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Purpose: This study aims to compare the impact of Australian onshore and offshore immigration detention centres (IDCs) on detainees' health and health-care events. Design/methodology/approach: It uses data extracted from the Australian Government's quarterly health reports from 2014 to 2017. These reports contain a range of data about the health and well-being of detainees, including complaints/presenting symptoms and number of appointments and hospitalisations. To compare onshore and offshore data sets, the authors calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population. They ran a series of two-proportion z-tests for each matched quarter to calculate median z- and p-values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant. Findings: The results suggest that adults detained onshore and offshore have substantial health needs, however, almost all rates were far higher in offshore detention, with people more likely to raise a health-related complaint, access health services and be prescribed medications, often at two to three times the rate of those onshore. Originality/value: This paper adds to a modest body of literature that explains the health of people detained in Australian IDCs. To the best of the authors' knowledge, this is the first paper to explore health service utilisation and a range of other variables found in the Australian Government's quarterly health reports. These findings bolster the evidence which suggests that detention, and particularly offshore detention is particularly harmful to health. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach: A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings: The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications: This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications: Social implications: This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value: To the best of the authors' knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change. [ABSTRACT FROM AUTHOR]

Purpose The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general practices, and examine the feasibility of implementing an ICS, within a predominantly fee-for-service delivery model.Design/methodology/approach Mixed methods were used to analyse the implementation of the ICS, including practice-level patient data on changes in service provision. This includes unit-record data on 130 enroled patients across three rural sites, as well as qualitative data collection from providers.Findings There were significant increases in both revenue-generating and non-revenue-generating activities (primarily care coordination activities) associated with implementing the ICS. Each occasion of service involved greater contact time with practice staff other than GPs, as well as greater administration time. There is evidence that ICS activities such as case conferencing and team care planning substitute for traditional GP consultations. Overall, the study found that a significant investment of resources – namely staff time devoted to a range of activities – was required to support the implementation of the ICS. Such an investment was supported both externally and through revenue-generating practice-level activities.Research limitations/implications The data collection and evaluation project is ongoing, with analysis based on the first wave of data from three sites.Practical implications At the practice level, a substantial commitment of resources is required to invest in, and sustain, a new model of integrated care (IC). This commitment can currently be supported both through higher revenue generation at the practice level, and externally by health system stakeholders, but changes in financial settings could impact on financial viability.Originality/value This paper provides evidence on the role of blended payment mechanisms in facilitating the implementation of IC in a rural setting where there are medical workforce constraints. [ABSTRACT FROM AUTHOR]

Purpose: Whistleblowing is a procedure where an existing or past participant of an establishment reveals actions and practices believed to be illegal, immoral or corrupt, by individuals who can influence change. Whistleblowing is an important means of recognising quality and safety matters in the health-care system. The aim of this study is to undergo a literature review exploring perceived barriers of whistleblowing in health care among health-care professionals of all grades and the possible influences on the whistleblower. Design/methodology/approach: An integrative review of both quantitative and qualitative studies published between 2000 and 2020 was undertaken using the following databases: CINAHL Plus, Embase, Google Scholar, Medline and Scopus. The primary search terms were "whistleblowing" and "barriers to whistleblowing". The quality of the included studies was appraised using the Critical Appraisal Skills Programme criteria. The authors followed preferred reporting items for systematic review and meta-analysis (Prisma) in designing the research and also reporting. Findings: A total of 11 peer-reviewed articles were included. Included papers were analysed using constant comparative analysis. The review identified three broad themes (cultural, organisational and individual) factors as having a significant influence on whistleblowing reporting among health-care professionals. Originality/value: This study points out that fear is predominantly an existing barrier causing individuals to hesitate to report wrongdoing in care and further highlights the significance of increasing an ethos of trust and honesty within health care. [ABSTRACT FROM AUTHOR]

Purpose – This paper seeks to provide an overview of the concept of training needs analysis (TNA), current practice, models and the impact that training needs analysis currently has on nurses in public hospitals in Australia. Thus, the paper should aid future research in the area of TNA of nurses through helping researchers to clarify the conceptual boundaries of training needs of nurses; providing a theoretical framework that could help researchers in framing their research efforts in the area; and establishing a research agenda and identifying the impact this research will potentially have on Human Resource managers in hospitals across Australia. Design/methodology/approach – This paper examines the TNA process by examining literature regarding the importance and benefits of TNA, issues relating to TNA and current practice and models. This paper then looks at how TNA applies to, and is currently practised within, the healthcare industry, specifically amongst a group of nurses. This paper also addresses how TNA tools relate to healthcare workers, particularly nurses, within Australia and how it may be able to improve the current TNA process for nurses in Australia. Findings – The specific contribution of the current paper is in developing a logical model of TNA for nurses employed in healthcare organizations in Australia. In so doing insights are drawn from a number of discreet literature bases. Originality/value – Research in this area has been carried out primarily in the UK, in the USA, and in other countries. Unfortunately, TNA for nurses in Australia is very much an under-researched topic. Equally, there is scant research available into the importance and benefits of conducting appropriate TNA for nurses in Australia. The research that has been conducted involving training needs of nurses in Australia has not been focused on a TNA using a psychometrically valid tool, nor has the research considered the factors that may influence the training needs of particular nurses or organizations. [ABSTRACT FROM AUTHOR]

