first highlighted in 2013 by the USCDC, which found at least 2 million Americans were developing antibioticresistant infections (ARI) every year, with more than 23,000 cases becoming fatal.
“Clearly, we need to find ways to manage wastewater to minimise the transmission of ARGs into the environment; this includes from hospitals,” Geraghty-Dusan said.
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NMENTALMANAGEMENT
iStockphoto.com/epic_fail
HUMAN HEALTH
“Clearly, we need to find ways to manage wastewater to minimise the transmission of ARGs into the environment; this includes from hospitals.”
ANIMAL HEALTH
Human health management impacts the environment
Just as the environment can impact human health, so too can human health management impact the environment. In the realm of IPC, hospitals are responsible for vast volumes of material waste, consuming around 85–95% of the 150 billion pairs of disposable gloves manufactured each year.
“Reuse and recycle can only go so far. With a One Health mindset, we really need to call on engineers and manufacturers to find better options — like compostable materials — that don’t harm our environment, because we know how cyclical this harm can be,” Geraghty-Dusan said.
National framework needed
While One Health originates from First Nations’ understanding of interconnectivity, it was first used as a term in 2003. Since then, it has gained prominence in a postpandemic world, becoming a founding principle of the new Australian Centre for Disease Control, and a feature of the National Health and Climate strategy. The United Nations quadripartite now also has a shared definition of the term.
However, as yet, there is no national One Health framework for Australia.
Geraghty-Dusan believes this is stunting progress, and that it may limit the efficacy of the pandemic agreement, currently being penned by global leaders in preparation for the next major outbreak.
“Whilst it [the agreement] does include things like financing for pandemic preparedness, equitable access to countermeasures and health works, there
are concerns that it doesn’t go far enough upstream in terms of prevention,” she said.
“And with the interim Australian CDC residing in the Department of Health, we aren’t getting that transdisciplinary authority we need to execute One Health.
“A One Health-focused CDC is certainly a step in the right direction and may give us more hope than other initiatives we have seen over the years. But we ultimately need a framework that goes beyond one sector.” 17–20
*Francette Geraghty-Dusan is a passionate One Health practitioner who has spent her career addressing the complex challenges of antimicrobial resistance, pandemic prevention and food security. Geraghty-Dusan is presenting at the ACIPC International Conference 2024 to be held from 17–20 November at the Melbourne Convention & Exhibition Centre. The conference — themed ‘Succession, sustainability, and the advancement of infection prevention and control’ — aims to address emerging challenges, promote innovative approaches, and create a collaborative environment where diverse perspectives are valued. To hear more of her insights and attend the conference, please visit the ACIPC Conference website: https://acipcconference.com.au/registration/.
mpox: the next health emergency?
Mpox infections have risen significantly across the world this year, with Australia registering some 905 cases so far to date, according to the National Communicable Disease Surveillance Dashboard. New South Wales and Victoria recorded the highest numbers with 483 and 314 cases, respectively.
In August 2024, the World Health Organization declared mpox a public health emergency of international concern (PHEIC) issuing temporary recommendations to prevent and control the spread.
The WHO released the Mpox Global Strategic Preparedness and Response Plan (SPRP) in September to guide public health preparedness and response efforts at the global, regional, and national levels.
“The primary goal of the SPRP is to stop outbreaks of human-to-human transmission of mpox and mitigate its impact on human health through coordinated global, regional, and national efforts. This will be achieved by implementing comprehensive surveillance and response strategies, advancing research, ensuring equitable access to medical countermeasures, minimising zoonotic transmission, and empowering communities to actively participate in outbreak prevention and control,” the WHO said.
Following the PHEIC declaration, the Australian Global Health Alliance (AGHA) called on the federal government to expedite resources towards mobilisation of an effective, internationally coordinated and equitable response that will contain the mpox outbreak.
“Australia and the global health community must uphold the principles of equity and solidarity in making a meaningful contribution to a coordinated international response that will stamp this health emergency and prevent another pandemic,” AGHA said in a statement.
The AGHA called on the government to:
• Provide direct support to contain the response in the African region, including via direct vaccine contributions, and supporting lead multilateral agencies.
• Support countries in our region through preparedness, prevention and early detection of mpox — ensuring they can meet obligations in the IHR through surveillance and response; and have the means to deploy vaccines, engage
priority populations at risk and respond to outbreaks. The AGHA acknowledged the important work already underway in the Pacific and South-East Asia to build pandemic-resilient health systems as part of the Australian Government’s Partnerships for a Health Region initiative.
• Support the neglected pipeline of research and development in new tools for mpox and priority pathogens with epidemic and pandemic potential, and enhance efforts to overcome bottlenecks in development and deployment of these tools globally. This is where Australian medical research can make a major contribution.
• Rapidly mobilise cross-portfolio government advisory groups, such as the
Human Animal Spillover and Emerging Disease Scanning (HASEDS) group, and engage with Australia’s Mpox Taskforce, recognising the cross-portfolio nature of the response while the new Australian CDC is still being formed. Linking departments of health and foreign affairs in all countries will also be crucial for effective response.
• Support all measures to protect vulnerable people and prevent stigmatisation, particularly of gay, bisexual and other men who have sex with men, and migrant communities in the response.
The current PHEIC declaration is the second time the disease has reached this level of concern. In 2022 an outbreak occurred in Europe and spread globally, affecting 111
countries before being controlled in May 2023 through rapid mobilisation and risk reduction among gay and bisexual men. This initial global outbreak is, however, ongoing with an uptick in 2024 and caused by a variant called clade II, predominantly affecting men who have sex with men and immunocompromised individuals,” said AGHA in a statement. “This second PHEIC has been triggered by the emergence of a highly infectious strain last year, clade 1b, which is of high concern as it is spread more easily to close contacts and has a higher mortality rate.1
“The 2022–23 global mpox outbreak stemmed from the international community’s neglect and failure to respond swiftly and invest in equitable surveillance and research, despite regular outbreaks in
Africa that eventually led to the disease’s spread to other continents.
“To prevent a repeat of history and learn from past lessons, we must act decisively to scale and coordinate our global efforts, working closely with the international global health community, including WHO and the Africa CDC, to support affected countries in containing the spread of this disease. Australia and the global health community must uphold the principles of equity and solidarity in making a meaningful contribution to a coordinated international response that will stamp this health emergency and prevent another pandemic,” the AGHA concluded.
Enhancing Patient Safety and Interoperability with GS1 Standards and Services
GS1 is a global partner in the healthcare industry that plays a pivotal role in enhancing patient safety and interoperability.
As a global leader, GS1 supports organisations throughout the entirety of the clinical supply chain, from global and local manufacturers to healthcare providers. Our standards and services are instrumental in ensuring product identification, managing recalls, and facilitating a clinically integrated supply chain.
GS1 Standards: A Pillar of Patient Safety
At the heart of GS1’s contribution to patient safety are Global Trade Item Numbers (GTINs). These unique identifiers ensure the right product is identified and used at the point of care. By digitising this process and integrating it into healthcare technology, the risk of sentinel or never events is drastically reduced. This digitisation not only ensures accurate product identification but also opens opportunities for enhanced patient safety.
GS1 Services: Ensuring
Efficient
Recall Management
In addition to GTINs, GS1’s industry-based Recall Health platform is a service that enables efficient management of medical product recalls. This platform is a critical tool for healthcare providers, ensuring that any product recalls are handled swiftly and effectively, thereby safeguarding patient safety.
Facilitating Interoperability with GS1 Standards
GS1 standards are integral to various business processes in the clinically integrated supply chain. GTINs, Global Location Numbers (GLNs), and Global Service Relation Numbers (GSRNs) are used to identify products, physical locations, organisations, caregivers, and care receivers. The National Product Catalogue, acting as the source of truth for product master data, ensures up-to-date information is available at every point in the process. This interoperability creates opportunities for the right product to be easily located and issued to the right patient, further enhancing patient safety.
GS1 and Unique Device Identification (UDI)
Looking ahead, the TGA’s upcoming Australian Unique Device Identification regulations to be introduced in 2024, will revolutionise the identification of medical devices in the clinical supply chain. As a recognised issuing agency, GS1 will play a key role in linking devices to patients for traceability.
Case Study: The Scan4Safety Project
The successful implementation of GS1 standards is evident in the UK’s Scan4Safety project. This initiative demonstrates how
effectively GS1 standards can be leveraged to enhance patient safety and supply chain efficiency. https://www.gs1uk.org/industries/ healthcare
GS1’s
Role in Tackling Healthcare Challenges
GS1 has made significant strides in addressing challenges in the healthcare sector, particularly in the areas of master data management and preventing product misapplication. The National Product Catalogue serves as a single source of truth, ensuring accurate and reliable product data is always available. Additionally, scanning GTINs at the point of care prevents the wrong product from being applied, further enhancing patient safety.
With the upcoming UDI regulations and the continued use of GS1 standards, the foundation is set for enhanced patient safety, efficiency, and real-time informed decisionmaking in a complex, clinically integrated supply chain. GS1’s commitment to improving patient safety and interoperability is clear, and our role in healthcare will be vital in the years to come.
Learn more about UDI standards in Healthcare https://bit.ly/48aVk1n
» Learn more
Transforming diagnosis
Around four decades ago, Stuart Crozier, an Australian inventor of 30 patented magnetic resonance imaging (MRI) technologies, secured a vacation placement in the biomedical engineering department at Brisbane’s Princess Alexandra Hospital.
During his placement, Crozier saw engineers creating devices to help spinal-injury patients perform basic actions like lifting a cup which inspired him to focus on technology that benefits patients.
Passion to make a difference
Following graduation and further studies in medical physics, he worked as a biomedical engineer and medical physicist across several hospitals.
This led him to a research position in biomedical engineering with an MRI research group — led by Professor David Doddrell — at the Mater Hospital in the late 1980s. The first commercial MRIs had just come to market when he began his doctorate work and, “while the tissue contrast was spectacular compared
to CT, the signal-to-noise ratio (SNR) was considerably lower than it is now and there were several artefacts that limited image quality”. Crozier completed his PhD with the same MRI research group.
The centre moved to The University of Queensland (UQ) and a milestone was the group’s invention of a signal correction technology that corrected magnetic field distortions, producing faster, clearer and more accurate MRI images without increasing costs.
“Two-thirds of the world’s clinical MRI machines use this signal correction technology, improving the quality of diagnosis at an earlier stage of disease and increasing the success rate of early medical intervention. In the 35 years since, the MRI research undertaken at UQ has led to multiple commercial successes, with proceeds from our initial innovations funding further research and breakthroughs.
“My research has always focused on designing or improving diagnostic medical
devices that fill a clinical need. It is essential to work closely with clinicians and to canvas the areas where new innovations are needed.”
Fuelling innovation and progress
Over the past four decades, MRI and other imaging modalities have progressed significantly with massive improvements in CT, ultrasound and other modalities, expanding their use cases and improving safety, usability and diagnostic information, Crozier said.
“Ultrasound technology, for example, has seen a remarkable transformation. The advent of portable and user-friendly devices has expanded its reach beyond traditional clinical settings.
“Handheld ultrasound devices can now generate high-resolution 3D and 4D foetal images, significantly enhancing prenatal care prenatal care, and the development of ultrasound contrast agents is pushing the boundaries of this modality.
iStock.com/Eoneren
“In MRI, the advent of high field systems (and now almost helium-free) allowed improved SNR as well as the ability to use stronger gradients without artefacts, something I am pleased to have had a small part in by way of the method mentioned above. Phased array radiofrequency coils opened the door to parallel imaging and when combined with compressed sensing enabled great reductions in imaging time such that cardiac imaging, for example, became a clinically useful MR method.
“The rise of deep learning (aka AI) denoising and other applications has revived interest in low-field imaging and improved the quality of low- and higher-field images and applications. Also, new methods are emerging using different types of signals to make diagnoses that perhaps were not previously viable.
“The exponential rise in computing power has enabled some of these new methods. I am particularly excited about electromagnetic microwave imaging given my involvement with EMVision Medical Devices,” Crozier said, who is a co-inventor of the EMVision imaging
“Of course, deep learning and other similar methods have a growing role to play but their application must be carefully verified and validated.”
technology and now works as the company’s Chief Scientific Officer.
Reducing costs and improving access
There is considerable interest in trying to reduce the cost of imaging modalities and also to make them more accessible to those outside of large metropolitan areas. This is where the technology being developed by EMVision and Magnetica (another company Crozier is involved in) and others can play an important role, Crozier said.
