Tuesday, July 24, 2012

Ehealth Online Learning Centre

This website is an online learning centre which details how the Australian Government’s new electronic health record system will work for patients and practitioners.  You will discover how an eHealth record is created, what it contains, how you can use one and how it is kept safe. 

What is an eHealth record?
Every time you visit a healthcare professional, or a hospital or other medical facility, important information about your health is created and stored at that location. Currently it's hard to access and share this information with the health professionals involved with your care. An eHealth record is an electronic record that contains a summary of your health information. You can add information to it and you can allow healthcare professionals to view this information and to add new information.
ehealth online learning website image

Monday, July 23, 2012

Review of the National Competencies Standards for Australian Nurse Practitioners

National competency standards for Registered Nurses (RNs) were first adopted by the Australian Nursing and Midwifery Council in the early 1990s, and shortly thereafter, competency standards for Enrolled Nurses, Midwives and Nurse Practitioners (NPs) were developed. These standards were adopted by the Nursingand Midwifery Board of Australia in 2010. Subsequently, there have been substantial developments in both the role and scope of practice of NPs (Fotheringham, Dickie, & Cooper, 2011; Gardner & Gardner, 2005). The recent move to a national system of regulation and accreditation of health related courses provides an ideal opportunity for a review of the NP competency standards. This review will ensure that the standards accurately reflect contemporary NP practice, and that the educational preparation which NPs currently receive is appropriate for the tasks and duties which they perform as part of their role.

The aim of the project is to develop a revised document, called the “National competency standards for the NP”. The project is being undertaken for and funded by the Nursing and Midwifery Board of Australia under the management of the Australian Health Practitioner Regulation Agency (APHRA). It is expected that the document will reflect actual practice (rather than “aspirational” practice), be current and useful. 

The project will be undertaken in three phases.

Phase 1- Research Foundation Phase
  • The project will include an extensive review of the literature surrounding the current scope of practice and role responsibilities of NPs across Australia, with some analysis of the international literature included where relevant. In particular, the review will note variations in practice between jurisdictions and/or sectors (and the possible reasons for these variations); the impact of employment arrangements on role and scope of practice, and relevant legislation and regulations.
  • To supplement this literature review and synthesis, audio-taped interviews are planned to be held with the Chief Nurses and relevant professional officer/advisor for NPs in each state and territory and the APHRA representatives in each State/Territory. Interviews seek to identify how the NP competencies are monitored and whether additions or deletions are required in the Standards. Participants will also have an opportunity to check on the definitional accuracy of significant terms.
  • An analysis of the gap between the current competency standards for the NP and the findings from the interpretative synthesis will be undertaken. A discussion document and revised standards will be submitted to the Nursing and Midwifery Board of Australia. Once approved by the Board, the discussion document and draft standards will be released for consultation with stakeholders in accordance with the guidelines.

Phase 2 – Consultation phase
  • The consultation phase provides participants with an opportunity to review and comment on the draft of the revised standards. Three NP focus groups and several consumer and carer focus groups will be conducted. These groups will explore current understanding of the standards and their applicability to knowledge of what a NP is and does. Key informants, including those involved in the first phase will be contacted with the request to participate in telephone interviews. The key informant group will be increased to include the Council ofDeans of Nursing and Midwifery and representatives from the Australian College ofNP. Telephone interviews will be negotiated for the Chief Nurses, Information sheet 17/07/12
  • Principal Advisors NP, AHPRA staff in each jurisdiction and representative from the CDNM and ACNP.
  • Written comments will be sought from other interested parties via the AHPRA website. The discussion document and draft standards will be available in the form of a structured Survey Monkey response document. For consumers and carers, the researchers will circulate the structured response document through the national Consumer and Carer groups. A narrative synthesis will bring together the multiple data points into a coherent narrative (Popay et al., 2006)

