Centre for Health Systems and Safety Research | AIHI - Australian Institute of Health Innovation

Centre for Health Systems and Safety Research | AIHI - Australian Institute of Health Innovation

About the Centre

Information exchange is the core of a safe, efficient and effective health system. The Centre for Health Systems and Safety Research (CHSSR) conducts innovative research aimed at understanding and improving the way in which health care delivery and patient outcomes are enhanced through the effective use and exchange of information.

Health systems internationally are coming under increasing pressures driven by demographic, social and technological change. Existing models of health care delivery will not be sustainable in future decades. Information and communication technologies have a significant role to play in creating opportunities for new models of care delivery. Examples range from telemedicine applications supporting care delivery in the community to sophisticated clinical decision support systems accessible to clinicians at the point of care.

Such interventions are designed to improve the efficiency, effectiveness and safety of the health system. Health systems around the world are making vast investments in such technologies often with limited evidence regarding the extent to which these systems will deliver desired benefits.

Our research centres on designing rigorous and innovative approaches to evaluate these health informatics interventions and to apply these methods to provide evidence of effectiveness, efficiency and safety. A unique aspect of the Centre’s work is the application of rigorous evaluation approaches which bring together highly quantitative methods grounded in epidemiological techniques married with the use of qualitative approaches including techniques such as video observational studies and social network analyses. We focus upon investigating and measuring both expected outcomes, for example reduced medication error rates following introduction of electronic prescribing systems, as well as unexpected outcomes in care delivery such as changes in the nature and amount of face-to-face communication between health care providers.

The Centre is internationally recognised for this work and constitutes the largest health informatics evaluation research team in Australia. Our work is highly competitive with other international research teams in this area and our research program is characterised by strong engagement with national and international academics from a board range of disciplines, health practitioners, government bureaucrats, policy-makers and information system industry leaders. We aim to make significant scientific contributions to the disciplines of health informatics, health information management, evaluation methodologies and safety and quality in health care. Further we seek to promote the translation of our research findings into health care policy, implementation and evaluation approaches within the health care sector.

Vision

Our vision is to lead in the design and execution of innovative health systems research.

Mission

Our mission is to lead in the design and execution of innovative health systems research focused on patient safety and the evaluation of information and communication technologies in the health sector, to produce a world-class evidence-base which informs policy and practice.

Aims

The Centre's research is underpinned by a systems perspective, exploiting multi-methods. Our research team is characterised by their talent and enthusiasm for working within and across discipline areas and sectors. The Centre has a focus on translational research, aimed at turning research evidence into policy and practice.

The Centre's research program has four central aims:

  • Produce research evidence of the impact of information and communication technologies (ICT) on health care delivery (efficiency and effectiveness), health professionals'; work and patient outcomes;
  • Develop and test rigorous and innovative tools and approaches for health informatics evaluation;
  • Design and apply innovative approaches to understand the complex nature of health care delivery systems and make assessments of health care safety; and
  • Disseminate evidence to inform policy, system design, practice change and the integration and safe and effective use of ICT in health care.

Functions and goals

The functions of the Centre are to:

  • Build capacity and research capability in health systems research, patient safety and health informatics
  • Deliver research output in the form of grants, publications and presentations
  • Participate in the development and sharing of infrastructure and research expertise for research across the Centres of the AIHI
  • Encourage and support collaboration across the Centres
  • Forge relationships between the Institute Centres and other entities within and external to the University
  • Continue to build and consolidate an international reputation in health systems and safety research

This will be achieved through:

  • Strong collaborative research programs supported by continued peer-reviewed grants and commissioned research
  • Extensive linkages with industry, practitioners and policy makers at local, state and national levels to improve the relevance and impact of research
  • Increased numbers of skilled researchers undertaking research and evaluation activities in the area of health systems and safety research
  • Increased numbers of post graduate research students
  • Exercising influence via dissemination and transfer of research findings through publications, presentations and forums with a focus on academic, industry, practitioner and policy maker audiences.

Our research areas 

Pathology and imaging informatics

Pathology and medical imaging services perform a major role in the delivery of patient care by ensuring reliable and accurate results are delivered in a timely fashion to inform clinical management decisions.  Over the last three decades, there has been considerable growth in the number of requests for pathology and medical imaging services. Our research is investigating the use and impact of electronic pathology and imaging systems to improve the appropriate and efficient use of pathology and imaging services in hospitals. Topics of investigation include the impact of IT systems on improved laboratory test turnaround times, and the follow-up and management of test results to inform decision-making. Read more

Human factors evaluation and design

Understanding and improving the fit between users and their work environment (including information technology) ensures that work is safe, productive, and efficient. We apply a broad range of methods, including field observations, interviews and focus groups, simulation, and system logs to understand how information technology is being used by clinicians, and to identify well-designed and poorly designed features of systems. Projects have included, for example, exploring the use of mobile technologies by doctors on ward-rounds, and evaluating and optimising the design of computerised alerts for prescribers. Read more

Medication safety and eHealth

Medication error and inappropriate medication therapy are two of the oldest, most costly and least tractable safety problems which health systems face.  Information technology has the potential to make medication management safer and more effective. With that expectation, health systems worldwide are making vast investments in information technology. Our research is investigating the ways in which information technology can reduce medication errors and support improved medication therapy decisions and outcomes. Medication safety within residential aged care facilities is a particular area of focus. Read more

Work innovation, communication and eHealth

Understanding the way clinical care is delivered is central to supporting effective and safe delivery models including the design of new models.  Applying novel measurement techniques, the Centre has undertaken leading research investigating the impact of interruptions on error production and patient safety. Information and communication technologies (ICT) provide an opportunity to reshape the composition of teams who deliver care, and the processes of care delivery. ICT may both enhance and disrupt patterns of work. Our research investigates patterns of clinicians’ work, and how ICT influences workflow and workloads. We apply a broad range of methods including direct observational methods, social network analysis and qualitative techniques. Projects have included investigation of the relationship between organisational culture and ICT use, the impact of electronic health record systems on workflow and efficiency, and clinicians’ actions in response to electronic decision support alerts. This research covers broad discipline areas such as cognitive psychology, process engineering, communication processes, health informatics and operations research. Read more

Safety and integration of aged and community care

Delivering care and services to ageing populations is a significant challenge internationally.  Communities and health systems are seeking effective ways to plan and manage the health and support services required to enable citizens to actively engage in society and maintain a high quality of life.  Information and communication technologies (ICT) can help meet these challenges by offering direct assistance (e.g. telehealth) which promote individuals’ engagement and social connection and, through large-scale electronic health record systems, which can enhance the integration and coordination of care across health care sectors. Our research is investigating these issues, including the use of community support services and impact on social engagement, the effects of consumer-directed care in supporting improved outcomes, the quality of care provided within residential aged care facilities and the role of ICT. Read more

Primary care safety and digital health

The field of patient safety in primary care is an emerging research area which encompasses a broad range of settings and themes.  There is limited scientific evidence of the risks to patient safety in primary care settings, although there is some understanding that the provision of primary health care from a safety perspective could be greatly improved.  Digital health is integral to many of our daily processes in the delivery of safe primary health care in Australia and other countries with a similarly developed health care system - it is a major component in the interface of primary care with secondary and tertiary health care settings.  Our Centre is focused on research that explores these subjects. We are working to expand our understanding of them, and to close the gap between what we know and what we do.  We are currently conducting projects that are defining the nature of threats to patient safety in primary care, and examining interventions that reduce these threats.  We are investigating the use of digital health in primary care settings, including electronic clinical information systems, My Health Record, secure messaging and electronic medication management and decision-support systems. Read more

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