The NICS Leadership Program Alumni comprises those people who have completed a NICS Fellowship or Scholarship.
Dr Melanie Benson, NICS-VQC Fellow 2006 - 2008
Project: Improving the management of cancer pain
Dr Benson’s project was a multi-level intervention at Peter MacCallum Cancer Centre, Melbourne, targeting resident medical officers, senior clinicians, and the organisation itself. The project aimed to influence clinical behaviour and improve the gap between evidence and clinical practice in the area of cancer pain management. Focussing on pain assessment and prescribing, Dr Benson surveyed clinicians at the ‘coal face’ of managing inpatients to understand their knowledge, attitudes and prescribing behaviour. She also conducted a barrier assessment at the organisational level, to gain a better understanding of organisational barriers to implementing best practice in the management of patients with cancer pain.
Dr Benson's fellowship was supported by the Victorian Quality Council (VQC).
Dr Taryn Bessen, NICS-RANZCR Fellow 2006-2008
Project: Improving the uptake of imaging guidelines in the emergency department
With an increasing number of emergency department attendances and the resultant radiology referrals, Dr Bessen’s project was intended to improve the effectiveness of care by ensuring that imaging use is appropriate and based on best available evidence.
Dr Bessen was implementing the Ottawa Ankle Rule within the Royal Adelaide Hospital and Noarlunga Health Service's emergency department. The objective was to design and implement interventions that effected a change in the core process of test ordering and were capable of affecting rotating and shift work staff who may have been unfamiliar with the Ottawa rules. Lessons learnt are useful for implementation of future evidence-based imaging protocols in emergency departments.
Dr Bessen's fellowship was supported by The Royal Australian and New Zealand College of Radiologists (RANZCR).
Clinical Associate Professor Stacy Goergen, NICS-RANZCR Fellow 2006-2008
Project: Promoting evidence-based diagnostic testing for suspected venous thromboembolism: the importance of pre-test risk assessment and D–dimer evaluation before imaging
Dr Goergen’s project aimed to improve the use of evidence-based guidelines for diagnostic testing of patients with suspected venous thromboembolism. The project involved introducing, disseminating, and implementing evidence-based guidelines for the use of imaging in patients with suspected pulmonary embolism or deep venous thrombosis of the lower limbs.
Through monitoring clinicians’ implementation of the guidelines and addressing barriers to getting the guidelines into day-to-day clinical practice, Dr Goergen aimed to reduce inappropriate or unnecessary testing of patients. The implementation project took place with the emergency departments of the three campuses of Southern Health in outer suburban Melbourne, Victoria.
Dr Goergen's fellowship was supported by The Royal Australian and New Zealand College of Radiologists (RANZCR).
- Stacy Goergen Fellowship Profile (PDF, 75KB)
- Poster of Dr Stacy Goergen's Fellowship project (PDF, 303KB)
Ms Cheryl Kimber, NICS-SA DoH Fellow 2006-2008
Project: Preventing osteoporosis-related fractures from happening again
Studies have found that a majority of patients with osteoporosis-related fractures do not receive the evaluation and/or treatment for osteoporosis called for by clinical guidelines. Ms Kimber’s project aimed to improve the identification and management of osteoporosis in patients with low trauma wrist fractures at Flinders Medical Centre in Adelaide, South Australia.
Through a targeted strategy including discussion forums, audit and feedback and reminders, Ms Kimber aimed to encourage medical and nursing staff’s participation and uptake of osteoporosis guidelines. With clear evidence showing that a single low trauma fracture indicates a sufficient risk of future fracture, improved management of patients with osteoporosis-related fractures will lower the risk of further fractures occurring.
Ms Kimber's fellowship was supported by the South Australia Department of Health.
