Students Get A Taste Of Research Translation Through Summer Scholarship Projects

Health Translation SA's inaugural Summer Research Scholarship program has proven to be an outstanding success, with immediate benefits for both the organisation and the participating students.

In collaboration with the University of Adelaide, three undergraduate psychology students, Alex Palazov, Amy Randell, and Hannah Freeman, are spending their summer holidays contributing to  priority projects within the South Australian Health and Medical Research ecosystem.  

Amy and Alex have been working on an innovative new project as part of the Northern Adelaide Health and Wellbeing Partnership to help better understand the full scope of research activities occurring in the north of Adelaide.

Meanwhile, Hannah is has been immersed in the important area of Consumer and Community Involvement in research by supporting a strategic review of HTSA’s Community Interest Register.

For the students, the unique opportunity to further their learning by contributing to real-world projects was too good to pass up.

"Being provided an opportunity to gain valuable experience in a local research translation project that would not only teach me a great deal but have positive health impacts within South Australia felt like an unreal opportunity”, says Alex.

Health Translation SA, located within the South Australian Health and Medical Research Institute, serves as a catalyst for collaboration, focusing on accelerating research findings into healthcare policy and practice.

It’s no easy task- something that the students have quickly learnt in their time embedded within the small, but dedicated team.

“I’ve learnt that without truly passionate people, research translation is near impossible” reflects Amy.

“Research translation requires a unique level of collaboration from partners, researchers, clinicians, policy makers and consumers. Health Translation SA is the driving force in this conversation”.

In addition to broadening their knowledge and understanding of health research translation, the students agree that their time embedded with the Health Translation SA team has furthered their personal and professional development.

“The Scholarship has enhanced my self-awareness, independence and initiative, as well as my problem solving, public speaking and critical thinking abilities” says Hannah.

“It’s fostered a sense of personal growth and confidence.”

For Health Translation SA’s Executive Director, Wendy Keech, the value for both the students and the organisation is clear.

“We’ve been able to use these potential research leaders of the future to help drive the priority projects of today.”

Health Translation SA plans to offer the Summer Research Scholarship as an annual opportunity, aiming to collaborate with other academic partners and stakeholders while exploring interdisciplinary learning opportunities.

Unveiling the Inaugural MRFF Catalyst Grant Scheme Recipients

Last week we hosted our annual HTSA Stakeholder Forum where we presented a strategic overview of HTSA’s key activities in 2023 and also announced the recipients of the inaugural HTSA Medical Research Future Fund (MRFF) Catalyst Grant Scheme (the Scheme). 

The Scheme aimed to incentivise collaboration across health services, academic research organisations and the community as well as address health service and system challenges and was financially supported by The Hospital Research Foundation Group and the Women’s and Children’s Hospital Foundation.

We were impressed with the calibre of the applications and would like to extend our congratulations to the six successful projects:

During the Forum the project leads engaged in a panel discussion, reflecting on how the requirements of the Scheme had very positively impacted their applications. While the key indicator of success is submitting a MRFF (or other) collaborative research proposal in 12 months’ time, it was really pleasing to hear that two of the project teams are already preparing proposals to external funding schemes based on the new collaborations and projects they have formed.

We are proud of the Scheme’s development, recognising that its success is attributed to the support, guidance, and input from numerous contributors. A big thank you to all involved.

It is great news that both of the Foundations have committed to further funding in 2024 and we are looking for other funders to join this collaborative funding model. 

If you are interested please get in touch us via enquiries@healthtranslationsa.org.au or download a copy of the information flyer today.  The 2024 Scheme is expected to launch in May.

Reflecting on the NHMRC Country Heart Attack Prevention (CHAP) Partnership Project

A $3.3 million clinical research and translation project has transformed cardiac rehabilitation for people living in rural and remote areas, making the lifesaving, evidence-based programs more accessible and improving health outcomes for these communities.

The Country Heart Attack Prevention Project (CHAP) began in 2019, with the goal of improving attendance at cardiac rehabilitation programs in Australia.

Cardiac rehabilitation involves a collection of interventions that ensure the physical, psychological, and social well-being of a patient after they experience an acute cardiovascular event. A large focus of cardiac rehabilitation is education regarding a patient’s heart condition and the long-term lifestyle changes they can make to improve their health, as well as support to achieve their goals.

However, despite its clear benefits, the engagement of consumers and clinicians with cardiac rehabilitation is limited in Australia.

“Despite high level evidence supporting the proven benefit of risk factor modification to reduce secondary events through cardiac rehabilitation, statistics from Australia and around the world report that only 20-50% of eligible patients attend, and attendance has not improved in the past 20 years.”

The CHAP project aimed to tackle this attendance issue from several key angles. The team first identified four major barriers to participation in cardiac rehabilitation, which included limited referrals to the programs, a lack of patient-centred approaches, a lack of sustainable lifelong commitment to secondary prevention, and heterogeneous quality among the available programs.

They addressed each of these barriers in turn with innovative solutions. To improve referrals to cardiac rehabilitation, the team created the Country Access to Cardiac Health (CATCH) system, which provided a centralised referral process for all patients discharged from hospital after a cardiac event. CATCH also implemented a telehealth-based service to improve accessibility and the patient-centred nature of cardiac rehabilitation, the efficacy of which was supported by evidence collected in the early stages of the project.

To improve the sustainability and lifelong commitment to cardiac rehab, the team also developed a model of care which relied on a strong collaboration between general practitioners and local nurses, along with telehealth services. This model was created in partnership with the consumers and clinicians to ensure it suited their needs.

All along the way, the team also evaluated each of these approaches, collecting high-quality evidence to assess and support the translation of the CHAP model into mainstream clinical practice.

Now, at the conclusion of the CHAP project, the team has shared the final outcomes and impacts of their efforts, and the benefits are crystal clear.

“As a result of three years implementing current evidence into practice, South Australian country cardiac patients now have access to the best, evidence-based, patient-centred and cost-effective international standard of cardiac rehabilitation in the nation,” explained project lead Professor Robyn Clark at the final CHAP showcase.

