Centre for Clinical Governance Research in Health (CCGR)

The Centre for Clinical Governance Research in Health is a research facility in the Faculty of Medicine at the University of New South Wales with a successful track record of undertaking research and evaluation projects on health sector issues since 1991. Its core interest is to investigate issues of policy, governance and leadership in the health sector. It is involved in conducting original research into clinical governance issues, providing a scholarly capability by which to evaluate health sector policies, programs and projects, and contributing to undergraduate medical, postgraduate health services management, and public health and doctoral education.

To achieve these the Centre makes use of assembled expertise and collaborators, and builds on existing staff expertise through external collaborations within Australia and internationally, including with the NSW Health Department, Clinical Excellence Commission, NSW, Australian Council on Healthcare Standards, Health Informatics Research and Evaluation Unit at the University of Sydney, the International Society for Quality in Health Care (ISQua), the Society for the study of Organising in Health Care and the World Health Organization.

Please click here to watch Professor Jeffrey Braithwaite discuss the research of the Centre.

Mission Strategy People Collaboration

Research Publications Projects

Initiative for Health and Human NH&MRC Patient Safety Program Australian Institute of Health Innovation

CCGR News

Our Deputy Director, Professor Julie Johnson received the “Permanente Service Quality Award” for a poster entitled “Global Strategies to Improve Patient Transitions.”

The conference was the 2010 Institute for Healthcare Improvement National Forum in Orlando, Florida.

Culture and recognition and response systems

Please click here to view a conversation about culture and recognition and response systems featuring Professor Jeffrey Braithwaite.

ABC News Medical Reporter Sophie Scott interviewed Professor Jeffrey Braithwaite for a story on hospital funding and the implications for patient safety. Watch the full story here.

The ABC ran a program on October 9 on ABC News 24 along with a talk on health in developing countries. The program was called the “Hot Seat” and featured several well known researchers including our very own Professor Jeffrey Braithwaite and Professor Ken Hillman talking about improvements to the health system. Please click here to view. The full program is also there for you to download. Happy viewing.

To read Professor Jeffrey Braithwaite's keynote address and panel discussions at the Canon Institute of Global Studies' Symposium: "Healthcare Reform and Economic Growth", held in Tokyo, Japan on 13 July 2010, please click here.

Researching accreditation has been a feature of the Centre’s work for many years. This month, Professor Jeffrey Braithwaite and Professor Johanna Westbrook were successful in a round 2 Australian Research Council Linkage grant [LP100200586] totalling, including industry partners’ contributions, $2.35 million. This is the largest ARC Linkage grant awarded in NSW in the round.

The partner investigators include Mr Brian Johnston, CEO of Australian Council on Healthcare Standards, Dr Steve Clark, CEO of Australian General Practice Ltd, Mr Mark Brandon, CEO of Aged Care Standards Accreditation Agency, Professor Cliff Hughes, CEO of the Clinical Excellence Commission, Adjunct Professor Margaret Banks of the Australian Commission on Safety and Quality in Health Care, Dr Andrew Georgiou and Dr Jo Callen of the Centre for Health Systems and Safety Research, and Dr Marjorie Pawsey and Associate Professor Angus Corbett of the Centre for Clinical Governance Research. Our international advisory team for this project involves Professor John Øvretveit, Karolinska Institute, Sweden, Professor Cathy Pope, University of Southampton, UK, Professor Charles Shaw, European Society for Quality in Healthcare and Professor Rosa Suñol, Institut Universitari Avedis Donabedian, Spain.

Accreditation, a system of organisational improvement based on applying standards and surveying services, is increasingly deployed nationally and internationally. While there are supporters of accreditation amongst stakeholder groups, the empirical evidence for its contribution is inconsistent or does not support the levels of investment.

We seek to investigate how and the extent to which accreditation leads to improved organisational performance, quality of care and patient satisfaction in the health system, an early adopter sector with advanced accreditation processes. The project aims to conduct a multi-method, triangulated series of studies with key investigators, partner investigators, policy collaborators and international advisors.

