Asia-Pacific Journal of Health Management <p>The&nbsp;<em>Asia Pacific Journal of Health Management</em>&nbsp;(<em>APJHM</em>) is a peer reviewed journal for managers of organisations offering health and aged care services. It was launched as the official journal of the Australasian College of Health Service Management in 2006. The target audience is professionals with an interest in health and aged care services, research, management and policy development.</p> <p>The mission of the&nbsp;<em>APJHM</em>&nbsp;is to advance understanding of the management of health and aged care service organisations within the Asia Pacific region through the publication of empirical research, theoretical and conceptual developments and analysis and discussion of current management practices.</p> Australasian College of Health Service Management en-US Asia-Pacific Journal of Health Management 1833-3818 In This Issue <p>This is the third and final issue for 2018. We continue in transition from publishing three issues a year to the concept of publish as ready. This has resulted in delays to processing and publishing, so we extend our apologies to both authors and readers. We currently have some twenty articles in review and delays are also occurring in this area in finding willing and receptive reviewers. We would appreciate authors suggesting reviewers as they submit articles.....</p> David Briggs ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i i 10.24083/apjhm.v13i3.129 Health Reform: What have we learned and were to next! <p>Recently I was talking to a colleague of mine from Hong Kong and he reminded me that Hong Kong had had 28 years of health reform. A period just slightly longer than we had known each other. We are deeply imbued in the management and organisation of health services and health systems and, therefore public health policy. He suggested that there should be a lot of learning for us all from that period and, he was exploring how that might happen. I agreed with the idea and the need to think it through. I also recognised potential for the Journal to play some role in that suggestion. Most national health systems have undergone extensive reform so there should be a lot of learning for all of us from that reform.....</p> David Briggs ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 ii ii 10.24083/apjhm.v13i3.111 The Common Barriers and Facilitators for a Healthcare Organization Becoming a High Reliability Organization <p><strong><em>Background: </em></strong>Implementing high reliability organization principles can enhance quality and safety in healthcare. Evidence-based instructions on how to effectively change the organizational culture in healthcare setting are required.</p> <p><strong><em>Objectives: &nbsp;</em></strong>A systematic review investigating methods, facilitators, and barriers to assist healthcare organizations in becoming a high reliability organization.</p> <p><strong><em>Method: </em></strong>Literature searches were performed in PubMed, MEDLINE, CINAHL-Complete, EMBASE, and Scopus for articles published between January 2012 and October 2017. The included articles were case reports, case studies, and protocol development studies on implementing high reliability organization principles. The articles were appraised using a modified Critical Appraisal Skills Programme tool. Thematic synthesis was conducted using manual coding.<strong><em>&nbsp;</em></strong></p> <p><strong><em>Results: </em></strong>Of the 14 eligible articles nine were case studies, four were case reports, and one was a framework development report. The study populations varied from whole healthcare systems to a single department of a hospital. The most common methods were supportive leadership, staff education, and analysing the safety events and sharing the knowledge. Cost was one of the barriers. Remuneration came in reduction of safety events and costs avoided.</p> <p><strong><em>Conclusion</em></strong> Implementing high reliability organization principles in healthcare settings is slow and challenging, but doing so improves quality, resilience, and safety, thus increasing productivity.</p> Elina Karalis Gaery Barbery ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i05 i05 10.24083/apjhm.v13i3.119 Evaluation of the State-Wide Implementation of an Allied Health Workforce Redesign System: Utilisation of the Calderdale Framework <p><em><strong>Background:</strong> </em>Increasing demand for allied health services is driving workforce redesign towards greater productivity within budgetary constraints. To date, there has been limited research into workforce redesign tools at an organisational level. The aim of this article was to evaluate an implementation of The Calderdale Framework for state-wide service delivery workforce redesign within allied health settings across Queensland.</p> <p><strong><em>Method:</em> </strong>A multi-phase methodology with mixed methods of data collection was used. This included analysis of documents, staff surveys, and semi-structured, in-depth interviews with staff from work units utilising the Framework across the state.</p> <p><strong><em>Findings:</em> </strong>The primary mechanisms for implementation were staff training and provision of centralised resources. Across the state, all health services engaged in training and most completed associated workforce redesign projects. However, the number and type of projects varied across the state as did the successful projects. Feedback from staff indicated the structured nature of the framework was viewed positively, but was time intensive to perform. Local contextual factors heavily influenced workforce redesign success.</p> <p><em><strong>Conclusion:</strong></em> Key factors pertaining to state-wide workforce redesign include: providing coordinated and centralised systems to support staff, ensuring adequate training, prioritising the development of key local staff, and proactively managing local contextual factors.</p> Tilley Pain Sarah Patterson Pim Kuipers Petrea Cornwell ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i20 i20 10.24083/apjhm.v13i3.121 Adverse Events Sustained by Children in The Intensive Care Unit: Guiding local quality improvement <p><em><strong>Objective:</strong> </em>To determine the frequency, nature and consequence of adverse events sustained by children admitted to a combined general and cardiac paediatric intensive care unit (PICU).</p> <p><em><strong>Design:</strong> </em>Retrospective analysis of data collected between January 1st 2008 and December 31st 2017 from PICU.</p> <p><em><strong>Setting:</strong></em> The Royal Children’s Hospital, a paediatric tertiary referral centre in Melbourne, Victoria, Australia. The PICU has thirty beds.</p> <p><em><strong>Results:</strong></em> During the study period, PICU received 15208 admissions, of which 73% sustained at least one adverse event with a frequency of 67 adverse events per 100 PICU-days and 3 per admission. One adverse event was sustained for every 35 hours of care. The risk of an adverse event was highest in children less than a month of age, or if mechanically ventilated, a high Pediatric Index of Mortality (PIM2) score, longer PICU length of stay, had a pre-existing disability or a high risk adjustment for congenital heart surgery (RACHS) score. Those patients who sustained an adverse event, as compared to those who did not, were mechanically ventilated for longer (80 hrs Vs. 7 hrs, p=&lt;0.001), had a longer PICU length of stay (131 hrs Vs. 35 hrs, p=&lt;0.001), had a longer hospital length of stay (484 hrs Vs. 206 hrs, p=&lt;0.001) and had a higher mortality rate (3% vs. 0.1%, p=&lt;0.001).</p> <p><em><strong>Conclusion:</strong></em> Whilst admission to PICU is an essential aspect of care for many patients, the risk of adverse events is high and is associated with significant clinical consequences. Monitoring of adverse events as part of quality improvement enables targeted intervention to improve patient safety.</p> Christopher James Carmel Delzoppo James Tibballs Siva Namachivayam Warwick Butt ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i20 i20 10.24083/apjhm.v13i3.113 Managers of Health Services in Australia 2006-2016 <p><em>Purpose:</em> Activity in health services is expanding faster than population growth and that of the production of all goods and services in Australia. This paper is concerned with the number and characteristics of its managers in relation to the number of people employed and resources used. It also assesses different trends in hospitals and other medical and health services.</p> <p><em>Methodology/Design:</em> Design of the analyses follows specifications set by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2016.</p> <p><em>Analysis:</em> Assesses changes in the number and variations in the characteristics of managers of hospitals and medical and other health services, in relation to the number of people employed, contrasted with changes in all industries.</p> <p><em>Findings:&nbsp;</em>There are different trends in hospitals and medical and other health services, with a decline in the number of employees per manager in medical and other health services and a slight rise in hospitals. The older average age of health service managers continued to rise, similarly to that for all industries. The proportion of female managers in health services, below the average for all employees, increased somewhat during the decade. The distribution among the various fields of study remained about the same; but level of education, higher than the average for all industries continued to rise.The growth in average income of managers during the decade was somewhat lower than in all industries, due to a lower increase rate in medical and other health services. The proportion of managers of indigenous status rose substantially – almost double the proportion in all industries.</p> <p><em>Implications</em>: The findings are of relevance to those concerned with the management of health services and training of the growing number of managers of health services in Australia.</p> Jo M Martins Godfrey Isouard ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i26 i26 10.24083/apjhm.v13i3.125 A Study on Management of Health Care Infrastructure Development in Rural India: Critical analysis of current status and future challenges <p>The study has focused on the role of rural health infrastructure development in India. Currently the health infrastructure development of India is poor and it needs fundamental reforms to deal with new emerging challenges. The role of private providers is increasing but simultaneously healthcare facilities are becoming costly. The study surveys the present position of rural health care infrastructure growth, the development of infrastructure, health care facilities, position of human resource, and quality of service delivery.</p> <p>The paper suggests future challenges of Indian healthcare infrastructure development in rural area, as the burden of disease, financial deficiency in a large section of the population, vaccination policy and poor access to health care. Longevity, literacy and per capita income are further considerations.</p> Nenavath Sreenu ##submission.copyrightStatement## 2018-12-16 2018-12-16 13 3 i35 i35 10.24083/apjhm.v13i3.123 Library Bulletin <p>Welcome to this edition of the Health Planning &amp; Management Library Bulletin.&nbsp; It is a comprehensive journal articles and documents related on healthcare managment.&nbsp;&nbsp;</p> Yaping Liu ##submission.copyrightStatement## 2018-12-09 2018-12-09 13 3 10.24083/apjhm.v13i3.107