Phase 3- Validation
  • The revised standards will be validated through a real time observation process examining and documenting NP practice in a range of clinical settings throughout Australia. The elements of practice will be reviewed against the revised standards. Participants will be selected so as to reflect the range of settings, sectors and clinical areas within which NPs practice. A stratified sample of NPs based on distribution identified in Australian literature and triangulated with AHRPA registration details will be used. The draft standards will form the schedule for observation of samples of work. It is anticipated that 100 work samples will be collected.
  • As the sample will be selected from across Australia, including remote locations, a team of nursing peer observers will be sourced from local service providers. Video conference sessions will be conducted to educate observers on the use of the observation schedule. Inter-rater reliability will be promoted through scenario-based simulation. The observers will record practice against the standards and using the structured response format will document practice that is not captured in the standards. Peer observers will be offered a per diem in recognition of their time.
  • As part of the validation process, employers of NPs from across Australia will be asked to submit position descriptions to allow the team to map criteria against the draft standards. This will determine transferability to the practice setting. Further to this, the standards will be circulated to a sample of Consumers and Carers to determine effectiveness in informing this group of what HPs do and are.

Australian Nursing and Midwifery Council. (2006). National Competency Standards for the Nurse Practitioner. Melbourne: ANMC.
Fotheringham, D., Dickie, S., & Cooper, M. (2011). The evolution of the role of the Emergency Nurse Practitioner in Scotland: a longitudinal study. Journal of Clinical Nursing, 20(19-20), 2958-2967. doi: 10.1111/j.1365-2702.2011.03747.x
Gardner, A., & Gardner, G. (2005). A trial of nurse practitioner scope of practice. [Research Support, Non-U.S. Gov't]. Journal of Advanced Nursing, 49(2), 135-145.
Popay, J., Roberts, H., Sowden, A., Petticrew, M., Britten, N., Arai, L., . . . Rodgers, M. (2006). Guidance on the conduct of narrative synthesis in systematic reviews. Lancaster: Institute for Health Research: Lancaster University. Information sheet 17/07/12

Review Team:
Professor Andrew Cashin, Discipline Lead, Professor of Nursing, Southern Cross University, Adjunct Professor Charles Darwin University and University of Technology, Sydney.
Dr ThomasBuckley, Senior Lecturer/ Co-ordinator Master of Nursing Nurse Practitioner, University of Sydney/ Southern Cross University
ProfessorSandra Dunn, Professor in Health and Clinical Practice, School of Health, Charles Darwin University.
Dr Marie Heartfield, Senior Lecturer Chronic Condition Management, Flinders Human Behaviour and Health Research Unit, Flinders University.
Associate Professor Donna Waters, Associate Dean (Research), Sydney Nursing School, University of Sydney.
Ms Julianne Bryce, Senior Federal Professional Officer, Australian Nursing Federation.
Ms Helen Gosby, Nurse Practitioner, Emergency Department, The Children’s Hospital, Westmead, NSW.
Adjunct Professor John Kelly, Chief Executive Officer of Aged and Community Services, Australia.
Ms Darlene Cox, Executive Director of the Health Care Consumers Association, ACT.
Dr Helen Stasa, Post Doctoral Research Fellow in Collaborative Research Network Project University of Sydney/ Southern Cross University.
Emeritus Professor Judith Donoghue, Senior Research Fellow, Collaborative Research Network Project University of Sydney/ Southern Cross

Information sheet 17/07/12

Wednesday, July 11, 2012

Health Issues Group - 24 July 2012

Dear members and friends,

We would like to extend an invitation to you to attend out next Health Issues Group on Tuesday 24 July from 12.30 – 2.30 at the HCCA offices in Hackett.

Executive Director of Rehabilitation, Aged and Community Care for the Health Directorate, Linda Kohlhagen and Senior Manager from the Health Planning Unit Jacinta George, will be speaking about the development of the community health centres. They will provide an overview and update on the development of community health centres that form part of the Health Infrastructure Program. This will include where they are being built and what services are being included.

Light refreshments will be provided and for catering purposes we do need to have RSVP’s. If you would like to attend, please call the HCCA office on 6230 7800. If you have any special dietary requirements please let us know.

Alisha Summerton
Consumer Representatives Program

Friday, July 6, 2012

Employment opportunities at HCCA

We have two vacancies on our staff team that we are looking to fill. An overview of each position and their job descriptions and selection criteria are below.