Dr Sepehr Shakib, NICS-SA DoH Fellow 2006-2008
Project: Improving the management of heart failure at the interface of the hospital and community
Dr Shakib’s project aimed to improve the evidence-based management of patients with congestive cardiac failure who are discharged from Royal Adelaide Hospital’s general medicine. Implementing a holistic, multidisciplinary approach, Dr Shakib developed a range of systems and tools for implementation in a congestive cardiac failure clinic.
In consultation with patients and GPs, individualised, evidence-based goals were established, aimed at improving the management of each patient’s condition within the community.
Dr Shakib's fellowship was supported by the South Australia Department of Health.
Dr Jane Munro, NICS Fellow 2005-2008
Project: Kids' comfort: improving procedural pain management in children and adolescents within a tertiary paediatric hospital
Many studies within the adult and paediatric literature, both nationally and internationally, emphasise the consistent theme of inadequate management of pain in hospitals. Dr Munro's project investigated the barriers to proper pain relief for children and adolescents through the development of interventions that promote the adoption of evidence into practice. Her project aimed to improve procedural pain management in children and adolescents undergoing medical procedures, such as blood tests, wound dressings and intravenous line insertions at the Royal Children's Hospital, Melbourne.
Dr Luke Bereznicki, NICS Scholar 2004-2007
Project: Improving the safety and efficacy of anticoagulant drug therapy in clinical practice
This project aimed to improve the safety and efficacy of anticoagulants through trialling an anticoagulation pharmacist position in the hospital environment for six months. The project also involved training newly initiated warfarin patients to measure and adjust their own warfarin therapy with the aid of a portable monitor. In particular the aim was to improve the initiation of warfarin therapy, improve communication in the transition between acute and primary care and improve the use of low molecular weight heparin in the hospital setting.
Dr Robyn Clark, NICS Scholar 2004-2007
Project: Chronic heart failure beyond city limits: improving evidence-based care for rural and remote patients
Dr Clark's project was part of the NHMRC/Monash University Department of Epidemiology and Preventative Medicine, Chronic Heart Failure Assistance by Telephone study (CHAT). The study evaluated the impact of supporting chronic heart failure patients through combining telenursing and the National Heart Foundation of Australia evidence-based guidelines for the management of heart failure.
Associate Professor Steven Doherty, NICS Fellow 2004-2007
Project: Increasing the uptake of guidelines in rural emergency departments
This project aimed to implement evidence-based guidelines on asthma and paediatric emergency conditions throughout hospitals in the New England region, NSW. Although various evidence-based clinical guidelines had been disseminated to emergency departments, the use of the guidelines in day-to-day clinical practice was low.
Associate Professor Doherty developed a tailored implementation plan including guideilne formatting, education, audit and feedback, reminders and use of opinion leaders. The evidence-based implementation was successful in improving the use of guidelines in emergency care, with immediate positive changes in clinical behaviour, and sustained gains at 12 months.
- Steven Doherty - Main Messages (PDF, 30KB)
- Steven Doherty - Executive Summary (PDF, 33KB)
- Poster of Steven Doherty's Fellowship implementation project (PDF, 275KB)
- Steven Doherty Fellowship Profile (PDF, 68KB)
Dr Claire Harris, NICS Fellow 2004-2007
Project: Promoting the uptake of evidence in paediatric care
Focusing on identifying and documenting which strategies are most successful in implementing evidence in paediatric care, Dr Harris' project involved an in-depth observational and qualitative investigation of the 'Health for Kids in the South East' project.
- Claire Harris - Main Messages (PDF, 36KB)
- Claire Harris - Executive Summary (PDF, 40KB)
- Claire Harris Fellowship Profile (PDF, 67KB)
Ms Sonja Hood, NICS Scholar 2004-2008
Project: Getting evidence into practice: the management of heart failure in Australia
Ms Hood’s project identified projects which have aimed to improve the pharmacological management of heart failure, and the factors which have facilitated and hindered implementation of change in these projects. Heart failure is a major cause of death and disability in Australia, however evidence shows that many patients with heart failure do not receive optimal management of their condition.