Evaluation of the CHAP approach revealed that completion of cardiac rehabilitation programs were both significantly higher in those patients exposed to the CHAP model, which was also more cost-effective for healthcare providers and patients.

Importantly, the patients who experienced the CHAP model reported very positive experiences and were hopeful that the programs would continue into the future, with one participant explaining,

“The only thing that I would suggest would be to have more rehabilitation sessions and modes of delivery so patient have a choice of how they will attend after discharge.”

“After having a heart attack, I undertook cardiac rehabilitation in the Barossa for six weeks, but I think it should be available to me for the rest of my life,” said Clayton Bester, one consumer who was involved throughout the CHAP project.

This project was built on a foundation of strong multi-disciplinary partnerships and consumer engagement, including long-term support from Health Translation SA (HTSA) as a collaborative partner.

Wendy Keech, Executive Officer of HTSA provided leadership regarding the translational aspects of the project as an Associate Investigator from the very beginning, facilitating interactions across health networks and institutions.

“The whole team has done so many things right. They’ve consulted with all the right people from the start, had a clear game plan, and thought about the impact they wanted to have,” said Wendy.

“HTSA has been really pleased to see how this project has brought the academic rigour and the vision of academia together with health services. That’s what HTSA is all about.”

Even though the CHAP project has now come to a close, the work is far from over. Reflecting on the future of CHAP, Wendy Keech said,

“The question I keep coming back to is, how do we actually change the system to accommodate the findings that have been established. How do we actually take this knowledge and pass this onto the next people so the findings don’t just sit in a drawer once a project comes to a close.”

For Professor Clark and the rest of the CHAP team, the next steps are clear.

“The ultimate outcome for a translation project is to become policy for practice – we want to get the CHAP model into care across the state and even across Australia, and we’re thrilled to be working with the South Australian Cardiac Rehab Clinical Network to see this through.”

“We’ve created a statewide clinical network adaptation of the CHAP model which encompasses everything we’ve been working on for the past years, including the central referral service and all the other fantastic resources that have been developed.”

“Every person in South Australia will have the option to have their cardiac rehabilitation their way….a brilliant example of research based person centred care…and all of this work originating in South Australia.

WCH Foundation Announces 2023 Bloom Research Recipients

The Women’s & Children’s Hospital Foundation (WCH Foundation) has awarded $5.7 million in funding to research into childhood brain and central nervous system cancer, asthma management and pregnancy health in its inaugural Bloom Research Program grant round.

On Thursday 24 August, Health Translation SA attended an awards night to celebrate the outcome with successful research teams, WCH Foundation staff and board members, Women’s and Children’s Health Network (WCHN) representatives and the Honourable Chris Picton MP, Minister for Health and Wellbeing.

The competitive three-stage application process included a round table event during which Health Translation SA presented to research teams regarding research translation and consumer engagement, and provided feedback to support the development of applications.

Following full application, four grants were awarded to:

These projects will be undertaken over the next two to five years and will see more than 15 senior researchers, 20 early and mid-career researchers, at least three PhD students, and more than ten partnering organisations involved.

The WCH Foundation is hopeful that the focus on health translation throughout the application and review process means that the projects have the best chance of making a direct and tangible impact on the health of women, children and families under the care of the WCHN and across South Australia.

For more information about the funded projects, visit https://wchfoundation.org.au/2023-bloom-research-program-outcomes/

The WCH Foundation Bloom Research Program will open for applications again in early 2024. Visit https://wchfoundation.org.au/bloom-research/ to find out more, or contact research@wchfoundation.org.au

Update from the Desk of the SA Medical Research Future Fund (MRFF) Network

Welcome to the latest update from the SA MRFF Network! We are excited to share some important information and updates we have compiled in relation to the Medical Research Future Fund (MRFF) in recent weeks. Let’s dive in!

New MRFF Grant Opportunities

We are thrilled to share the availability of these new MRFF Grant Opportunities that have opened since our last update. These grants present exciting funding possibilities for cutting-edge research in various areas. Here are the latest opportunities up for grabs:

Remember that you can see what MRFF grant opportunities are open, forecast and closed  here:

https://www.health.gov.au/our-work/medical-research-future-fund/mrff-grant-opportunities-calendarKeep up to date

Invitation to Learn about Consumer Involvement in MRFF-funded Research

Consumer involvement plays a vital role in improving the quality, relevance, and impact of research. Join this upcoming webinar to learn more about consumer involvement in MRFF-funded research. 

The webinar, hosted by Mr. John Stubbs AM, Chair of the MRFF Consumer Reference Panel, and Dr. Masha Somi, Chief Executive Officer, Health and Medical Research Office, will cover the following topics:

Save the date and register for the webinar at 12:00 pm (AEST) on 3 August 2023.

https://kapara.rdbk.com.au/landers/f90dea.html

Funding Rates for Health and Medical Research

Between 2020 and 2022, the MRFF opened 61 grant opportunities across 21 MRFF initiatives and awarded 454 grants, totaling $1,177.3 million. These grants represent half of all MRFF grants awarded since the fund’s inception.

To learn more about funding rates for MRFF grant opportunities that opened between 7 November 2020 and 5 November 2022, we encourage you to read the Financial assistance to support the Australian Medical Research and Innovation Priorities 2020–2022 report.

https://www.health.gov.au/resources/publications/financial-assistance-to-support-the-australian-medical-research-and-innovation-priorities-2020-2022?language=en#:~:text=Funded%20rates%20of%20MRFF%20grant%20opportunities%202020–2022

National Consultation: Improving Alignment and Coordination

The Australian Government is committed to ensuring that health and medical research investment delivers maximum benefit to the community while driving long-term economic sustainability. To optimize this investment, the Department of Health and Aged Care and the National Health and Medical Research Council (NHMRC) are undertaking a national consultation to improve alignment and coordination between the Medical Research Future Fund (MRFF) and Medical Research Endowment Account (MREA).

This consultation aims to identify ways to enhance strategic alignment and coordination between the two funds. Potential models for reform include:

– A coordination mechanism with broad representation to provide coordinated advice and oversight for greater strategic alignment.