Health Care Consumers’ Association Inc
Multicultural Liaison Officer (SCHADS Level 5)

Do you recognise that there is a need for a stronger voice in health care from the multicultural community? The team at the Health Care Consumers’ Association (HCCA) is seeking a highly motivated and organised individual to join us as our Multicultural Liaison Officer.

You will need to have experience in networking with consumers and community groups to further consumer involvement in decisions regarding the Health Infrastructure Program (HIP), including outreach to marginalised and vulnerable communities (including but not limited to: people living with having chronic conditions, being from a cultural and linguistically diverse background, as having a disability, or young people and children). The role involves contact with internal and external stakeholders. Written and oral communication skills and attention to detail are essential.

The working hours and days are negotiable, up to 30 hrs per week. This is a contract positionuntil 30 June 2013.  Other conditions of employment will be based on the Social, Community, Home Care and Disability Services Industry Award 2010.

HCCA promotes a healthy work/life balance and is committed to offering employees a supportive family friendly working environment.

All applications must include:
1. A covering letter stating your intention to apply for the position and addressing the selection criteria listed below.
2. A current CV.
3. Information for 2 Referees. (Name, Title and Organisation, Relationship to applicant, contact telephone, contact email address)

Applications close on Monday 16 July 2012 at 4pm and should be addressed to:
Darlene Cox
Executive Director, HCCA
100 Maitland St Hackett ACT 2602

Job Description

The part-time Multicultural Liaison Officer will foster networks with multicultural community organisations and diverse communities to increase their knowledge about the health system, particularly the Health Infrastructure Program (HIP), consumer participation and health literacy. The officer will also work with the HCCA team to develop suitable information resources and facilitate consultative fora.

The Health Infrastructure Program is a significant body of work for the ACT Government and has great potential to bring about structural changes to clinical practice, and to improve efficiencies as well as health outcomes for consumers. There is a continuing need for strong, effective consumer input to this Program to assist in developing solutions to seemingly intractable problems in our health system. We are committed to continuing our work with the ACT Government to improve the quality of health services and the Multicultural Liaison Officer will play an important role in ensuring that the experiences and perspectives of multicultural people are included in considerations of the development of new services. HCCA works within a Community Development Framework and is informed by the Social Determinants of Health.

Our focus is in four main areas.
· Identification of consumer needs through consumer consultation, including outreach to marginalized and vulnerable communities;
· Raising awareness of the Health Infrastructure Program within consumer and community organisations;
· Creating new opportunities for training and support for consumer representation, including further developing our health literacy program;
· Monitoring how consumer input is used to have a real impact on the health outcomes of all consumers.

The Multicultural Liaison Officer will be part of the HIP Team at HCCA and report to the HIP Team Leader. Tasks and responsibilities will include to:
·         Work closely with consumer and community organisations and the HCCA team members to ensure there are opportunities for input from a diversity of  health consumer representatives.
·         Plan, organise, facilitate and document consumer consultative fora to identify consumer needs of the health system.
·         Create new opportunities for and deliver training, including further developing health literacy, encompassing an understanding of the Australian Charter of Health Care Rights and QUIT smoking cessation program.
·         Monitor and report on emerging issues in consumer representation, participate in projects, policy development and advice regarding activities and organisational development with regard to the HIP.
·         Network and develop interest in consumer participation within consumer and community organisations to support the User Groups.
·         Liaise with ACT Government about opportunities for consumer involvement.

Selection Criteria

  1. Demonstrated ability to work with people from diverse language and cultural backgrounds and build and maintain good relationships.
  2. Knowledge and understanding of the particular barriers to participation faced by people of diverse ethnic, cultural, linguistic and religious backgrounds as they relate to health and wellbeing.
  3. Strong understanding of community development and experience in community engagement, including the capacity to represent the organisation in public forums and facilitate meetings, information sessions and workshops.
  4. Demonstrated ability to work effectively with others in a work team, taking personal responsibility for achieving work outcomes.
  5. An interest in health care and commitment to the values of the organisation.
  6. Good technology skills, including good organisational skills, including the ability to multi-task, prioritise and meet deadlines.

