Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#ICEM22
#IndigenousClimateJustice21
#NAISA22
#NNF2021
#RANZCP2021
#RANZCP2022
#RTP22
#SAHeapsUnfair
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
ACSQHC series 2019
ACSQHC series 2020
ACSQHC series 2021
ACSQHC series 2022
CATSINaM 25 Years
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
@WePublicHealth2022
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
ICYMI
Inside Story
Journal Watch
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Donor-funded journalism
Donor-funded journalism – 2020
Donor-funded journalism – 2021
Donor-funded journalism – 2022
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2022-23
Federal Election 2022
SA election 2022
The Election Wrap (2022)
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
Flooding 2022
Global health
NHS
NSW 2022
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
Aged care
Allied healthcare
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
Health reform
health regulation
Health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
Mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
Nursing and midwifery
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
Primary Health Networks
Primary healthcare
private health insurance
Rural and remote health
Safety and quality of healthcare
screening
sexual health
Social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
Health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
Monkeypox
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
Public health
Public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
commercial determinants of health
discrimination
education
Housing
justice
Justice Reinvestment
NBN
Newstart
poverty
Racism
social policy
Summer reading 2020-2021
Summer reading 2021-2022
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#CommunityControl Twitter Festival
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#ICEM22
#IndigenousClimateJustice21
#NAISA22
#NNF2021
#RANZCP2021
#RANZCP2022
#RTP22
#SAHeapsUnfair
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
ACSQHC series 2019
ACSQHC series 2020
ACSQHC series 2021
ACSQHC series 2022
CATSINaM 25 Years
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
@WePublicHealth2022
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
ICYMI
Inside Story
Journal Watch
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Donor-funded journalism
Donor-funded journalism – 2020
Donor-funded journalism – 2021
Donor-funded journalism – 2022
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2022-23
Federal Election 2022
SA election 2022
The Election Wrap (2022)
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
Flooding 2022
Global health
NHS
NSW 2022
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
Aged care
Allied healthcare
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
Health reform
health regulation
Health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
Mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
Nursing and midwifery
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
Primary Health Networks
Primary healthcare
private health insurance
Rural and remote health
Safety and quality of healthcare
screening
sexual health
Social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
Health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
Monkeypox
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
Public health
Public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
commercial determinants of health
discrimination
education
Housing
justice
Justice Reinvestment
NBN
Newstart
poverty
Racism
social policy
Summer reading 2020-2021
Summer reading 2021-2022
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#CommunityControl Twitter Festival
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

How healthcare is going green, with the help of rhinoceroses and other champions

Introduction by Croakey: As Australians demonstrate their support for political action on climate change, “strong, determined leadership” in the healthcare sector is driving changes to promote sustainability and reduce the carbon footprint of services.

Many examples of such initiatives were profiled at the recent Choosing Wisely Australia National Meeting, held online on May 3.

Choosing Wisely Australia (CWA) is part of a global healthcare initiative to improve the safety and quality of healthcare by reducing unnecessary tests, treatments and procedures. Presenters pointed out the clear links between reducing unnecessary and low value care and minimising the system’s carbon footprint.

The new Federal Government has promised to implement a national climate and health strategy, and the Climate and Health Alliance has previously released a framework for this strategy. It recommends establishing national and subnational plans by 2023 to decarbonise healthcare by 2035, and supporting the health sector to lead on mitigation of healthcare-related greenhouse gas emissions.

Croakey’s Jennifer Doggett reports below for the Croakey Conference News Service.


Jennifer Doggett writes:

Reducing low value healthcare has clear safety and quality of life advantages for patients and can also make a real difference to the impact that the health system has on the environment and climate change.

In her introductory presentation to the conference, Choosing Wisely Australia CEO Katherine Burchfield highlighted the importance of reducing unnecessary tests, treatments and procedures, given that low value care in Australia contributes to 20 percent of the waste in the health system.

Chair of Choosing Wisely Canada, Dr Wendy Levinson, agreed that this should be a priority for the Choosing Wisely movement globally, adding that in Canada five percent of greenhouse gases come from healthcare.

Levison discussed the “hidden” environmental impact of many medical tests and treatments, such as a CT scan, which she said has the equivalent carbon footprint of driving a car for 32.5km.

“Reducing low value care is good for patients and good for the environment,” she said.

Burchfield also emphasised the equity implications of sustainability, explaining that it is important to ensure we have enough resources to deliver high quality healthcare for all so that our health system is capable of meeting our needs into the future.

The breakout sessions showcased specific projects being undertaken across the health system in order to reduce unnecessary care and improve health system sustainability.

Green rhinos and pharmacy

A presentation from Grace Wong, Senior pharmacist at Western Health and founder of Pharmacists for the Environment Australia, reported on the work being done by the Western Health Pharmacy Department to establish a pharmacy environmental sustainability program.

Slide from Grace Wong’s presentation

Wong reported the findings of a 2018 study showing that pharmaceuticals and hospitals are the main contributors to the carbon footprint of the health system in Australia.

