Keeping Australians out of hospital

Harnessing implementation science and complexity science and evidence-based care to keep Australians out of hospital: leveraging seven natural experiments in New South Wales. (MRFF: APP1178554)

Project Members - Macquarie University

Dr Janet Long - Senior Research Fellow  E:janet.long@mq.edu.au

Professor Jeffrey Braithwaite - Professor and Director  E:jeffrey.braithwaite@mq.edu.au

Dr Emilie Francis-Auton – Postdoctoral Research Fellow  E:emilie.francis-auton@mq.edu.au

Dr Henry Cutler – Director, Macquarie University Centre for the Health Economy  E:henry.cutler@mq.edu.au

Dr Andrew Partington – Honorary Research Fellow  E:andrew.partington@mq.edu.au

Project contact

Dr Janet Long

Project members – external

Prof Jean-Frederic Levesque Chief Executive, NSW Agency for Clinical Innovation

Dr Diane Watson Chief Executive, Bureau of Health Information

Project Main Description

This study aims to leverage seven state-based Leading Better Value Care projects as natural experiments, to identify the factors and levers that stimulate and inform the spread of local, multi-agency, evidence-based clinical projects into sustainable, nation-wide impacts.

Background

Our health care system is facing huge challenges as our population grows and ages, diagnoses and treatments become more sophisticated, and preventable hospital readmissions remain prevalent. While excellent, evidence-based interventions are not lacking, the challenge remains in identifying how to implement them into our complex healthcare system.

The project is centred on seven evidence-based interventions. The interventions address a range of high prevalence chronic diseases to improve patient outcomes and lower readmissions, length of stay and emergency department presentations.

Aims are to measure these projects for their impact on hospital avoidance to date, leverage the evaluation data and results and undertake realist evaluations to support system wide implementation in different contexts. We will develop an optimised and adaptable intervention model and share the knowledge gained with other health systems throughout Australia.

Publications

Sarkies, M., Francis-Auton, E., Long, J, C., Partington, A., Pomare, C., Nguyen, H, M., Wu, W., Westbrook, J., Day, R., Levesque, J-F., Mitchell, R., Rapport, F., Cutler, H., Tran, Y., Clay-Williams, R., Watson, D, E., Arnolda, G., Hibbert, P., Lystad, R., Mumford, V., Leipnik, G., Sutherland, K., Hardwick, R., Braithwaite, J. Implementing large-system value-based healthcare initiatives: A realist study protocol for seven natural experiments. BMJ Open (accepted)

Sarkies, M., Long, J.C., Pomare, C., Wu, W., Clay-Williams, R., Nguyen, H.M., Francis-Auton, E., Westbrook, J., Levesque, J-F., Watson, D.E., Braithwaite, J. Avoiding unnecessary hospitalisation for patients with chronic conditions: a systematic review of implementation determinants for hospital avoidance programs. Implementation Science, 15(1), 91. DOI: 10.1186/s13012-020-01049-0

Project sponsors

Funded by Medical Research Futures Fund APP1178554

Collaborators

NSW Ministry of Health

NSW Bureau of Health Information

NSW Agency for Clinical Innovation

Macquarie University Centre for the Health Economy

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