Population, Community and Primary Health
2009-2010
Project title: Population health apporaches to planning for the Victorian healthcare system
Investigators: Professor Helen Keleher, Dr Charles Livingstone, Dr Nikos Thomacos, Dr Tsharni Zazryn, Ms Tess Tsindos
Project funding: Victorian Healthcare Association (VHA)
Description: Integrated and responsive population health approaches to planning have been shown to deliver better health outcomes for communities (Baker, Crudder, Riske, Bias, & Forsberg, 2005; Binns & Leong, 2000; Luther et al., 2003; Mills & Harvey, 2003; Warburton, Katzmarzyk, Rhodes, & Shephard, 2007). Additionally, such approaches have also been shown to improve the efficiency and effectiveness of planning processes in individual health and social care agencies and the health care sector as a whole (Arah & Westert, 2005; Etches, Frank, Di Ruggiero, & Manuel, 2006; McNeil & Flynn, 2006; Remington, Simoes, Brownson, & Siegel, 2003). Population health approaches are able to deliver such outcomes as they are grounded in a social determinants model of health (to integrate the health needs of populations with broader social needs such as housing, employment and environmental impacts) and because they consider illness prevention and health promotion as integral to the maintenance and enhancement of the health of populations (Foote, 2006; McDowell, Spasoff, & Kristjansson, 2004; Wilson & Fridinger, 2008). However there are major impediments to achieving these better health outcomes due to the fragmented nature of current population health-based planning practice (Galea & Ahern, 2005; Gotsadze, Zoidze, & Vasadze, 2005; Lopez & Mathers, 2006). Evidence suggests fragmentation is the result of a range of factors, including the diversity of understanding and skills of those undertaking and using such plans (Arah & Westert, 2005; Kerkering & Novick, 2008) and a lack of coherent frameworks to help guide better integrated and targeted planning (Glasgow et al., 1999; Meador & Linnan, 2006; Zhao, Ash, Ellis, & Slaughter, 2002). This project has been commissioned and funded by the Victorian Healthcare Association to develop a more coherent planning framework for population health.
Based on the findings of the literature review and discussions with the Victorian Healthcare Association's Board of Management and Population Health and Area-based Planning (PHAP) Committee this project aims to:
* document how and what is done in relation to population health planning in Victoria currently;
* identify the capacity and skills required to improve population health planning in Victoria; and
* develop a position statement, toolbox, case studies of best practice and guidelines for population
health planning Victoria.
Population Health Project Flyer
Project Title: Social Inclusion Training Manual
Funding: Brotherhood of St Laurence and Anglicare Australia's Keeping Connected in the Community Project
The Manual aims to document and share Brotherhood's Social Inclusion Program, a leisure and lifestyle program for older people with national and state aged and community care services. The Manual also aims to engage organizations and community groups from other community sectors to be more engaged in helping older people overcome social isolation.
Chief Investigator:
Professor Helen Keleher
Research staff
Tess Nagorka-Tsindos
2007-2008
Project title: Primary and community care nurses: what policy frameworks, funding models and models of nurse education would support a sustainable primary care nursing workforce to meet the needs of the future
Investigators: Professor Helen Keleher, Dr Rhian Parker, Dr Karen Francis, Dr Omar Abdulwadud (Research Fellow)
Project funding: Australian Primary Health Care Research Institute (APHCRI)
Description: Nurses are the largest health workforce group. They are educated primarily and somewhat inflexibly, to meet the needs of the acute sector where apparently there are shortages of nurses. Tens of thousands of Australian nurses are not working, and very few are attracted to careers in general practice and community settings for which competencies and career pathways differ from those of acute nursing. Yet, it is in general practice and community settings that increasingly complex health care issues are managed. There are rapidly emerging needs for general practice and community care nurses in a range of settings as well as for case managers and coordinators particularly for chronic and complex conditions - nurses are potentially the most versatile health workforce to take on these roles but are under prepared and therefore under utilised in the primary and community sectors. Funding models and career pathways in Australia are not designed to attract nurses to work outside acute care settings. There is a lack of primary health and community care education in undergraduate nursing programs; disincentives from a lack of career structure, low pay structures, limited opportunities for affordable postgraduate training and continuing education in primary health and community care knowledge and competencies; and problems related to retention and recruitment. There are also impacts on the current nursing workforce, from nursing shortages and high workloads. This proposal is for an evidence synthesis that examines threshold questions about nursing in relation to primary health and community settings as well as in relation to policy, health workforce management, financing, education, partnerships and leadership. What are the effective policy models that target nursing workforce participation and education levels which are cost effective in the primary health and community sectors?
2007
Project title: Hastings Neighbourhood Program 2007 Community Survey
Investigators: Professor Helen Keleher, Jacqui Doyle (Research Fellow)
Project funding: Department of Human Services
Description: This research was conducted for Frankston City Council to better understand community views on a range of social, economic and environmental factors that can affect health and wellbeing. The research was conducted on the premise that people’s health is related to their social and physical environments as well as economic circumstances, community connectedness and strength, and the accessibility of services and facilities. This information is intended to contribute to the evidence base for policy and planning in community wellbeing in Frankston and to provide the basis for identifying priority wellbeing issues for Council for the period 2006 – 2010.
Project title: Identification of Practice Change Models for Improving Chronic Care
Investigators: Professor Helen Keleher, Virginia Haggar (Research Fellow)
Project funding: Helen Macpherson Smith Trust
Description: Early Intervention in Chronic Disease (EIiCD) is a Victorian Department of Human Services program that provides funding to Community Health Services and Primary Care Partnerships to provide early intervention services to people with chronic diseases. The EliCD program requires change to the way Community Health Services have been delivered, so the Department of Human Services has adopted the Wagner Chronic Care Model as a guide to transform systems for chronic disease care in community health. The Wagner model describes six essential elements of chronic illness care at the community, organisation and health care system level. This research was a collaboration between three Melbourne-based Community Health Services: Knox, MonashLink and Darebin Community Health Services with the Department of Health Science at Monash University. The study aimed to identify changes to management and care practices within and across organisations, and how individual health workers can further develop the necessary skills that support improvements in care for people with chronic medical conditions within Victorian Community Health Services. The qualitative research methods used included a review of relevant published literature, focus groups and interviews with key informants, document review and a consultation workshop.
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