Desirable Qualifications:

  1. Relevant tertiary or other recognised qualifications.
  2. Current drivers licence.

Health Care Consumers’ Association Inc
Administration Officer
SCHADS  Level 4)
(expected vacancy)

If you are an experienced administration officer looking for a varied role in a small, enthusiastic and motivated team, we would like to hear from you.  The team at the Health Care Consumers’ Association (HCCA) is seeking a highly motivated and organised individual for this position.

You need to have experience managing an executive diary and be able to effectively prioritise competing workloads in a busy environment. The role involves daily contact with internal and external stakeholders. Written and oral communication skills and attention to detail are essential. Knowledge of Microsoft Office is required. Other tasks include setting up meetings, organising functions (including taking RSVPs and arranging catering), compiling and sending out newsletters.

The working hours and days are negotiable, up to 30 hrs per week. There will be occasional requirements to work at weekends or after normal office hours. This is a contract position until 30 June 2013, with a possibility of extension. Other conditions of employment are based on the Social, Community, Home Care and Disability Services Industry Award 2010.

HCCA promotes a healthy work/life balance and is committed to offering employees a supportive family-friendly working environment and continuing opportunities for in-service and personal development.

Applications must include
1. A covering letter stating your intention to apply for the position and addressing the selection criteria below.
2. A current CV, including transcripts of qualifications.
3. Contact information for 2 Referees. (Name, Title and Organisation, Relationship to applicant, contact telephone numbers, contact email address)

Applications close Friday 20 July 2012 at 4pm and should be addressed to:
Darlene Cox
Executive Director, HCCA
100 Maitland St Hackett ACT 2602

Job Description

The Administration Officer reports to the Executive Director and plays a central role in supporting the day-to-day operations of the Health Care Consumers’ Association.

·         Provide a first point of contact between members and the community and the HCCA. This involves - answering phone calls, servicing the HCCA email address and greeting people visiting the office;
·         Provide executive support to the Executive Director, including managing the diary, drafting letters, booking travel, other duties as required;
·         Assist the Executive Director in processing financial transactions, manage petty cash and reconciling invoices;
·         Order stationery and supplies for the office and HCCA team;
  • Manage the membership process including membership renewals, maintain the register of members;
·         Maintain the Contact management and mailing list databases;
  • Maintain office equipment and liaise with IT service providers to ensure electronic communications are functioning;
  • Maintain the office procedures manual;
·         Schedule meetings and take minutes of meetings as required;
·         Call for and collate agenda and papers for Executive Committee Meetings;
·         Organise venues, take RSVPs, arrange catering etc for functions and meetings both on and off-site;
·         Provide support to other staff members as necessary.

Selection Criteria

Communication Skills
  1. 1.    Good communication skills and the ability to contribute positively to team operations as well as the ability to work independently and take initiative
  2. 2.    Build and maintain good relationships with internal and external stakeholders
  3. 3.    Demonstrated interpersonal, oral and written communication skills, with the ability to obtain and convey information with a high level of accuracy
  4. 4.    Demonstrated commitment to providing quality customer service

Organisational Skills
  1. 5.    Good organisational skills, including the ability to multi-task, prioritise and meet deadlines
  2. 6.    Good office technology skills, including MS Office applications -- especially Outlook, Word and Excel
  3. 7.    Demonstrated ability to work with minimal supervision and to plan, organise and monitor work priorities and to meet deadlines with a high level of accuracy

Personal attributes
  1. 8.    Demonstrated ability to work effectively with others in contributing to the work of the team, taking personal responsibility for achieving work outcomes
  2. 9.    An interest in health and commitment to the values of the organisation

About the Health Care Consumers’ Association

The Health Care Consumers' Association of the ACT (HCCA) is the peak health consumer advocacy organisation in the ACT. It has supported and developed health consumer perspectives and policy in the ACT for over 30 years. HCCA is a body through which health care consumers can participate in policy, planning and service decisions which affect their health. HCCA works to improve the quality and availability of health services, supports consumers to identify shared priorities about health, and represents these views to the ACT Government.

