The Translating Research Into Practice (TRIP) Fellowship was previously named the National Institute of Clinical Studies (NICS) Fellowship. The following information provides a complete listing of the NICS Fellows and Scholars. NHMRC gratefully acknowledges the support of the co-funding partners:
- Cancer Australia's National Centre for Gynaecological Cancers
- Department of Veterans' Affairs
- Gastroenterological Society of Australia
- HCF Health and Medical Research Foundation
- Heart Foundation
- Melbourne Health
- Motor Accident Commission
- Multiple Sclerosis Research Australia
- National Breast and Ovarian Cancer Centre
- National Prescribing Service
- Queensland Health
- South Australia Department of Health
- South Australia Health Nursing and Midwifery Office
- Therapeutic Guidelines Limited
- The Royal Australian and New Zealand College of Radiologists
- Transport Accident Commission
- Victorian Quality Council
- Western Australian Department of Health
National Institute of Clinical Studies (NICS) Fellows and Scholars
Dr Celia Chen, NICS-Multiple Sclerosis Research Australia Betty Cuthbert Fellow
Ophthalmologist, Flinders University, SA
Optimising the management of acute optic neuritis in people with Multiple Sclerosis
80% of people with Multiple Sclerosis (MS) will have at least one episode of optic neuritis, an inflammation of the optic nerve, which results in painful loss of vision. Prompt treatment can result in faster recovery and as MS is a chronic disease, patient knowledge and motivation is vital to ensuring optimal management however, suitable information is not always readily available. Dr Chen will develop and implement information tools about the symptoms and treatment options for optic neuritis, to help ensure people with MS make informed decisions about their care.
Dr Chen’s Fellowship is co-funded by MS Research Australia.
Mr Michael Frank, NICS-Melbourne Health Fellow (current)
Pharmacist, Melbourne Health, VIC
Improving the management of nicotine withdrawal in Melbourne Health’s inpatients.
One in five Australians smoke despite the fact that it is the single greatest cause of preventable death and illness in Australia. Although evidence suggests that people are receptive to accept help to quit smoking when admitted to hospital for a smoking related illness, this help is not routinely offered in all hospitals. In order to support inpatients wishing to cease smoking while in the smoke free environment of the Royal Melbourne Hospital, Mr Frank will develop and implement a customised guide to prescribing nicotine replacement therapies (NRT). A range of these drug therapies exist and can improve the chance of successful quitting by reducing the impact of nicotine withdrawal. Mr Frank will deliver education and tools to staff to support correct and consistent prescribing of NRT across the hospital.
Mr Frank’s Fellowship is co-funded by Melbourne Health.
Dr Mary Ryan, NICS – Cancer Australia National Centre for Gynaecological CancersFellow
Clinical Nurse Consultant, Gynaecological Oncology, The Royal Hospital for Women, NSW
Improving nutritional status and physical conditioning in women affected by gynaecological cancer
Weight loss and loss of physical condition are known consequences of gynaecological cancers which can delay treatment delivery and recovery. Early intervention and the motivation to self manage aspects of care can have a significant impact on quality of life.
Improved health outcomes including decreased length of hospital stay following surgery and less wound infections can result when women with cancer and their health care providers proactively manage nutrition and physical condition. However, assessment of these conditions is not routinely undertaken at the time of diagnosis or during the course of the disease. Dr Ryan will develop and implement an assessment tool at the Royal Hospital for Women, working with staff and patients to make assessment and management a routine component of patient care.
Dr Ryan’s Fellowship is co-funded by Cancer Australia's National Centre for Gynaecological Cancers.