“The miniaturisation of diagnostic tools will enable point-of-care testing, bringing critical health assessments closer to patients, possibly in resource-limited settings.”
EMVision is focused on developing a cost-effective, portable device using electromagnetic microwave imaging for diagnosis and monitoring of stroke and other medical applications.
“The technology is born out of over 10 years of research and development by researchers at The University of Queensland (UQ), which I contributed to alongside Professor Amin Abbosh, who led the group. It is aimed at providing point-of-care and immediate imaging of stroke or brain injury in settings where access to CT or MRI may be limited; for example, in an ambulance or in an ICU,” Crozier said.
He is particularly excited about the potential impact of in-home blood tests and portable brain diagnostics for rural communities; for example, the First Responder device that leverages the principles and mode of operation of EMVision’s bedside emu brain scanner device. The First Responder portable scanner is designed to deliver prehospital stroke diagnosis and enable more timely care for patients irrespective of their location. Suitable for use by paramedics and emergency physicians in both road and air ambulance services, the device is currently undergoing prototype development.
“Early diagnosis and therefore earlier treatment is known to drastically improve patient outcomes in stroke, as does regular monitoring during treatment and postoperative recovery,” said Crozier, emphasising that in his role as the CSO he is responsible for the strategic direction, oversight and execution of the research and development efforts that underpin the company’s devices, as well as working closely with academic colleagues and clinical partners to bring these products to market.
Illuminating the future of imaging
Commenting on the advancements in imaging, Crozier said, “Several research groups are combining imaging modalities to give synergistic advantages. For example, MR-PET systems allow fine anatomical detail from the MR images while the PET images allow functional oncological imaging to check for metastatic spread in cancer patients. This both reduces the number of visits patients need to make and adds greater accuracy and fidelity to the diagnostic information. Similarly, image-guided therapy is an exciting, combined modality.
“I was fortunate to be part of the Australian MRLinac program where we developed a novel split 1T MR system with an integrated linear accelerator that could be guided by the rapid MR images to enable more accurately localised radiation therapy, particularly for organs that are moving during treatment due to breathing or peristalsis. This system is in use at the Ingham Institute at Liverpool Hospital.
“Of course, deep learning and other similar methods have a growing role to play but their application must be carefully verified and validated.”
Overcoming challenges
The rise in chronic diseases, cancer and an aging population are all driving demand for imaging, Crozier said.
“This puts pressure on a workforce already experiencing shortages. Interpreting complex scans can be subjective and timeconsuming, with the potential for missing subtle abnormalities. Telemedicine-enabled devices allow specialists in large tertiary hospitals to contribute to patient care outside large cities.
“Artificial intelligence (AI) presents a promising solution to automate repetitive tasks and streamline workflows, potentially assisting radiologists in triaging those cases with the highest urgency.
“Equity of access is another area of concern. High costs associated with advanced imaging can significantly limit access for patients in low- and middle-income countries, or even within developed nations.
“Lack of specialist resources, such as radiographers, to operate the advanced imaging equipment can also be a challenge. Ensuring more affordable, easier to use and portable imaging devices make it to market will be crucial to bridging this gap,” Crozier concluded.
O3M Health Care is now Solventum
n 1st April 2024, Solventum completed its spin-off from 3M and became the newly independent healthcare company.
For more than 70 years, you’ve trusted 3M for breakthrough solutions to your toughest healthcare challenges. Now, we’re carrying that legacy of listening and innovating forward with the new independent company, Solventum. Solventum originates from two words: “solving” and “momentum.” “Solving” captures the company’s dedication to finding breakthrough solutions. “Momentum” symbolises swifter, nimbler innovation. With every healthcare challenge we solve, we gain momentum.
Medical Surgical experts
Helping care providers restore lives
At Solventum, we enable better, smarter, safer healthcare to improve lives. We’re a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges. And we’re just getting started.
Rooted in a history of diverse expertise spanning the industry — from medical surgical and dental solutions to health information systems and purification and filtration — we’re ushering in a new era of care. By pioneering game-changing innovations at the intersection of health, material and data science, we’re advancing solutions that change patients’ lives for the better — while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.
That’s why we’re pushing the boundaries of what’s possible by partnering closely with the brightest minds in healthcare. And ensuring every innovation we create melds the latest technology with compassion and empathy to change lives for the better. Our ultimate goal? Move humanity forward by improving health for everyone. Because at Solventum, we never stop solving for you.
We know the world needs you at your best. That’s why Solventum’s medical surgical experts create breakthrough solutions: to help you save valuable time and restore patients’ lives. We listen closely to understand your toughest challenges, then find new ways to solve for better outcomes and more efficient care. With industry-leading products, education and support — spanning the patient journey — Solventum enables you to lead the way in healthcare.
Dental Solutions experts
Reimagining oral care delivery
Beautiful, healthy smiles: That’s the focus of Solventum’s dental solutions experts. Sharing your passion for oral health, we understand the unique challenges of your business, and we partner with you to
transform your practice. Connecting leadingedge materials with data science, we help you solve your toughest challenges — and advance dental care.
Health Information Systems experts
Driving e�iciency, improving outcomes
No matter how complex your goals are, the health information systems experts at Solventum will find ways to optimize efficiency and value. We act as a strategic partner, supporting your vision from the first patient interaction through post-care analysis. With fully tested solutions and dedicated services, we help you make smart, data-based decisions to achieve success quickly.
Purification and Filtration experts
Streamlining the innovation process
Solventum purification products increase efficiency and help your innovations go from idea to full-scale production — fast. Our application experts solve your tough challenges and collaborate closely to achieve your goals. That translates to more effective vaccines, purer medical filtration, bettertasting beverages and more lives improved.
With 22,000 employees across 38 countries, we have the global reach and expertise to make this vision a reality. Our 7,300 patents and 2,100-strong R&D team demonstrate our relentless commitment to advancing the field of healthcare.
Solventum’s diverse portfolio of trusted, reputable brands, includes Littmann®, Prevena™, V.A.C®, Bair Hugger™, Filtek™, RelyX™, Scotchbond™,360 Encompass™, Zeta Plus™ etc.
Why don’t we have equitable access to
meningococcal vaccines yet?
Professor Robert Booy, Infectious Diseases Paediatrician
Invasive meningococcal disease remains a serious and life-threatening infection in Australia.
Is it fair that some Australian children are protected from a rare but serious, lifethreatening infection and others are not?
After a long career in paediatric medicine, I am frustrated at the great divide that continues to be a hallmark of our health system — especially when it comes to invasive meningococcal disease (IMD).
This rare but potentially fatal infection poses an ongoing threat to babies, toddlers and adolescents across the country. Australia continues to see cases of IMD1 with meningococcal serogroup B (MenB) responsible for approximately 80% of cases in 2022 and 2023.2
This nuance is important. At the moment, all Australian children are routinely vaccinated at 12 months of age against meningococcal strains A, C, W and Y via the National Immunisation Program. There is a vaccine to help protect against the most common strain, MenB, but only Aboriginal and Torres Strait Islander children and those with certain highrisk medical conditions, have funded access via this system.3
Some state governments — South Australia and Queensland — have chosen to fund state-based programs for children under two and teenagers between 15 and 19 years old.4,5 In addition, it now looks like the Northern Territory government will also come on board and fund a state-based program,
after a commitment from the incumbent Country Liberal Party prior to taking office last weekend.6,7
I applaud those jurisdictions for taking the initiative to prioritise public health and help to protect the most at-risk community groups from MenB.
But it makes the national inconsistency even more glaring. It leaves families in several important states in the country — NSW, Victoria, Tasmania and Western Australia — having to privately fund vaccination against meningococcal B. Unfortunately, this is an expense that many families simply cannot absorb in the current cost-of-living crisis.
Recent postcode data from VIC and NSW compiled by pharmaceutical company GSK provides an insight into what is really happening. It clearly shows that families in typically wealthy suburbs are far more likely to vaccinate their children against MenB. In lower-income pockets, children and adolescents are far less likely to be vaccinated against the disease.8
What this means is we have a two-tier system, where the ‘haves’ have access and the ‘have nots’ are going without — not because they don’t care about their family’s health, but because it might be considered a ‘nice to have’ not a ‘must have’ when household budgets are already so stretched.
Some GP’s have admitted they would be loath to even mention the availability of a privately funded vaccine, because they know a family may not be able to meet an additional cost.
A level playing field would prioritise the health and well-being of all children, as well as providing broader public health protection.
We can begin by raising our voices again. I now urge all healthcare professionals who want to see equitable access to the MenB vaccine for all children and adolescents to contact their local Member of Parliament or the Australian Medical Association.
It is simply too dangerous to play ‘postcode lottery’ when it comes to diseases like meningococcal B.
References:
1. National Notifiable Disease Surveillance System (NNDSS), https://nindss.health.gov.au/pbi-dashboard/ [Accessed August 2024]
3. National Immunisation Program Schedule. https:// www.health.gov.au/resources/publications/nationalimmunisation-program-schedule?language=en
4. Queensland Health. Queensland MenB Vaccination Program. Last updated 18 July 2024. https://www.health. qld.gov.au/clinical-practice/guidelines-procedures/ diseases-infection/immunisation/meningococcal-b [Accessed August 2024]
5. SA Health. Meningococcal B Immunisation Program. Last updated: 06 July 2023. https://www.sahealth.sa.gov.au/ wps/wcm/connect/public+content/sa+health+internet/ conditions/immunisation/immunisation+programs/meningo coccal+b+immunisation+program [Accessed August 2024]
6. Country Liberal Party. Free MenB vaccine for Territory babies and teens. July 22 2024. https://www.clp.org.au/ news/free-menb-vaccine-for-territory-babies-and-teens [Accessed August 2024]
Rural LAP: Bringing skilled healthcare professionals to rural and remote Australia
Delivering quality healthcare services in rural and remote regions presents unique challenges. Limited access to healthcare professionals, resource shortages, and geographical isolation make it difficult to maintain consistent care standards. The Rural Locum Assistance Program (Rural LAP) can help to address these challenges. Rural LAP is a government-funded program providing skilled locums in aged care, allied health, nursing and midwifery, GP and specialist obstetricians, and GP and specialist anaesthetists.
In many remote areas, healthcare services struggle to find healthcare professionals available and with the skills to fill in when staff take annual leave or Continued Professional Development (CPD) leave, or to fill vacant positions* to prevent gaps in service. North West Remote Health (NWRH) services some of Queensland’s most isolated communities and knows the challenges all too well, having faced staff shortages that stretched their team and threatened the quality of care provided. In March of 2024, NWRH engaged Rural LAP and were able to bring in Rachael, a highly skilled Personal Care Worker.
“As a healthcare provider delivering services to rural and remote Queensland to people who would not usually seek healthcare, it is important for us to have the right staff supporting our clients. A Care Support Worker
with experience in remote service delivery and support has been second to none. Rachael has been a fantastic fit for our team and we have received so many compliments from our clients. The process of working with the Rural LAP team has been easy — reassuring and supportive.” Sarah – General Manager Community Services, NWRH.
Rachael’s experience in working in diverse settings, from community healthcare to aged care facilities, allowed her to adapt quickly to NWRH’s needs. She was welcomed by the staff and community who were appreciative of her efforts in supporting their in-home aged care services. Her connection with the residents has been complimented by NWRH residents in her care and they raved about how “she is just so nice and is wonderful to talk to”.
The Rural LAP Difference
The Rural LAP team work closely with healthcare providers to ensure the locums are well-prepared to meet the specific needs of their placements. This also helps to ensure that the right locum is being sent to the right placement. Rural LAP reduces the administrative burden on the healthcare service by recruiting for the locum then completing all credentialing, onboarding, arranging contracts, and organising and paying for travel and accommodation. The healthcare service is only responsible for
submitting a request and paying for salary, superannuation and any applicable taxes.
For NWRH this was a game-changer. With Rural LAP’s support, they no longer had to make rushed hiring decisions or compromise the quality of care due to staffing shortages.
Success with Rural LAP
The success NWRH has had with Rural LAP reflects the broader impact that the program is having on aged care and healthcare services in rural and remote Australia. Rural LAP helps bridge the gap between the growing demand for healthcare services and the limited availability of skilled professionals in these regions.
In addition to offering support during staff leave, Rural LAP fosters long-term relationships between healthcare providers and locum professionals. Rachael’s positive experiences, both personally and professionally, highlight the rewarding nature of working in rural healthcare and the difference it can make in the lives of both staff and residents.
Rachael said, “Locum work is the best thing I have done in my life. It is a rewarding job. I have met so many new friends along the way. I have been welcomed open arms in Mt Isa every contract”.
