Allied Health Research and Translation

• Physiotherapist Catherine Williams is the first Barwon Health and Deakin University Clinician Scientist Pathway Scholarship Recipient. The Clinical Scientist Pathway is an innovative collaboration between Barwon Health and Deakin University supporting clinicians to maintain a clinical role at up to 0.5 FTE with protected PhD research time, blending patient care with research.
• Allied Health were successful in securing an Australian Physiotherapy Association Pat Cosh Trust Fund Grant to support ongoing research aiming to improve support for clinical educators. Clinical educators, performing their roles within a healthcare setting, are integral to supporting optimum patient care, delivery of best practice and the professional development of colleagues. The findings of the study will inform the development of a competency-based framework to facilitate improvements in service-based education for physiotherapy practitioners.
• For the first time, Barwon Health oncology dietitians implemented the Victorian Cancer Services Malnutrition Point Prevalence Study. This survey is undertaken every 2 years across Victoria to assess the prevalence of malnutrition risk and identify areas requiring local improvement in the management and treatment of malnutrition in Victorian Cancer Services. This was a great opportunity to be involved in an ongoing regional research project, with credit to the oncology dietetics team for making it happen.
• The HIPSTER study [HIP fracture Supplemental Therapy to Enhance Recovery] has completed recruitment. HIPSTER is a multi-site Australian trial funded by NHMRC that investigates the effects of a more intensive early physiotherapy program on the recovery of patients with hip fractures. It is a huge credit to Rupert Sangster (Principal Investigator), a great team, and the broader physiotherapy department who assisted with the delivery of the trial at Barwon Health that recruitment was completed in May. Data collection will continue until April 2025.
• The Allied Health Clinical Trials Unit is in its formative stages. While currently focusing on oncology trials [supported by grant funding from Cancer Council Victoria, the Victorian Cancer Agency and Western Alliance] the team, led by Catherine Williams, are developing mechanisms to support allied health staff involvement in clinical trials, alongside input from consumers. With the introduction of the National Clinical Trials Governance Framework and the inclusion of clinical trials in healthcare service accreditation, the unit aims to ensure allied health are equipped to do clinical trials, and to do them well.
• The 2024 award of the Dr Renée Sheedy Scholarship were received by the Barwon Health Speech Pathology team with funds awarded to progress research supporting a risk feeding policy and education programme. The programme of work will be led by Speech Pathologist Chloe Brown. Beth Davidson (Allied Health Clinical Trials Co-ordinator [ACT-ONC project] and Dietitian) received funding to support her attendance at World Indigenous Cancer Conference.

There are a number of projects active projects in this stream including:

The Allied Health Clinical Trials Unit – Oncology Project (ACT-ONC Project)

The primary aim of this project is to build capacity for allied health professionals to lead clinical trials in cancer supportive care and survivorship. This is a multi-stage 3-year project funded by a Clinical Trials Management Scheme Competitive Grant from Cancer Council Victoria and the Victorian Cancer Agency ($500,000), and a Funding Support Grant from Western Alliance ($20,000).

The education and training needs of allied health professionals to engage with and lead clinical trials are being explored as part of a Barwon Health/ Deakin PhD by the Project Lead.
Consumer perceptions of allied health clinical trials will also be investigated – recruitment is about to commence in a qualitative study examining consumer needs when engaging with allied health clinical trials as trial participants. Consumers are also as a part of the study design team.

For further information on the ACT-ONC Project please contact Project Lead Catherine Williams, Physiotherapist.

The Exercise Prehabilitation Trial (EXERT)

This is a feasibility trial investigating the use of a remote monitoring digital platform and wearable technology to improve the safety and accuracy of at-home exercise monitoring during prehabilitation (clinician-led exercise) prior to autologous stem cell transplant for individuals with Multiple Myeloma.

This collaborative project between the Institute of Physical Activity and Nutrition (IPAN-Deakin) and Barwon Health (Allied Health and Cancer Services) is about to commence recruitment.

Further background on this trial and a second trial about to start recruitment (the Trismus trial being delivered by the Barwon Health Speech Pathology team, and supported by Chris O’Brien Lifehouse) can be found here.

For further information on this study please contact lead researcher Catherine Williams, Physiotherapist.

Surgery for breast cancer – Barriers and enablers to engagement with prehabilitation

Breast cancer is the most common cancer in Australia. Unfortunately, breast surgery can commonly result in loss of shoulder and neck movement, increased pain and limited ability to participate in everyday life. Actively engaging in clinician-led exercise before surgery for breast cancer (prehabilitation) offers an opportunity to improve fitness, reduce long term issues with shoulder movement, arm strength and pain. Despite established benefits, the Barwon Health prehabilitation service was poorly utilised.

This research aimed to investigate why, with the goal of shaping a service that facilitates more people to access prehabilitation and potential improvements in patient outcomes relating to fitness, neck and upper limb pain and dysfunction. April and the team were awarded a $5,000 Western Alliance Emerging Researcher Seed Grant to support this work.

Preliminary analysis of results indicate that clinician time restraints for discussion about, and referral to prehabilitation may impact on participation rates, while patients expressed motivation to participate in prehabilitation  to improve their overall fitness and wellbeing prior to breast surgery. Analysis and peer review are currently ongoing to enable the team to act on the information to implement improvements to tackle some of the barriers identified by staff and patients. These may include the input of professionals involved in prehabilitation at pre-operative appointments, less time consuming referral procedures and telehealth based resources to supplement face to face information.

For more information on this project, contact the lead researcher, April Chiu, Physiotherapist.

Advancing psycho-oncology care services

Psycho-oncology services are a key element in optimising outcomes for patients undergoing cancer treatment.

Evaluation has been undertaken to appraise an online group psychoeducation intervention for cancer patients that has been integrated into a stepped-care model. The success of this model has generated international interest with the Barwon team leading the way in implementation and evaluation. Further exploration of this model of care is being undertaken as a qualitative study in collaboration with Deakin University.

Quantitative findings that show the psychoeducation intervention appears to be acceptable with high uptake and satisfaction; a significant reduction in waiting times from referral to first intervention and the proportion of patients requiring more intensive 1:1 therapy. Senior Psychologist Fiona Lynch presented findings from this study at the International Psycho-oncology Society (IPOS) World Congress 2023.

For more information on this project, contact the lead researcher Fiona Lynch, Psychologist.

Psychological prehabilitation for people undergoing autologous stem cell transplant: a qualitative study

This project is underway to evaluate the perspectives of patients and healthcare professionals on psychological prehabilitation prior to autologous stem-cell transplant. Barwon Health staff are working in collaboration with Deakin University Masters Research Student Kathryn Wilkin, using qualitative research to guide developments in patient-centred care. Data has been collected and the team are currently analysing the results.

For more information on this project, contact Fiona Lynch, Psychologist.

Family Violence impacts patients and workforce at Barwon Health. From 2018 to mid-2021, Barwon Health received funding to roll out the Strengthening Hospital Responses to Family Violence (SHRFV) initiative, and provide support to Colac Area Health, Hesse Rural Health and Great Ocean Road Health Service to implement this enhanced response to family violence. This initiative sits alongside the Victoria-wide Multi-Agency Risk Assessment and Management Framework (MARAM). Policies, procedures, practice guidance and tools supporting the response to family violence need to align with the MARAM framework and encompass ongoing legislative requirements of the Child and Family Violence Information Sharing Schemes.

Our current research aims to provide an evidence-based understanding of the impact, outcomes, and processes that have evolved through the implementation of the SHRFV project and the expanding legislative requirements. Alongside assessing the impact of implementation, we will be exploring staff perceptions of training that supports engagement in addressing family violence and defining the requirements for a sustainable, effective and legislation-aligned model for the future.

This research aims to support Barwon Health to be instrumental in reducing family violence, family violence injuries, deaths from family violence and facilitate the effective provision of support.

The team is currently in the process of collating a final report of research findings.

This project is led by members of the social work team; Karen Todd & Jacinta Bourke can be contacted for further information.

Elder abuse ravages the lives of older people, decreases quality of life, and increases mortality risk by 40%. This MRFF funded cluster randomised controlled trial aims to improve the lives of older people by providing all subacute health providers with the skills to identify and respond sensitively to this difficult issue. This is a national trial with 10 sites participating across Victoria, New South Wales, South Australia and Western Australia.

No More Shame is a national, world first research study, funded by the Medical Research Future Fund (MRFF), to improve health workers recognition, response, and referral of elder abuse.

Barwon Health is one of ten Australian health providers participating in this randomised control trial (RCT). It has been running at McKellar Centre since February and we have had 17 Allied Health and Nursing colleagues sign up to take part in the study. We are really thankful to the staff who took the time to sign up and complete the baseline questionnaires.

We have now reached the intervention phase of the study. The intervention includes online elder abuse training for health workers; use of the Australian Elder Abuse Screening Instrument; and support from the Barwon Health No More Shame Site Champion – Maggie Sapunar.

The intervention is currently being implemented on the Central, North (Neuro, not Palliative Care) and South wards of the In-Patient Rehabilitation Centre (IRC). Social Work is the main profession delegated to use the screening tool however anyone who completes the training will have access to it. The online training is now available for all clinical staff working on the participating wards.

If you have any questions about this study or would like access to the free, self-paced training feel free to contact Maggie Sapunar,  NMS Site Champion or Karen Todd (Social Work Manager), NMS Primary Investigator.

The Summer Foundation is an organisation who focus on support and advocacy for people with disability who are at increased risk of entry into residential aged care.

This project focuses on the experiences of NDIS participants as they progress from hospital to the community. In order to improve outcomes and timeliness of discharge once medically stable, the processes and challenges need to be investigated and understood.

A number of health services are contributing data to inform the Summer Foundation-led research project, including Barwon Health, by providing relevant information in relation to barriers to discharge.

The Social Work team, led by Karen Todd, are committed to improving the experience of inpatients with disability, as they work closely with people who are eligible for NDIS supports. There are many different ways we actively work to achieve systems change to ensure people who are eligible for NDIS are supported to efficiently access necessary supports.

The provision of this state-wide data has potential to achieve significant change in policy and processes, with the ultimate goal being reduced length of stay in hospital, achieved by speeding up approval times by the NDIS for necessary supports.

For further information, please contact Karen Todd (Social Work Manager) or Erin Parker.

Within healthcare, a major challenge is translating research findings into clinical practice, such that the process of translation, or implementation, has become a science in its own right.

Barwon Health is one of 8 centres engaged in the ‘SENSe Implement’ knowledge translation research project to identify barriers/enablers to implementing evidence-based practice, in partnership with the Florey Institute and Latrobe University.

Targeting assessment and treatment of sensory loss after stroke, this project investigates the use of evidence-based knowledge translation strategies to increase the use of SENSe therapy by physiotherapists and occupational therapists working with stroke survivors

Barwon Health started phase 1 of the trial in 2018, and are currently halfway through completing phase 2.

For more information please contact Melissa Mew (Occupational Therapy).

Every year more than 22,000 Australians break their hip, with this number expected to grow to 60,000 by 2050.

Early movement and walking are key to enabling people to reduce their hospital and rehabilitation stays and return to day to day life, however, historically the amount of physical activity performed by patients who have had a hip fracture whilst in hospital is low.

Barwon Health is proud to be taking part in the “HIPSTER: HIP fracture Supplemental Therapy to Enhance Recovery” randomised controlled trial. This research is a multi-site Australian trial funded by NHMRC that investigates the effects of a more intensive early physiotherapy program on the recovery of patients with hip fractures.

Full recruitment for this study was achieved in May 2024 and data collection will continue until May 2025.

Rupert Sangster, Physiotherapist, Principal Investigator at Barwon Health can be contacted for more information.

The North Primary Care team regularly provide services to refugee and asylum seeker communities and recently, were able to add bicultural workers to the allied health team. There are now 3 bicultural workers supporting some of the most prevalent refugee communities who access care at Corio Community Health Centre.

The primary aim of this team-based research project was to explore the gaps and barriers to health service utilisation for Geelong refugee communities. The research team comprised three bicultural workers, Eh Blu Moo Htay Thoo, Aisha Sallam, Maryam Esghaei; psychologist Joseph Daffy; social workers Erin Parker and Simone Haines and Tracey Young (nurse and primary care coordinator).

Qualitative data was collected from four focus groups from the Karen and Afghan communities. Bicultural workers and refugee health nurses, as well as the wider north area team, assisted with the recruitment of participants.

The data collected indicated several challenges for refugee communities, particularly in relation to use of interpreters. Participants highlighted challenging personal experiences of trying to access a range of health services, including pharmacy, GP’s, optometry and specialist appointments.

Participants overwhelmingly expressed a desire to improve health literacy and requested in person information sessions on health-related topics to do this. Group sessions were requested, with participants stating they welcomed the opportunity to learn from one another. Participants also expressed gratitude to the research team and the health service for having an interest in refugee experiences.

The team are now working on developing new ideas, processes and quality improvement initiatives to act on the learnings from the focus groups. A bicultural worker drop-in clinic is now in place offering group education sessions, which has resulted in increased engagement with health professionals. The team continue to explore further strategies to address the challenges identified.

If you would like a copy of the research report or further information, please contact Erin Parker (Social Worker).

There is an increasing emphasis on involving the public in designing (or redesigning) health services. At Barwon Health, this is referred to as consumer engagement. The National Safety and Quality Health Services Standards have ‘Partnering with Consumers’ as the second of eight standards (Australian Commission on Safety and Quality in Health Care, 2021). This standard details how health services must include consumers in the “planning, design, delivery, measurement and evaluation of systems and services”.

While there are multiple potential benefits of public involvement, many authors have concluded the benefits are lacking in strong evidence. Studies have been primarily focused on outcomes for participants, rather than outcomes for health services, or how these have been evaluated. It is not known how outcomes are, or should, be evaluated.

The purpose of this programme of research is to explore:

• what outcomes from public involvement in health service design occur,
• if and how they have been evaluated,
• the barriers and enablers to evaluation, and
• how evaluation might be improved

This research has benefits for consumers, future practise and policy, and research. Previous research findings indicate that members of the public want to know their contributions to health service design have made a difference. Without improved evaluation, these differences are unknown. It is expected a planning guide/resource will improve the likelihood, ease and quality of evaluations being conducted by key stakeholders at Barwon Health. Improved evaluation will increase knowledge about the outcomes and processes of public involvement in health service design. Evaluation also has an important role in learning for improvement. Improved evaluation and dissemination of these findings will translate into a growing body of research evidence in this area, which benefits Barwon Health and other public health services.

The final study started in July 2024. Together with a group of Barwon Health staff and Consumer Advisors, we are designing materials to support evaluations of consumer involvement. These materials could be used by other health services as well as Barwon Health.

This research is being conducted as part of a PhD at La Trobe University.

Contact physiotherapist Nicola Lloyd for further information.

Lloyd, N., Hyett, N., & Kenny, A. (2023). Barriers and enablers to evaluating outcomes from public involvement in health service design: An interpretive description. Qualitative Health Research, 1-12. https://doi.org/10.1177/10497323231191048

Lloyd, N., Kenny, A., & Hyett, N. (2021). Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review. BMC Health Services Research, 21(1), 364-364. https://doi.org/10.1186/s12913-021-06319-1

A food allergy refers to the reaction of the immune system to a substance (allergen) in the environment which is usually harmless (such as food). An allergic reaction occurs when a person develops symptoms following exposure to an allergen. Dysphagia refers to difficulties in swallowing. People with food allergies and/or dysphagia have specific meal requirements (e.g. no peanuts, texture-modified food, thickened fluids) and may require ‘specified higher-level care’ which involves a specific set of strategies to ensure safety when eating and drinking. These supports may include supervision, assistance with eating/drinking, verbal prompting and regulating the rate of eating/drinking and/or size of mouthfuls. Inappropriate management of food allergies and dysphagia can have life-threatening consequences including choking, aspiration and severe allergic reactions.

Our research has identified challenges in the provision of appropriate food and drinks for patients/residents in healthcare settings. Some challenges are attributable to the enormity & complexity of the food/fluid operation and the inherent risks. However, we have identified a breakdown in the communication and documentation of dietary information to be an attributable factor, amenable to intervention strategies. Our current project aims to implement and evaluate tailored interventions that improve the provision of appropriate food, drink and supervision requirements for patients in inpatient settings and to optimise safety and high quality care. The project aims to benefit over 1051 patients across 21 sites in Victoria’s largest regional health service.

This project has been supported by a $10,000 Western Alliance STaRR Emerging Researcher Grant.

Contact speech pathologists Cara Hill or Rhianon Beggs for further information. for further information.

Identifying patterns of access, use, and discharge from care in the Pain Management Unit

The Barwon Health Pain Management Unit (PMU) is a multidisciplinary service that provides assessment and management of people presenting with persistent pain. Within the PMU, the involvement of different discipline(s) is subject to the individual’s presentation. People with persistent pain may be seen by a single discipline or multiple disciplines, with multidisciplinary care delivered concurrently or asynchronously. The current wait time to access care in the PMU is frequently reported to be problematic and a source of frustration for clients, their referrers, and staff working in the PMU.

A review of routinely collected clinic data aims to establish current wait times to access care in the PMU, as well as service level factors that may be impacting on this wait time, such the amount, duration, and type of care each person receives in the PMU. This data review and analysis will inform the direction of service improvement strategies and the direction of research undertaken by the multidisciplinary PMU team driving initiatives for timely, equitable access to care and innovations in service provision.

For more information contact PMU physiotherapists Erika Kotowicz, Bree Gaylor or Ryan Dahlhouse.

“It’s like it was specifically designed for me”. A Pilot Study Examining iRest Yoga Nidra as a Mind-Body Intervention for Persistent Pain Management

Integrative Restoration (iRest) is a modern, trauma-sensitive adaptation of Yoga Nidra which follows a replicable 10-step protocol.

Starting in 2021, a six week ‘iRest for Pain’ program was offered, via telehealth, to suitable clients as an adjunct to standard care for pain treatment and management. This program was offered by a Clinical Psychologist within PMU, who is also trained as a Level 2 iRest Yoga Nidra teacher. In collaboration with Deakin University School of Psychology, a qualitative feasibility and acceptability trial began in 2022.

Two intakes of iRest for Pain participants were interviewed about their experience of the program. Analysis of this data identified three themes which reflected a range of therapeutic benefits and increased self-efficacy: 1) “Nothing Ventured, Nothing Gained”, 2) “It’s like It Was Specifically Designed for me”; 3) “I Am Not Pain, I Have Pain”.

This qualitative study provides preliminary evidence that iRest is an acceptable and beneficial mind-body intervention for people with persistent pain by facilitating foundational self-management of pain skills including; awareness of sensations, emotions and thoughts, self-regulation, relaxation and mindfulness. Valuable insights were gained into how iRest could meet critical gaps in service delivery and future directions for research, including utilising iRest to support opioid reduction. These findings were presented at the 2024 Australian Pain Society 44th Annual Scientific Meeting in Darwin in May 2024.

The iRest for Pain program is ongoing at Barwon Health with plans to undertake further quantitative exploration of acceptability, and effectiveness of this novel intervention as an adjunct to multidisciplinary pain management in 2024.

For more information contact Meg Barber (Clinical Psychologist).

Evaluation of Structured Group Supervision for allied health clinicians across varied groups

Clinical supervision is necessary to support allied health professionals in their roles, facilitate continued professional development and to ensure patient safety and clinical care. Group supervision has been shown to be an effective and efficient way to achieve the benefits of clinical supervision for allied health professionals. However, little is known about how the profession, group composition or the model of supervision influence the effectiveness of group supervision.

This project aims to determine the feasibility and effectiveness of highly structured group supervision, utilising groups with different compositions of allied health professions. Twelve groups of allied health staff have nominated to participate in group supervision. Participants will participate in 12 months of group supervision and complete evaluation surveys.

For further information on this study please contact Angela Brommeyer – Allied Health, Centre for Education and Training.

Supporting physiotherapy clinical educators – Identifying key competencies as a foundation for physiotherapy clinical educator career progression within a healthcare environment

Clinical education takes place throughout the career lifespan for Allied Health professionals, from being students to advanced practice staff working in highly specialised roles. Clinical staff also take on the role of clinical educators throughout their career, some specialising in this field and taking on designated clinical educator roles.

Providing clinical education requires a number of skills that vary at different career stages. The value of high-quality clinical supervision/education has the potential to be impactful across a number of patient care and profession-related factors.

The aim of this study is to explore what the perceived competencies & capabilities are for physiotherapists delivering clinical education at different levels of their educator career progression. These findings will be used to identify professional development requirements and underpin a Clinical Educator Framework to support physiotherapists developing their skills in clinical education delivery.

This project is being supported by grant funding from the Pat Cosh Trust Fund

Please contact Paula Harding (Director of Allied Health) or Denise Jones (Allied Health Research and Knowledge Translation Lead) for more information.

The AdvICE course: leveraging clinician experience in interprofessional education to promote collaborative practice

As part of the global agenda to increase the interprofessional collaborative practice capability of the healthcare workforce, it is recognized that post-qualification health professionals require interprofessional education (IPE) to upskill them in the key competencies of collaborative practice. Previously published accounts of IPE initiatives directed as post-qualification health professionals have been based in a specific practice setting within a health service or related to a specific health condition. Differing from these initiatives, the Advancing Interdisciplinary Clinical Excellence (AdvICE) IPE course is offered to experienced clinicians across settings and professions at Barwon Health. This study evaluated the impact of the AdvICE course on participants’ interprofessional collaborative practice beliefs, attitudes and behaviours.

Participants experienced improvements in self-perceived interprofessional beliefs, attitudes, and behaviours, and willingness to work in interprofessional relationships. Participants also reported interprofessional learning related to role clarification, interprofessional communication, conflict resolution, clinical teaching and supervision. Interprofessional education initiatives, such as the AdvICE course, that target experienced clinicians across a health service may be valuable in contributing to the World Health Organization’s recommendation to develop champions of interprofessional collaborative practice

Shaw, N., Evans, S., & Hewitt, Y. (2023). The AdvICE course: leveraging clinician experience in interprofessional education to promote collaborative practice. Journal of Interprofessional Care, 37(5), 832-835.

Please contact Nicole Shaw (Clinical Education Team) for more information

Improved values- based goals of care documentation through interprofessional communication education  

This study explores the impact of interprofessional education (IPE) for communication skills on goals of care documentation in an acute setting

Shared decision making for goals of care decisions is a process that is influenced by informal and formal communication interactions with all health care professionals. Medical discussion for goals of care is a formal process. However, informal conversations between patients, their significant others and other health care workers has been shown to be influential in shared decision making for advance care planning, goals of care and end of life decision making.

This study found that Interprofessional education, characterised by two or more professions learning with, from, and about each other for communication skills, correlated significantly with improvement in documentation of values-based goals of care for patients with life limiting illness in acute care.

Preliminary results were presented at ANZAHPE (Australian & New Zealand Association for Health Professional Educators) conference in Adelaide.

Barwon Health Audiology is a key regional collaborator with the Bionics Institute, in an exciting trial researching new hearing technology, aiming to improve speech development.

Babies born with hearing impairment will benefit from a $500,000 grant from the Victorian Government’s Victorian Medical Research Acceleration Fund (VMRAF), which will accelerate development of a new hearing test for babies.

EarGenie is a revolutionary technology from the Bionics Institute that uses near-infrared light to measure the brain’s response to sound in infants, allowing audiologists to confidently select the best treatment for the first time. The EarGenie technology comprises a soft band containing near-infrared light sources and light detectors, which is wrapped around the baby’s head while asleep.

When a sound is played, specialised software records the brain’s response through changes in the reflected light, which can help audiologists to select an appropriate hearing aid or know when to refer the baby for a cochlear implant.

The research team is seeking infants under the age of 24 months to participate in the clinical trials so the technology can be developed for use in clinics as quickly as possible. Geelong newborns will be part of a trial at Barwon Health where the audiology team will be using a prototype EarGenie device to collect data and provide clinician feedback on the system design.

Recruitment will commence at Barwon in 2024.

For more information on participation, go to: Participate in Infant Hearing Research or contact Rachael Hyder, Manager Audiology, Barwon Health and site Principle Investigator for further information.

Endometriosis is a chronic condition in which cells similar to the lining of the uterus, or endometrium, grow outside the uterus and can be associated with is a disease associated with severe, life-impacting pain. Persistent pelvic pain (PPP) can be associated with pelvic floor muscle tenderness and tension. These problems may be associated with pelvic pain continuing after medical or surgical treatments for endometriosis.

Specialist physiotherapist Naomi Nalder is the Barwon Health Principal Investigator for this study aimed at women with pelvic pain who are going to have laparoscopic (keyhole) surgery. The study involves an investigation of pelvic floor muscles and pain experiences before and after surgery. Recruitment for this study is currently ongoing and more details can be found here.

For further information on this study please contact Naomi Nalder (physiotherapist).

The innovative Paediatric Eating Disorders Service Hospital in the Home (HITH) program was designed to address the increased prevalence of paediatric eating disorders during the Covid-19 pandemic; the difficulty accessing prompt and effective treatment and the increased need for long hospital admissions due to high patient acuity. The HITH program aims to maintain the same weight gain success obtained by an inpatient admission, but with reduced burden of inpatient care and myriad associated benefits.

Results confirm comparable clinical effectiveness of the HITH program. Secondary outcomes reflect reduced need for inpatient admission. The HITH program has the potential to radically change the way we care for paediatric patients with an eating disorder, leading to a substantial reduction in the time spent as an inpatient; reducing the need for protracted, expensive inpatient hospital admissions and facilitating safe and effective patient and family-centred care.

Findings of this study were presented at the Australia & New Zealand Academy for Eating Disorders Conference and an award winning poster at the Better@Home annual forum.

For further information please contact Dr Johanna (Jo) Centra (Visiting Medical Specialist) or Emily Hamilton (Dietitian

Osteoarthritis (OA) commonly affects the knee and hip joints and is a leading cause of pain and disability worldwide. International and national guidelines recommend exercise-therapy and education as primary treatments but there is a known gap between this recommended OA management and the care provided to Australians. The Good Living with OA in Denmark (GLA:D®) was developed to provide a program of clinician education; structured supervised exercise and education sessions to people with OA and the systematic collection of outcome measures. This programme has been adapted to the Australian setting and is now delivered nationally.

Current Australian data reflects comparatively poor access to GLA:D® Australia within the public health system and a subsequent imbalance in the outcome data gathered and applicability of findings across healthcare providers. Barwon Health is among the first public health services to adopt the GLA:D® Australia education and exercise programme. This is now integrated into care pathways at Barwon Health, providing access to best-practice care and enabling our patients to contribute to the national data base that will guide the development of evidence-based care delivery.

Working with the GLA:D® Australia team at La Trobe University has enabled staff to become familiar with the rigor required to maintain the integrity of data within a national research programme and supported the development of Allied Health research capacity.

For more information, please contact Denise Jones (AHRKTL), Gabby Schultz or Jess McDonald (Physiotherapists).

Study site: University Hospital Geelong

More than 120,000 hip and knee joint replacements occur in Australia each year and this number is expected to double over the next 10 to 20 years. To improve access to safe and effective surgical care, Enhanced Recovery After Surgery (ERAS) protocols are being implemented internationally. ERAS protocols are designed to provide standardised evidence-based care to patients before, during and after surgery. Barwon Health is currently implementing ERAS protocols for a colorectal and joint replacement surgery.

This quality assurance activity will investigate if outcomes following joint replacement surgery have changed following the implementation of ERAS. Primary outcomes include patient length of stay, complications and the patient’s experience of care.

Implementation of the ERAS protocol is a quality improvement activity at Barwon Health. Inherent to this activity is program evaluation including process evaluation and outcome evaluation. The current ethics application is to enable the potential dissemination of the results of this quality improvement activity beyond Barwon Health.

Sample size

It is anticipated that approximately 150 patients will be eligible to participate in ERAS each year.

Interventions

The ERAS protocol has been designed by key stakeholders at Barwon Health and includes evidence-based optimisation of patient care before, during and after surgery.

Outcomes

• Compliance with the ERAS components
• Hospital length of stay
• Postoperative complications
• Unplanned return to theatre
• 30-day Emergency Department presentation
• 30-day hospital readmission
• 30-day falls following discharge
• Analgesia resupply requirements and additional dressing changes post-discharge
• Patient experience
• Patient reported outcomes measures

Collaborators: This project is a collaboration between all departments that contribute to Care for people undergoing replacement surgery of the hip or knee

For further information on this project, please contact Stephen Gill (PhD, Physiotherapist)

Western Alliance is committed to building research in western Victoria and supporting the translation of research findings into healthcare. Our congratulations to these emerging Barwon Health researchers, who have been awarded Western Alliance research grants and scholarships:

STaRR Emerging Researcher Seed Grant

• April Chiu, Physiotherapist, Barwon Health: Barriers and Enablers to Prehabilitation prior to Breast Cancer Surgery in a Regional Health Service.

STaRR Emerging Researcher Translation Grant

• Rhiannon Beggs and Cara Hill, Speech Pathologists, Barwon Health: Improving the provision of prescribed food, fluid, and mealtime supervisions requirements in inpatient aged care settings.

Western Alliance Higher Degree By Research Scholarship

• Cara Hill has been awarded a PhD with Deakin University to implement best-practice meal-related dysphagia interventions to improve mealtime-related quality of life for people living with dysphagia in rural and regional aged care facilities in western Victoria. Cara works clinically as a Speech Pathologist and also as a research assistant. This PhD program will be based at Grampians Health and will complement the work she will be leading as part of her Western Alliance Rapid Applied Research Translation Grant.

Barwon Health is proud to highlight the recent research publication presenting the work undertaken by Dr Renee Sheedy as part of her PhD research.
Dr Renee Sheedy, Senior Acute Neurological Physiotherapist, was one of Barwon Health’s pioneer allied health clinician researchers. Renee’s PhD research formed part of the A Very Early Rehabilitation Trial (AVERT) study, which investigated the impact of early physical mobilisation after stroke.

Renee sadly passed away following a battle with brain cancer before her work could be published. She was granted a well-deserved Doctor of Physiotherapy (Professional Doctorate) posthumously by La Trobe University, Melbourne.

With the assistance of Renee’s colleagues at Barwon Health and her family who helped acquire the data needed to complete this manuscript, Renee’s co-authors were able to publish her research in the journal Stroke Research and Treatment.

The paper demonstrates that the vast majority of stroke patients are inactive in the first few days following a stroke. This is concerning given that the Clinical guidelines for stroke management promote the commencement of out of bed activity within the first few days of the stroke (unless contraindicated). It is hoped that the findings of this research will prompt some evidence-informed changes to clinical practice.