Dr Nigel Toussaint, NICS Fellow (current)
Nephrologist, Monash Medical Centre, VIC
Reducing the risk of cardiovascular disease in people with chronic kidney disease by improving management of bone and mineral disorders
Chronic kidney disease (CKD) affects approximately 15% of the Australian population. A major consequence of CKD is vascular calcification (calcium deposited in blood vessels) which in turn can lead to cardiovascular disease (CVD), a leading cause of mortality faced by people with CKD. Disorders of bone and mineral metabolism in people with CKD can lead to this build up of calcium, therefore improved management of mineral disorders is an important step to reducing the burden of CVD. Guidelines to manage optimal levels of these mineral markers exist but these levels are not routinely achieved. Dr Toussaint will work with health care staff and people with CKD in kidney clinics and dialysis units, to identify barriers to optimal control of mineral metabolism disorders. He will promote improved detection and management of these disorders through an awareness-raising and education program.
Dr Alissa Walsh, NICS – Gastroenterological Society of Australia (GESA) Fellow
Gastroenterologist, University of New South Wales, NSW
Increasing prevention of opportunistic infections in people with inflammatory bowel disease
Inflammatory bowel disease (IBD) describes two diseases, ulcerative colitis and Crohn’s disease. It is primarily a disease of young adults and causes debilitating inflammation of the bowel. New medications are effective in managing symptoms and improving quality of life. However they suppress immunity and can result in a greatly increased risk of opportunistic infections which can be life threatening. Despite the effectiveness of immunisation in preventing these infections, patients are not routinely screened or protected. Dr Walsh will implement a program at five Sydney hospitals to help identify patients at risk and ensure clinicians recommend suitable preventive measures. Dr Walsh plans to offer this program to other sites in Australia in the future.
Dr Walsh’s Fellowship is supported by the Gastroenterological Society of Australia.
Dr Paula Wye, NICS – HCF Foundation Fellow
Psychologist & Program Manager, Hunter New England Area Health Service, NSW
Decreasing risk factors for coronary heart disease: reducing smoking in patients in mental health inpatient settings.
Smoking is a leading cause of coronary heart disease. Up to 90% of people with a mental health illness smoke and as a consequence, are more likely to die from smoking related diseases, such as coronary heart disease, compared to people in the community. Helping people with mental health illness stop smoking provides an important opportunity to improve their cardiovascular and general health but is not routinely provided. Ms Wye will increase awareness of the need to provide smoking cessation assistance and develop processes to support staff to implement such programs.
Ms Wye’s Fellowship is co-funded by the HCF Health and Medical Research Foundation.
Ms Anne-Laure Couineau, NICS Fellow 2008-2010
Senior Lecturer, Clinical Specialist, Australian Centre for Posttraumatic Mental Health, University of Melbourne, VIC
Improving the psychological treatment of people suffering from post-traumatic mental health problems
More than 50 per cent of Australians will experience at least one traumatic event in their lives. A proportion will develop post-traumatic stress disorder (PTSD) as a result of these events, and in any one year, up to ¼ million Australians will experience this condition. Without appropriate intervention, PTSD is likely to become a chronic condition that can be associated with other problems including drug and alcohol abuse, anxiety and depression. Well recognised assessment and treatment options exist, but they are not often used, despite Australian guidelines for the treatment of Acute Stress Disorder and PTSD being released in 2007. This project aims to address the variation in treatment and improve the services offered to traumatised people by implementing these evidence-based guidelines with two organisations.
Dr David Hewett, NICS-QLD Health Fellow 2008
Staff Specialist Gastroenterologist, Queensland Health Skills Development Centre and Royal Brisbane and Women’s Hospital, QLD
Providing better outcomes in bowel cancer detection by improving the quality of colonoscopies
Bowel cancer is the second most common cause of death from cancer in Australia. Early detection is critical to reducing mortality. As the polyps that cause most bowel cancers grow slowly and are often without symptoms, bowel screening is vital to detection.
A colonoscopy is the least invasive means of examining the bowel and allows for immediate removal of precancerous polyps. Although the quality of colonoscopy performance is an important factor in patient outcomes, this quality is known to vary. Dr Hewett aims to address this variance and improve patient care by introducing simulation based interventions and training to colonoscopists in private and public sectors.
