The data deficit for asthma emergency presentations might surprise you : how RAHDaR addresses the data chasm
- Terry, Daniel, Peck, Blake, Kloot, Kate
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
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- Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
- Full Text:
- Reviewed:
- Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.
Lived experiences and insights into the advantages important to rural recruitment and retention of general practitioners
- Terry, Daniel, Nguyen, Hoang, Schmitz, David, Baker, Ed
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
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- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
Community assets and capabilities to recruit and retain GPs : the community apgar questionnaire in rural Victoria
- Terry, Daniel, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
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