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Objective: This study gathered information from public hospital chief medical officers to better understand underlying mechanisms through which public reporting affects institutional behavioural change and decision making towards quality improvement. Methods: This qualitative study used thematic analysis of 17 semistructured, in-depth interviews among a peak group of medical directors representing 26 health services in Victoria, Australia. Results: The medical directors indicated a high level of in-principle support for public reporting of identifiable, individual clinician-level data. However, they also described varying conceptual understanding of what public reporting of performance data is. Overall, they considered public reporting of individual clinicians' performance data a means to improve health care quality, increase transparency and inform consumer healthcare decision making. Most identified caveats that would need to be met before such data should be publicly released, in particular the need to resolve issues around data quality and timeliness, context and interpretation and ethics. Acknowledgement of the public's right to access individual clinician-level data was at odds with some medical directors' belief that such reporting may diminish trust between clinicians and their employers, thus eroding rather than motivating quality improvement. Conclusions: Public reporting of identifiable individual healthcare clinicians' performance data is an issue that merits robust research and debate given the effects such reporting may have on doctors and on hospital quality and safety. What is known about the topic?: The public reporting of individual clinician-level data is a mechanism used in some countries, but not in Australia, for increasing health care transparency and quality. Clinician-level public reporting of doctors' performance attracts contention and debate in Australia. What does this paper add?: This paper informs debate around the public reporting of individual clinician-level performance data. Among a discrete cohort of senior hospital administrators in Victoria, Australia, there was strong in-principle support for such public reporting as a means to improve hospital quality and safety. What are the implications for practitioners?: Before public reporting of individual clinician performance data could occur in Australia, resolution of issues would be required relating to legality and ethics, data context and interpretation, data quality and timeliness. [ABSTRACT FROM AUTHOR]

Objective. To date, there are few data on pharmacy-specific placement programs and their impact on students' work after graduation. The present study evaluated an innovative rural pharmacy placement program targeted at influencing students to work and live in rural areas after graduation. A secondary aim of the study was to explore the students' intentions to come back and practice in rural areas as a result of their involvement in the rural pharmacy program. Methods. A questionnaire was distributed, by hand, to a total of 58 third and fourth (final) year pharmacy students undertaking their rural placement in the Gippsland region, in rural Victoria in 2011 and 2012. Results. Fifty-seven responses were returned (response rate = 98%). Students stated that understanding pharmacy practice from a rural perspective, visits to rural health professionals and sites and the attitude of their preceptors were essential to their satisfaction with their rural placements. A significant number of students (72%) intend to seek employment in rural areas if opportunities arise as a result of their increased rural awareness. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. Conclusion. The evaluation of the rural placement program revealed that students valued their visits to rural sites and their interaction with other rural health professionals the most. What is known about the topic? Rural undergraduate student programs have been initiated as a result of several Australian government strategies to address shortages in rural health workforce. Subsequently, various rural placement programs have been integral parts of several disciplines, including medicine, dentistry, nursing, occupational therapy and pharmacy among others. To date, there are few data on pharmacy-specific placement programs and their impact on students' work after graduation What does this paper add? The rural pharmacy program is important in influencing students' perceptions and interest in a career in rural areas. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. What are the implications for practitioners? Interprofessional learning and collaboration are inevitable due to the shortage of health professionals and the move towards holistic management of patients in healthcare settings. The development of an interprofessional rural education that combines rural medical and pharmacy students together highlights the importance of an interprofessional approach to preparing students to work in rural areas. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this study was to describe preparations for extreme hot weather at Victorian public sector residential aged care services for the 2010-11 summer, and to examine the role of the Residential Aged Care Services Heatwave Ready Resource in this process. Method. Qualitative data was collected through semi-structured interviews of senior staff of Victorian public sector residential aged care services. Interviews were conducted at monthly intervals from November 2010 to March 2011, and data were analysed thematically. Results. All interviewees described pre-summer preparations for hot weather undertaken at the health services they represented. Staff awareness and experience, and having a heatwave plan, were reported to have facilitated heat preparedness, whereas challenges to preparations mainly concerned air conditioning. The Residential Aged Care Services Heatwave Ready Resource was used to inform heatwave plans, for staff and family education, and as an audit tool. Conclusions. An extensive and well-considered approach to minimisation of harm from extreme heat by a sample of residential aged care services is described, and the Residential Aged Care Services Heatwave Ready Resource is reported to have supported the heatwave preparedness process. What is known about the topic? Heatwaves cause illness and death and are likely to become more frequent and severe in the future. Residents of aged care services are particularly vulnerable to harm from heatwaves. The Residential Aged Care Services Heatwave Ready Resource has been developed to support staff of residential aged care services in Victoria to prepare for heatwaves. What does this paper add? This exploratory study provides insight into the types of preparations for extreme hot weather that are undertaken at Victorian residential aged care services before and during summer. What are the implications for practitioners? A combination of staff knowledge and experience, and having a heatwave plan, supported by a publication that includes educational resources and a checklist is reported to facilitate the preparedness of Victorian residential aged care services for extreme hot weather. [ABSTRACT FROM AUTHOR]

Objective. The aims of the present study were to describe the views of senior clinical and executive staff employed in public sector residential aged care services (RACS) about the benefits and limitations of using quality indicators (QIs) for improving care, and to identify any barriers or enablers to implementing the QI program. Methods. Across-sectional qualitative study using semistructured interviews and direct observation of key informants involved in the QI program was performed across 20 public sector RACS in Victoria, Australia. Participants included senior clinical, executive and front-line staff at the RACS. The main outcome measures were perceived benefits and the enablers or barriers to the implementation of a QI program. Results. Most senior clinical and executive staff respondents reported substantive benefits to using the QIs and the QI program. A limited number of staff believed that the QI program failed to improve the quality of care and that the resource requirements outweighed the benefits of the program, resulting in disaffected staff. Conclusions. The QIs and QI program acted as a foundation for improving standards of care when used at the front line or point of care. Senior executive engagement in the QI program was vital to successful implementation. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study was to present the views of four stakeholder groups, namely general practitioners (GP), employers (EMP), injured workers (IW) and compensation agents (CA), about the content and usability of the draft of thenew Victorian sickness certificate. Methods. A cross-sectional mixed-methods qualitative study was conducted in GP clinics and community settings in Melbourne, Australia. Interviews were conducted with GPs, EMPs and IWs and one focus group discussion was completed with CAs (n = 29). Data were collected between October and December 2013. Thematic analysis was performed. Results. All stakeholders viewed the new draft certificate as an improvement on the old one. GPs saw the certificate as a form of communication, whereas EMPs and CAs saw it as a therapeutic device. GPs continued to certify based on incapacity and provided little information about what IWs could do on return to work. All groups said that assessments for mental health needed more clarity and specificity. GPs, EMPs and CAs also said that the new certificates must be electronically available and integrated into existing medical software to streamline uptake. Conclusions. To ensure appropriate use of the new certificate, stakeholders must share a common understanding about its purpose and the certificate must be incorporated into existing medical software. Content on mental health assessment, an area of continued difficulty, needs additional refinement. Thenewcertificate replaced the old certificate inMarch 2015; after it has been established in clinical practice, an impact evaluation should be completed to determine whether GPs are certifying capacity and earlier return to work. [ABSTRACT FROM AUTHOR]