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Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services. What is known about the topic? Value-based healthcare provides an approach to restructure healthcare systems to improve health outcomes and the holistic experience of care for people and communities. What does this paper add? This paper details the development of a framework to support health services to transition to a value-based approach. What are the implications for practitioners? By reflecting on the diversity of health practitioners, managers and consumer experiences and the unique opportunities and challenges of individual healthcare services, the framework provides a structure and starting point for services to transition to value-based healthcare. This article belongs to the Special Issue: Value-Based Healthcare. [ABSTRACT FROM AUTHOR]

Objective. Health-related apps on mobile devices (mHealth apps) have become an effective selfmanagement tool and treatment support for patients. There is limited research, however, on how older people (50 and over) perceive the opportunity of using mHealth apps. Our aim was to investigate the perceptions of older people in Australia regarding the opportunity of using prescribed or doctor-recommended mHealth apps and provide insights which can enhance their uptake of mHealth. Methods. This was a qualitative study using semi-structured interviews involving 21 participants aged 51-82 years. Qualitative thematic analysis was used to categorise the factors that influence the adoption of mHealth apps by older adults. Results. We show that beyond the prominent influencing factors from technology adoption research (such as performance and effort expectancy, social influence and facilitating conditions), health-specific factors such as a trusting doctor-patient relationship and strong health self-efficacy positively influence the intended adoption of mHealth apps among older adults. In addition, the IT security and accurate interpretation of participants' input in an mHealth app can present barriers to mHealth app adoption. Conclusion. Our analyses provide additional insights complementing existing technology adoption research. Their successful adoption and utilisation require further empirical evidence on its effectiveness along with attention to the voices of those who are meant to use them. To address potential barriers, improve the quality and security of mHealth apps, and thus achieve greater patient safety, the involvement of consumers, regulators and health professionals is necessary. [ABSTRACT FROM AUTHOR]

Objectives: To explore general practitioners' perspectives on the discharge summaries they receive about their patients who have been discharged from hospital. Methods: A survey of general practitioners in the catchment of a major metropolitan South Australian health service consisting of three teaching hospitals was undertaken. Surveys were disseminated electronically and via hardcopy mailout to general practitioners. The 36-question survey focused on five constructs of discharge summaries: accessibility, length and clarity, format, transparency, and medicines content. Results: A total of 150 general practitioners responded (response rate, 27.6%). Respondents were vocationally registered (96%), predominately from metropolitan practices (90.2%), and 65.8% were female. Overwhelmingly, 86.7% of general practitioners stated that the optimal time for receipt of discharge summaries was <48 h post-discharge, and 96.6% considered that late arrival of discharge summaries adversely impacts patient care. The ideal length of discharge summaries was reported as <4 pages by 64% of respondents. A large proportion of respondents (84.6%) would like to be notified when their patients are admitted and discharged from hospital, and 82.7% were supportive of patients receiving their own copy of the discharge summary. A total of 76.7% general practitioners reported that they had detected omissions or discrepancies in the discharge summaries. Provision of rationale for medication changes was viewed as important by 86.7%, however, only 29.3% reported that it is always or often communicated. Conclusions: General practitioners supported timely receipt, concise length of discharge summary and format refinement to improve the utility and communication of this important clinical handover from hospital to community care. What is known about the topic? Discharge summaries are an important handover document when transitioning care from hospital to general practice. Delays, omissions and inaccuracies in discharge summaries can contribute to adverse patient outcomes. What does this paper add? This paper provides contemporary perspectives of general practitioners about discharge summaries and scope for improvements. What are the implications for practitioners? General practitioners value receiving discharge summaries that are timely, follow a format, provide clear details for ongoing care, and are an appropriate length. [ABSTRACT FROM AUTHOR]

Objective: The need to improve existing services to Aboriginal communities is prioritised by Australia's National Oral Health Plan. Although only an emerging area in dentistry, continuous quality improvement (CQI) approaches have positively impacted the delivery of primary health services to Aboriginal communities. This scoping review maps the applicability of CQI strategies to Aboriginal Australian oral healthcare services. Methods: A scoping review was conducted and studies that reported using CQI approaches to improve existing oral health services or quality of care deemed relevant to Aboriginal Australian communities were included. Results: A total of 73 articles were retrieved and eight articles were included in the final synthesis. Several CQI tools were identified, including: plan–do–study–act cycles, dental quality alliance measures, prioritisation matrices, causal mapping and the use of collective impact methodology. Conclusion: Data exploring CQI in the context of Aboriginal oral health is scarce. The plan–do–study–act cycle and its variations show potential applicability to Aboriginal oral health care. However, for CQI approaches to be adequately implemented, the prevailing model of dental care requires a paradigm shift from quality assurance to quality improvement, acknowledging the impact of structural and process elements on care. What is known about the topic? Continuous quality improvement strategies (CQI) have been widely used in primary health care to successfully manage chronic disease. What does this paper add? This paper highlights the scarcity of evidence around CQI initiatives in Aboriginal oral health care and identifies CQI tools such as plan–do–study–act cycles, causal mapping, driver diagrams and prioritisation matrices that can be translated to improve oral health outcomes among Aboriginal communities. What are the implications for practitioners? This paper presents a variety of CQI strategies and foundational elements required for practitioners to adopt in clinical practice. [ABSTRACT FROM AUTHOR]