– NHMRC managing both funds separately, supporting both investigator-led and priority-led research.

– NHMRC managing the merged funds, supporting research at every stage of the pipeline to meet the needs of Australia’s complex healthcare system.

For more details and to contribute to this important consultation, please refer to the Discussion Paper, which includes guiding questions to shape your response. All stakeholders are invited to submit written contributions by 11.59 pm on Friday, 14 July.

For any inquiries, please contact HMRconsultations@health.gov.au.

https://consultations.health.gov.au/health-economics-and-research-division/improving-alignment-and-coordination-mrff-mrea/

Stay tuned for more updates and opportunities from the MRFF!

Note: The South Australian MRFF Network is dedicated to promoting MRFF initiatives and disseminating relevant information to the research community in South Australia. For more information or assistance, please contact enquiries@healthtranslationsa.org.au

Internship Project Brings Seamless Care Into Sight

A local industry placement internship with Health Translation SA and Digital Health SA has delivered a critical step towards improving continuity of care through real-time data sharing between community and hospital healthcare providers. 

Health Translation SA’s Connected Care project began in 2019, and was supported by the Australian Government’s Medical Research Future Fund (MRFF) as part of the Rapid Applied Research Translation program. (MRF9100005).   Critical leadership for the Connected Care Project has been provided by partner organisations including SA Health’s Office of the Chief Medical Information Officer (OCMIO), the Commission on Excellence and Innovation in Health (CEIH), the University of South Australia, Adelaide Primary Health Network, and the Country SA PHN.

The project aims to address the long-established problem of discontinuity of care, wherein critical details relating to a patient are lost in the transition between primary care and hospital care settings. These two disparate healthcare settings use very different data systems and without significant effort from clinicians and administrative staff it can be nearly impossible for up-to-date, accurate patient records to be shared across the sector. 

This means that critical details about patient management and treatment can be lost, valuable time is lost trying to chase information, and diagnostic tests are often unnecessarily repeated. Such discontinuity in the transition between primary and acute care leads to poorer outcomes for patients and is even associated with a higher risk of extended hospitalisation or death. 

A solution is urgently needed to bridge this gap and ensure continuity of care throughout the patient journey, but navigating a complex healthcare system to create an effective solution is no mean feat and requires an enormous team effort. 

During his six-month internship, which was coordinated through the Australian Postgraduate Research Intern (APR.intern) program, Swinburne University of Technology PhD student Dominic Lin completed a critical step in this project, bringing us closer to the creation of a technical data sharing solution that could interconnect the primary and acute healthcare settings. 

“Health Translation SA had already conducted the early phases of this project, including significant engagement with practitioners and consumers in the healthcare system to understand their needs,” Dominic explained.

“My primary goal during this phase of the project was to deliver a comprehensive draft of the business and technical requirements of an effective data exchange solution to this problem, and actually identify potential technical solutions in partnership with Digital Health SA.”

To do this, Dominic researched the technical operations of SA Health’s data storage and exchange capabilities and compared these with the capabilities of the primary care operators. With support from senior colleagues at Digital Health SA, he investigated the high-level system architecture of each system to characterise their compatibility and identified potential bridges between the primary and acute care settings. The end result of this important work was a comprehensive report containing the technical details needed to consider potential solutions to this continuity of care problem.

“With the work that Dom’s done, we’ve ended up with very detailed and tangible documentation around what the requirements are for both functional and non-functional components of this solution,” said Rhys Parker, Chief Clinical Information Officer at Digital Health SA.

“A real big-ticket item for health is that ability to interconnect primary care and acute care settings and be able to manage that patient journey end to end.”

Dominic’s internship not only highlighted the importance of data sharing across healthcare settings, but also highlighted how essential the relationships between the partner organisations are to pushing this work forward. 

“We appreciate what the internship program does. We like the model of it and we like what it does from a capacity-building perspective,” said Wendy Keech, CEO of Health Translation SA.

“The strong partnership between HTSA and Digital Health SA, as well as the Office of the Chief Medical Information Officer is absolutely critical to getting this work done, and we could not do it without the support of all the passionate individuals who have worked on this project.”

The successful outcome from this internship also speaks to the effectiveness of the APR.intern program, with National Program Manager Glen Sheldon adding,

“This is a fantastic internship result where there’s been work on a real problem that everyone’s really interested in the solution for.”

At the conclusion of his internship, Dominic was grateful for the opportunity to flex his technical skills, and to have built new skills in an unfamiliar industry.

“Throughout the six-month internship I learned many things from my industry mentors,” he said.

“They perfectly demonstrated how to drive a research project forward to become a product, and they linked me with different key people for the project and demonstrated how to effectively communicate with different levels of people,”

“These soft skills are extremely beneficial for my future.”

HTSA Flagship in Focus: Research Policy Partnerships Masterclass 2023

2023 Masterclass: Maimising impact from Research-Policy Partnerships

-Carmel Williams, Director: Centre for Health in All Policies Research Translation

The third Maximising Impact from Research – Policy Partnerships Masterclass is scheduled to run on the 29- 30 August and 23 October 2023. The practical two- and half–day workshop aims improve collaboration between researchers and policy makers and support improved translation of research into policy and practice and lead to the creation of better public policy. 

The Masterclass targets both academics and researchers working across a range of disciplines, and policy actors from government and the non- government sector. The course is very interactive and focuses on skill development, drawing on course participants lived experience and expertise. The Masterclass brings researchers and policy actors together in the same space, to learn from each other. 

The Masterclass is convened by the Centre for Health in All Policies Research Translation (CHiAPRT), jointly based at Health Translation SA and the School of Public Health, University of Adelaide. CHiAPRT works with policymakers and academics at the international, national and local level to strengthen the capacity for research translation in the development and implementation of public policy with a focus on the determinants of health, multisectoral action such as Health in All Policies, the creation of Wellbeing Economies and health equity. 

The Masterclass is structured into three modules with Module 1 Concepts and Frameworks and Module 2 Tools and Skills to be delivered in August, with Module 3 Bringing it all Together scheduled to be run on 23 October 2023. 