Dr Hewett’s fellowship was co-funded by Queensland Health.
Ms Wendy Jansen, NICS-South Australia Health Nursing and Midwifery Fellow 2008-2010
Mary Potter Nursing Research Fellow, University of Adelaide, SA
Improving the quality of palliative care services to all terminally ill patients in the hospital setting
Palliative care provides relief from symptoms for people in the last stages of life. It integrates the psychological and spiritual aspects of care and offers a support system to help family cope during the patient’s illness and following their death. Specialist palliative care is provided across Australia in dedicated inpatient hospital units, hospices and in the community. However, a terminally ill person is not always an inpatient of a palliative care unit as they may be an inpatient in another specialised unit within the hospital, where the level of palliative care available may vary. This project aims to improve access to palliative care for these patients by implementing the Liverpool End-of-Life Care Pathway (LCP). This pathway will be adapted for the Australian context at the Lyell McEwin Hospital (LMH), which services the northern suburbs of Adelaide. The pathway will provide a guide to nurses and others to provide effective management of end-of-life symptoms to support patients and their families through this challenging time.
Ms Jansen’s fellowship was co-funded by South Australia Health Nursing and Midwifery Office.
Dr Saravana Kumar, NICS-MAC Fellow 2008-2010
Deputy Director and Senior Research Fellow, Centre for Allied Health Evidence, University of South Australia, SA
Improving the management of whiplash associated disorders by physiotherapists and chiropractors
The prevalence of whiplash associated disorders (WAD) is growing internationally and contributes to approximately 42 per cent of all compulsory third party claims. Despite a range of costly treatment and rehabilitation options, many people with WAD remain in constant pain and develop long term complaints. This project will evaluate current practice in the assessment and management of WAD and will also provide a multi-dimensional strategy to support guideline implementation by physiotherapists and chiropractors. Consumers will be provided with a consumer guide to ensure they understand their condition and the treatment options offered. By raising awareness of best practice recommendations amongst clinicians and consumers, Dr Kumar will address an important evidence-practice gap in whiplash associated disorders management.
Dr Kumar’s fellowship was co-funded by the Motor Accident Commission (MAC).
Dr Andrew Lee, NICS Fellow 2008-2010
Consultant Neurologist, Flinders Medical Centre, SA
Increasing the efficiency of stroke diagnosis and treatment by emergency medical services
In order to minimise the number of people who die or become disabled after suffering an ischaemic stroke, tissue plasminogen activator (tPA), or clot bursting drugs, must be given within three hours of the onset of symptoms. This narrow window for therapy requires ambulance paramedics trained in stroke treatment and the seamless transfer of these patients to stroke units. As formal stroke education for emergency department staff and paramedics is lacking in Australia, Dr Lee’s project includes the development and delivery of an education program. Dr Lee will also implement a system of pre-hospital notification of stroke patients and the use of a standardised scale to assess the severity of stroke.
Dr Peter Mansfield OAM, NICS-TGL Fellow 2008
General Practitioner, Lecturer, University of Adelaide, SA
Assisting GPs to choose the most useful information source for prescribing decisions
One of the best ways to improve medical care is to encourage health professionals to take evidence-based clinical practice guidelines into account. While guidelines are underused in many areas of medicine including prescribing practice, most GPs are exposed to drug promotion. In order to increase the use of evidence, Dr Mansfield will develop an interactive and educational website which allows GPs to critically evaluate information from both drug companies and the independent information from Therapeutic Guidelines (TGL).
Dr Mansfield’s fellowship was co-funded by Therapeutic Guidelines Limited (TGL).