A report listing the current research outputs from the Centre’s ARC linkage project with ACT Health is available to view here.

Some new papers have been published this month. There are links provided.

Braithwaite, J., Greenfield, D., Westbrook, J., Pawsey, M., Westbrook, M., Gibberd, R., Naylor, J., Nathan, S., Robinson, M., Runciman, B., Jackson, M., Travaglia, J., Johnston, B., Yen, D., McDonald, H., Low, L., Redman, S., Johnston, B., Corbett, A., Hennessy, D., Clark, J. and Lancaster, J. (2010) Health service accreditation as a predictor of clinical and organizational performance: a blinded, random, stratified study. Quality and Safety in Health Care, 19:14-21

Braithwaite, J. and Westbrook, J. (2010) What makes the health system tick? International Journal for Quality in Health Care, 22(1):1-2

Professor Jeffrey Braithwaite has been awarded two new grants from NSW Health: A Capacity Building Infrastructure Grant which will run from 2010 to 2013 valued at $1.75 million., A contract to develop a set of indicators that can be used to assess and measure the organisational health of clinical units which will run from February-April 2010 [awardees: Professor Jeffrey Braithwaite, Dr Joanne Travaglia, Ms Deborah Debono. Ms Jenny Plumb, Dr Janice Wiley and Ms Jacqueline Milne].

We are proud to announce that Dr Marjorie Pawsey, AM, Senior Research Fellow in the Centre was awarded an Australian honour this year. She has been installed as a Member of the Order of Australia for service to community health as a contributor to the development of health care standards, quality assurance systems and professional accreditation programs, particularly in the area of women's health. This award was marked by a morning tea and ceremony in the Institute. Marjorie appeared in a good news story in the local press, too: http://north-shore-times.whereilive.com.au/news/story/top-quality-healthcare-no-1-priority/

Creswick, N., Westbrook, J. and Braithwaite, J. (2009) Understanding communication networks in the Emergency Department. BMC Health Services Research, 9:247

Dr Peter Nugus wins prestigious Jean Martin Award Dr Peter Nugus' PhD thesis, The Organisational World of Emergency Clinicians, completed in 2007, was awarded the prestigious Jean Martin Award from the Australian Sociological Association (TASA) for 'the best PhD in the Australian Social Sciences, 2007-2009'. Read more here ... Dr Peter Nugus and Professor Jeffrey Braithwaite on "selling patients" in the British Medical Journal Dr Peter Nugus, Professor Jeffrey Braithwaite and Dr Jackie Bridges (from City University London) published an empirical article in the prestigious British Medical Journal. The article outlines how and why health services "sell" patients. Read more here ... Watch Dr Nugus' interview on UNSWTV: http://tv.unsw.edu.au/video/how-hospitals-sell-patients

Dr Peter Nugus on "SBS Insight"

Dr Peter Nugus, from the Centre for Clinical Governance Research, was one of four featured guests on SBS Insight's program devoted to Emergency Departments.

Watch Dr Nugus on "SBS Insight".

Seminar





Power and the people in Australian health care: and where were “the people” in the NHHRC?



Date: Wednesday 24th September 2009
Time: 11:00am - 12:00pm

Venue: Hugh Dixson Theatre, Ground Floor, AGSM Building, Gate 11 Botany Street, UNSW.

Speaker: Professor Gavin Mooney



Abstract


This paper argues that too little thought is given to the political economy of health care in Australia. My own discipline of health economics - but it is just as true of others - does much good work in evaluating different policies but the difference all this analysis makes in practice is in general small.
Much of this is to do with the way that power is exercised in the health care system with too much resting in the hands of those in the system, especially doctors as corporate bodies, and too little in the hands of citizens and the community.
What would happen if it were citizens’ values that drove Australian health care? Would that make a difference to what we currently have?
The paper examines the findings from some Citizens’ Juries on these issues. It also wonders why the NHHRC did not go down this road in reaching its recommendations but settled for proposing only their adoption in looking at priorities for the future.