The 2021 and 2022 Masterclass attracted between 30 plus participants including people from all three South Australian universities, research agencies and policy makers from a diverse range of government agencies including, education, environment, health, corrections, education, and child protection.  Past participants share some of their experience below: 

“The two-day Research- Policy Partnerships Masterclass was exactly what I was looking for, it provided the insights I need to push our research agenda forward and certainly gave me food for thought regarding our policy development processes and how we can work more effectively with researchers and involve them much earlier in our strategic level policy decisions”

Kristy Nixon, Manager, Health Promotion, SA Dental | Central Adelaide Local Health Network

“The Masterclass was a unique opportunity to hear the perspectives of policy actors and to understand the role of research in their work. I also came away from this dynamic, information-packed two-day event with a raft of new contacts in the policy space”

Dr Helen Dinmore | Research Fellow, UniSA Business

The Course Curriculum was developed in collaboration with policy professionals and researchers from across Australia, to help ensure that the course was tailored to meet both the needs of policy professionals and researchers. Course evaluations have been very positive, with many participants indicating they valued the opportunity to network with researchers and policy actors outside their usual networks. Following multiple requests from Masterclass Participants, plans are underway to establish a Research – Policy Community of Practice, which will initially be coordinated by CHiAPRT. The Research – Policy Community of Practice is scheduled to be launched in October 2023. 

Register for the upcoming masterclass HERE

National Effort Aims to Enhance Efficiency and Impact in Clinical Trials

Clinical trials in South Australia are active and ongoing, with a variety of studies investigating a variety of clinical interventions. Nationally, there is a push for increased investment in clinical trials, with the goal of improving healthcare outcomes for all Australians. 

During clinical trials, a significant amount of data is typically generated. However, at the conclusion of the trial, this data is usually archived and not accessible or available for any secondary purposes- long noted as a missed opportunity given the potential value that this data could provide.

Many researchers have trouble simply finding details about what data has been collected and whether it is of potential use to their projects. In addition, the variety (or lack) of processes for gaining access to data impacts the efficiency and timeliness of research and, in the worst-case scenario prevents research from proceeding.

Enter: HeSANDA. Led by the Australian Research Data Commons (ARDC), the Health Studies Australian National Data Asset (HeSANDA) program aims to give data generated in the course of clinical research a second life, by delivering a mechanism that allows investigator-initiated clinical trials to be discoverable and requestable. 

Over the past three years, Health Translation SA (HTSA) has been part of  this national initiative to support the sharing and reuse of health research data in ways that bring value to the research community, increase the efficiency of research, and provide benefits for the health of Australia’s population.

What initially began as a comprehensive consultation & co-design process evolved into the launch of the South Australian HeSANDA ‘Node’ in 2021with Health Translation SA at the helm. 

Fast forward to 2023, HTSA is poised to deliver their final HeSANDA report after a successful pilot with partners SAHMRI & Flinders Uni, and expansion well underway with other partners across South Australia. 

The culmination of this work, the ‘Health Data Australia Catalogue’ and ‘Data Request Management System’ will be launched on June 30th, and is the result of both state-wide and national collaborations. 

HTSA’s focus now shifts to working with partner organisations to ensure ‘business as usual’ policies and processes are established to ensure sustainability of the HeSANDA program. 

Future expansion of ARDC’s HeSANDA program may include other types of clinical research.  

National Health and Medical Research Council Backs Research Impact for South Australia

Health Translation SA (HTSA) has been successful in its bid to be formally re-accredited as a Research Translation Centre by the National Health and Medical Research Council (NHMRC) for an additional 5 years.


Along with 9 other centres across Australia, HTSA’s reaccreditation was formally announced on April 5th
by NHMRC CEO Professor Ann Kelso.

NHMRC Research Translation Centres are collaborations between health care organisations,
research and education/training organisations and are a key mechanism driving the translation of
health and medical research into clinical practice, policy and health systems.

In order to be reaccredited, existing centres had to demonstrate continued leadership and
collaboration, research excellence, translation of research into health care, and capability and capacity building in research and research translation.

Chair of HTSA’s board, Dr Leanna Read, says that the announcement is a testament to the important role
that HTSA plays for South Australia.

“Now more than ever, we need organisations such as HTSA to support our clinical and academic
researchers to think nationally, and globally, and guide them as they navigate the complex journey
towards successful, and enormously important, health research collaborations and impact” says Dr Read.

Previously called the SA Academic Health Science and Translation Centre, the South Australian
organisation was one of the first four inaugural Advanced Health Research Translation Centres to be
formally accredited by the NHMRC in 2015.

Since then, HTSA has grown to incorporate 11 partner organisations representing academic, research and health care agencies within South Australia.

It is one of 3 Advanced Research Translation Centres nationally that operate with a state-wide focus.
Executive Director Wendy Keech says that HTSA’s re-accreditation reaffirms the NHMRC’s commitment
to reducing research duplication and driving research impact.

“HTSA is about what we can do together that we can’t do apart” says Keech, “by acting as an
independent catalyst and broker, we can accelerate the translation of research into impact to improve
health outcomes.”

HTSA demonstrated its strengths as an advanced research translation centre through its Flagship
Programs, including the SAHMRI based Omega 3 test and treat program.

Program lead and SA Scientist of the year, Professor Maria Makrides, says the input from HTSA has been vital to the project’s ongoing success.

“Those connections, those collaborations - they’ve been so important in helping us embed our project
into clinical and public health practice” says Prof Makrides, “we’re very fortunate to have had the support
of the HTSA team.”

All 11 accredited Research Translation Centres, as well as a number of Emerging Centres, collaborate
nationally as the Australian Health Research Alliance (AHRA). Information about AHRA, including its work
on translating research for improved patient outcomes and health systems, is available on AHRA's website.

Further information on the NHMRC Research Translation Centre Initiative is available on Recognised
Research Translation Centres.

Regional Health Network Puts Virtual Health Connection At The Centre of Better Aged Care

With increasing numbers of older people with complex needs seeking hospital care the rapid applied translational research initiative State Action on Avoidable Rehospitalisations and Unplanned Admissions (STAAR-SA) project is delivering innovative and significantly improved pathways of care for older South Australians.