Mr Kevin Mc Namara, NICS-NPS Quality Use of Medicines Fellow 2008-2010
Lecturer in Pharmacy Practice, Monash University, VIC
Research Fellow in Rural Pharmacy, Flinders University, SA
Improving blood pressure control for people with hypertension
Despite being a major risk factor for cardiovascular disease, the majority of people with high blood pressure (hypertension) are either unaware of their condition or not receiving optimal treatment. Community pharmacists have an important role to play in working with other primary care providers to achieve optimal control of blood pressure. Pharmacists can advise on the best use of medication for individual patients, as well as reinforcing relevant dietary and other lifestyle modification messages. They can also identify patient groups for whom the consequences of poor blood pressure control are most severe, and intervene to ensure awareness of the issue and encourage monitoring.
Mr Namara will deliver a professional development program with strategies to help community pharmacists fulfil this role in the community setting.
Mr McNamara’s fellowship was co-funded by the National Prescribing Service (NPS).
Dr Felicity Pool, NICS-RANZCR-NBOCC Fellow 2008-2010
Radiologist, Pittwater Radiology, NSW
Optimising communication about breast imaging using a structured reporting and classification system
Breast imaging has a central role in breast cancer screening, diagnosis and treatment planning and is also an important part of the clinical evaluation of patients with breast symptoms. The findings of breast imaging are communicated by the radiology report. Evidence suggests that reports using a checklist or synoptic format are more comprehensive and complete than unstructured reports. The ‘Synoptic breast imaging report including imaging classification (1-5)’ was developed in 2002 by the National Breast and Ovarian Cancer Centre in collaboration with The Royal Australian and New Zealand College of Radiologists. However, subsequent studies have shown limited use of this format, particularly in community radiology private practice, where most imaging of patients with breast symptoms is carried out. This project aims to improve this uptake within a local private practice setting with successful strategies potentially being extended to other practices within the community
Dr Pool’s fellowship was co-funded by The Royal Australian and New Zealand College of Radiologists (RANZCR) and the National Breast and Ovarian Cancer Centre (NBOCC).
Associate Professor Julie Redfern, NICS-Heart Foundation Fellow 2008-2010
Research Fellow, ANZAC Research Institute, Concord Repatriation General Hospital, NSW
Reducing the risk of future heart attack through a patient-centred risk reduction program
Twenty-two per cent of Australian deaths are due to sudden heart attack, and people who survive one heart attack have a significantly increased risk of having another. The risk of future events, hospitalisations and surgery can be greatly reduced by participating in a formal risk reduction program. Despite international recommendations, most Australian patients who have survived a heart attack don’t access these programs. There is strong evidence that individualised, patient-centred programs which support self-management of risk factors are effective, but are not readily available. Dr Redfern will develop and implement this program based on current guidelines for reducing risk in heart disease.
Associate Professor Redfern’s fellowship was co-funded by the Heart Foundation.
Dr Nicholas Waldron, NICS-WA Health Fellow 2008-2010
Consultant Geriatrician, Sir Charles Gairdner Hospital, WA
Using best practice to prevent further falls in older people presenting to the emergency department
Older people are at increased risk of falling and suffering injury which requires hospitalisation and extensive health care. The personal cost is considerable as elderly people who fall often become physically frail, lose independence and can experience a marked decrease in quality of life. Falls also contribute to over 1,000 deaths in Australia every year.
Interventions to correctly assess and manage patients with a fall can significantly decrease further risk. Dr Waldron will implement best practice with such a program for patients attending the emergency department at Armadale Kelmscott Memorial Hospital who have fallen and are at risk of further falls.
Dr Waldron’s fellowship was co-funded by the Western Australian Department of Health.
Mr John Cannell, NICS Fellow 2007-2009
Rehabilitation Physiotherapy Supervisor, Launceston General Hospital, TAS
Achieving optimal arm function in people rehabilitating following stroke
Ensuring best possible arm function in people rehabilitating from stroke is the goal of Mr Cannell's project. Stroke is the second highest cause of death in adult Australians. It is also one of the leading causes of disability, affecting over 345,000 people. While an average of 70 per cent of stroke survivors are able to walk, only a third of those who suffer arm weakness as a result of stroke recover functional usage of their arm. Six evidence-based treatment strategies will be implemented to improve outcomes for people who have arm weakness following a stroke. These include Functional Electrical Stimulation, Constraint Induced Movement Therapy and Group Therapy. Training packages will be developed as part of this project and will be shared with other hospitals and rehabilitation providers around Australia.
