POPH90302 Introduction to Health Services Research

Word limit

• Word limit: 1500 words in total (+/- 10% - standard MSPGH policy will apply which will result in a loss of 10% of your marks)
• Individual word count guides provided for each question are a guide only, to help direct your time and effort for each question. The total word count across all answers together should be 1500 words (+/- 10%).
• References (at the end, or in text) do not count towards the word limit

Presentation

• You are expected to know, and comply with, UoM policy on plagiarism
• If you are using acronyms, please show them in full the first time they are used
• Please use
  • A Microsoft word file or pdf – if you are using mac e.g. pages - please export to a word version.
  • Please show the total word count (excluding any references) on your front page
  • Double spaced
  • Size 12 Times New Roman
  • Student ID at top right-hand corner of each page
  • Page number at centre of bottom of each page
  • Submission through Canvas via Turnitin with file name as “2022_HSR1_Assignment1 _last name_first name”

Referencing

• You may use any referencing style so long as it is used
• References do not count as part of the word limit
• Always reference the source of data such that it can be traced – if you cite a website also give the date accessed
• Use “ “ when using a direct quote and include a page number in the reference
• Try and put things in your own words (with citation) unless the way in which the authors say it is so good it is worthy of a direct quotation
• Referencing should be sufficiently clear that the reader to tell when an idea is yours versus when it is being appropriately attributed to someone else
• You do not need to reference core aspects health services research and accepted terminology

– you should not reference lecture slides

1. Andrew is a nurse who works in a ward of a major hospital. He has noticed that there have been an increasing number of errors with medication dosing in his He talks to his Nurse Unit Manager about this and wants to reduce these errors. He plans a short intervention to make some changes to the labelling of medication, and then measures the number of errors after this change. He makes some further changes to improve the labelling based on feedback from other staff, and then measures the impact of these changes again. He finds that after 2 months the medication dosing errors have reduced, and is able to report his success to the hospital executive committee.

(Answer word count guide: 150 words)

1. Describe and compare the main features of quality improvement (QI) and health services research (HSR) projects. (8 pts)
2. State whether you think this project is QI or (One word answer) (2 pts)

2. Hospital managers are working with a team of health services researchers to develop an intervention, called The “Speed Up” Trial, to decrease the time that patients wait to be seen in the knee replacement clinic at The Royal Melbourne Hospital. They have proposed the following research question to be examined: “Does the speed up intervention improve patient wait times?”

(Answer word count guide: 100 words)

1. Why is this a weak research question? (5 pts)
2. Rewrite this research question to provide an example of a good quality research (5 pts)

3. A clinician within a public dental clinic has noticed that refugees make up 60% of their local community population, however, they only make up 20% of their regular They have a ‘hunch’ (they suspect there might be a problem, but they aren’t sure) that there are problems with barriers to accessing dental care, resulting in visits for refugees with more severe dental problems.

(Answer word count guide: 250 words)

1. What might the next steps be in the process of trying to investigate and address this ‘hunch’? (5 pts)
2. Find no more than two published articles on this topic, and list the key points about access to dental care for refugee populations perhaps in Australia or similar countries. (A dot pointed, appropriately referenced, list is acceptable for full marks). (5 pts)
3. What might be some key considerations in the way you approach the steps you outlined in answer a. above, when working with refugees with dental needs? (10 pts)

4. The Australian healthcare system faces many challenges, including an ageing population, growing incidence of chronic disease and increasing costs of care. Often, these challenges interact with each other to create a compounding problem for the healthcare

(Answer word count guide: 250 words)

1. What are some of the ways in which the role of primary healthcare and primary health funding models are failing to address these challenges? Use data/literature to support your (15 points)

5. A family living in Regional Victoria, several hours out of Melbourne, has a child who has a complex medical condition. The family are struggling to have enough money to cover their basic needs and are working multiple jobs. They have a need for multiple appointments with many different services including general practice (GP) care, specialist appointments, social services (who pay for and organise their government benefits), and occupational They constantly feel like they are repeating themselves, and find it difficult to keep all their appointments.

(Answer word count guide: 150 words)

1. What could integrated care look like for these service providers and organisations? (3 pts)
2. What are some of the challenges these service providers and organisations might face in achieving integrated care? (4 pts)
3. If these services were to become integrated, describe the potential benefits for this (3 pts)

6. You have noticed that there is a ‘hot spot’ of much higher-than-average knee arthroscopies being conducted in your local area, as reported in the Australian Atlas of Healthcare New medical advice from the Royal Australasian College of Physicians (RACP) suggests arthroscopic knee surgery for osteoarthritis is 'low-value' and can be harmful for some patients. Assuming there is no legitimate driver of this variation in care (i.e. that this is ‘unwarranted variation’); one could argue that patients aren’t being protected, and quality of care is reduced.

(Answer word count guide: 150 words)

1. What are the three main aims of healthcare legislation? (3 pts)
2. How (if at all) do each of these apply to this problem of healthcare variation? (7 pts)

7. One of the Royal Australasian College of Physicians (RACP) ‘Top 5 Do Not Routinely Do’ lists states that clinicians should "avoid prescribing antibiotics for upper respiratory tract infection”. A review of data within a regional GP clinic has found high rates of this kind of prescribing, and the local Primary Health Network is keen to work with the GP clinic to address

(Answer word count guide: 200 words)

1. What are some potential harms of this example of ‘low value care’? (Please focus your answer only on direct impacts to the patient and the healthcare system). (3 pts)
2. Using the Theoretical Domains Framework as a guide, describe three potential barriers to implementing change in this Be specific to this instance of care. (6 pts)
3. For each of the three barriers that you choose, describe how you might begin to overcome this barrier. (6 pts)

8. Jane is 29 years old and has ruptured her Anterior Cruciate Ligament (in her knee) while She knows that Australia has high out of pocket (OOP) costs compared to other countries, and knows she has a long patient journey ahead of her, including a potentially painful surgery and recovery. She does not have private health insurance.

(Answer word count guide: 250 words)

1. Briefly define OOP costs in your own words. (3 pts)
2. List the possible stages of Jane’s patient journey, and at which stages of this journey she might encounter OOP costs, starting with a GP visit. (7 pts)
3. What implications might high OOP costs have on access to care for people who are on lower incomes, vulnerable populations, or people who find it difficult to access care. Refer to the domains of Health Services Research in your (10 pts)