*vacant positions are only covered as part of our Aged Care service.
» For more information about Rural LAP and how it can benefit your organisation, visit www.rurallap.com.au
Driving innovation
Not-for-profit organisation NextSense’s new $75 million facility is custom-built for people with hearing and vision loss.
Located in the Macquarie University precinct and Macquarie Park Innovation District, the centre will bring the organisation closer to its key partners already on campus, such as Macquarie University Hearing, Cochlear and Hearing Australia.
The facility will be the focal point for the organisation’s national operations and will house allied health, disability and cochlear implant services for children and adults, a school and preschool, and a major research and professional education program.
This new centre for innovation is an important investment in removing barriers for people who are deaf, hard of hearing, blind or have low vision, NextSense Chief Executive Chris Rehn said.
“It is a nationally significant piece of social infrastructure that will cement the leading role Australia already plays on the world stage in hearing and vision service delivery and research. We welcome the Australian Government’s significant financial support of $12.5 million to this project — it will change lives and create new opportunities for the way education and services are delivered to all people with sensory disability,” Rehn said.
A key feature of the centre is its building design, which puts people with hearing and vision loss first, with equipment and spaces tailored specifically for them, including
the highest-possible acoustic standards, wayfinding braille signage, and walls and furniture with high-contrast elements to allow better depth perception.
“We’ve come such a long way from our beginnings in 1860 when Thomas Pattison established us as Australia’s first Deaf school,” Rehn said.
“Since then, we have achieved many firsts, from championing compulsory education in the 1900s for children who were deaf and blind, and pioneering teacher training in the 1930s, to creating the first digital version of the Auslan Dictionary, building Australia’s largest cochlear implant program, and launching the world’s first online braille training program.
The new centre will explore ways to advance education for all children with hearing and vision loss, regardless of their location. And it will help NextSense scale up to meet the growing need for in-person and remote hearing and vision services right across Australia.
“By 2050, more than 6 million Australians will have hearing loss and more than 1 million will be blind or have low vision, and this will continue to grow,” Rehn said.
“We know that despite being the largest group affected by hearing loss, adult awareness of its huge health and social impacts is low. If we improve this awareness and access to adult hearing care, we can go a long way to keeping our aging population
“By 2050, more than 6 million Australians will have hearing loss and more than 1 million will be blind or have low vision, and this will continue to grow.”
healthy and connected, reducing the risk of social isolation, falls, mental ill health and cognitive decline.
“We also know acting early when children have hearing or vision loss is critical in setting them up for life and giving them a level playing field. Advancing knowledge around best practice early intervention services and making sure families can access them is vital. With this new centre, we’re now in a better position to be there for those who need us and shape the way services are delivered across the sector.
“We plan to use our centre for innovation to better connect our rich expertise as a leading service provider with what we learn from others — we need collective thinking if we’re going to drive change,” Rehn said.
How healthcare providers prevent infection
The spread of infection in the healthcare sector is an ongoing challenge for operators, so what can providers do to minimise risk and protect patients, staff and visitors?
Within healthcare settings such as hospitals and care homes, MRSA and clostridium difficile are among the most common infections and an outbreak can place additional strain on stretched staff and resources.
It’s clear, therefore that proper surface cleaning and disinfection routines are key to preventing the spread of viruses, with a starting point being high-touch surfaces that can harbour bacteria.
While the scale of surface cleaning differs between low-risk (foyers, waiting rooms, offices and corridors) and high-risk (operating theatres and intensive care wards) areas, it’s vital that cleaning programme managers do not become complacent.
Seemingly innocuous equipment shared by staff such as keyboards, stethoscopes and ultrasound probes cannot be underestimated as they are a major cause of cross contamination and should all be wiped down regularly with disinfectant. The same is true of chair arms and seats in waiting areas.
Meanwhile, call bells, grab rails, door handles and opening buttons/panels are touched
countless times each day and are among the most likely surfaces to transmit infection.
And in all toilet areas, from wards to public washrooms, it’s essential that high-touch surfaces including taps, flush handles, dispensers, hand dryers and door handles are not neglected due to a focus on obvious areas such as toilet bowls, sinks and floors.
To achieve exceptional surface-cleaning standards, chemical dispensers used for dosing concentrated and pre-mixed solutions into sinks, spray bottles, mop buckets and scrubber dryers must combine precision and consistency with robustness and longevity.
In fast-paced, high-pressure environments such as operating theatres where excessive force and accidental collisions are common, a robust, impact-resistant dispenser casing helps to ensure consistent, reliable performance while reducing the cost of maintenance, repair and replacement.
Budget constraints may make lightweight dispensers an attractive prospect, but while such systems are cheaper per unit they are also unreliable and have a short lifespan, costing more in replacements in the long run compared with higher-quality, longerlasting equipment.
In many cleaning stations it’s common to see concentrated chemical containers such as 20-litre drums stored unbunded on the floor,
causing a potential leakage or trip hazard. Or, worse still, staff dosing detergent and other solutions manually, exposing them to potentially harmful concentrated chemical.
Integrated chemical storage can help solve this issue, enabling operators not only to save space and make cleaning stations tidier and more presentable, but also providing vital health and safety benefits by keeping the chemicals off the floor and avoiding possible spillage and trip hazards.
Such systems typically feature a cabinetstyle enclosure where various-sized chemical containers can be stored and connected to the built-in dispenser. Lockable cabinets help to prevent theft and tampering and protect employees against exposure to harsh concentrated chemical.
When it comes to maintaining exceptional standards in healthcare, it’s clear that sensible investment can go a long way. Cleaning and hygiene expert SEKO knows this better than most as the company has been helping operators for decades with a dedicated range of chemical dilution, dispensing and dosing equipment.
These include the modular ProMax dilution system, which allows users to dispense premixed chemical solutions into spray bottles, mop buckets and scrubber-dryers as well as the modular, fully compatible SekureMax and SekureDose storage cabinets.
Treating knee osteoarthritis
Each year, more than 53,500 knee replacements are performed to treat osteoarthritis in Australia1 and the figure is rising. By 2030, knee replacements are expected to increase by 276%.2
In Australia, osteoarthritis is the most common form of arthritis with around 2.1 million (8.3%) people in the country estimated to be living with the condition in 2022.
Surgery is often seen as an inevitable magic bullet for those who live with pain and disability from osteoarthritis of the knee. But most people can successfully reduce their pain and improve mobility without major surgery and the associated costs, recovery period and potential complications.
To better support people with knee osteoarthritis, the Australian Commission on Safety and Quality in Health Care has released a revised national Standard that outlines the right way to care for this disease, reflecting solid evidence of strong health outcomes without surgery.
Performed at the right time for the right people, surgery can have a dramatic benefit, the commission clarified. However, a significant number of patients remain dissatisfied after joint replacement due to unmet expectations.3
The ‘poor cousin’
Since the release of the original standard in 2017, studies have reinforced that nonsurgical treatments are preferred for most people, the commission noted.
Knee arthroscopy — ‘keyhole’ surgery to examine the joint and remove damaged tissue — is now rarely recommended for osteoarthritis. The procedure is shown not to improve pain or function and saw a dramatic 47% decrease between 2015 and 2022 for people aged over 45 years.4
While often seen as the poor cousin of treatment options, physical activity and weight management are key. Despite popular misconceptions, exercising is safe and effective when tailored to a person’s needs.
The 2024 Osteoarthritis of the Knee Clinical Care Standard explains best practice care throughout a patient’s journey — in the community by GPs, physiotherapists, exercise
physiologists and dietitians, as well as rheumatologists, orthopaedic surgeons and other specialists.
A lever for change
Medical Advisor for the Commission and general practitioner, Dr Phoebe Holdenson Kimura, said the standard was a vital lever for change, to embed the latest research in dayto-day medical practice.
“Our understanding of osteoarthritis and the pathology of the knee joint and soft tissues has changed,” Kimura said.
“There must be a corresponding mindset change in how we both think and talk about osteoarthritis of the knee as a disease, to have a more holistic view of the person.”
The updated standard includes practical communication tips for clinicians on how to talk with patients.
“Let’s avoid language that catastrophises osteoarthritis, including phrases like ‘bone on bone’ and ‘wear and tear’, which suggest we will damage our joints by moving them — that’s simply not true,” Kimura said.
“Non-operative approaches such as physical activity, exercise and weight management are proven to make a big difference to quality of life for most people with knee osteoarthritis. This is great news for patients who can better manage their condition and may avoid or delay knee replacement surgery.”
Kimura said the standard empowered patients to take control and encouraged clinicians to support non-surgical treatments, rather than waiting for surgery or relying solely on pain relief medicines.
Rethink investigations and referrals
Over the past decade, treatment for knee osteoarthritis has changed, said Gold Coast orthopaedic surgeon Adjunct Professor Christopher Vertullo, who has performed knee surgeries for 20 years.
“There is an opportunity to shift the conversation to focus on active management and to reduce unhelpful beliefs — such as fear and avoidance of physical activity,” she said.
Osteoarthritis is more common in people aged over 45 years. With Australia’s ageing population, the number of people with knee osteoarthritis increased 126% between 1990 and 2019.5
Weight is also a contributing factor, as a person who is overweight has double the risk of developing knee osteoarthritis.
The Deputy Clinical Director of the Australian Orthopaedic Association National Joint Replacement Registry, and one of the experts involved in reviewing the Standard, said knee surgery should never be seen as a ‘quick fix’ for osteoarthritis.
According to Vertullo, the most important aspect of the revised clinical care standard is the focus on reducing unnecessary imaging, and ultimately, surgery that isn’t needed.
“For most middle-age and older patients with atraumatic onset — where knee pain has come on by itself, without injury — the pain is likely to settle down, and immediate
investigations with imaging is not usually required,” he said.
“Patients and healthcare practitioners need to rethink investigations and referrals for knee pain unless they are clinically appropriate.
“In my own practice, about a third of referred patients don’t need to see me, and about 60% of all my patients have had an inappropriate investigation or scan, without any initial management for osteoarthritis. I am having regular conversations about the need to maximise non-surgical management.
“In Australia we have seen a gradual fall in rates of knee arthroscopy. Yet at the same time, we’ve seen rising rates of investigations such as X-rays, MRIs, ultrasounds and CT scans, reduced rates of proper clinical assessment, and lower rates of appropriate management before a patient is referred for surgery.”
Vertullo said the beneficial effects of improved weight management and increased
“Patients and healthcare practitioners need to rethink investigations and referrals for knee pain unless they are clinically appropriate.”
physical activity meant many patients with knee osteoarthritis may never need to see a surgeon or have surgery.
“A patient should only be considered for joint replacement once they have maximised nonoperative management as much as possible, and reached a point where their pain is untenable or unmanageable.
“No one should enter surgery lightly. It is fantastic for end-stage osteoarthritis of the knee when someone has severe pain, but for an occasional ache, you are likely to be dissatisfied with the outcome,” he said.
1. Australian Institute of Health and Welfare. Chronic musculoskeletal conditions: Osteoarthritis. AIHW 2024.
2. Ackerman et al. BMC Musculoskeletal Disorders. (2019) The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030.
3. Hafkamp, F. J., Gosens, T., de Vries, J., & den Oudsten, B. L. (2020). Do dissatisfied patients have unrealistic expectations? A systematic review and best-evidence synthesis in knee and hip arthroplasty patients. EFORT open reviews, 5(4), 226–240. https://doi.org/10.1302/20585241.5.190015
4. Australian Commission on Safety and Quality Health Care analysis of Medicare Benefits Schedule (MBS) Claims data, 2023. Data extraction date 15 March 2023.
5. Ackerman IN, Buchbinder R, March L. Global Burden of Disease Study 2019: an opportunity to understand the growing prevalence and impact of hip, knee, hand and other osteoarthritis in Australia. Intern Med J. 2023 Oct;53(10):1875–82
Portable pathology tests:
are they accurate?
Onsite pathology tests for infectious diseases in rural and remote locations can be just as reliable and accurate as tests carried out in a hospital laboratory, according to a new report from Flinders University.
“Our study demonstrates that when point-of-care testing models are effectively established and managed, the quality of pathology results can be equivalent to laboratory tests, and the benefits for patients are overwhelmingly evident,” said Dr Susan Matthews from the International Centre for Point-of-Care Testing at Flinders University.
Matthews and team tested the quality of onsite pathology testing, or point-of-care-testing (POCT), for molecular-based, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in over 100 remote Aboriginal and Torres Strait Islander communities across Australia.