Speaker Profile

Gavin is based in Western Australia. He is an internationally recognised health economist and was recently awarded an Honorary Doctorate by the University of Cape Town as ‘one of the founding fathers of health economics’. He holds professorial positions at the University of Sydney, the University of New South Wales, the University of Cape Town and Aarhus University (Denmark).
Gavin has worked as a health economist for nearly 40 years, first in the UK, then Denmark and more recently in Australia. He has well over 200 publications in health economics, including 20 books. His latest book (2009) is Challenging Health Economics from OUP. Gavin has worked as an adviser on many occasions for WHO and OECD and for various governments and health departments. His main interests within health economics are equity and ethics.

The Australasian Association for Quality in Health Care, together with NSW Health, are holding the 7th Australasian Conference on Safety and Quality in Health Care, being held on 7-9 September 2009, at the Sydney Convention and Exhibition Centre, Sydney, Australia.

The 2009 program will encompass a number of key areas focused around the theme of ‘Bridging the Gap’ to facilitate a better understanding of the various roles of the professions working in the safety and quality health care sector and to enhance the safety and quality of our health care services. Professor Jeffrey Braithwaite and Professor Enrico Coiera are giving a keynote address at the conference, and Dr David Greenfield, Ms Joanne Travaglia and other Centre and Institute staff are presenting research papers and making other contributions.

The Conference program is now available on the Conference Website. The 2009 program encompasses a dynamic range of international speakers and an array of workshops that relate to safety and quality in health care.

For all of the latest information on new Keynotes Speakers, the Conference Program, the Social Program, accommodation and to register for the 7th Australasian Conference on Safety and Quality in Health Care, please visit the Conference Website.

The 7th Australasian Conference on Safety and Quality in Health Care continues to be the premier event for those interested in quality and safety and has grown to become among the largest international event of its kind.

7th Australasian Conference on Safety and Quality in Health Care Managed by arinex pty limited.

GPO Box 128, (Level 10, 51 Druitt Street)
Sydney NSW 2001, Australia
Phone: +61 2 9265 0700
Fax: +61 2 9267 5443
Email:aaqhc2009@arinex.com.au
Website: http://www.aaqhc2009.org.au

On Wednesday 26th August 2009 Professors Jeffrey Braithwaite, Enrico Coiera and Ken Hillman held the successful UNSW Launch of the Australian Institute of Health Innovation (AIHI). AIHI was established in late 2007 within the Faculty of Medicine, and recently occupied its purpose built premises on level 1 of the AGSM Building. The AIHI brings together three successful UNSW research Centres working in the separate but related areas of clinical governance, health informatics and clinical practice and health services research. The Centres are the: Centre for Clinical Governance Research in Health; Centre for Health Informatics Simpson Centre for Health Services Research. To view Professor Clifford Hughes' talk please click here.

Pre-order copies of 'Culture and climate in health care organisations', Professor Braithwaite and colleagues' new book, by going to http://www.palgrave.com/products/title.aspx?PID=353942.

Title: Culture and climate in health care organisations
Editors: Jeffrey Braithwaite, Paula Hyde, Cathy Pope
Publisher: Palgrave Macmillan
Due for release: 11 December 2009

One of the Centre's papers has been chosen as highly commended award winner at the Emerald Literati Network Awards for Excellence in 2008. It is:



Outstanding papers - Leadership in Health Services


Braithwaite J. (2008) L(H) ≠ ∑(m1, m2 … mn), Leadership in Health Services, 21(1):8-15 > Link to Paper

Dr David Greenfield and Centre co-investigators have been awarded two grants from the Department of Health and Ageing totaling $1.9 million. The industry grants [Chief Investigators: Dr David Greenfield, Dr Peter Nugus, Ms Joanne Travaglia and Professor Jeffrey Braithwaite] are being conducted in collaboration with the ACT Division of General Practice, ACT Health and Australian National University (A/ Professor Paul Dugdale). One grant is for a project to integrate primary health care providers and patients-as-professionals in interprofessional learning activities aimed at encouraging active patient self-management of chronic disease. The second grant is to conduct an evaluation project to investigate the interrelated issues of interprofessional learning/networking, chronic disease and patient self-management. The evaluation project will empirically examine in situ, over time, the factors that unite the professional network developed in the first project. In addition, it will explore the stresses and challenges that must be continually addressed for the network to achieve ongoing self-maintenance. In doing so, the evaluation project will investigate the process of translation of proposed gains into actuality. This is an important issue, as previous projects have documented how predicted and sought-after gains have not been realised. It is envisaged that the lessons from this work will be applicable to other areas of chronic care and other professional networks. Furthermore, the results can inform the knowledge base for the Australian National Chronic Disease Strategy.

Professor Braithwaite and his co-investigators have been awarded an NHMRC research grant totalling $8.4 million. The NHMRC Program Grant [Chief Investigators, Professor Jeffrey Braithwaite, Professor Johanna Westbrook, Professor Enrico Coiera, Professor William Runciman and Professor Ric Day] totals $8,400,000 over five years and will examine, across Australia, patient safety. Internationally, patient safety is a growing concern. Patient harm occurs in 10% of hospital admissions. A million adverse events occur in general practice each year in Australia. Overseas data reports that patients receive recommended care only 50% of the time. We will significantly advance this work by investigating how and why this occurs, with a focus on the roles of teamwork, safe medication use and the application of information technology to support improved decision-making.

Professor Braithwaite and his co-investigators have been awarded research grants this month amounting to $3.88 million. This is the culmination of strong international and national collaborative research activities over several years.

The ARC Discovery Grant [Chief Investigators, Professor Jeffrey Braithwaite and Professor Johanna Westbrook] totals $1,580,000 over five years and will examine, across Australia, teams, communities of practice and clinical networks that are the building blocks in providing effective health services. We are using novel and exciting research methods to do this, and will be developing a framework for future evaluation work. Internationally, no one has done this. This is the largest ARC Discovery grant awarded this year.

The ARC Linkage Grant [Chief Investigators Professor Johanna Westbrook and Professor Jeffrey Braithwaite; Partner Investigators A/Professor Katherine Gibson and Dr Richard Paoloni] totals $2,306,000 [$1,550,000 from the ARC and $756,000 from the industry partner, Sydney South West Area Health Service, will investigate information technology and its capacity to support innovations in health care delivery. This is at the cutting edge of health informatics evaluation research. This is the largest ARC Linkage grant awarded this round.

Read about the evolutionary basis of human behaviour and its application in modern settings in a discussion on Radio National breakfast on 2 October between Professor Jeffrey Braithwaite and the ABC's Fran Kelly > Link to Podcast

We need better led health services. Read Professor Jeffrey Braithwaite's recent analysis of this in the journal Leadership in Health Services with the intriguing title L(H) ≠ ∑(m1, m2 … mn).

The OBHC2008 Conference was a resounding success, with some 80 delegates from Australasia, North America and Europe. See the details at www.obhc2008.org.

Download Professor Jeffrey Braithwaite's keynote address Between the devil and the deep blue sea: patient safety and risk in hospitals [PDF] and Dr Marjorie Pawsey's presentation The Relationship Between Accreditation Criteria Results and Clinical Indicators [PDF] on behalf of the ARC Accreditation Research Team to the 5th Australian Conference on Safety and Quality in Health Care "The Power of Us", 6th - 8th August 2007, Brisbane, Australia.

Read the address Professor Jeffrey Braithwaite gave to the Australian Health Care Association's Think Tank in Translating evidence into practice: an action plan, on 10th August 2007, entitled Towards safer, better health care: leveraging the strength of networks. [PDF]

Read Professor Jeffrey Braithwaite's recent review in the British Medical Journal on How to restructure-proof your health service. [PDF]

Organisational Behaviour in Healthcare Conference
The 6th International Conference in Organisational Behaviour in Health Care is to be held in Sydney, Australia from 26-28 March, 2008. The theme is: Culture and climate: cracking the code. The chair is Professor Jeffrey Braithwaite of the University of New South Wales who is hosting the conference on behalf of the Society for the Study of Organising in Health Care. Please visit the website at www.obhc2008.org for more information.

December 2006