The Aged Care Onsite Pharmacist (ACOP) program in Australia: a qualitative study to examine key considerations for successful implementation in residential aged care homes.

Introduction: The Aged Care Onsite Pharmacist (ACOP) program was recently launched in Australia to enable pharmacists to deliver clinical governance, clinical pharmacy and education services on the ground in residential aged care homes (RACHs). As the program is now being scaled up nationally, it is crucial to understand the complex interactions between various factors at the individual and organisational levels to ensure the program is successfully implemented and achieves its ultimate goal of improving the quality use of medicines in RACHs.

Aim: This qualitative study aimed to explore stakeholders' perspectives on medication management, perceived value of onsite pharmacists, and key considerations for successful program implementation in RACHs.

Quality indicators for safe and effective use of medications in long-term care settings: A systematic review.

People accessing aged care services are increasingly older and often experience multimorbidity and polypharmacy, which puts them at risk of medication-related harm. Quality indicators (QIs) can assist with monitoring, benchmarking and informing initiatives to reduce medication-related harm. This systematic review aimed to identify and summarize QIs that assess the safe and effective use of medications in long-term care services.

Factors affecting the provision of guideline-recommended pain care in rural Australia: A consolidated program theory from a realist needs assessment.

Little research has investigated what factors affect rural healthcare providers' provision of guideline-recommended pain care. The authorship team developed a realist approach to conducting a needs assessment to investigate such factors. A realist program theory was refined and consolidated through realist-informed interviews and in-person and online focus groups with rural Australian healthcare providers who support patients affected by chronic pain.

Perceptions and Experiences of Consumer Representatives on Patient Safety Investigation Teams: A Qualitative Analysis.

Introduction: There is growing recognition of the importance of consumer representatives (CRs), consumers with lived experience, and advisors and volunteers in health systems to foster consumer-oriented care. As part of this changing perception, some health services are inviting CRs to be on patient safety investigation teams. However, little is known from empirical studies about these representatives' experiences and perceptions of their roles.

Systems analysis of clinical incidents: development of a new edition of the London Protocol.

The investigation of incidents and accidents, together with subsequent reflection and action, is an essential component of safety management in every safety-critical industry, including healthcare. A number of formal methods of incident analysis were developed in the early days of risk management and patient safety, including the London Protocol which was published in 2004. In this paper, we describe the development of a new edition of the London Protocol.

How Is Chronic Pain Managed in Rural Australia? A Qualitative Study Exploring Rural Healthcare Professional and Consumer Experiences.

Introduction: Guideline-based care for chronic pain is variably provided. Existing data on chronic pain management in Australia come primarily from metropolitan samples. As the initial investigations for a wider needs assessment, we sought to understand how chronic pain is managed in rural Australia, focused on investigating the gap between guideline-recommended care and provided care.

Increasing access to pain care services to improve rural pain management: a realist review investigating factors affecting uptake, implementation, and sustainability.

Guideline-based care for chronic pain is challenging to deliver in rural settings. Evaluations of programs that increase access to pain care services in rural areas report variable outcomes. We conducted a realist review to gain a deep understanding of how and why such programs may, or may not, work.

Building a culture of safety in Australian residential aged care facilities: protocol for a longitudinal mixed methods research programme.

Introduction: The quality and safety of care within residential aged care facilities (RACFs) have been linked to their organisational culture. However, evidence for understanding and improving culture in this setting is limited. This research programme aims to validate a survey to measure organisational culture and determine the relationship of culture with safety and quality of care, then to evaluate an organisational culture change programme in Australian RACFs.

Improving health system responses when patients are harmed: a protocol for a multistage mixed-methods study.

Introduction: At least 10% of hospital admissions in high-income countries, including Australia, are associated with patient safety incidents, which contribute to patient harm ('adverse events'). When a patient is seriously harmed, an investigation or review is undertaken to reduce the risk of further incidents occurring. Despite 20 years of investigations into adverse events in healthcare, few evaluations provide evidence of their quality and effectiveness in reducing preventable harm.

Birang Daruganora: what do Aboriginal and Torres Strait Islander communities need in a new hospital? A qualitative study.

Objectives: To elicit the Aboriginal community's cultural and healthcare needs and views about six prominent and emerging models of care, to inform the development of a new hospital.

Design: Cross-sectional qualitative study co-designed and co-implemented by Aboriginal team members.

Setting: Western Sydney, New South Wales, Australia.

Paediatric medication incident reporting: a multicentre comparison study of medication errors identified at audit, detected by staff and reported to an incident system.