The STAAR-SA project, funded by a Medical Research Future Fund Rapid Applied Research Translation Grant and facilitated by Health Translation SA, has brought together the full scope of health and aged care experts and practitioners with consumers to work together to develop models of care designed to improve health outcomes for older people and reduce avoidable hospitalisations.

In just one example of how STAAR-SA’s Quality Improvement Collaborative is building a culture of innovation in aged care, SA Health’s Rural Support Service (RSS) piloted a six-month project in partnership with the Riverland Mallee Coorong Local Health Network (RMCLHN) that has already delivered significant results in reducing hospitalisations for older people in its community.

RMCLHN is the largest provider of Home Care Packages (HCP) in regional South Australia and supports more than 300 older Australians to remain in their homes, by providing health, domestic and social support. 

A key focus of the project was to forge closer collaborations across Aged Care Assessment Teams, HCP Community Support Workers and the Virtual Clinical Care Home Telemonitoring Service.

Through significantly improved networking among local hospitals, doctors and staff involved in these services, the RMCLHN trial showed that early intervention through home telemonitoring prevented 31 emergency department presentations and 22 hospital admissions between January and June 2021.

These positive outcomes were a result of boosting HCP Community Support Workers’ capacity to identify older consumers who were at the greatest risk of decline using an instrument to measure activities of daily living; weight and nutrition; awareness; condition; cognition and social engagement (AWACCS).

The most vulnerable older people with complex health problems were then referred to the RSS Virtual Clinical Care Home Telemonitoring which provides in-home tools to record daily health statistics that can be remotely monitored by specialist nursing staff.

While the Virtual Clinical Care Home Telemonitoring Service was established in 2015 and has a long history of reducing hospital presentations and admissions for people with chronic conditions, new links between this service and the staff delivering care and support in the home were developed through the STAAR-SA project.

The RSS Manager of Service Initiatives, Andrea Church, says while the goal of the project was to see if a more integrated service delivery model would reduce unwarranted hospitalisations, empowering health workers and consumers through education was also a key focus.

The established outcomes for the project were to:

“Many of the frailest people are dealing with a range of comorbidities – from diabetes, and arthritis, to asthma, emphysema and heart failure and other cardiac conditions,”

Andrea Church

“They can have between 10 and 20 medications to manage, and they all live in different household circumstances, many living alone, so their health issues can be daunting and stressful.

“The Virtual Clinical Care Home Telemonitoring Service proved invaluable in helping to assess and triage consumer needs, whether that be changes to the medications prescribed, referrals to allied health professionals, recommending dietary improvements, or liaising with often over-stretched GP practices to ensure consumers at risk of hospitalisation are prioritised.

“Qualitative feedback from the project has also been positive with both consumers and health care workers reporting an improvement in health care knowledge and feeling more empowered to make important decisions that will support them to age in place and reduce stressful and avoidable hospitalisations.”

The success of the project is now the basis for further assessment to see if a roll out of this connected-up home care model can be applied in other regional communities across the state.

Further information about the Virtual Clinical Care Home Telemonitoring Service can be found on the SA Health Website – Virtual Clinical Care, or by emailing VCChub@sa.gov.au

This project was supported by the Australian Government’s Medical Research Future Fund (MRFF) as part of the Rapid Applied Research Translation program.

STAAR-SA Delivering Long Term Benefits for Older Australians

As the Australian population ages and confronts more challenging and complex health issues, it’s not surprising that they are admitted to hospital more often. 

In fact, people aged over 65 years, while representing 15 per cent of the population, account for 20 per cent of presentations to emergency departments nationwide, and 42 per cent will go on to be admitted into hospital the same day

Researchers, aged care clinicians and population health experts also understand that the chances of being re-hospitalised are higher for older Australians in the weeks that follow a first admission. 

Finding ways to reduce avoidable hospital admissions and readmissions, is a tricky and complex problem, one exacerbated by a two-tiered health funding system across state and federal governments, where support for in-home and other care supports may not align with hospital discharge.

This has been the focus of a comprehensive South Australian research project that for the first time, has brought together the full scope of health and aged care experts and practitioners with consumers to both better understand the issues, and work to develop models of care designed to improve health outcomes for older people and reduce avoidable hospitalisations.

The project, State Action on Avoidable Rehospitalisations and Unplanned Admissions (STAAR-SA), has been funded by a Medical Research Future Fund Rapid Applied Research Translation Grant and is facilitated by Health Translation SA

The project includes three related work packages all contributing the foundations for new models of coordinated care that can be adopted quickly. 

Study lead, Professor Maria Crotty, Professor of Rehabilitation and Aged Care, at Flinders University says many people leave hospital while they are still on a waiting list for a Commonwealth in-home care package.

“We drew on qualitative research, where older people including those who had been repeatedly readmitted to hospital were all very clear that between leaving hospital and going home, there was something missing in the middle,” Prof Crotty says.

“They didn’t have enough support for a successful transition. And that is really at the heart of this research. 

“There is no one thing that can fix the problem because people are coming into hospital for different reasons. So, as researchers we had not only to analyse why people were being readmitted, but then look at those cohorts and work out what alternative services might help prevent avoidable readmissions.”

Prof Maria Crotty

Prof Crotty says Work Package 1, led by researchers from the Registry of Senior Australians (ROSA), set some broad parameters around what types of older people were most at risk of repeated hospitalisation.

The ROSA research focussed on people aged over 65 years who had been hospitalised or presented at an Emergency Department within 90 days of receiving an assessment by an aged care assessment team member (ACAT).  The analysis identified a range of risk factors at this important transition period. 

Men were more at risk and individuals with a history of delirium, higher difficulties managing daily living activities, behavioural needs, and complex healthcare conditions, as well as those with high medication loads were more likely to experience unplanned hospitalisations.

“Being able to narrow down who we need to focus on when we talk about all these people coming back into hospital, has been hugely important for the project,” Prof Crotty says.

“It has given us a much clearer picture of where we can make a difference and for the teams brought together to create initiatives that will make an impact.

“ROSA has taken their research and developed five categories which we can use to determine if older consumers at low risk need a simple package of support, say just a regular phone call to check their wellbeing, right through to a bundle of integrated care supports for high-risk consumers when they are discharged from hospital.

“These are risk profiles we can use in our wider service design and planning.”

Central to Work Package 2 was the consumer experience of using out-of-hospital services.  This work was undertaken by the Council of the Ageing (COTA) SA, through its social enterprise initiative, The Plug-in.  

The Plug-in interviewed clients, family members and carers of clients, who had received out-of-hospital services within the previous 12 months, from selected outreach services.  The findings showed that older people valued the services and trusted the staff.  Having one main point of contact was important in providing continuity of care, support, and assurance to older people following their stay in hospital.

Work Package 3 established a quality improvement collaborative (QIC) where front-line clinicians from across the sector and their service managers were brought together to learn, share, and benchmark outcomes with the goal of increasing the quality of care for older people at times of transition from hospital.

With collaborative problem solving high on the agenda, the groups worked in teams to address key issues from medication management, through to end-of-life care, mental health, and improved outreach to older Australians in regional communities.

Internationally recognised expert in implementation science and leader in the field of knowledge translation, Professor Gillian Harvey, from the Caring Futures Institute at Flinders University, says outcomes from the Quality Improvement Collaborative have been significant.

“Managing behavioural symptoms that occur as a result of distress, for example aggression from residents in aged care settings, without use of restraints, is a particular challenge.

The Aged Care Royal Commission noted that chemical and physical restraint “fundamentally impacts on the liberty and dignity of the care recipient” but also acknowledged aged care staff were under-skilled to manage changed behaviour in other ways.

“A hallmark of high-quality care is for older residents to feel physically and psychologically safe, to feel they have self-determination and are respected, and the Commission Report showed clearly that much more needs to be done to achieve that.”

Dr Cations says her goal is to provide evidence-based answers to some of these issues and develop translatable models of care that can be adopted in residential facilities.

“Part of my work will be to develop a way to measure what the impact of receiving mental health services has on residents and the people who care for them,” she says.

“Being able to measure any health cost savings and management and wellbeing improvements from a system more attuned to the mental health needs of residents will be an important driver for innovation in the sector.”

She says there also needs to be acknowledgement that up to 86 per cent of aged care users have at least one mental health condition and many of those will be living with the aftermath of some sort of psychological trauma.

“In an environment where common care practices such as assisted bathing and dressing are part of the everyday routine, we need to be more aware that these and a range of other aspects of care support, might be triggering for people who have experienced personal psychological trauma,” Dr Cations says.

“Such traumas make it difficult for individuals to regulate their emotions and their responses. 

“And for aged care workers without the right mental health training, coping with sometimes extreme emotional responses from residents in the course of regular daily tasks, is difficult.

“We had fantastic support and engagement from a large cross section of organisations and individuals from the health and aged care sectors to work in the collaboratives and the next step for us is developing ways to sustain and build on those innovations to maintain the momentum,”

Prof Gillian Harvey

“Part of what we set out to do was establish a network of knowledge users, researchers, and policy makers working across differences in resources, knowledge, skills, and culture, that would have the potential to tackle other complex problems associated with caring for the older population across SA.

“We have delivered that, and it will continue to make an impact on improving aged care in South Australia.

“This is the translational end of research, and we know that good translation happens largely through social processes, not through a sort of cookbook approach – it is very much about relationships, people, and networks.”

This project was supported by the Australian Government’s Medical Research Future Fund (MRFF) as part of the Rapid Applied Research Translation program. 

Women's Health Research Translation & Impact Network Launches in SA

On August 31st, a sold out SAHMRI auditorium sat together with one shared goal; to create change for the women of South Australia.

Developed as part of a national initiative led by AHRA, Health Translation SA officially launched the South Australian chapter of the Women’s Health Research Translation Network after a successful debut event.

Special guest speaker, MP Louise Miller-Frost said that the work of the network would be vital in making an impact for women across the state. 

‘This is a really great opportunity for us to take steps forward in terms of women’s experience of health, women’s issues health.. but also women as professionals and researchers’ said Ms Miller-Frost. 

The packed program featured presentations from a diverse range of speakers including academics, clinicians & politicians, and also contained perspectives from various cultural backgrounds and career journeys.

Attendees listened to topics such as current challenges and barriersstrategies to bring academics and clinicians together, and key ingredients to driving successful research translation.

The formal portion of the evening concluded with a panel discussion focused on the network’s future, with invited guests sharing insightful commentary on what needs to change to increase success for women’s researchers.  

Health translation SA’s CEO, Wendy Keech, closed the event with a motivating look forward, and shared the nine priority areas that will inform the network’s focus. 

‘We’re here to support each other, to work forward and to make change’ said Ms Keech. 

‘These things don’t happen if we don’t invest in people to make them happen.’ 

Wendy Keech

To learn more about SA WHRTN, download the flyerjoin the mailing list, or view the launch event presentations.

Building Better Aged Care Through Mental Health Support

It is one of the chronically neglected fields in mental health research, but now, thanks to funding from the NHMRC and the Medical Research Future Fund, Senior Research Fellow at Flinders University Dr Monica Cations is embarking on wide-ranging research to examine the mental health of older Australians and their access to services and support.

Dr Cations’ NHMRC/MRFF Emerging Leadership Investigator Grant sees her focus particularly on people over 65 years who are living in residential aged care but has implications for older people ageing in place and accessing services in their homes. 

“At a very broad level, for many people the process of ageing involves losing control over some of their decision making and their choices, and that can be confronting and lead to anxiety or depression, exacerbate existing mental health conditions, or trigger past traumas,” Dr Cations says.

“In my research I want at first to understand the prevalence of mental ill-health for older Australians and then consider what the barriers are to receiving Medicare-funded mental health services, especially for people living in residential aged care.”