Dr Shane Jackson, NICS Fellow 2004-2006
Project: Reducing the risk of stroke in atrial fibrillation
Using an evidence-based approach, Dr Jackson's project aimed to increase the use of anticoagulants (such as warfarin) in patients with atrial fibrillation (AF), where the benefits of these drugs clearly outweigh the risks. The use of anticoagulants in patients with AF (a rapid and irregular heart beat) has been shown to reduce the risk of stroke by over two-thirds but can be associated with an increased risk of bleeding complications in some patients.
- Shane Jackson - Main messages (PDF, 48KB)
- Shane Jackson - Executive summary (PDF, 40KB)
- Poster of Shane Jackson's Fellowship implementation project (PDF, 225KB)
- Shane Jackson Fellowship Profile (PDF, 75KB)
Dr David Pierce, NICS Fellow 2004-2007
Project: Improving management of depression in primary care
With depression affecting at least 750,000 Australians each year, this project aimed to assist general practitioners' (GPs) treatment of this condition. Commonly used treatments are medications (antidepressants) and counselling (psychological treatments), with many patients expressing a wish for the latter. This project aimed to support increased provision of an evidence-based psychological treatment - problem solving therapy - by GPs. The project aimed to develop GPs' competence in providing problem solving therapy (PST) as a depression treatment that is practical, effective and evidence-based, as well as being suitable for use in day-to-day practice.
The project involved developing and implementing a targeted training program. This program is the first Australian program dedicated to training GPs in PST; it is much shorter, and potentially more accessible, than previous programs; and it involves the use of actor patients to develop GPs' knowledge, skill and confidence in providing PST. The training was effective in improving GPs' PST competence, with most GPs' knowledge of PST, confidence in providing PST and skill in using PST in a simulated consultation increasing. In addition GPs expressed intention to use PST and measured use of PST in actual consultations increased.
Dr Kevan Polkinghorne, NICS Fellow 2004-2007
Project: Commencing haemodialysis with appropriate vascular access
Dr Polkinghorne's project aimed to increase the number of kidney failure patients commencing dialysis with the best possible vascular access, the arteriovenous fistula. The project examined the factors that prevent timely surgical creation of a fistula (a method of accessing the blood circulation by surgically connecting a vein in the arm to an artery) and developed targeted interventions to implement best evidence-based practice.
Ms Ruth Sladek, NICS Scholar 2004-2008
Project: Cognitive biases and uptake of evidence in clinical practice
When we make decisions we often rely on ‘mental rules of thumb’ (also known as heuristics). These are based on past experience and are used more frequently in times of uncertainty. Ms Sladek investigated the role of individual differences in reasoning between doctors, and how these differences might influence clinical decision making and the uptake of new research evidence. Using a theoretical framework of dual processing models of reasoning, she explored differences in cognitive processing which have been found to influence the two proposed modes of reasoning: the experiential and the rational.
Dr Vitali Sintchenko, NICS Research Fellow 2004-2006
Project: Improving the effectiveness of doctors using evidence through electronic decision support.
Dr Sintchenko, along with colleagues at the Centre for Health Informatics at the University of New South Wales, has systematically reviewed the literature on the effectiveness of electronic decision support as a means of improving clinical decision making. He has undertaken a survey of GPs across Australia, exploring the information needs of clinicians in using electronic decision support systems.
A note on report format
The format of the reports on this page follows an adaptation of the Canadian Health Services Research Foundation’s 1:3:25 page style.
The main messages are presented in one page. These are the lessons that decision makers can take from the project findings.
A three-page executive summary follows. Here the project’s findings are condensed to serve the needs of the busy decision maker.
The third element is the full project report.
This approach aims to give busy people an opportunity to dip into projects and look further into areas they may be interested in, without having to read full reports. It also gives readers an idea of which reports may be most relevant for them to read to develop their knowledge of an area of implementation science.