HARC scholars focus on challenge of reducing clinical variation in healthcare

Five future healthcare leaders are set to embark on research in areas ranging from responding to the threat of antimicrobial resistance to tackling clinical variation in cancer care, after being awarded 2017 HARC scholarships.

HARC (Health Alliance for Research Collaboration) is a collaboration between the Sax Institute, the Clinical Excellence Commission (CEC), the Agency for Clinical Innovation (ACI), the Cancer Institute NSW and the Bureau of Health Information (BHI). It aims to build the NSW health system’s capacity to close evidence-practice gaps by fostering the use of research evidence in policies and programs.

The Collaboration’s focus for 2016-17 is to better understand the role of clinical leadership in effecting change in the health system to address unwarranted clinical variation. The scholars were invited to apply to conduct projects either on this theme, or on closing evidence-practice gaps.

The 2017 HARC Scholars are: 

Amy Bisson, Project officer, Healthcare Associated Infections at the CEC

Amy Bisson from the CEC is one of five HARC scholars.
HARC scholar Amy Bisson from the CEC will study multi-drug resistant organisms.

Ms Amy Bisson is set to investigate ways of reducing unwarranted clinical variation and harm from multi-drug resistant organisms for NSW patients, with a particular focus on the emerging threat posed by carbapenemase-producing Enterobaceriaceae (CPE).

Having previously worked as a nurse, Ms Bisson said she was well aware of the frontline impact of the spread of multi-drug resistant bacteria. While Australia had not seen the same numbers of CPE infections as some other countries, it was recognised as a public health priority, with the first Australian hospital outbreak documented in 2012 and cases rising since.

“It is the last line of antibiotic treatment after other options have failed, and that is why it is so critical,” she said. “Infections are often in very sick patients, and the mortality rate is very high.”

Ms Bisson will use the scholarship to travel to Melbourne, Switzerland and the UK to study strategies that had been proven to bring about change in practice improvements, communication, education and quality improvement.

She said she hoped the information she gathered would help inform the CEC ‘s development of guidelines, outbreak plans and tools to reduce unwarranted clinical variation and patient harm when responding to multi-drug resistant organisms such as CPE.

Tina Chen, Medical and Scientific Advisor at the Cancer Institute NSW

Dr Tina Chen will use her scholarship to investigate how point-of-care, patient-reported outcome and experience measures can be used to achieve more effective, patient-centred care.

Dr Chen will look at what patient-reported data is most pertinent and how to best obtain that data at the point of care, as well as how to appropriately analyse such data to form pragmatic measures and linked clinical endpoints that will enable evaluation and comparisons of treatment effectiveness.

Lilian Daly, Lead Researcher at BHI

Ms Lilian Daly will visit Canada and England to build her knowledge and skills in the development of patient safety measures to assess hospital performance.

She said she would investigate the relative merits of composite measures such as harm-free care and risk-adjusted measures that were focused on particular complications in specific patient groups – such as joint surgery – to help build internal BHI capacity.

Tara Dimopoulos-Bick, Manager of Patient Experience and Consumer Engagement at ACI

Mrs Tara Dimopoulos-Bick is looking at what can be learnt from international evidence and experiences to improve the uptake of shared decision making within NSW health services.

She said Australia was behind other countries in using shared decision making processes and decision aids, and the project would help to connect ACI to experts in countries that had progressed further in the field, including the US, England, France, Germany, Netherlands and Canada.

Ruyamuro Kwedza, Manager, Quality and System Performance at the Cancer Institute NSW

Dr Ruyamuro Kwedza will use the HARC scholarship to investigate ways to strengthen approaches to collaboratively understanding and addressing clinical variation in cancer care across NSW.

In her application, Dr Kwedza said the process of moving from identifying variations in care – such as cancer care – to determining if variation is unwarranted and then to reducing undesirable variation remained a challenge for health systems. The project will enable her to visit international agencies with expertise in this area, as well as to conduct a literature review, to help inform future approaches for the Cancer Institute.

Find out more