The five-year Fellowship will support Dr Cations to progress the research in stages. Already her analysis of the Registry of Senior Australians data has shown that rates of mental ill-health have increased for older Australians and are now four and nine times higher than the general population for depression and anxiety disorders, respectively. Despite this, use of Government-funded subsidies for mental health services is very low for aged care residents.

This is a tangible example of how data collected by the Registry of Senior Australians (ROSA) is providing invaluable support nationally for age related research projects that are influencing healthcare practice and policy. ROSA was established in 2017 by a cross-sectoral partnership of researchers, clinicians, aged care providers and consumer advocacy groups from several organisations and along with HTSA, is a collaborative venture of SAHMRI

“In identifying the scope of the problem, we can start to analyse the barriers to receiving mental health care and learn more about how this aspect of health care is being addressed in the sector,” Dr Cations says.

“At least one part of the problem is the availability of staff trained to understand and identify mental health concerns. There is also a wider issue in the simple availability of mental health experts and clinicians.

“We know the aged care sector is pretty good at keeping people physically well, but mental health must be considered as part of the full picture of health and wellbeing.”

“Managing behavioural symptoms that occur as a result of distress, for example aggression from residents in aged care settings, without use of restraints, is a particular challenge.

The Aged Care Royal Commission noted that chemical and physical restraint “fundamentally impacts on the liberty and dignity of the care recipient” but also acknowledged aged care staff were under-skilled to manage changed behaviour in other ways.

“A hallmark of high-quality care is for older residents to feel physically and psychologically safe, to feel they have self-determination and are respected, and the Commission Report showed clearly that much more needs to be done to achieve that.”

Dr Cations says her goal is to provide evidence-based answers to some of these issues and develop translatable models of care that can be adopted in residential facilities.

“Part of my work will be to develop a way to measure what the impact of receiving mental health services has on residents and the people who care for them,” she says.

“Being able to measure any health cost savings and management and wellbeing improvements from a system more attuned to the mental health needs of residents will be an important driver for innovation in the sector.”

She says there also needs to be acknowledgement that up to 86 per cent of aged care users have at least one mental health condition and many of those will be living with the aftermath of some sort of psychological trauma.

“In an environment where common care practices such as assisted bathing and dressing are part of the everyday routine, we need to be more aware that these and a range of other aspects of care support, might be triggering for people who have experienced personal psychological trauma,” Dr Cations says.

“Such traumas make it difficult for individuals to regulate their emotions and their responses. 

“And for aged care workers without the right mental health training, coping with sometimes extreme emotional responses from residents in the course of regular daily tasks, is difficult.

“With the right skills and educated approaches to understanding the needs of individual residents, there is enormous potential to deliver trauma-informed care that improves outcomes for both residents and aged care workers.”

Working with aged care providers, Dr Cations will be leading trials to introduce elements of trauma-informed care in residential aged care settings. 

The project will examine the impact of care changes on the use of chemical restraints, damage to property, resident hospitalisations, and the need for extra staff, and weighing the costs and savings.

While Dr Cations says the research is in its ‘early days’ her goal is to tangibly improve the safety and quality of aged care in Australia.

“The research program will strengthen Australia’s reputation as an innovator in aged care and build the capacity of the sector to drive innovation in aged care globally,” she says.

“As populations age, the demand for access to care that maximises wellbeing will only grow.

“My goal is to demonstrate that prioritising psychological wellbeing is our best opportunity to achieve better aged care outcomes for residents and aged care workers, and to do that from a strong evidence-base.”

She says receiving a Fellowship can change the trajectory of a researcher’s career.

“This Fellowship has allowed me to build my track record as an independent researcher and investigate problems that are very important to me and to older people. It has been an enormous vote of confidence from my peers that my work is worthwhile and can make meaningful change to the world.

“As a junior researcher you need to be somewhat strategic and think ahead to build a strong research record and demonstrate to Fellowship reviewers that you have the skills and a team around you to deliver high-impact research. 

“For me undertaking research that I really care about and that has clear pathways to improving outcomes is so important – it makes all the late nights worth it.”

Launch of My PreHab Collaboration Delivers a Healthier Path to Surgery

My PreHab is an innovative new program turning the wait time for planned elective surgery into a positive health opportunity. 

Launched in June, My PreHab is being piloted at the Royal Adelaide and Queen Elizabeth Hospitals in the Central Adelaide Local Health Network (CALHN) for patients referred for hip or knee joint replacement surgery and non-urgent general surgeries such as hernia repairs. 

According to project lead, Professor Jane Andrews from the CALHN Surgery Program, the My PreHab program will help support better outcomes for patients and the health system.  

“About 20 per cent of people, that is one in five, experience post-operative complications,” Prof Andrews says.

“That leads to poor health outcomes for the individual, but it also doubles their length of stay in hospital, at a time when the strain on the hospital system is only increasing.

“Because the health system is over capacity, if we can improve access to care and evidence-based information at a low cost it is something we should be doing as soon as possible.

The program has been developed using the Personify Care digital platform to ensure an easy-to-use patient pathway that invites participants to self-screen their overall health.

Once completed, a tailored care plan is generated that patients can take to their local GP who can provide extra advice and support on how they can monitor and improve their health.

The My PreHab website also provides links to evidence-based health information and services, outlining the influence of certain factors on surgical recovery and what can be done to reduce those risks.

My PreHab gives patients a clear path to monitoring and improving their health in partnership with their general practitioners (GPs) and other health care professionals in the community, reducing their risk of avoidable post-operative complications, and in some cases, even prevent the need for surgery” Prof Andrews says.

The My Prehab program is supported by Health Translation SA (HTSA) and the Adelaide Primary Health Network (APHN) and received a grant of $190,000 from The Hospital Research Foundation to help fund the first year of the pilot program in general surgery and orthopaedic joint replacement. 

The design and testing of My PreHab were project managed by HTSA and included extensive stakeholder engagement and a co-design process involving surgeons, hospital nurses and physicians, general practitioners, allied health professionals and people who had recently been through surgery.

Chief Executive Officer of HTSA, Wendy Keech, says the My PreHab project is a shining example of what collaboration can deliver.