Objectives: To compare medication errors identified at audit and via direct observation with medication errors reported to an incident reporting system at paediatric hospitals and to investigate differences in types and severity of errors detected and reported by staff.

Methods: This is a comparison study at two tertiary referral paediatric hospitals between 2016 and 2020 in Australia. Prescribing errors were identified from a medication chart audit of 7785 patient records.

Patient characteristics of, and remedial interventions for, complaints and medico-legal claims against doctors: a rapid review of the literature.

Background: It is uncertain if patient's characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised.

Methods: We conducted a rapid review of recent literature to answer: Question 1 "What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?" and Question 2 "What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received from a doctor?".

Is it possible to make 'living' guidelines? An evaluation of the Australian Living Stroke Guidelines.

Background: Keeping best practice guidelines up-to-date with rapidly emerging research evidence is challenging. 'Living guidelines' approaches enable continual incorporation of new research, assisting healthcare professionals to apply the latest evidence to their clinical practice. However, information about how living guidelines are developed, maintained and applied is limited.

Consumer and provider perceptions of the specialist unit model of care: A qualitative study.

Background: Specialist care units cater to targeted cohorts of patients, applying evidence-based practice to people with a specific condition (e.g., dementia) or meeting other specific criteria (e.

The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study).

Background: This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations.

Methods: Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators.

What are the experiences of team members involved in root cause analysis? A qualitative study.

Background: Conducting root cause analysis (RCA) is complex and challenging. The aim of this study was to better understand the experiences of RCA team members and how they value their involvement in the RCA to inform future recruitment, conduct and implementation of RCA findings into clinical practice.

Methods: The study was set in a health network in Adelaide, South Australia.

Unsafe care in residential settings for older adults: a content analysis of accreditation reports.

Residents of aged care services can experience safety incidents resulting in preventable serious harm. Accreditation is a commonly used strategy to improve the quality of care; however, narrative information within accreditation reports is not generally analysed as a source of safety information to inform learning. In Australia, the Aged Care Quality and Safety Commission (ACQSC), the sector regulator, undertakes over 500 accreditation assessments of residential aged care services against eight national standards every year.

Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre-post study protocol.

Introduction: Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinical variation can provide important insights into the effectiveness of the consensus process.

Comparing rates of adverse events detected in incident reporting and the Global Trigger Tool: a systematic review.

Many hospitals continue to use incident reporting systems (IRSs) as their primary patient safety data source. The information IRSs collect on the frequency of harm to patients [adverse events (AEs)] is generally of poor quality, and some incident types (e.g.

Experience-based codesign approach to improve care in Australian emergency departments for complex consumer cohorts: the MyED project protocol, Stages 1.1-1.3.

Introduction: Emergency department (ED) care must adapt to meet current and future demands. In Australia, ED quality measures (eg, prolonged length of stay, re-presentations or patient experience) are worse for older adults with multiple comorbidities, people who have a disability, those who present with a mental health condition, Indigenous Australians, and those with a culturally and linguistically diverse (CALD) background. Strengthened ED performance relies on understanding the social and systemic barriers and preferences for care of these different cohorts, and identifying viable solutions that may result in sustained improvement by service providers.

Birang Daruganora: a protocol for a qualitative study to elicit Aboriginal and Torres Strait Islander community views about cultural needs and experiences for a new Australian health facility.

Introduction: To address challenges regarding the delivery of healthcare, governments and health services are focusing on the implementation of models that are flexible, person-centred, cost-effective and integrate hospital services more closely with primary healthcare and social services. Such models increasingly embed consumer codesign, multidisciplinary teams and leverage digital technologies, such as telehealth, attempting to deliver care more seamlessly and to continually improve services. This paper provides a study protocol to describe a method to explore Aboriginal and/or Torres Strait Islander consumer and healthcare provider needs and expectations for the design and development of a new healthcare facility in Australia.

Innovative models of healthcare delivery: an umbrella review of reviews.

Objective: To undertake a synthesis of evidence-based research for seven innovative models of care to inform the development of new hospitals.

Design: Umbrella review.

Setting: Interventions delivered inside and outside of acute care settings.

Innovative models of care for the health facility of the future: a protocol for a mixed-methods study to elicit consumer and provider views.

Introduction: To address the challenges of rapidly changing healthcare, governments and health services are increasingly emphasising healthcare delivery models that are flexible, person centred, cost-effective and integrate hospital services more closely with primary healthcare and social services. In addition, such models increasingly embed consumer codesign, integration of services, and leverage digital technologies such as telehealth and sophisticated medical records systems.

Objectives: This paper provides a study protocol to describe a method to elicit consumer and healthcare provider needs and expectations for the development of innovative care models.