Our Vision
Consumers in control of our own health
Driving better health outcomes through consumer empowerment
The organisation is underpinned by a commitment to the following values:
·         Lived experience as vital to evidence-based health policy and services and to consumer participation in planning and decision-making
·         Accountability for what we do and for how the health system supports consumers and to being a healthy and strong workplace and organisation
·         Strong and effective partnerships, based on integrity and mutual respect with others, including other consumer organisations and groups, governments, other NGOs, health care providers and researchers
·         Respect for the diversity of cultures, individuals and views which exist in our community and organisation
·         Working in a representative and respectful manner with members
·         Equitable and fair access to health services and to resources which promote good health.

Sunday, July 1, 2012

Australia's Health 2012 - Conference Report

A group of HCCA staff and consumer representatives attended Australia’s Health at the National Convention Centre in Canberra on Thursday 21 June 2012.  Australia’s Health is the biannual publication of the Australian Institute of Health and Welfare.  This year marks the 25th anniversary of AIHW and many of the presentations on the day involved some reflection on our community’s health status and identifying challenges.

What follows is a summary of some of the things I heard and found interesting. I have done my best to accurately document the issues and figures.  If you are interested to find out more then go to the AIHW website and have a look at the In Brief document, a 50 page summary of the 650+ page report.

David Kalisch, Director of AIHW, gave an overview of some of the new information contained in the report.  Overall we are healthier and living longer however the incidence of chronic disease and cancer is increasing.  Of particular note:
  • Our smoking rates in the 25 year period have improved markedly but smoking rates are still highest among those in lowest socio ec group and Indigenous rates of smoking are %50
  • 1 in four Australians are obese, and many of us do not eat enough fruit and vegetables nor undertake the level of physical activity that we  need to have in order to prevent illness.  This is especially the case for those people who experience social or economic disadvantage.
  • Screening rates for bowel, cervical and breast screening are improving outcomes with earlier detection of cancers.  The report states that national bowel cancer screening for people over 50 years old are 38%, cervical screening is at 57% and 58% of woman are accessing breast screening.

Mr Kalisch also noted that some of the gaps in service.  For example, there has been considerable commitment to general practice providing counselling advice for nutrition, exercise, weight loss, alcohol use and other lifestyle issues but the data shows that consumers haven’t been accessing GPs for these issues in the last decade and the pattern is not changing.  I was intrigued by this and see that there is a real issue for general practice. Perhaps this means that doctors are not the right people for us to see for prevention programs and that there is a role of nurses and allied health professionals?  I’m keen to see what Medicare Locals think about this and am keen to complete research into consumer perceptions and expectations.
  • Our health system is spending the most money on cardiovascular, oral health and mental disorders.
  • Our health workforce is ageing but we have an expectation that those currently in the workforce will continue working until they are 65 and older.  There was a series of chuckles from people behind me and one man commented, “Well, thank you”. I’m not sure that he was altogether serious.

Mr Kalisch identified that there is the data gap In primary care and that the AIHW need to focus their attention on this.  We also need to determine the type of data that we need to collect.  He indicated that there was interest in what people are being diagnosed with at their GP and what GPs doing about this.  He also indicated an interest in consumer experience of health services, including in general practice and community services.  Medicare Locals may play a role in this but AIHW are still determining how this can happen.

Mr Kalisch acknowledged that the community is expecting information to be presented in more accessible, engaging and understandable forms.  He commented that the AIWW is responding to this and that they are providing free access to material on the website.

Professor Jim Bishop – clinical oncologist, Executive Director of the Victorian Comprehensive Cancer Centre.
I was interested to see Prof Bishop in a different capacity.  I had briefly worked with him on a committee reviewing the Dental Act in 2009 when he was Commonwealth Chief Medical Officer.  He is a knowledgeable fellow and I find him to be a good communicator.  Prof Bishop now leads the Victorian Comprehensive Cancer Centre.

Prof Bishop looked back at the improvements in health care over the past decade with particular reference to Cancer.  He drew on a range of data from AIHW as well as the cancer registries and NSW Cancer Institute.  Early in his talk he referred to the Provocative Questions in Cancerby Harold Varmus. Why do obese people get cancer more often? How can some turtles live more than a century without ever developing tumours while mice can develop them in a year? Could treatments that hold tumour cells in check without destroying them keep people alive longer? Answering questions like these may lead to the next big cancer breakthroughs and are important questions for consumers to ponder.