“At HTSA we’re always keen to think about how things that are led and developed in a local health service can be scaled and done across the state,” Keech says.

“We want to see research brought into practice by helping make the links and connections that will make it easier for health services to embed research in what they do so that we can build the best health service for South Australia and the best service for patients and consumers."

“It is not a one size fits all approach, but it is about eliminating silos and ensuring that we share and collaborate where innovation can make a difference,” she says.

The collaboration and consultation evident in the development of the My PreHab project is just one example of how powerful this model of health translation can be.

“The APHN has been an important partner of the My PreHab project providing advice and helping to recruit GPs to ensure the project is suitably informed by primary health services,” Keech says

“As My PreHab is rolled out, we expect that strong collaboration will encourage the kind of feedback that provides ongoing opportunities to learn, improve and refine the program.”

CALHN My PreHab Clinical Manager, Ellie Bills says the roll out of the program will include opportunities to further refine the new platform by collecting feedback from consumers and GPs.

“We’re going to be listening to the experiences of patients and healthcare professionals who are involved and look at the uptake and response to the program, including whether any patients are able to avoid having surgery because of participating in the program,” Bills says.

“While we acknowledge that elective surgery wait-times for joint replacements are long, we see this extended timeframe as an opportunity to turn what is normally a very passive time in a patient’s surgical journey into an active one, and a time where they can be engaged in improving their health outcomes.”

For more information head to My PreHab or Health Translation SA.

New AI Tool Helps Patients With Their Mental Health, and Other Chronic Diseases Could Be Next

With hospital emergency departments facing chronic overcrowding, researchers are working with doctors on ways to reduce the number of people needing emergency care. One South Australian project is creating a way for doctors and patients to ‘get ahead’ of their symptoms and reduce the chances of ending up in hospital. 

Actionable Intime Insights, or AI2, is an artificial intelligence program developed by Flinders University’s Digital Health research team, headed by Associate Professor Niranjan Bidargaddi who is supported by the Barossa Fleurieu Local Health Network. Created in consultation with doctors, clinicians and patients, AI2 aims to reduce the impact of mental illness on patients by allowing them to prevent relapses before they even occur. 

Up to 80% of mental health patients will relapse within five years of their initial treatment, so reducing these setbacks will make a significant difference for patients and the health system itself.

AI2 compiles data from several digital sources, including Medicare, electronic health records, and My Health Record. It then analyses that data to recognise patterns that may indicate an impending relapse of symptoms before they become noticeable to doctors or the patient themselves.

“This isn’t like a treatment that has been developed and we’re pushing out. This is a missing block in healthcare delivery that we’re trying to fill”

A/Prof Niranjan Bidargaddi

As healthcare is increasingly digitised, the information collected and stored about patients is increasing substantially. However, as that information accumulates, often across separate platforms, it can conversely make it more difficult to recognise early warning signs and trends. 

“The challenge is how we turn all that information into care that is more patient-centric and responsive to early warning signs, rather than reacting to a crisis that has happened,” says Bidargaddi. “AI2 is a data curation technology that transforms those accumulating health reports through algorithms and turns them into intervention responses for health professionals.”

“AI2 is an attempt to provide the right information at the right time.”

With early-warning signs detected in patient records, AI2 updates healthcare providers about a patient’s status and prompts them to follow up with the patient about their care. However, this risks overburdening an already stretched health system by flooding it with notifications, admits Bidargaddi. Instead, his team are now extending AI2 to first provide ‘nudge’ suggestions to patients that help them take steps to self-manage their condition. If the algorithm detects no improvement for the patient, it only then escalates to a healthcare provider.

That app is being created with patient groups and will effectively work as an everyday navigator, leading the patient along a strategy depending on their circumstances. “That’s the missing link now. Patients currently go to a GP or a hospital. But in between, there is nothing.”

The Digital Health team partnered with SA Health to trial the program, and AI2 is now used by mental health clinics in four regions around the state. The algorithms and how they’re used are being further developed in partnership with Digital Health SA and the national Digital Health Cooperative Research Centre. 

Another partnership vital for the research, says Bidargaddi, was with Health Translation SA. HTSA invested over $1 million in funding for the project from three Australian Government Medical Research Future Fund rounds. And this, he says, was invaluable in helping the project progress. 

“This project wouldn’t have happened without HTSA’s support.”

The three funding rounds helped the Digital Health team develop and build a prototype, turn that prototype into a pilot study in one clinic, and then expand the trials across multiple clinics. Without the funding, the research would not have been able to develop to the point where it can help patients.

However, HTSA provided more than just funding, say the researchers. In particular, HTSA helped the team shape the project and build relationships with consumers to provide input based on their lived experiences. While the researchers came up with ideas and research directions, this consumer input helped refine those ideas and boost the effectiveness for those who use AI2

The project has been so positively received that the health systems using it have adapted their services to incorporate AI2’s input more effectively. This includes offering more proactive support, rather than reacting to patient crises. 

One clinician who has used AI2 is Jörg Strobel, a Senior Consultant Psychiatrist with the Barossa Fleurieu Local Health Network. “It (AI2) gives you a pattern of behaviour, and deviations from what you expect… is a starting point for a conversation: ‘Tell me more, help me understand’.”

“If you want a quality-driven health system, you need to gather data, and you need to look at that risk data longitudinally,” says Strobel.

With the successful rollout of AI2 helping mental health care, the researchers are now turning their attention to other chronic health conditions. Using the same approach, Bidargaddi’s team believe they can have a similar impact on diabetes, cardiovascular disease and other chronic conditions, which often occur together in patients.

“We want to extend this platform to people with multiple chronic conditions… to set this up to help GPs to optimally support groups that have those multiple conditions,” says Bidargaddi. “It’s very complex for GPs to work out how to prioritise (disease management and care) for someone who has 4 or 5, which is the bulk of people with chronic conditions.”

“It comes down to making sure you have the right medical appointments at the right time, the right tests at the right time, and the right medications.”

“The system we have built is designed to identify when there are gaps occurring and turn that into an intervention response.”

And that, he says, will mean less stress on the health system and better care and outcomes for patients.