What is in this issue
Topic focus: NSQHS-Standard 5.2 : Applying quality improvement systems
New to the Library
Topic of interest: Vehicle emissions and population health
CME/CPD Tracking
Research Review Australia
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NSQHS - Standard 5.2: Applying quality improvement systems
Quality Improvement (QI) is the intentional process of making system-level changes in clinical processes with a continuous reassessment to improve the delivery of a product. If you are planning to make changes to support the delivery of care, you will need to concider strategies to improve care, and how you will review, measure, and assess the effectiveness. Here are some articles to support you thinking about Standard 5.2:
Braithwaite, J., Clay-Williams, R., Taylor, N., Ting, H. P., Winata, T., Hogden, E., Li, Z., Selwood, A., Warwick, M., Hibbert, P., & Arnolda, G. (2020). Deepening our Understanding of Quality in Australia (DUQuA): An overview of a nation-wide, multi-level analysis of relationships between quality management systems and patient factors in 32 hospitals. International Journal for Quality in Health Care, 32(Supplement_1), 8–21. https://doi.org/10.1093/intqhc/mzz103
Crowl, A., Sharma, A., Sorge, L., & Sorensen, T. (2015). Accelerating quality improvement within your organization: Applying the Model for Improvement. Journal of the American Pharmacists Association : JAPhA, 55(4), e364–e376. https://doi.org/10.1331/JAPhA.2015.15533
McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve Plan-Do-Study-Act cycle fidelity: a retrospective mixed-methods study. BMJ Quality & Safety, 28(5), 356–365. https://doi.org/10.1136/bmjqs-2017-007605
McQuillan, R. F., Silver, S. A., Harel, Z., Weizman, A., Thomas, A., Bell, C., Chertow, G. M., Chan, C. T., & Nesrallah, G. (2016). How to measure and interpret quality improvement data. Clinical Journal of the American Society of Nephrology : CJASN, 11(5), 908–914. https://doi.org/10.2215/CJN.11511015
For board and senior managers, understanding the board's role in quality healthcare and how we convey quality reports to them - Brown A. (2020). Communication and leadership in healthcare quality governance. Journal of Health Organization and Management, 34(2), 144–161. https://doi.org/10.1108/JHOM-07-2019-0194
There are also some new books about the topic of quality improvement avaliable in the Library.
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Topic of interest: Vehicle emissions and population health
Human health is dependent upon environmental health. Air pollution is a leading cause of morbidity and mortality globally, and climate change has been identified as the single greatest public health threat of the 21st century (Eckelman, 2018). A positive outcome of the COVID-19 lockdowns is that there has been a substantial reduction in asthma and Chronic Obstructive Lung Disease (COPD) emergency presentations in part due to the reduction in air pollution (Alsallakh, 2021, Davies, 2021).
Air pollution in Australia and New Zealand comes primarily from motor vehicle emissions, electricity generation from fossil fuels, heavy industry, and home heating using wood and coal. In Australia and New Zealand we see a ‘massification’ of our vehicles. On both sides of the Tasman the average car, like the average person, has put on weight (Woodward, 2019). These bigger cars have not helped with our average fuel economy and emissions.
What can we do as individuals?
We can improve public health by participating in and promoting active transport (e.g. cycling, scooting, walking) around town and the use of zero emission vehicles. Did you know that SWH's Warrnambool Base Hospital has bike parking and shower/change rooms in both underground care parks?
What can hospitals and health care staff do?
| Vehicle fleet |
Optimize fleet size and vehicle use |
| Promote car pooling |
| Promote electric vehicles (e-cars and e-bikes) |
| Ensure suitable infrastructure (e.g. charging points) |
| Active transport |
Promote walking and cycling as alternatives to vehicle use, for example bike share schemes, subsidies for e-bikes for staff |
| Provide facilities (safe bike parking, lockers and showers) |
| Telemedicine |
Use home-based care or telemedicine where possible |
| Public transport |
Work with local government to ensure accessible connections to public transport |
| Public transport |
Provide free fares for patients attending hospital appointments |
| Subsidize bus and train fares for staff |
Table of suggestions from Woodward, 2019.
In May the Victorian Government announced it was incentivising Victorians to choose to buy an ZEV sooner through the Zero Emissions Vehicle Subsidy Program, saving people up to $3,000 on the purchase of a ZEV and driving Victoria’s transition to a net-zero emissions future.
https://www.energy.vic.gov.au/renewable-energy/zero-emissions-vehicles
https://www.solar.vic.gov.au/zero-emissions-vehicle-subsidy
https://www.greenvehicleguide.gov.au/ (Quickly compare vehicle emissions, fuel consumption, and noise pollution here).
If you are considering buying an electric vehicle and would like a bonus 1,500km of supercharging you can use my referral link: http://ts.la/hannahlee54461
Readings:
- Eckelman, M. J., Sherman, J. D., & MacNeill, A. J. (2018). Life cycle environmental emissions and health damages from the Canadian healthcare system: An economic-environmental-epidemiological analysis. PLoS Medicine, 15(7), e1002623. https://doi.org/10.1371/journal.pmed.1002623 (This article also includes a comparison to the environmental emissions of the Australian healthcare system.)
- Gunn L. D. (2020). Can a liveable city be a healthy city, now and into the future?. Internal Medicine Journal, 50(11), 1405–1408. https://doi.org/10.1111/imj.15063
- Hime, N. J., Marks, G. B., & Cowie, C. T. (2018). A Comparison of the Health Effects of Ambient Particulate Matter Air Pollution from Five Emission Sources. International Journal of Environmental Research and Public Health, 15(6), 1206. https://doi.org/10.3390/ijerph15061206
- Kjellstrom, T. E., Neller, A., & Simpson, R. W. (2002). Air pollution and its health impacts: the changing panorama. Medical Journal of Australia, 177(11-12), 604–608. https://doi.org/10.5694/j.1326-5377.2002.tb04982.x
- Woodward A. (2019). Climate change and the surgeon: what is the problem? Why is it so hard? What can be done?. ANZ Journal of Surgery, 89(11), 1358–1363. https://doi.org/10.1111/ans.15562
Declaration of conflict of interest: I like riding bikes, they are fun, and I own an EV.
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CME/CPD Tracking
Many professionals need documentation of time spent reading clinical resources to demonstrate they are keeping their knowledge and skills current and learning about the latest, evidence-based developments. Continuing medical education (CME) or continuing professional development (CPD) hours can be easily reported with the help of these Library resources:
ClinicalKey
Did you know that time spent reviewing books, journals and clinical overviews within ClinicalKey ( www.clinicalkey.com.au and www.clinicalkey.com.au/nursing) is automatically tracked as time based CME credits ready for claiming with an easily generated certificate? Ensure you create a personal account to unlock this as well as remote access and many more features.
UpToDate
UpToDate also tracks your CME if you remember to login while searching for clinical answers. For Australian doctors make sure your credit type is changed to Time-based tracking (ACD, ACRRM, ANZCA/FPM, Inpractice (NZ), RACP, RACGP, RANZCOG, RNZCGP, RNZCUC) in the CME settings. |
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Research Review Australia
Have you heard of Research Review Australia? Research Review publications "bring the best of 10,000 global medical journals" to your email inbox every issue, with commentary from Australian experts. There are over 40 areas including Cardiology, Dentistry, Diabetes, Oncology, Obstectrics and Psychiatry. Specialist opinions on guidelines, medicines and conferences. All Research Review publications are free to receive. The reviews are a summarised interpretation of the published studies and are aimed at assisting the process of clinical reading.
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