Support for hard-to-reach patients
“In Australia, POC testing supports hard-to-reach patients, including Indigenous communities in rural and remote areas, where long distances and social and cultural factors can prevent individuals from getting tested, meaning that infectious diseases can often be left untreated.
“The high prevalence among the Aboriginal and Torres Strait Islander population of infectious diseases like COVID-19 has consolidated demand for point-of-care diagnostic solutions particularly due to their cost-effectiveness, accessibility and ability to deliver immediate results,” she said.
The report assessed analytical quality in the Aboriginal and Torres Strait Islander COVID-19 Point-of-Care (POC) Testing Program in Australia, which was launched in April 2020 to improve access to rapid molecular-based SARS-CoV-2 detection in remote communities.
“The program reached 105 communities across Australia and was found to have contributed to averting a significant number of
COVID-19 infections, resulting in substantial cost savings to the healthcare system,” Matthews said.
Training and quality assessment
The analytical quality of the COVID-19 testing was supported by a robust operator training program and the implementation of a customised External Quality Assessment (EQA) program, the latter developed in partnership with the Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP).
“The EQA program allowed us to assess the accuracy and reliability of the COVID-19 test results and confirmed the technical competency of the trained remote health service POCT operators.
“Our findings highlight an ongoing need for well-designed, costeffective and externally accredited EQA programs, not just for SARSCoV-2 but also for other diseases that require POC testing.
“The COVID-19 program has now been expanded to include testing for Influenza A and B, and respiratory syncytial virus (RSV), as well as SARSCoV-2, and has the potential to stem acute and infectious diseases in rural and remote areas whilst saving the government billions of dollars in health costs,” she said.
POCT was first introduced to remote health centres in 1999 through the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) Program, which the Flinders University International Centre for Point-of-Care Testing continues to manage on behalf of the Australian Government.
The paper, by Susan J Matthews, Kelcie Miller, Kelly Andrewartha, Melisa Milic, Deane Byers, Peter Santosa, Alexa Kaufer, Kirsty Smith, Louise M Causer, Belinda Hengel, Ineka Gow, Tanya Applegate, William D Rawlinson, Rebecca Guy and Mark Shephard, has been published in Diagnostics.
Wiping away infections – the CLEEN way!
Cleaning shared medical equipment with a disinfectant wipe at least once a day saves lives by reducing infections in hospitals, according to groundbreaking new research.
Infection control has always been a critical focus in healthcare, but new world-first research highlights just how impactful even the simplest of measures can be. The CLEEN study, a landmark randomised controlled trial led by Professor Brett Mitchell from Avondale University in Australia, has shown that cleaning shared medical equipment at least once a day has a profound impact on patient outcomes.
The study, conducted in a hospital on the Central Coast, involved introducing an enhanced cleaning protocol using Clinell Universal and Sporicidal (PAA) wipes. This intervention included not just additional cleaning, in conjunction with routine cleaning, but also comprehensive education on effective techniques, as well as meticulous audits and feedback on cleanliness standards through the Evaluclean™ auditing system. Importantly, this wasn’t left to already overstretched healthcare workers. Instead, dedicated cleaners were brought in, who committed an extra three hours each day to disinfecting shared equipment, using Clinell Universal on items such as infusion pumps, blood pressure monitor, drip stands, and walking aids and Sporicidal (PAA) wipes on commodes and during outbreaks.
These products were specifically chosen for their effectiveness in reducing microbial loads on surfaces. To assess the effectiveness of these efforts, researchers employed the Evaluclean method: placing fluorescent marker gel dots on the surface of the equipment. These dots, invisible to the naked eye once dried, can only be detected under special light and resist removal by anything less than a thorough clean. Before the intervention, thorough cleaning was sporadic, with the hospital removing only about 25% of the fluorescent dots placed on equipment. However, following the implementation of the enhanced cleaning protocols—where cleaners spent an additional three hours daily on this task—this figure jumped to 65%. Most importantly, the study recorded a 34.5% reduction in all healthcare-associated infections (HAIs). This reduction was statistically significant, with the prevalence of HAIs dropping from 14.9% in the control phase to 9.8% during the intervention phase. Moreover, the thoroughness of cleaning improved substantially, with the percentage of cleaned equipment rising from 18.2% to 56.6% during the intervention. The intervention was also
effective in reducing specific infections, with bloodstream infections, urinary tract infections, pneumonias, and surgical site infections decreasing from 6.3% to 4.0%.
These findings are particularly significant given the broader context: previous research by Professor Mitchell and his colleagues estimated that 165,000 HAIs occur in Australian hospitals each year.1 The impact of these infections is not just financial but also deeply personal, with lives lost due to complications arising from these infections.
Randomised controlled trials in this area are rare, this is largely due to the complexities involved in controlling the numerous variables that can affect study outcomes, as well as the large number of participants needed to produce reliable data. Overcoming these challenges also requires significant investment.
Gould et al. have praised the CLEEN study as a significant success, highlighting its robust design and practical implementation. They noted that the trial was well-executed and emphasised the importance of its findings for infection prevention and control (IPC). However, they also pointed out some limitations, such as the study being conducted in a single hospital, which may limit the generalisability of the results. Despite these constraints, the study is seen as a crucial step forward in demonstrating that rigorous IPC research is both achievable and impactful
The implications of the CLEEN study are clear: hospitals should be investing more—not less—in cleaning. The CLEEN study demonstrates that with the right tools, training, and commitment, hospitals can make a significant impact on patient safety. This study serves as a powerful reminder that improvements in cleaning protocols lead to substantial health benefits.
Scan the QR code to learn more about the CLEEN study.
GAMA Healthcare Australia Pty Ltd., Suite 1, 33-37 Duerdin Street, Notting Hill, Victoria 3168, Australia +61 (03) 9769 6600 | info@gamahealthcare.com.au | www.gamahealthcare.com.au
1. Russo, P. L., Stewardson, A. J., Cheng, A. C., Bucknall, T., & Mitchell, B. G. (2019). The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrobial Resistance & Infection Control, 8 (1). https://pubmed.ncbi.nlm.nih.gov/31338161/ GHA240250
Losing our minds
phenomenon
Professor Matthew Kiernan AM*
There is a perfect storm brewing, largely unnoticed, in the 21st century: the convergence of two high-prevalence, high-impact and growing groups of brain conditions — mental illness and dementia.
While previously these conditions were studied in silos, recent medical research has uncovered a growing body of evidence revealing strong links between the two. It is still uncertain exactly what is cause and what is effect, but what is known is that we are losing our minds at an unprecedented rate and scale. And not just in Australia.
Neuroscience has taught us that above all else, it is the health of our brains that will determine our trajectory through life and particularly
as we age. Currently, one in five Australians suffers from a mental health disorder during their lifetime, ranging from depression and anxiety, through to psychotic illness such as schizophrenia or bipolar disorder.
According to the Australian Institute of Health and Welfare, for every 1000 Australians, one in 15 is affected by a form of cognitive impairment — Alzheimer’s disease and vascular dementia representing the most common causes.
The latest WHO statistics indicate that globally, more than 970 million people live with a mental health disorder and 55 million have dementia; 60% of the latter live in middle- to low-income countries.
The Western Pacific region, which comprises 37 countries including Australia, houses the largest and fastest-growing aging population in the world, which will account for more than 50% of global dementia cases by 2050.
Our growing understanding of the interconnectedness of mental health and dementia presents an opportunity to channel this perfect storm and explore novel approaches to prevention, risk reduction, early diagnosis, treatment and care to provide benefits not just to Australia, nor the Western Pacific, but more globally.
Families share conditions that affect the brain and the mind. For instance, conditions such as bipolar disease, schizophrenia and
autism are more common in the families of people diagnosed with dementia. In turn, that may suggest that psychiatric therapies such as lithium may be useful to treat dementia. And conversely, monoclonal antibody therapies for dementia which treat inflammation in the brain may yet be successfully introduced for psychosis.
On 17 September, Neuroscience Research Australia (NeuRA) and The Lancet Regional Health – Western Pacific launched a Dementia Series: global reviews of the best scientific and clinical evidence in order to provide a roadmap for the region.
For example, depression and hearing loss have now been added to the list of
modifiable risk factors for dementia. Other key risks previously identified include hypertension, obesity, tobacco use, alcohol intake and physical inactivity. The Lancet Commission asserts today that 45% of dementia cases (an increase on prior estimates) could be delayed or reduced if modifiable risk factors were addressed.
Meanwhile, the Productivity Commission calculated that the direct economic costs of mental illness range up to AU$70 billion a year in expenditure and reduced economic productivity. Separately, Dementia Australia estimated the total economic cost of dementia as AU$15 billion a year. If we worked to address both health issues in tandem, we may potentially solve an annual AU$85 billion problem. And these figures do not take into account the direct and indirect impacts of mental illness and dementia on the individuals affected and their carers.
As one of the few high-income countries in the Western Pacific, Australia is well placed to step up and adopt a leadership position to reduce the rate and scale of mind loss.
Australia’s National Dementia Plan can help guide similar initiatives across the Western Pacific, to collectively address the burden of depression and dementia in a fashion that is culturally appropriate and engages local communities. A key priority relates to prevention, and to education: as a region, we must develop education programs to target modifiable disease risk factors, with a specific focus on depression.
Allied to education is a need to accelerate diagnostic capacity, while further integrating models of care for both depression and dementia, tailored to the diverse cultural and ethnic groups in the region and expanding supportive services for carers. To achieve these goals, we must close existing research gaps by focusing on the diverse populations within our region. In the face of this need, we must address an imbalance whereby dementia research accounts for less than 3% of the total global health research output.
One of the most alarming findings of the forthcoming series to be published in The Lancet Regional Health – Western Pacific is that across the region, there are many lowto middle-income countries and cultures where brain impairment is simply accepted as a normal part of aging. And further, that families expect to bear the burden of care. In so doing, they inadvertently liberate governments, healthcare systems, industry and research enterprises from their responsibility to address the problem.
In a new take on the old African proverb “It takes a village to raise a child”, investment in multi-sectoral, collaborative consortia will be required — at both national and international levels — to reduce the cognitive impairments induced through dementia and mental illness. Science has opened the door for us; now we must support global approaches so that we
may collectively walk through it, together, but always listening to, and being guided by, the consumer voice: people with lived experience and their carers.
What can you do?
For those of us working in the health, mental health and aged care spaces, there are immediate steps we can take to help turn the tide on the growing prevalence of both mental illness and dementia. We can continue to improve our understandings for these conditions and their interconnectedness. We can listen to our patients and communities. We can support people to understand modifiable risk factors.
We can support them to test their hearing and blood pressure; and tackle their diabetes, harmful use of alcohol, smoking, obesity, physical inactivity, depression and social isolation. In fact, a 20% reduction in exposure to diabetes, hypertension, obesity, physical inactivity, depression, smoking and low educational attainment would result in a 15% reduction in Alzheimer’s disease by 2050.
New treatments for dementia are coming. It is anticipated that monoclonal antibody therapies directed against amyloid, currently under review by the Australian Therapeutic Goods Administration, will become available for Alzheimer’s disease in the coming 12 months.
Research into these growing brain diseases, new treatments and the connections between them is continuing. In the meantime, we need to ensure we’re taking a holistic and multidisciplinary approach to care, with clinicians, nurses, psychologists and allied health care working together to support people with mental illness and those with dementia.
*Professor Matthew Kiernan AM is NeuRA’s Chief Executive Officer and Institute Director. Kiernan is a distinguished clinical academic and scientist renowned for his expertise in neurodegenerative diseases, particularly motor neuron disease (MND) and frontotemporal dementia (FTD).
Prior to joining NeuRA, Kiernan served as Co-Director of the Brain and Mind Centre since its inception in 2015.
He earned his PhD at UNSW Sydney and completed his specialty training at Prince of Wales and Prince Henry Hospitals. In 2015, he was elected as a Fellow of the Australian Academy of Health and Medical Sciences and received the prestigious Order of Australia in 2019 for his remarkable contributions to medicine and medical education in the field of neurology.
In 2022, Kiernan became the recipient of the esteemed Sheila Essey Award from the American Academy of Neurology.
A Day in the Life of Cat Irvine
Bereavement Support Worker, Hospital to Home Program, Red Nose
07:00 My children and I normally wake up at 7 am. Like many parents, my mornings are all about the school rush — getting kids ready, drop-offs and wishing them a lovely day.