She described her role as the “Green Champion” of the pharmacy department in contributing to the local sustainability action plan for the hospital network, part of its environmental management roadmap.

Part of this action plan is a commitment to develop and support environmental sustainability ideas. This involved brainstorming sessions with staff, many of whom were new to the idea that their work could impact the environment and climate change.

At the brainstorming sessions, waste management was identified as a key priority and an initial rubbish bin audit found that the department produced 100,000 kilograms of waste per year – the equivalent of 55 adult rhinoceroses.

Slide from Grace Wong’s presentation

Wong launched a “green rhinos” education campaign, which resulted in interventions to reduce waste, including changing to recycled paper in their printers, going paperless where possible and organising for a local recycler to take their polystyrene.

Slide from Grace Wong’s presentation

Wong discussed how pharmaceutical waste is a complex issue, with ethical, legal and practical dimensions involving many layers of healthcare management and health professionals.

As well as grassroots action, she has been the project lead on the Victorian Pharmaceutical Waste Advisory Group, which developed the Victorian Framework for the handling and disposal of pharmaceutical waste.

Guideline compliance for colonoscopies

Dr Corey Joseph and Dr Jonathan Foo, from the Cabrini Institute, outlined the results of an audit they conducted on colonoscopies performed at six Victorian public hospitals.

This audit looked at whether colonoscopies targeting people at increased risk of bowel cancer were being performed in accordance with current evidence-based guidelines.

The audit found that only 30 percent of colonoscopies were concordant with current guidelines, with 47 percent performed too early and eight percent too late. In 15 percent of cases colonoscopies were recommended but not indicated based on evidence.

Slide from presentation by Dr Corey Joseph and Dr Jonathan Foo

To increase concordance with guidelines, Foo and Joseph recommended tailored strategies to address barriers to implementation and to optimise treatment recommendations.

Imaging reports and low value care

Caitlin Farmer, a PhD candidate from Monash University, undertook a systematic review of modifications to diagnostic imaging reporting to determine if they improved patient care.

She found some evidence that modifying reports may improve patient care, specifically if the reports include information about appropriate care.

Slide from presentation by Caitlin Farmer

Decision aids to improve treatment decisions

Joshua Zadro, an NHMRC Emerging Leadership Fellow from the University of Sydney, presented his research into whether a decision aid for shoulder surgery improved treatment decisions and outcomes.

Zadro said one reason for this might be that the decision aid was introduced to patients after most of them had already seen a surgeon and decided on a treatment.  He suggested that further research should look at whether it could have more impact if used earlier in the treatment journey.

Slide from presentation by Joshua Zadro

Evidence-based antipsychotic prescribing

Antipsychotic prescribing in people admitted to hospital with dementia or delirium was the focus of a study conducted by pharmacists Caitlin Hardman and William Tumusiime.

They audited a sample of patients with dementia or delirium over 65 and found that over half had been prescribed antipsychotics without evidence of adherence to prescribing guidelines (which include trying other strategies first).

This led them to conclude that many doctors are using anti-psychotics as a first approach to treating people with delirium and dementia, which is problematic given that the evidence indicates that these medications are not beneficial for most people.

Slide from presentation by Caitlin Hardman and William Tumusiime

Another finding from the study was a clear lack of management plans for antipsychotic review post-discharge, despite the fact that ongoing use of these medications was high risk.

Hardman and Tumusiime recommended the introduction of limitations on the prescribing of antipsychotics and requirements for regular reviews and de-prescribing. They also suggested mandating antipsychotic discharge plans.

Limiting unnecessary pathology

Dr Holly Theile reported on a project she conducted with colleagues at the Sunshine Coast University Hospital to limit unnecessary preoperative pathology tests.

Initial research undertaken as part of the project found that 41 percent of patients had incorrect pathology. This led to the development of new protocols to reduce unnecessary testing and ensure patients do not have to incur the inconvenience and risks associated with tests they do not need.

Slide from presentation by Dr Holly Theile

Action at Mercy Health

Two presentations focussed on action being taken by Mercy Health to decrease their carbon footprint and support the sustainability of the health system.

Dr Lisa Rasmussen, Clinical Lead, Care for People and Planet Strategy, at the Mercy Hospital for Women, described work being undertaken at the Mercy to increase sustainability. This includes establishing  a new emergency department “green team”, including a GP liaison officer and an overall waste and recycling strategy, currently being finalised.

Rasmussen stressed the need for “strong determined leadership and brave models for change” in order to address climate crisis.

Sharon Desmond, Group Manager, Caring for People and Planet at Mercy Health, presented a poster outlining Mercy Health’s Caring for People and Planet strategy, a comprehensive approach to climate change and social justice action.

This strategy included appointing a Choosing Wisely Sustainability Officer to engage with clinicians across Mercy Health’s Health Services, and embed Choosing Wisely as usual business.

So far the strategy has resulted in the development of Local Area Sustainability Plans for operational areas and Choosing Wisely plans for individual clinical areas.