One the very interesting things Prof Bishop spoke about was the innovation of genomics.  Now, I don’t pretend to have followed much of his talk about this topic and but did catch a few things.  He was suggesting that an understanding of genomics can identify high risk populations and there are markers for early detection from blood test which will help consumers to modify our behaviours to reduce likelihood of developing cancer.  He also talked about new classifications for cancer and that research has found ways to turn off some cancer cells.  This has a positive effect on treatment as they can find individuals who will and will not respond.  Anyway, the key message here is that genomic are developing rapidly and we need to know more about it.

The Victorian Comprehensive Cancer Centre: Prof Bishop stressed that co-location will not improve outcomes alone.  It is about bringing the strength of the partner organisations: university research capability, links to general practice, and application of computer science with the high quality treatment program from the Peter McCallum Cancer Centre and surgical treatment expertise from other partners.  He signalled that one of the challenges is for proud organisations with long histories to let go of their independence and contribute to the collective.
Cancer burden on individuals and our health services is substantial.  The drivers of success so far are tobacco control, earlier interventions and new therapeutics.  Prof Bishop identified areas for work in the future:
  •  - Use of new evidence, especially about genomics
  •  - Enhance services and access for high risk groups for early intervention
  •  - We need to make a deeper impact on those cancers with poor prognosis such as lung, bowel, pancreas, and adult leukaemia.  The 5 year survival rates for these cancers is poor. The Pancreas 4% Lung 16%.  Dr Bishop stated that localised breast cancer has 5 year survivor rates of 98% which he attributes to screening and adjuvant therapy.
  •  - Comprehensive cancer centres offer hope of rapid progress in these areas.

Professor Bishop talked about the importance to have an increased focus on people living in rural communities and on the fringes of large metropolitan centres.  He commented that 5 year survival rates for people living in the outer suburbs of capital cities are akin to outcomes for people living in rural areas.  He stressed that this is not just about access  as many people in these areas have a poor hand of disadvantage, with low screening rates, high smoking rates, high levels of obesity and low rates of physical exercise.  He referred to this as bands of disadvantage.  Prof Bishop also mentioned that people in these areas are also diagnosed with cancer at a later stage and he commented that suggests a failure in general practice and primary care. Dr Bishop told the audience that when he was in NSW they found that there is under-referral rate for lung cancer, which means that people with lung cancer do not get referred to specialists.  He went on to say that evidence based treatments improve survival rates for lung cancer and that this is not acceptable.

Andrew Refshauge Chair, AIHW
Dr Refshauge has a long history in medicine and reflected on 25 years of practice and the  AIHW. The First AIHW report was in released in 1998 when health spending was $18bn annually; it has now increased to $128bn.  The cost of health care has grown at the rate of between 7-10%  each year.  This is most concerning as it is much higher than inflation (and indexation). 

We are now living longer, living healthier lives with less disability.  We have reduced smoking rates from 25% to 15% of the population but there are some communities that have smoking rates of up to 50%, including aboriginal communities.  There has been improvement in cancer survivor rates, as Prof Bishop outlined.

There are emerging issues of concern with the population increasingly becoming fat and slobby, with relatively high rates of chronic lung disease, diabetes and heart disease.
Transport accidents are on the rise. Motor vehicle accidents are increasing by 1.8% each year. Interestinly, cycle accident rates are increasing at 6% per year and has increased 25% per year for men between 45-55 years old.  He referred to the MAMIL Syndrome affecting emergency departments around the nation, Middle Aged Men In Lycra.

Dr Refshauge commented that our major concern continues to be the health of our Aboriginal and Torres Strait Islander peoples. He commented that our response to their health needs is “seriously deficient”.  Dr Refshauge reflected on his experience at the Redfern Aboriginal Medical Services.  He learnt that it is only when you provide services with people will get you results   If you don’t work with the people you will not get the results you want.  You achieve some positive results if you deliver services to people and for people but needs to be a hand in hand response, listening and sharing with each other.  This made my heart sing, to hear an experienced and committed leader talk about the need to value the role consumers play in our own health.

Darlene Cox
Executive Director