09:30 The first of my Zoom/phone support sessions starts at 9:30 am or 10 am if I’m meeting them faceto-face. When families are newly bereaved, leaving the house feels impossible, so I love that I’m able to meet them in their own space where they feel safe and comfortable. Sometimes my clients want to go for a walk together, have a coffee down by the beach, or meet me at their child’s grave.
My morning usually involves two support sessions before lunchtime; 30 minutes between sessions to write case notes and a five-minute reset for myself before my next session.
12:00 I do a second round of new referrals. I work two days a week, so I get in touch with new referrals as soon as possible — I know how important immediate support can be for families really struggling in their grief.
08:45 Make myself a much-needed coffee before my day starts.
09:00 New referrals for our Hospital to Home program is the first thing I check — if there are any, I send a text message to introduce myself and organise their first support session. Depending on the day and where my client sessions are located, I may work in the office or from home.
A Day in the Life is a regular column opening the door into the life of a person working in their field of health care. If you would like to share a day in your working life, please write to: hh@wfmedia.com.au
As a mother to two wonderful boys, and four babies she heartbreakingly never got to bring home (three miscarriages and one termination for medical reasons at 20 weeks’ gestation), Cat Irvine immediately resonated with her role as Bereavement Support Worker for Red Nose’s Hospital to Home Program.
Cat has lived in the UK, New Zealand and the USA, but she now calls Perth her home again. Previously a travel agent, the pandemic halted her career but it also proved to be a silver lining as she knew the role with Red Nose would fulfil her sense of purpose.
Propelling her passion to support other bereaved families in navigating the significant practical and emotional challenges they face in adjusting to life without their baby, Cat says, “After Isabel’s death, I felt so incredibly alone, even with the support of my family and friends. I remember thinking ‘nobody can even start to understand what this feels like as they haven’t gone through it’. I attended my first face-to-face support session with Red Nose just weeks after Isabel died. I wasn’t sure whether I’d like it, but I knew that these were my people, that I’d found my people who were going to help me survive this.”
Currently in her final year of Bachelor of Midwifery at Charles Darwin University, Cat loves connecting with her clients (bereaved families). She provides short-term immediate support for families following the devastating loss of a child through stillbirth, termination for medical reasons, neonatal death, SIDS and SUDI (sudden unexpected death of an infant).
12:30 I’m at a local hospital providing bereavement education to midwives as some hospitals experience numerous perinatal losses. I spend 20–25 min educating midwives on the services Red Nose has available, provide key points that help them in their practice, then open the floor for questions and information sharing. I also provide education for the midwifery students at all the local WA universities, once a semester, which goes more in-depth in bereavement support and how to care for themselves when supporting bereaved families.
14:00 Face-to-face session with one of my pregnancy after loss clients. We know that falling pregnant again doesn’t make the grief go away; pregnancy after loss can be incredibly complex, anxiety-provoking and difficult to navigate. We talk through her fears around labour and birth, ways to help protect herself and create a safe space to bring this next baby into the world. We also discuss what she needs from her birthing support team to support her mental health.
For clients who have engaged with Hospital to Home after a pregnancy loss, we offer four support sessions. It is so rewarding being able to support some of our families through their losses and see them through their happy ever afters with their subsequent babies — a true full circle moment.
16:30 Given the nature of the role, being well supported is important — I attend group supervision as well as individual supervision once a month. Every fortnight we have an Australia-wide Hospital to Home team meeting. As a team we are committed to ongoing training and development; I attend both internal and external training sessions on topics such as ADHD and autism in grief, domestic violence awareness training and self-awareness.
17:00 I have two very active sons, so if we’re not at a sports game or practice, we’re usually kicking a ball around or shooting hoops. Being in my final semester of my Midwifery degree, I don’t have a lot of ‘me’ time. Any free time I do have is dedicated to classwork and university assignments, although I do like to play netball once a week.
Red Nose’s Hospital to Home is a program operating throughout Australia, providing outreach support within three months of loss to bereaved parents. Visit www.redno.se/H2H to make a referral.
Images: Supplied.
Images: Supplied.
diabetes care Remodelling
Anew research initiative — the Australian Diabetes Clinical Trial Network (ADCTN) — aims to increase the number of clinical trials for diabetes.
Established by Diabetes Australia and the Australian Centre for Accelerating Diabetes Innovation (ACADI), the initiative will support diabetes researchers by providing expert review and feedback for clinical trial protocols and grant funding applications.
Diabetes Australia Group CEO Justine Cain said clinical trials are a cornerstone of medical research and innovation because of their realworld application.
“Clinical trials ensure that new treatments deliver real benefits to people, while also identifying any potential risks or side effects.
“Our new network will increase the number of diabetes clinical trials being funded and conducted in Australia. This will make a huge difference in the lives of people living with diabetes because it means new and innovative treatments and interventions can be tested and hopefully become available.”
ACADI director and head of Medicine at Melbourne University Professor Elif Ekinci said, “By advancing our understanding of how different treatments work and evaluating their impact, clinical trials play a crucial role in improving the care of people living with diabetes. Their results contribute to the development of more effective, safer healthcare options and help inform evidence-based practices in medicine.”
The REMODeL trial
Princess Alexandra Hospital’s REMODeL research team leader, endocrinologist Dr Anish Menon, is leading a clinical trial where advances in technology and online access to health practitioners are improving outcomes for patients with complex type 2 diabetes.
The Rethinking Models of Outpatient Diabetes Care Using eHealth (REMODeL) trial enables
patients to record and upload their blood glucose readings using a Bluetooth glucose meter and receive automated feedback based on parameters set on a clinician dashboard app. Clinicians review results in real time via a “smart alert” triaging feature that helps identify patients who need priority support. The REMODeL trial received funding from ACADI.
“Imagine a world where managing diabetes is made easier by checking your phone!” Menon said.
“That’s the future REMODeL is creating. This innovative nurse-led model of care using digital tools is empowering people with type 2 diabetes, letting them track their health stats and share that info with their nurses in real time. No more waiting for appointments or worrying about missed calls — it’s like having a diabetes expert in your pocket!”
Menon said the additional benefit is that clinicians get more time to focus on what matters most: providing complex (highvalue) care.
Since the REMODeL research began in 2016, participants have achieved an average 1% reduction in HbA1c (average glucose levels over two to three months), which translates into reductions of 21% in diabetes-related deaths, 14% myocardial infarctions (heart attacks), and 37% of microvascular complications (affecting kidneys, eyes, lower limbs etc). There are also
reduced in-person clinic visits rather than the traditional care model.
The research team has successfully demonstrated that these benefits can also be experienced by people from regional areas to improve quality of life and decrease diabetes distress. The current plan is to explore this model of care in disadvantaged and CALD populations.
A personalised approach
Director of Diabetes and Endocrinology at the Princess Alexandra Hospital Dr Lisa Hayes said REMODeL’s personalised approach supports better health outcomes with greater ease and precision, marking a significant step forward in diabetes care.
“We’re hoping that remote funding could be provided in the near future, which would mean that this will become routine care for people attending diabetes clinics,” Hayes said.
“Our findings show that through changes to the way we care for people with diabetes, we can improve their outcomes.
“REMODeL findings have the potential to change the health and life expectancy for Australians with diabetes wherever they live.
“If more people living with type 2 diabetes had access to continuous glucose monitoring devices, we could make this even more efficient and effective,” she said.
Designing for sustainability
The new Critical Services Building at the Canberra Hospital has officially opened with global construction company Multiplex completing the expansion project.
Located at 77 Yamba Drive in Garran, the eight-storey Critical Services Building provides a total of 45,000 square metres of purpose-built healthcare space and will see many acute care services located across the campus moving into the one building.
The new building includes: a new Emergency Department, with a dedicated children’s emergency area, expanded Fast Track and new Behavioural Assessment Unit; an expanded intensive care unit; perioperative services, including 22 operating theatres, which have been
equipped with a range of advanced technologies; extra treatment spaces, including an expanded coronary care unit and Cardiac Catheterisation Laboratories; and an additional inpatient accommodation.
The completion of the new hospital building also delivers Australia’s first allelectric hospital building. The building will be powered by the ACT’s 100% renewable electricity, reducing its emissions impact by approximately 1886 tonnes of CO2 every year.
ACT Minister for Health Rachel Stephen-Smith said, “The new Critical Services Building was thoughtfully co-designed with staff, consumers, carers and other stakeholders to create a modern health facility that is accessible and welcoming.
“Clinicians will have access to state-of-the-art equipment to support innovative models of care and deliver the best possible health care to their patients.”
With the new main entry and reception of Canberra Hospital open to the public, and sterilising services already operating in the building, the clinical services that will be moving include: emergency department; intensive care unit; operating theatres and day surgery admission; inpatient cardiology services and cardiac catheterisation labs; medical and surgical inpatient units; medical imaging; and helipad.
The new facility, designed by BVN and built by Multiplex, creates an environment of healing and connection, is open and modern, with outdoor terraces and courtyards serving as family and
visitor waiting areas, providing an elevated experience for all hospital users.
A key element of its design is its Welcome Hall, a public space connecting the new Critical Services Building with the existing campus and functioning as the hospital’s new main reception. This engaging hub is an inclusive space that was designed in collaboration with the community and honours First Nations peoples with artwork by local Indigenous artists, according to Multiplex.
It also features outdoor intensive care space including two sheltered terraces that have been designed and equipped to support medical equipment, allowing patients and families to use the outdoor area while visiting and receiving care.
Driven by sustainability, the Canberra Hospital Expansion building has a 5 Star Green Star design rating. Notable sustainability features of the industryleading design include 21 massive heat pumps that have replaced traditional gas boilers to heat the building’s water, solar shading and a high-performing facade glazing of thermally broken double-glazed units to minimise the cooling required in summer and heating required in winter, said Multiplex in a statement. There is also energy-efficient and intelligent heating, ventilation and cooling systems, a holistic building management and control system that monitors and controls all systems in the building and recycled water used for landscaping and irrigation.
“The new Critical Services Building was thoughtfully co-designed with staff, consumers, carers and other stakeholders to create a modern health facility that is accessible and welcoming.”
Multiplex also minimised carbon throughout the build by using electrified cranes, locally sourcing a low-carbon concrete mix for the structure and repurposing or salvaging 96% of the materials during the demolition of the previous buildings, the company said.
David Ghannoum, Multiplex Regional Managing Director for NSW and the ACT, said, “We are delighted to hand over this world-class health facility that will cater to the growing needs of the local community. It
truly embodies innovation and cutting-edge sustainability, drawing upon our expertise in the medical and healthcare sector.”
The constrained site posed a challenge to construction — surrounded by existing hospital infrastructure, residential roads and the private hospital and university buildings. Multiplex strategically managed the site, working hard to minimise impacts on the operation of the existing hospitals, the nearby Garran Primary School and local residents.
According to Multiplex, construction of the Canberra Hospital Expansion spanned a three-year period with 4000 people working on site and a combined total of 1.7 million hours of labour.
More than 40 people were employed through Multiplex’s Connectivity Centre, a hub to provide employment, training and job support services for local job seekers and connect them with employment opportunities onsite.
Some 52,000 cubic metres of material was excavated on the site, with 145 building piles and 20,000 cubic metres of reinforced concrete used in the new building — along with seven kilometres of plant room ductwork. Multiplex has delivered hospitals and healthcare facilities across Australia and is currently completing more than $5bn in health projects nationally. In NSW these include the John Hunter Health and Innovation Precinct in the Hunter Region and the Eurobodalla Regional Hospital on the NSW South Coast, and in Victoria, the new Footscray Hospital.
Aggression in the ED — are we doing enough?
Aggression and violence against frontline workers in hospital emergency departments (EDs) is on the rise, with current strategies to manage the issue found to be insufficient. This is according to new research from Edith Cowan University (ECU).
“Participants in our study in Perth were overwhelmingly telling us that the occurrence of violence is on the increase. It is not a matter of if, but when,” said PhD candidate Joshua Johnson from ECU’s Simulation and Immersive Digital Technology Group.
In-hospital assaults in Australia have increased by 60% in Victoria, 48% in Queensland and 44% in New South Wales from 2015 to 2018. This represents a continued and prevalent rise in aggressive behaviour against nursing staff, with a 2017 survey conducted with members of the College of Emergency Nursing Australasia stating 87% of nurses surveyed reported experiencing patient-related violence.
Changing styles, behaviours
A recent survey of Queensland’s health workers by the Australian Workers’ Union found that close to 70% of staff had either been assaulted or witnessed an assault in the workplace.
Participants reported “that the style of violence has become more aggressive in nature. Over the last 20 or so years, it has progressed from verbal or occasional physical abuse, where someone might be throwing a cup at a frontline worker, to the assaults we’re seeing now,” according to Johnson.
The study, which held focus groups with a number of medical doctors, nurses and health safety staff across five Perth EDs found that the factors that could be influencing the likelihood of aggression and violence could include drug and alcohol use, mental illness and psychiatric disorders.
Understaffing and overcrowding in the triage area of the EDs, which results in longer wait times and communication barriers, also contribute.
Johnson said that while there were a number of initiatives in place in hospital EDs which aim to reduce the impact of violence or improve staff’s ability to cope with the violence, these initiatives were perceived to be ineffective.
“Some of the training that staff receive at hospitals to manage aggression and violence is great. These training sessions span over a few days and include both lecture-based material and role-play or hands-on techniques.
Training or the lack thereof
“However, other participants in our study reported that they only received two hours of training once every year, and that this training is only lecture-based. This training could also happen during very busy work periods, meaning that staff are unable to step away from their duties, or it takes place on days when staff are not at work, meaning they
have to attend the training on their day off,” Johnson said.
“There appears to be quite a large variation in the quality of training that is being delivered at different hospitals, as well as the frequency of this training. There is a definite need for hospitals to focus on reducing those barriers to accessing effective training, and a standardised delivery of training should be investigated.”
The current incident reporting process for instances of aggression or violence is cumbersome, requiring staff to take time away from their duties and resulting in a backlog of work.
“A number of participants also felt that when they were going through the process of incident reporting, oftentimes the changes that were implemented weren’t very visible and were perceived to have no tangible effect to the participants,” Johnson said.
Stress and burnout
Study participants identified exposure to aggression and violence in the workplace often leaves frontline workers with increased levels of stress resulting in burnout, with clinicians often reporting a reduction in job performance, impacts on their own mental health and an ultimate choice to leave the profession.
“Previous research has shown that student nurses who are planning on moving into the field often reconsider their chosen field when exposed to these aggressive and violent incidents while on clinical placement.
“This demonstrates that exposure to these events greatly impacts staff and student mental health and could potentially lead to people leaving the field. This in turn puts greater stress on an already strained system, and further exacerbates the issue,” Johnson said.
The research appeared in Collegian.
Improving Patient Comfort, Care and Connection
Making thoughtful changes to create healthier work environments for hospital and healthcare professionals can help organizations address many of the challenges facing care today. Investing in positive work experience not only strengthens your people — it can foster better patient care. We cover the current drivers impacting well-being and retention with actionable ideas that can help renew and revitalize caregivers in the short and long term. Short-term fixes and understanding your current environment is a good starting point, but to make the largest impact on caregiver well-being and retention, plan for long-term initiatives:
Update Technology for New Workflows
A McKinsey study found that telehealth usage is currently 38 times higher than it was prepandemic. Experts believe telehealth usage will continue, solidifying this shift in how we provide and receive care. Organizations now can replace any temporary telehealth set-ups with long-term, professional-grade solutions that support flexible workflows and improved communication between patients and providers. Choose either a combination of mobile workstations with cameras that can move from room to room, or wall-mounted workstations that offer space saving and privacy. Investing in videoconferencing technology and equipment that can be mobile and ergonomic for the end users, provides the flexibility of using telecommunication solutions between patients, families and professional medical practitioners supporting positive caregiver and patient experience.
Invest in Ergonomic Solutions
Caring for hospital and healthcare professionals in the long-term goes beyond technology updates. It’s about recognizing the importance of ergonomics, neutral postures and the balance between movement and rest. In a recent survey, 95% of respondents said that better ergonomic equipment could improve their well-being at work. In today’s digital care environments, caregivers spend hours each shift completing documentation. It’s critical that this time spent on a computer is health-promoting and does not add mental and physical stress. The right ergonomic solutions are height-adjustable with easy monitor movement that provides a personalized charting experience. The option to sit or stand allows caregivers to choose the right position for them — whether it’s standing to quickly add vital numbers or sitting to complete a more comprehensive task. Checking payback calculator for ergonomic workspace investment: www.ergotron.com/en-au/tools/ payback-calculator.
Limit Overtime Requirements
To help mitigate the risk of burnout for hospital and healthcare professionals, carefully consider any overtime requirements in place — both voluntary and mandatory. Overtime is often an unfortunate reality of the continued staffing crisis, but it can have a negative impact on caregiver health, retention and performance. Longer shifts and fewer days off force nurses to sacrifice the time they need to rest physically and
recharge mentally. Without this muchneeded time, nurses may be more likely to burn out or contribute to small or large errors. Overtime can be a major income source for nurses, so establishing caps on weekly hours can help support balance and overall well-being.
Create Resimercial Spaces
There’s no better time to recommit to well-being of healthcare professionals than during a redesign or new build. The residential-commercial trend (“resimercial”) is already ushering in more home-like, warm designs in healthcare spaces to promote healing environments for patients. This can, in turn, benefit the caregivers who work in these areas daily. Private rooms, careful sound-proofing and natural light can lessen distractions and uplift the spirits of nurses, providers and other staff. Incorporating medical vendors into the design process to ensure their products will be a good fit in the space or thoughtfully considering the placement of supply closets and other resources can also go a long way in improving the daily workflows of staff.
Build Environments for Staff to Feel Their Best
There are many opportunities to make small changes that can have a meaningful impact on caregiver well-being and retention. By creating environments where caregivers feel physically and mentally at their best, they’ll be able to better care for themselves and their patients. Listen to a full discussion about strategies for improving caregiver well-being here:
Robin Burgess
Email: robin.burgess@ergotron.com
Mobile: +61 421 080 303
» For more information visit www.ergotron.com
Securing the backbone of health care
Kevin Kline, SolarWinds Database Technology Evangelist
Unified, reliable databases provide healthcare organisations with immediate access to comprehensive patient records, allowing for informed decision-making in critical situations.
These databases ensure that accurate and up-to-date information is available to healthcare professionals, supporting efficient and effective care delivery. Their role is crucial in maintaining the integrity, security and availability of sensitive medical data, safeguarding patient safety and the overall functioning of healthcare systems.
The databases that store and manage patient information are the backbone of healthcare institutions, helping ensure that patient data is accessible, accurate and protected. Here are the top three reasons why robust databases are indispensable to modern healthcare organisations:
Regulatory compliance
Healthcare organisations are subject to rigorous regulations designed to protect patient data. In Australia, the Privacy Act regulates the collection and management of personal information, including health data. It also provides individuals with the right to access their personal information. Additionally, the Office of the Australian Information Commissioner (OAIC) oversees the handling of health information within an individual’s My Health Record and the management of healthcare identifiers.
Compliance with regulations is not just a legal obligation but a critical component of protecting patient privacy. Secure databases play a pivotal role in compliance by safeguarding patient data against security breaches. One of the ways many healthcare organisations protect patient data is by implementing continuous monitoring tools designed to align with cybersecurity regulations. As part of a system’s larger database solution, these tools can detect and respond to potential threats in real time, providing an additional layer of protection for protected health information (PHI). A powerful and effective database solution should have
tools like this to help contribute to meeting various stringent regulations and to help promote the security of PHI.
Additionally, reliable and secure databases foster accountability and transparency within an organisation. By maintaining accurate and consistent records, healthcare organisations can not only demonstrate compliance with regulatory requirements but also build trust with patients. In the event of a data breach or other security incident, a reliable database can provide a clear audit trail, helping to identify the source of the problem and then address it.
Supporting disparate systems
Some hospital systems may encompass hundreds of facilities nationwide, making data management particularly challenging. This can lead to fragmented patient data, which can make it difficult to provide a unified view of a patient’s medical history. A reliable database system helps ensure that if a patient is admitted to one facility, their medical history is instantly accessible at any other facility within the network.
An effective database provides a unified view, offering a single source of visibility where all important data and information are consolidated. Thus, healthcare providers can access comprehensive patient records anytime, anywhere. This can help improve the quality of care, reduce the risk of medical errors, and enhance overall operational efficiency.
Additionally, a centralised, well-maintained database simplifies and accelerates the process of expansion, making it more efficient and less challenging. In an environment where a healthcare organisation’s system is less accessible, and data is spread across disparate functions and locations, any sort of effort to grow the business in a sustainable manner would be daunting. An integrated database system can facilitate powerful growth for any healthcare organisation, where systems are often disparate and complex. It is important to note that the state of an organisation’s database can have a major impact on the company’s financial outlook.
Uninterrupted access to patient records
Real-time access to patient data and electronic health records is critical in vital care hospitals. Therefore, ensuring high availability of databases is paramount.
One way organisations can guarantee high availability of their data is by ensuring that the database itself remains healthy and functions properly. Databases have historically been incredibly difficult to access in terms of those internal systems. Modern database observability solutions provide a resolution to this issue, as they allow users to be able to see what’s going on inside of the system, in case of any issues or bugs. With proper observability features, a modern database should be able to provide users with a comprehensive view of the health of the system to ensure consistent functioning.
Beyond relying on observability capabilities to maintain database performance, some large healthcare organisations ensure high availability by implementing failsafe mechanisms and protocols. Additionally, regular backup procedures and disaster recovery plans are essential to minimise downtime and data loss. Without a reliable backup and failover system, a database server failure could result in the loss of critical patient data. A robust database system ensures quick recovery and continuous access to patient information.
Database solutions
By investing in solid database solutions, healthcare organisations can protect patient privacy and improve operational efficiency. This is vital for the optimal functioning of these organisations, which are essential to the wellbeing of our society. In an industry where even minor errors or delays can have serious repercussions, the importance of secure and reliable databases in protecting patient data and enhancing healthcare operations cannot be overstated.
Opioid use after hospitalisation
— what does the data say?
Anew study details the scale of prescription opioid use after a hospital or emergency department (ED) visit, providing insights on how often people then go on to long-term and potentially problematic use of these medicines in NSW.
The study from UNSW’s National Drug & Alcohol Research Centre (NDARC) and the Medicines Intelligence Centre of Research Excellence found the proportion of hospital or ED visits where people started opioids — such as oxycodone, morphine or tramadol — and remained on them long-term was small and declined over the 2014–2020 period.
Long-term use
“Australia has looked on with concern at the widespread harm from prescription opioid painkillers in the US,” said pharmacist and epidemiologist Kendal Chidwick, lead author of the study which was published today in the British Journal of Clinical Pharmacology
“While these medicines are an important tool for reducing moderate to severe pain in the short-term, they have significant side effects.
“Our analysis suggests that efforts to reduce opioid use in Australia have been successful, in terms of post-hospital use.”
The researchers used confidentialised health data to follow all hospitalisations and ED visits in NSW between 2014 and 2020, focusing on people who had not used prescription opioids in the year before.
Long-term use was defined as 90 or more days continuous opioid use at some time during the period between 90 to 270 days after starting.
The study is the largest of its kind in Australia to date, the authors claim. As the state with the largest population, results for NSW are likely representative of Australia-wide trends.
Measures to reduce use paying off
Until recently, Australia’s use of prescription opioids was increasing, and with it worries about dependence, overdose and death.
“Previous research suggests that about half of all prescription opioids are started after a hospital or ED visit,” said co-author Dr Malcolm Gillies, who is a biostatistician from the Medicines Intelligence Research Program at UNSW. “That can go on to long-term use.”
Over the last few years, Australia has deployed a range of measures to reduce
opioid use and related harms. Measures have included smaller pack sizes, restricting repeat dispensings and changing low-dose codeine to prescription-only, alongside realtime prescription monitoring and increasing implementation of opioid stewardship programs in hospitals.
“It appears that the tide has changed in Australia, with reductions in opioid use after hospital admissions,” Gillies said.
“Our study revealed that both starting an opioid after a hospital or ED visit, and remaining on it long-term, declined over time, which is good news.”
From 2014 to 2020, overall opioid initiations decreased by 16%, from 8.7% to 7.2% of hospital/ED admissions, and long-term opioid use decreased by 33%, from 1.3% to 0.8%.
“Ensuring that each patient has their pain effectively managed while minimising harms is key when it comes to opioid prescribing,” Gillies said.
“Looking at the bigger picture, bestpractice care of chronic pain will mean increasing access to coordinated multidisciplinary pain services.”
“Continued opioid stewardship is critical to ensuring the balance of benefits and harms.”
Patient demographic and admission characteristics
The study also found that one in four people admitted for trauma, such as a physical injury or road accident, started an opioid and 2.3% of them went on to long-term use. Traumatic injuries can result in chronic pain in some patients, which might lead to longterm opioid use. This rate of long-term use is somewhat lower than reported in previous Australian research.
One in 15 people attending ED started an opioid and 1.0% of them went on to long-term use. This is lower than estimates from the US.
“It’s reassuring to have evidence, at the population level, that Australia’s rates of long-term prescription opioid use following hospital and ED visits are low compared to some other countries,” Chidwick said.
“Our results highlight variation by patient demographic and admission characteristics.
“Continued opioid stewardship is critical to ensuring the balance of benefits and harms.”
Long-term use of opioids was low after Caesarean sections and planned surgeries such as hip replacements or tonsillectomies, despite high rates of starting an opioid among these groups, mostly for managing post-operative pain.
One in five obstetric admissions involving surgery and one in 10 planned surgical admissions resulted in an opioid dispensing; however, less than 1.0% of these progressed to long-term use.
The importance of linking data
In 2022, Australia released its first national clinical care standard on Analgesic Stewardship in Acute Pain. Before this, individual stewardship programs varied across hospitals.
“Insights from such large studies like ours will inform stewardship programs and promote quality prescribing practices,” said co-author Professor Sallie Pearson, pharmacoepidemiologist at the School of Population Health at UNSW.
“Linking health data across systems enables large sample sizes over long time frames and reveals the ‘real world’ use of medicines in Australia,” Pearson said.
Why more needs to be
done to support
home-grown innovations
It’s a brave person that gets involved in the medical technology, biotechnology and pharmaceutical sector.
Commercialising new medical devices or drugs is highly risky, extremely expensive and returns can take decades to be realised.
Getting a new medicine from the research lab to the patient can take 15 years or more and well over $1 billion. The Australian-invented Gardasil cervical cancer vaccine for example was a 17-year overnight sensation that earned US$8.9 billion in global sales last year.
Intellectual property protection, strict regulatory safety requirements which vary from country to country and opaque reimbursement frameworks complicate matters even further.
Global connections are also critical for medical science SME success, with access to new markets and global supply chains central to positioning them to compete internationally, while maintaining their operations in Australia.
And that’s not to mention the early-stage valleys of death, territory (mostly) vacated by risk-averse investors which can be impossibly challenging to bridge, even for the most committed and resilient innovator with the best new idea.
With the medical product translation and commercialisation journey so challenging, it’s easy to get into trouble.
Perhaps that’s why Australia has traditionally underperformed when it comes to commercialisation of new products. While we are recognised as a global leader in research, ranking in the top 10 of the Global Innovation Index, we slip down to 30th for outputs from that research.
While we count Gardasil, cochlear implants and the pacemaker among our commercialisation successes, we can do better.
Strategies for backing life sciences innovation and supporting startups and SMEs through the difficult early years of innovation are critical and this is where government has a major role to play, and where Australia has historically underperformed.
Australia’s investment in R&D is around 1.8% of GDP at the moment, well below the OECD average of 3%. As Industry and Science Minister, Ed Husic MP, recently highlighted, “we’re going to have to do better.”
It is worth noting that we have done better in the past, sitting at 2.24% of GDP back in 2008, so we know it can be done again.
When the funding starts flowing, the $15 billion National Reconstruction Fund, with $1.5
billion earmarked for medical science, and the $400 million Industry Growth Program are set to turbo-charge levels of investment in startups and SMEs and support their scale-up. The $20 billion Medical Research Future Fund endowment is already playing a role, including through accelerator programs operated by MTPConnect.
Access to funding remains the biggest challenge for startups and innovators. The capital markets, especially when you’re at an early stage with your innovation, are particularly tough.
But there are other powerful options for boosting spending on R&D more in line with competitor countries that should be discussed, like investment mandates for superannuation funds.
With their requirement to generate good returns for members, super funds generally steer away from inherently risky life science investments. But it is happening — the health care super fund HESTA invested in Inventia Life Science in 2022.
It’s through superannuation, with its $3.5 trillion in total assets under management that the millions of mum and dad investors who power the super system can potentially have transformational impact on the scaling-up of startups and SMEs.
Stuart Dignam*
But it’s not all about the money. There are other considerations.
An often overlooked and underappreciated ingredient for commercialisation success is the link between the product and the end user — the patient.
It is critical that new innovations meet community and consumer-identified unmet health needs to ensure that there will be uptake of the end product, and that tangible health and wellbeing impacts are realised.
To ensure that innovators are developing products and solutions that meet community needs, community voice and perspective needs to be embedded in the research and development from the start.
Co-designing the innovation will result in true innovation pull, and not technology push. And it is these patient-centric innovations that will be of most interest to investors and have the strongest likelihood of making it to the market.
A shout-out too to Australia’s clinical entrepreneurs; the nurses, doctors and allied health professionals working at the coalface of health care who are uniquely placed to both understand unmet need and identify commercial opportunity. Unfortunately, there is a significant skills gap for clinicians working on
product development and commercialisation and we risk missing out on their potential to contribute to the sector’s growth.
Initiatives like MTPConnect’s Australian Clinical Entrepreneur Program, running in Victoria and NSW, play an important role in equipping healthcare professionals with the skills they need to translate and commercialise their ideas into products and solutions that will be used by patients and healthcare providers. These initiatives also help with retention of talented clinical staff who might otherwise leave the health system to pursue their entrepreneurial ambitions.
So, while getting involved in inventing and commercialising new medical technology, biotechnology and pharmaceutical products may be crazy brave, it can also deliver the greatest of rewards — saving lives and improving health and wellbeing. It’s the motivation behind so many of Australia’s passionate life science innovators.
And by supporting founders and backing Australian start-ups and SMEs we’re maximising chances for increased commercialisation success, creating more jobs, building resilient companies, increasing sovereign capability and more secure supply chains for vital medicines, and all the while moving Australia up the global innovation league table.
*Stuart Dignam is the chief executive officer of MTPConnect, an independent, not-forprofit organisation working to accelerate the growth of Australia’s life sciences sector. With corporate executive experience across operations, finance, policy in the public and private sectors, media, communications and issues management, he was posted to Los Angeles as the Queensland Deputy Trade & Investment Commissioner for the Americas.
Dignam has worked as a broadcaster for ABC Radio and as a government media and policy advisor, and created MTPConnect’s popular podcast series, one of the first in Australia to showcase the people and issues shaping the medical technology, biotechnology and pharmaceuticals sector in Australia and globally.
EMR simulation system to train future nurses
Charles Sturt University has developed an electronic medical record simulation system, HealthiERSim, to help nursing students develop skills in real-life clinical documentation processes.
The system is designed to enhance students’ health digital literacy by providing a risk-free virtual environment to practise use of digital tools and electronic documentation processes.
Associate Professor of Nursing and Simulation Lead in the Charles Sturt School of Nursing, Paramedicine and Healthcare Sciences Pauletta Irwin said realistic patient scenarios and simulated digital workflows provide essential skills to confidently navigate and use digital health technologies beyond graduation.
“This technology prepares all our students for effective collaboration and patient-centred care in their future nursing roles,” Irwin said.
“HealthiERSim also offers rapid feedback, with built-in comprehensive assessment and feedback tools providing students with detailed insights into individual and team performance, facilitating targeted guidance and enhancing students’ readiness for professional practice.”
Simulation co-developer and technical officer in the Faculty of Science and Health Amy Barnett said, “Internationally, this technology is rapidly advancing but we have what is considered best on market in Australia and competitors are nipping at our heels to catch up.”
In the most recent teaching session, approximately 3000 students were able to put the HealthiERSim system to the test.
Second-year Bachelor of Nursing student in Port Macquarie Eloise Miller is one of those students and said she found the technology increased her confidence in her ability to document patient information electronically.
“HealthiERSim is a really useful way to practise documenting as a nurse as it is a great reflection of actual Electronic Medical Records (EMR) with tabs that allow us to document observations, progress notes and the like,” Miller said.
“It is so useful to move away from paper charts in our pracs to documenting online, as this is more of what we will be encouraged to use in the real world when we graduate.
“As a second-year student, it is a great relief to be able to practise this skill now.”
Irwin reiterated that HealthiERSim allows students to learn using realistic patient cases, spanning diverse healthcare contexts.
“The aim of this is to really prepare our students for the workforce by giving them exposure to scenarios they may, and likely will, encounter in their future nursing roles while developing critical thinking and clinical reasoning skills,” she said.
The technology is being used at Charles Sturt’s Port Macquarie, Wagga Wagga, AlburyWodonga, Bathurst and Dubbo campuses.
Mariam Barengayabo and Eloise Miller with the HealthiERSim technology in Port Macquarie.
VISIT THE 2024 ACIPC INTERNATIONAL CONFERENCE EXHIBITION HALL
Engage with Australasia’s largest gathering of infection prevention and control suppliers.
Passes are available to anyone interested in exploring and procuring IPC-related products and services.
VISITOR OPEN TIMES:
• 13:30 – 17:00, Mon 18 November
• 13:30 – 17:00, Tues 19 November
• 08:30 – 12:30, Wed 20 November
VENUE:
The Melbourne Room, Level 2, Melbourne Convention and Exhibition Centre
REGISTER:
Visitor passes are free; however, registration is required to enter the exhibition hall. Scan the QR code to visit the website and register.
EXHIBITOR PROFILE
• Health and medical suppliers
• Medical equipment suppliers
• Personal Protective Equipment suppliers
• Cleaning equipment suppliers
• Sanitization, sterilization and disinfecting specialists
• Pharmaceutical suppliers
• Hand hygiene suppliers
• Environmental hygiene specialists
• Disinfectant and decontamination specialists
• Instrument cleaning specialists
Concept to commercialisation
Top challenges and opportunities
David Burt, Director of Entrepreneurship, UNSW Founders
ustralia is globally recognised for its exceptional medical research output. Success stories like ResMed, a global leader in sleep technology, demonstrate Australia’s ability to translate scientific discoveries into improved
Australia’s Medical Science Co-Investment Plan notes, “Australia’s health and medical research is an outperforming sector … Australia is ranked 5th in the World Index of
However, despite our nation’s strong research activities and outputs, we have too many failures in the journey from research to product. Australia has some of the best medical research in the world, so why isn’t it making its way into clinical care?
Five critical challenges
Translating medical research in Australia from the lab bench to patients’ bedsides is challenging for several reasons.
The first one, and one that I am sure many of you are familiar with, is that of regulatory barriers. The Therapeutic Goods Administration (TGA) approval process is essential for ensuring patient safety but is a significant financial and time cost for a healthtech startup. This was exacerbated
by the TGA’s lack of funding and stagnant approval process.
Australia is a comparatively small market, so there is a larger incentive to focus regulatory efforts in the United States or European markets. The Medical Research Commercialisation Landscape Report highlights that these regulatory hurdles are a major reason Australia lags in commercialising our medical research.
The second is global market dynamics. Medical intellectual property (IP) is highly portable and much of Australia’s medical IP is exported for commercialisation in more competitive economies that have the full value chain of companies needed in a medical science ecosystem. Australia’s medical science priority areas output remains exceedingly low, at only 0.3% of the nation’s GDP.
The third is that of funding accessibility. Government programs, such as the $450 million Medical Research Commercialisation Initiative funded by the $22 billion Medical Research Future Fund, provide valuable contributions, but the Australian Medical Device
Venture Investment Summary Report notes that in 2023, Australia invested less than $350 million in the medical device sector. The report estimates that on average, Australia would require at least $660 million to sustain and graduate 10 innovative healthtech companies a year.
Turning obstacles into opportunities
There’s no sugarcoating that launching a healthtech startup in Australia is hard. However, despite the challenges, there are many opportunities that can help startups in this sector go on to become a global success.
Very importantly, healthtech founders should always focus on major unmet health needs, like women’s health, for example, which has only a fraction of the venture capital allocated to other sectors. To address this, UNSW Founders, in collaboration with The George Institute for Global Health and Virtus Health, has launched a Women’s Health Accelerator. The program supports innovation in women’s health, growing more companies like 23Strands, which are revolutionising reproductive health through genomics.
Forging teams is also really important. CardioBionic, which develops innovative heart assistive technologies, combines deep clinical and mechanical engineering expertise and a track record of bringing similar technology to market. With successful preclinical results, Cardiobionic is preparing for its first human implantation. As Parisa Glass, Director of Operations at UNSW’s Clinical Research Unit, explains, “Connecting health innovators with healthcare providers and consumers early on is a game changer. When they team up from the get-go, innovators can really zoom in on the actual needs and challenges that providers and patients face.”
One should also seek tailored support for health innovators. The synergy between universities and industry, such as UNSW’s Health 10x Accelerator, provides supported platforms for healthtech commercialisation.