At the conclusion of 2022, Mercy Health will evaluate, celebrate and communicate their climate mitigation successes, and will be a case study for other health services to investing in resource to embed Choosing Wisely as a key response to the climate emergency.

Choosing Wisely Champions

The winners of the inaugural Choosing Wisely champions also highlighted the relationship between reducing low value care and health system sustainability.

Professor Beena Kumar, program director of pathology at Monash Health, was the winner of the organisation category.

Kumar received this award for her work on a pathology stewardship project which introduced a traffic light model to encourage clinicians to stop and think before ordering tests.

Winner of the consumer category, Deb Letica, described how proactive awareness raising of Choosing Wisely and five questions can help consumers discuss whether a test or treatment is needed.

“We all need to question tests and why we want it. When bulkbilled we think it’s free but someone is paying. When costs are invisible patients have no idea what the carbon footprint is,” she said.

Award winners: Professor Beena Kumar and Deb Letica

New approaches needed

The need to take a systemic approach to reducing the health system’s carbon footprint was the focus of a keynote address from Dr Arnagretta Hunter, a physician, cardiologist and the Human Futures Fellow, College of Health and Medicine, Australian National University.

Hunter described climate change as a major health challenge and criticised the traditional approach of medicine, which she said is too focussed on biology of disease.

She stressed the importance of the social determinants of health, including environmental factors such as clean air and water, and highlighted the scale of this issue, pointing out that during the recent heatwaves in India around 10 percent of the world’s population was living in heat stress.

She also said that even in well-resourced areas people die in heatwaves.

Hunter stressed the important role of healthcare in combating climate change, given that seven percent of Australia’s carbon footprint comes from the health sector.

She urged the health sector to decarbonise as quickly as possible and suggested that the key factor here was to address “Scope 3 emissions” (emissions from all that is consumed through healthcare, including pharmaceuticals, disposables, construction and food).

Hunter said focus is often on the electricity system (Scope 2 emissions) but this only makes a small part of the health system’s carbon footprint, and that expanding the discussion to focus on Scope 3 emissions would see serious change in the health system carbon footprint.

By reducing low value care, the health sector will also decrease its carbon footprint. Hunter echoed the concerns of others at the Choosing Wisely meeting about systemic barriers to achieving this goal.

“Interventions carry a much greater carbon footprint than conversations. But even when conversations are better quality care, our system prioritises intervention,” she said.

Hunter hopes that the recent experience of extreme weather, which she estimates has impacted 50 percent of the Australian population, has led to increased awareness of the need for climate action.

She cited economics as the main barrier to reducing low value care in the health system.

“Hospitals – both public and private – make money out of doing stuff. If we cut this back by reducing low and no value healthcare, then our hospital system would run differently. This could affect the income of doctors and shareholders.”

She argued for the deep adoption of Choosing Wisely, which she said would dramatically change the health system, potentially resulting in fewer hospital admissions, and more investment in physical activity, social engagement and working arrangements so people have time to improve and maintain their health.

“I don’t buy the argument that patients always want stuff done,” Hunter said. “In my experience if there is a relationship of trust, it’s possible to have an honest conversation which allows patients to make an informed decision. Many of them will then choose not to go ahead with a low value test or treatment. But a system which rewards high volumes and doesn’t reward saying ‘no’ to treatment works against this.”

Hunter argued that Choosing Wisely can address these incentives but stressed the difficulties involved in pitching strategies to reduce low value care to a hospital manager if this means reducing incomes and changing roles of staff.  She also argued for better mechanisms for prioritising who needs care in the public health system.

She is also a strong supporter of doctors speaking out on climate change, given that they see the impacts of global warming on their patients.

“Wicked policy problems like climate change and obesity require a whole-of-system response. If we silo ourselves, we prevent progress in working across different disciplines,” she said.

“We need to get out of our lane – when we stay in our narrow speciality, we do our health system and society a disservice.”


Twitter analytics

During the period of Croakey’s coverage, 69 Twitter accounts participated in the #CWANM22 discussions, sending 893 tweets and creating more than 10.6 million Twitter impressions (1 May-26 May, 2022).

To stay in touch, follow this Twitter list of participants.

Bookmark this link for the Croakey Conference News Service coverage. Also see our coverage of the 2019 and 2018 conferences.

 

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#ICEM22
#IndigenousClimateJustice21
#NAISA22
#NNF2021
#RANZCP2021
#RANZCP2022
#RTP22
#SAHeapsUnfair
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
ACSQHC series 2019
ACSQHC series 2020
ACSQHC series 2021
ACSQHC series 2022
CATSINaM 25 Years
Healthdirect Australia series 2019
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
@WePublicHealth2022
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
ICYMI
Inside Story
Journal Watch
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Donor-funded journalism
Donor-funded journalism – 2020
Donor-funded journalism – 2021
Donor-funded journalism – 2022
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2022-23
Federal Election 2022
SA election 2022
The Election Wrap (2022)
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
Flooding 2022
Global health
NHS
NSW 2022
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
Aged care
Allied healthcare
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
Health reform
health regulation
Health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
Mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
Nursing and midwifery
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme