Centre for Health Systems and Safety Research

Centre for Health Systems and Safety Research

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 are 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 broad 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.

Centre mission


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


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.


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:

  1. 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;
  2. Develop and test rigorous and innovative tools and approaches for health informatics evaluation;
  3. Design and apply innovative approaches to understand the complex nature of health care delivery systems and make assessments of health care safety; and
  4. 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.

Research areas

Diagnostic informatics

Diagnostic testing (laboratory medicine, anatomic pathology and medical imaging) underpin much of our health care system, generating information that is crucial to the prevention, diagnosis, prognosis, stratification of risk and treatment of disease. Whilst diagnostic testing may account for a small (less than 5%) proportion of most hospital budgets, it is considered to have a huge influence on medical decision-making. Diagnostic informatics relates to the gathering, integrating, interpreting and communicating of data and information, an integral part of the diagnostic process and crucial to the quality and safety of patient care.  The diagnostic informatics research team is involved in major areas of research across the diagnostic analytical process.  This ranges from research about the clinical choice of diagnostic request, the quality and efficiency of the analytical process, right through to the interpretation and follow-up of test results and their impact on patient care outcomes. Read more

Medication safety and electronic decision support

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 in hospital and residential aged care facilities.  Read more

Work Innovation, Communication and eHealth

Understanding the way clinical care is delivered is central to supporting effective and safe care delivery models including the design of new service models.  Applying novel measurement techniques, the Centre has undertaken leading research investigating the impact of cognitive load (e.g. interruption and multitasking) on error production and patient safety. Information and communication technologies (ICT) can be used to potentially reduce cognitive load, supporting clinicians in dynamic clinical environments, but research is required to understand how best to design these systems to meet users’ needs.  ICT also provides the 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. Read more

Aged Care Evaluation and Research (ACER)

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. As aged care organisations embrace technology and electronic health record systems, our research is focusing on unlocking these valuable data and linking across health datasets in order to answer important questions about care trajectories and outcomes. Further, our work is focussed on how information technology in this sector can be used to monitor social participation and quality of life as important outcome indicators of community and aged care services, and to be able to assist in monitoring major policy initiatives such as consumer-directed care. Read more

Health Analytics

Information and communication technologies play a significant role in improving the efficiency, effectiveness and safety of the health system.  As such, technologies continue to make inroads into health care at all levels, generating huge volumes of dynamic data from electronic health record systems. Health data analytics provides insights into these rich data. Read more

Our people

Our people have expertise in health informatics, health services evaluation, digital health, medicine, epidemiology, human factors, patient safety, biostatistics, pharmacy, public health, aged care, psychology and health economics.

Director, Centre for Health Systems and Safety Research

Professor Johanna Westbrook

Professor Westbrook is Director of the Centre for Health Systems and Safety Research (CHSSR), Australian Institute of Health Innovation (AIHI).  Her research expertise centres on the design and execution of complex multi-method evaluations in the health sector with a particular focus on the effective use of information and communication technologies.

Academic staff

Professional staff

Visiting appointments

Higher degree research students

  Nicole Jeppeson PhD/Masters of Clinical Psychology
 Antoinette Pavithra PhD
 Gorkem Sezgin PhD
  Bella St Clair-Fenech PhD
  Wilson Punyalack MRes2
 Anil ShresthaMPH Research

Our projects

Our projects focus on the impact of information and communication technologies (ICT) on health care delivery, health professionals’ work and patient outcomes. We design and test innovative tools and apply rigorous approaches to understand the complex nature of health care delivery systems and disseminate evidence to inform policy, system design and practice change.

Key projects

Aged care evaluation and research (ACER) team

Ageing Well: social participation and wellbeing tools to enhance the delivery of quality, person-centred community aged care services

Connections Matter: the role of social networks in community aged care

Driving digital connectivity in residential aged care and the private system with My Health Record
Evaluating the impact of aged care policy reforms
iConnect: Improving the way social interactions are recorded in aged care facilities
Improving the quality of aged care in Australia
Leveraging information technology to monitor the health and outcomes of residential and community aged care clients
Diagnostic Informatics

Optimising the General Practice response to COVID-19 challenges

Enhancing pathology test requesting and result management

Evaluation and optimisation of sepsis risk identification tools

Frequency and variability of haemolysis reporting

Improving test result communication, management and follow-up

Quality use of pathology in general practice

Quality use of pathology services

Variation in hospital pathology investigations

Medication safety and electronic decision support

A qualitative evaluation of Australia’s National Inpatient Medication Chart GP e-Version

An evaluation of indication-based pre-written orders for antibiotics

Drug-drug interaction alerts in electronic prescribing and medication dispensing systems: A multi-system comparison of interfaces

Electronic medication management systems and their impact on pharmacists’ work

Enabling drug-drug interactions in an electronic medication management system: Impact on prescriber alert burden

Impact of alert rate and alert relevance on computerised alert effectiveness

Implementation of electronic medication management systems in hospitals – a literature scan

Investigator Grant - Delivering safe and effective medication management technology
Resilience, Mindfulness and Medication Safety with Electronic Systems (MindSElS)
Work innovation, communication and eHealth

An evaluation of indication-based pre-written orders for antibiotics

Creating a culture of safety and respect

Electronic drug monitoring in rheumatology

Electronic medication management systems and their impact on pharmacists’ work

WOMBAT - Work Observation Method By Activity Timing

Work and communication patterns

Health Analytics

Preventing patient harm in paediatric hospitals: automatic, real-time detection of adverse drug events using data from electronic clinical information systems

Preventing patient harm in hospitals: automatic, real-time detection of adverse drug events using data from electronic clinical information systems

Evaluation and optimisation of sepsis risk identification tools

Optimising computerised decision support to transform medication safety and reduce prescriber burden

 Sepsis epidemiology: a national longitudinal investigation
Other Centre projects

CareTrack Australia

Communities of practice and social-professional networks

Creating safe, effective systems of care: The translational challenge

Delivering safe and effective care for children

Health system sustainability

IT-enabled work innovation

Patient safety

The ACCREDIT project

Our resources

CHSSR has developed a suite of resources relevant to researchers, clinicians, medical practitioners, healthcare and government policy makers, healthcare administrators, students, and industry.

Content owner: Australian Institute of Health Innovation Last updated: 03 Sep 2020 10:22am

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