Tailored support for health innovators
As Dina Titkova, Senior Manager, says, “We have provided tailored health commercialisation education and support to over 150 teams, which includes access to our 500+ mentor network, and because of this support, the five-year survival rate of our healthtech startups is above 80%.”
Health 10x has backed startups like Preview Health, which is developing the world’s first commercial diagnostic test for Parkinson’s disease. By leveraging AI, the test can detect Parkinson’s up to 15 years earlier than current methods.
Leveraging strategic partnerships with international research institutions, global investors and industry is essential for scaling healthtech innovations. Nuroflux is a healthtech startup developing a non-invasive continuous stroke monitoring device. By partnering with The George Institute for Global Health, Nuroflux was able to costefficiently accelerate its path to clinical trials, a critical step in bringing its product to market.
Finally, no startup will make it past the research stage if it can’t be adequately funded. Over $1 million in federal government funding enabled the national expansion of the Health 10x program. This was further bolstered by a generous $1 million donation from Maha Sinnathamby AM, one of Australia’s most iconic entrepreneurs, recognised as one of Queensland’s 50 greatest thinkers of all time by NewsCorp in 2014. This early-stage support now needs to be followed by continued funding for healthtech startups to scale, manufacture and conduct clinical trials onshore.
Australia has proven it can turn its world-class research into life-saving medical products. Australia has the talent and research output to lead in healthtech commercialisation. With the right support systems in place, Australia’s healthtech sector will thrive, creating economic prosperity for Australia and bringing transformative solutions to global health challenges.
Evidence-based strategies to tackle burnout
Dr Jo Braid, Rehabilitation Physician and Certified Coach
The pandemic is behind us, yet clinician burnout persists. Recent surveys in Australia show clinician rates of burnout around 60% with higher rates in the specialities of ED and psychiatry, and more likely in women and younger clinicians.
This occupational phenomenon is talked about more widely than before; however, it continues to challenge individuals, teams and organisations to come up with strategies to address burnout that are effective.
The impact of burnout in health care includes higher rates of attrition and diminished productivity with effects on the organisation’s bottom line.
In health care, burnout doubles the risk of doctors making a medical error, and makes doctors more likely to make poor decisions regarding patient care as well as showing disinterest towards patients. This reflects the cumulative state of burnout with the three main features of emotional exhaustion, cynicism and depersonalisation.
When doctors notice they are not able to reach their high expectations of themselves, and struggle to focus, prioritise and complete tasks, there is a sense of disappointment and despondency.
There are shifts in their relationships not only with themselves, but also with their spouses and families, colleagues and peers.
Individuals in burnout often withdraw from contributing in team meetings, isolate
themselves and reduce the leadership they once had.
Burnout has impacts on our cognitive abilities with changes in short-term memory, focus and attention. Research shows people have challenges with verbal skills and impulse control when in burnout. Persistently raised cortisol levels in burnout disrupt neurotransmitters, shrink the hippocampus and reduce neuroplasticity.
It can be helpful for individuals, team leaders and management to be aware of the spectrum of burnout so early intervention measures can occur.
Below are the signs and symptoms of burnout, the contributors to this occupational phenomenon and evidence-based strategies for burnout prevention and recovery.
With awareness of the range of symptoms one can notice if they are drifting into burnout, and the contributing factors that increase the risk of burnout, let’s address what we can do about it. As with any approach to a problem, it is recommended to start with one solution and assess how things shift.
Below are four foundational elements of self-care that can start from home or in the workplace and reduce the burnout burden in a short amount of time.
Signs and symptoms of burnout include:
Evidence-based strategies to address burnout
Sleep
Studies in medical workers who slept less than 7 hours during workdays and days off had a higher risk of experiencing burnout.1
• Like we set an alarm to wake, set an alarm to go to bed and aim for more than 7 hours per night.
• Keep a regular sleep routine.
• Avoid alcohol and substances to cope.
Movement
• Any form of movement can act as stress relief.
• Reducing the level of cortisol and adrenaline in our bodies through movement is beneficial every day.
• Movement also increases our endorphins — our natural painkillers and mood elevators.
• The behavioural shift in regular exercise has emotional impacts in growing selfconfidence and energy levels.
Mindset
• Defining what activities are meaningful to you are has been shown to reduce
the risk of burnout in healthcare professionals. Individuals who have less than 20% of activities which they determine as meaningful, are 50% more likely to have burnout.2
• Growing awareness of how we perceive the world around us can help with developing mindset shifts inside and out of the workplace.
• Having a gratitude practice helps counteract our inbuilt negativity bias.
• Develop your own boundaries so you have time to move, rest and say no to additional tasks.
Support
• Building positive relationships is an antidote to life’s challenges.
• Finding a colleague, mentor, psychologist or coach can be a solution to reduce the risk or address clinician burnout.3
• Grow the culture in the workplace to be one of recognition of the contribution of the team individually and collectively.
Burnout will continue to be a workplace risk factor in health care for the foreseeable future and using strategies for individuals, teams and organisations that work is essential to minimise fallout from this occupational phenomenon. Participation in wellbeing strategies from executive and leadership levels influences the culture on the ground in health care, and is a great place to start implementation. Burnout affects workers at all levels and with the right approach, recovery is 100% possible.
For more evidence-based solutions for burnout prevention and recovery, visit The Burnout Recovery podcast by Dr Jo Braid.
1. Lin YL, Chen CH, Chu WM, Hu SY, Liou YS, Yang YC, et al.. Modifiable risk factors related to burnout levels in the medical workplace in Taiwan: crosssectional study. B Med J Open. (2019) 9:32779. 10.1136/ bmjopen-2019-032779 [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]
2. Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, Rummans TA, Dyrbye LN. Career fit and burnout among academic faculty. Arch Intern Med. 2009 May 25;169(10):990-5. doi: 10.1001/ archinternmed.2009.70. PMID: 19468093.
3. Fainstad T, Mann A, Suresh K, et al. Effect of a Novel Online Group-Coaching Program to Reduce Burnout in Female Resident Physicians: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(5):e2210752. doi:10.1001/ jamanetworkopen.2022.10752
In Conversation
with Anna McFagden, CEO, St Vincent’s Health Network Sydney
Amy Sarcevic
Anna McFagden, Chief Executive of St Vincent’s Health Network Sydney, was in her early twenties when she knew she was destined for healthcare leadership.
Having studied a degree in economics, newly graduated McFagden had been toying with the idea of a bank internship.
But when she saw an advert for a graduate program in healthcare management, she had a light bulb moment.
“I felt called to pursue it. It just made sense,” she said.
Years later, McFagden is flourishing in the sector’s highest ranking position.
Overseeing 4800 employees at one of Sydney’s best-known hospitals, the high-profile CEO is leading the health network into a new era, and adding weight to its reputation as a national innovation leader.
“Innovation is in our DNA at St Vincent’s Sydney. We have delivered the nation’s first heart transplant, the first Intensive Care Unit, the first Homeless Health Unit and the first long-COVID clinic. It’s exciting to be part of the next generation of innovation and clinical breakthroughs.”
Tackling wicked problems
Leading this charge in an ever-challenging healthcare climate — beset with “wicked problems” — is a credit to McFagden’s leadership.
“Like the rest of the sector, we are dealing with an aging population and patients with increasingly complex comorbidities, so we need to continually innovate — and in a really creative way,” she said.
With this in mind, St Vincent’s Health Australia recently overhauled its strategy, with a major focus on connecting care.
“The current healthcare system is still fairly disjointed and, while we’ve made some inroads over the last few decades, we still have a way to go.
“For example, we need to sync up hospital-based care with agedand home-based care; as well as primary with tertiary. This will really help us improve a patient’s journey across the system,” she said.
In a testament to her character, McFagden’s strategy is also focused on community impact.
“We have a duty, if you will, to the public, to our community, and to our funders, to be strong stewards, financially.
“Also, from a governance perspective, to make sure we are doing the best we can for our communities with scarce resources, and really driving efficiencies through innovation.”
To this end, McFagden is rolling out popular care models, like virtual health, to keep abreast with patient needs.
“People want to be treated in their homes. It’s convenient, much more pleasant, and often safer, depending on your clinical condition.
“That’s why we are partnering with our St Vincent’s Virtual and Home Healthcare Division and looking at what services we can provide — either in the home or closer to it — through remote monitoring, and other digital strategies.”
In a similar vein, McFagden is committed to improving the interface between public hospitals and aged care.
“Because most older Australians have multiple medical comorbidities, they often end up in hospitals, when they actually need to be in residential aged care settings.
“This isn’t great in terms of patient experience. So we’re working with our aged care division and exploring different models — for example, geriatric flying squads, where doctors are sent out to aged care facilities.”
A positive outlook
Despite the challenges she is dealing with, McFagden is optimistic about the future of St Vincent’s, and says its broad portfolio is more of a “strategic advantage” than a challenge.
“Because we’re across public and private hospitals, aged care, home and virtual health, we’re sort of like a microcosm of the overall healthcare system. This gives us a unique perspective.
“It helps us see all the challenges and opportunities, how they intersect across subsectors, and how we can work together as a system to achieve healthcare excellence,” she said.
McFagden also draws confidence from her earlier experience with the Victorian Department of Health, where she helped design ‘diversion and substitution models’, like virtual emergency wards.
“Because we’re across public and private hospitals, aged care, home and virtual health, we’re sort of like a microcosm of the overall healthcare system. This gives us a unique perspective.”
“This taught me that, if the conditions are right, and if all parties are willing to take some risk, you can get innovation done very quickly.”
This experience also helped inspire a ‘fail fast’ philosophy at St Vincent’s, where it is accepted that not all innovations will become long-term fixtures.
“We have a culture at St Vincent’s where we really encourage innovation and calculated risk-taking, in a supportive and controlled environment.
“It is really beneficial for us, and I believe it’s necessary in the current environment, where we — like everyone else — are dealing with workforce and funding constraints. We need to be creative in terms of how we use our workforce.”
The approach might also be an echo from McFagden’s past, where, as a fresh graduate decades ago, she took a chance on health leadership.
“I took a risk and it gave me the most rewarding career — one I continue to enjoy rain or shine.”
IPC: Succession, sustainability and advancement
The Australasian College for Infection Prevention and Control (ACIPC) International Conference 2024 is set to be held at the Melbourne Convention and Exhibition Centre, Victoria from 17–20 November 2024.
The conference, themed ‘Succession, sustainability and the advancement of infection prevention and control’, aims to address emerging challenges, promote innovative approaches, and create a collaborative environment where diverse perspectives are valued.
ACIPC, the peak body for infection prevention and control professionals (ICPs) in the region, advocates for ICPs and IPC by focusing on leadership, education and evidence-based practice for a healthy community.
The conference will feature national and international speakers and will help attendees network with like-minded professionals and meet with IPC industry suppliers.
Confirmed speakers include:
• Michael Borg, Head, Department of Infection Prevention and Control, Mater Dei Hospital, Malta
• Glenn Browning, Director, Asia-Pacific Centre for Animal Health
• Frances Geraghty-Dusan, Senior One Health Advisor, Indo-Pacific Centre for Health Security
• Heather Gilmartin, Health Senior Researcher, Implementation Scientist, Denver/Seattle Centre of Innovation, Rocky Mountain Regional Veterinary Health Administration Medical Centre
• Bronwyn King AO, Public health champion; Founder, Director, and CEO, Tobacco Free portfolios
• Lisa Hall, Director, Teaching and Learning & Professor, School of Public Health, Queensland University
Aged care workshop
ACIPC is also holding an Aged Care PreConference Workshop on Sunday, 17 November from 10 am to 5 pm, offering hands-on learning, engagement, collaboration and feedback opportunities, rather than a ‘presentation only’ event.
The workshop will be opened by ACIPC President A/Prof Stéphane Bouchoucha, followed by a brief overview of the ACIPC Aged Care Strategy.
The day will include three different workshop sessions, targeting topics that are at the
What: ACIPC International Conference
Where: Melbourne Convention and Exhibition Centre, Vic and Online
When: 17–20 November 2024
forefront of IPC change in aged care: navigating surveillance in aged care; AMS implementation in aged care; and animals in health care.
The workshop is aimed at those involved in, responsible for, or interested in aged care IPC. All graduates of the ACIPC Foundations of IPC course receive ACIPC educational membership, and will again receive free registration to the workshop (online). Delegates attending in-person and online must register.
For more information on speakers and presentation topics, and registration, visit: https://acipcconference.com.au/.