Dr Bridget Hamilton, NICS Fellow 2007-2009
Lecturer, University of Melbourne, VIC
Director of Nursing, St Vincent’s Mental Health, St Vincent’s Hospital, VIC
Reducing the use of seclusion in acute inpatient mental health care
Patients in acute psychiatric units identified by staff as being at risk of either harming themselves or others are sometimes placed in a room which cannot be opened from the inside. This practice is known as seclusion and is an intervention of last resort as it can cause patient distress and result in injury to staff or patients. There is growing evidence that seclusion should be minimised but current rates in Victorian services suggests it is not always an action of last resort. This project, undertaken at St Vincent’s Hospital, Victoria, aims to reduce inappropriate seclusion by introducing a range of alternative strategies and a program of support to inpatient teams. The strategies have been successfully implemented overseas and include organisation leadership and support of the project, use of seclusion data, seclusion reduction tools, consumer involvement and staff training and debriefing.
Clinical Associate Professor Charles Inderjeeth, NICS-Department of Veterans’ Affairs Fellow 2007-2009
Geriatrician and Rheumatologist, North Metropolitan Health Service, WA
Improving awareness, investigation and management of osteoporosis in patients presenting with a fracture
Osteoporosis costs the Australian health care system more than seven billion dollars annually; affecting one in two women and one in three men aged over 60 years. Osteoporosis resulting in fragility fracture is a common and increasing problem, especially amongst post-menopausal women. The impact of osteoporosis can be significant. Fragility fractures that result are associated with disability, increased mortality and future fracture risk. There are evidence-based Australian and International guidelines for the management of patients with osteoporosis with and without fracture. However, patients with previous fragility fracture remain untreated.
Improving awareness of osteoporotic fracture risk among patients with fracture and their clinicians is an important strategy. This project therefore targets patients presenting to hospital with a fracture. They are provided with an information sheet alerting them to their risk of osteoporosis and recommending review of their osteoporosis risk with their medical practitioner (improving patient awareness). In addition they are provided with an “Osteoporosis Management Guideline” which they are encouraged to take to their medical practitioner (improving GP awareness and management). Combined with this there will be a survey of medical practitioner attitudes and knowledge on osteoporosis and an education and awareness program through the local medical institution and the Divisions of General Practice.
Associate Professor Inderjeeth's fellowship was co-funded by the Department of Veterans' Affairs.
Mr Terry Marshall, NICS-Transport Accident Commission Fellow 2007-2010
Clinical Support Officer, Metropolitan Ambulance Service, VIC
Improving the assessment and management of acute pain by ambulance services
The Metropolitan Ambulance Service (MAS) provides emergency medical care for the greater Melbourne and metropolitan areas and responded to 271,419 cases in 2006. Over 10,000 were of a traumatic nature and many of these patients suffered severe pain as a result of their trauma. Effective therapies exist for the treatment of pain after traumatic injury. However, there is a gap between the current practice of pain management in the pre-hospital setting and the evidence-based recommendations for pain management. The treatment of pain includes the administration of inhaled methoxyflurane and/or morphine. There is now compelling evidence that additional pharmacological agents should be considered in the pre-hospital setting. Examples may include the use of paracetamol, ketamine and/or non-steroidal analgesics.
The role of this Fellowship is to establish an acute pain information service for the MAS and to better understand the epidemiology of pain treated by MAS. The Fellowship also seeks to better understand the barriers to effective pain management from the perspective of both the paramedic and the patient. This role may include the introduction of the new scoring system for pain and to introduce new pharmacological agents to better manage severe pain.
Mr Marshall's fellowship was co-funded by the Transport Accident Commission (TAC).
Professor Danielle Mazza, NICS-HCF Foundation Fellow 2007-2009
Associate Professor, Monash University, VIC
Promoting periconceptual folate supplementation in general practice in order to reduce neural tube defects
Despite evidence that folate supplementation can prevent 70 per cent of all cases of neural tube defects like spina bifida, less than 50 per cent of women take folate prior to and during the first three months of pregnancy (periconceptual period). This project will include research with general practitioners and women to identify barriers to improve the delivery and uptake of periconceptual care, including the increase of folate supplementation. The findings will be applied to improving maternal and neonatal outcomes.
Associate Professor Mazza's fellowship was co-funded by the HCF Health and Medical Research Foundation.
Dr Annie McCluskey, NICS-HCF Foundation Fellow 2007-2009
Senior Lecturer, University of Sydney, NSW
Increasing outdoor journeys and the community participation of people with stroke
Many people with stroke are socially isolated and cannot easily get out into the community. These individuals may be isolated because of reduced mobility, an inability to drive and/or communication difficulties caused by their stroke. Evidence-based guidelines from the National Stroke Foundation suggest the provision of occupational therapy home and community visits can double the number of outdoor journeys taken by people with stroke. Therapy sessions can help people to gain confidence crossing roads, negotiate busy shopping centres, and in some cases, return to driving. The aim of this project is to help two community stroke rehabilitation teams in Sydney South West to implement these visits and therapy sessions, as recommended in the national guidelines. These teams, in particular the occupational therapists, will provide a series of visits focussed on transport and community mobility to help people with stroke overcome social isolation and get out into the community.
Dr McCluskey's fellowship was co-funded by the HCF Health and Medical Research Foundation.
Ms Bhavini Patel, NICS-HCF Foundation Fellow 2007-2009
Director of Pharmacy, Department of Health and Community Services, NT
Improving management of chronic kidney disease in remote indigenous communities
The incidence of chronic kidney disease is increasing in Australia, most significantly amongst Indigenous Australians, with rates in remote areas being 35 times higher than amongst non-Indigenous Australians. When the kidneys fail, a person must receive a transplant or their blood must be cleansed of waste artificially (dialysis). There is strong evidence that effectively managing high blood pressure can delay the need for dialysis, a treatment which in remote areas, can require long distance travel to access services and result in separation from family, social and cultural support. There is also strong evidence that an arteriovenous (AV) fistula is the most effective means of providing permanent access to veins in people starting dialysis. When best practice is not applied, there is a significant psychological and financial cost to the individuals and their community. This project aims to implement and evaluate a care coordination model which uses quality improvement interventions to address both these issues. These improvements aim to provide sustainable solutions to the management of chronic kidney disease in remote communities.
Ms Patel's fellowship was co-funded by the HCF Health and Medical Research Foundation.
Dr Melanie Benson, NICS-Victorian Quality Council Fellow 2006-2008
Palliative Care Consultant, The Alfred Hospital, VIC
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 co-funded by the Victorian Quality Council
Dr Taryn Bessen, NICS-The Royal Australian and New Zealand College of Radiologists (RANZCR) Fellow 2006-2008
Senior Staff Radiologist, Royal Adelaide Hospital, SA
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 co-funded by The Royal Australian and New Zealand College of Radiologists(RANZCR).
Clinical Associate Professor Stacy Goergen, NICS-The Royal Australian and New Zealand College of Radiologists (RANZCR) Fellow 2006-2008
Director of Research, Department of Diagnostic Imaging, Southern Health, VIC
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.
Associate Professor Goergen's fellowship was co-funded by The Royal Australian and New Zealand College of Radiologists(RANZCR).
Ms Cheryl Kimber, NICS-South Australia Department of Health Fellow 2006-2008
Orthopaedic Nurse Practitioner, Orthopaedics, Flinders Medical Centre, SA
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 co-funded by the South Australia Department of Health.
Dr Sepehr Shakib,NICS-South Australia Department of Health Fellow 2006-2008
Director of Clinical Pharmacology, Royal Adelaide Hospital, SA
Improving the management of heart failure at the interface of the hospital and community
Dr Shakib’s project aims 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 is developing a range of systems and tools for implementation in a congestive cardiac failure clinic. In consultation with patients and GPs, individualised, evidence-based goals will be established, aiming at improving the management of each patient’s condition within the community.
Dr Shakib’s fellowship was co-funded by the South Australia Department of Health.
Dr Jane Munro, NICS Fellow 2005-2008
Paediatric Rheumatologist, Royal Children’s Hospital, VIC
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 is investigating the barriers to proper pain relief for children and adolescents through development of interventions that promote the adoption of evidence into practice. Her project aims 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.
Ms Tonia Bruhn, NICS Scholar 2005
NICS-RMIT Scholar, Royal Melbourne Institute of Technology, VIC
Understanding how a ‘community of practice’ network contributes to improving evidence uptake in health care settings.
This study will involve an in-depth exploration of the features and dynamics of the NICS Emergency Care Community of Practice (EC CoP). The research will focus on the factors that determine the effectiveness of the EC CoP in its current clinical setting and address the issues involved in both sustaining evidence-based behavioural change and transferability of the model to practice in different clinical contexts. This study represents a foundational in-depth synthesis of knowledge about a community of practice and will explore its potential as a valid, feasible and transferable model for evidence implementation in health care.
Dr Luke Bereznicki, NICS Scholar 2004-2007
TasmanianSchool of Pharmacy, University of Tasmania, TAS
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-Heart Foundation Scholar 2004-2007
Cardiovascular Health Project Officer, Heart Foundation, SA Division
Research Fellow and Project Manager, CARDIAC-ARIA and STROKE-ARIA, University of South Australia, SA
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 (or CHAT for short). The study evaluated the impact of supporting chronic heart failure patients through combining telenursing and the Australian National Heart Foundation evidence-based guidelines for the management of heart failure.
Dr Clark’s Scholarship was co-funded by Heart Foundation.
Associate Professor Steven Doherty, NICS Fellow 2004-2007
Director, Rural Clinical School, University of Newcastle, NSW
Emergency Physician, Tamworth Base Hospital, NSW
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 practice 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 guideline 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.
Associate Professor Claire Harris, NICS Fellow 2004-2007
Director, Centre for Clinical Effectiveness, Southern Health, VIC
Promoting the uptake of evidence in paediatric care
Focusing on identifying 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.
Dr Sonja Hood, NICS Scholar 2004-2008
Schoolof Population Health, University of Melbourne, VIC
Improving evidence-based pharmacological management of heart failure in Australia
Ms Hood’s project will identify 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
Senior Research Fellow, Tasmanian School of Pharmacy, University of Tasmania, TAS
Reducing the risk of stroke in atrial fibrillation: a hospital-based risk stratification assessment and intervention program
Using an evidence-based approach, Shane’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 AF has been shown to reduce the risk of stroke in patients with AF (a rapid and irregular heart beat) by over two-thirds, but can be associated with an increased risk of bleeding complications in some patients.
Dr David Pierce, NICS Fellow 2004-2007
Director, University Department of Rural Health, University of Melbourne, VIC
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.
Associate Professor Kevan Polkinghorne, NICS Fellow 2004-2007
Associate Professor of Nephrology, Department of Nephrology, Monash Medical Centre, VIC
Improving haemodialysis with appropriate vascular access
Associate Professor 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.
Dr Ruth Sladek, NICS Scholar 2004-2008
Senior Research Fellow and Manager, Research to Practice Group, Flinders Medical Centre, SA
Understanding doctors’ cognitive processes and how this influences uptake of new research evidence
Dr Sladek is investigating 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 is exploring 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 Fellow 2004-2006
Senior Lecturer, Centre for Infectious Diseases and Microbiology Medicine, Westmead Clinical School, NSW
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.