Purpose |!|#8211; The purpose of this paper is to investigate the regulator|!|#39;s attempt at redesigning the patient care process (PCP) |!|#8211; a core business process in public hospitals |!|#8211; by introducing dichotomous process performance indicators as an innovative management tool intended to align the State health care policy with the everyday management of operations at a hospital ward. Design/methodology/approach |!|#8211; The paper presents an ethnographic case study of redesigning the PCP according to the strategy originating outside the organization. The study employs competing theories that represent alternative epistemological and ontological views of the world in order to produce a tentative explanation of why the intended redesign of the PCP has not fully eventuated. Observational data and opportunistic interviewing are used to answer the research question of whether and how the information and operational flows on the ward were affected by introduction of process performance indicators. A business process redesign framework was employed for data analysis since it better reflects the objectives of the State-wide initiative and offers a convenient tool in dealing with data complexity. Findings |!|#8211; Introduction of the process performance indicators did not result in redesigning of the PCP as intended by health care authorities. Out of four process performance indicators, only one was consistently implemented, which merely produced a duplication of the previously collected information, therefore adding no value to the PCP. On a theoretical level, the results indicate that the emergent theory rather than the rational agent theory demonstrated a greater fidelity to the empirical observations. Originality/value |!|#8211; The paper assessed the feasibility of using innovative dichotomous process performance indicators as a tool for redesigning the business process at the ward level, in order to achieve macro-level policy objectives. The failure to successfully implement a top-down universal approach to redesigning business processes in health care is likely to reflect a lack of appreciation of emergent rationality that characterizes essential aspects of the PCP. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to develop an understanding of the nature of collaborative arrangements that partners in Australian hospital supply chains use to manage inventories. Design/methodology/approach – A case study involving a supply chain network of ten healthcare organisations (three pharmaceutical manufacturers, two wholesalers/distributors and five public hospitals) was studied. Data included 40 semi-structured interviews, site visits and examination of documents. Findings – This study highlights the existence of a variety of collaborative arrangements amongst supply chain partners such as the "Ward Box" system (a variant of the vender managed inventory system) between wholesalers/distributors and hospitals. The materials management departments were more willing than their pharmacy counterparts to participate in a variety of partial and complete outsourcing arrangements with wholesalers/distributors and other hospitals. Several contingent factors were identified that influenced development of collaborative arrangements. Research limitations/implications – This study is limited to the Australian healthcare sector. To improve generalisability, this study could be replicated in other industry sectors and countries. Practical implications – Application of collaborative arrangements between manufacturers and wholesalers/distributors would improve inventory management practices across the supply chains. Also, learning from materials management departments could be transferable to pharmacy departments. Originality/value – Several contingent variables for the implementation of collaborative inventory management arrangements between healthcare supply chain partners have been identified. Methodologically, data across three echelons in the supply chains (manufacturers, wholesalers/distributors and hospitals) were collected and analysed. [ABSTRACT FROM AUTHOR]

Purpose – The delivery of high quality healthcare services to the community requires the integration of information from a wide range of sources within a complex and highly dynamic environment. Using structural holes theory the challenges and opportunities of integration are explored from a facilities management (FM) perspective. Design/methodology/approach – Using a critical realism methodology, structured interviews with hospital stakeholders are undertaken in a case study of a large tertiary hospital in Australia. Data are analysed using social network analysis to explore the existence of structural holes. Findings – Effective FM in the health sector requires intrapreneurial skills to broker connections between functionally and culturally distinct actors located in a highly disconnected communication network structure. Originality/value – This research reveals, for the first time, the detailed communication structure of relationships among FM services in a hospital. By identifying the existence of structural holes in hospital organisations, it illuminates significant untapped brokerage potential of facilities managers in facilitating greater integration. These insights into communication structure have important implications for the practice of FM in better supporting healthcare service delivery. [ABSTRACT FROM AUTHOR]