Our research impact
Deficiencies in Australian youth justice legislation
Our Social Work research has impacted on policy reform in the youth justice system.
In collaboration with the Victorian Children’s court, Dr Susan Baidawi’s research generated robust Australian evidence of the characteristics of children involved with child protection services due to maltreatment, who are twelve times more likely to enter youth justice supervision. Despite being among the most vulnerable and disadvantaged youth, such “cross-over’ children were previously absent from the Victorian government’s policy framework, due to a lack of evidence to inform a targeted policy direction.
Specific reforms on crossover children outlined in the Victorian Youth Justice Strategic Plan (2020-30), were based on key recommendations from Susan’s study, including: targeted and intensive early intervention in the young persons’ life; strengthened approaches to diversion of young people away from legal processes; and the implementation of a state-wide policy to reduce the criminalisation of children in residential care.
Susan has also been commissioned by Anglicare to conduct policy and legislative analysis to support their National HomeStretch Campaign to extend out-of-home care up to 21 years. Young people leaving state care are among Australia’s most vulnerable youth, and experience disproportionately high rates of homelessness, mental health issues, and justice system involvement. A key concern was the sudden removal of state support for these young people on or before their 18th birthday.
Susan’s analyses and research reports highlighted deficiencies of Australia’s approach, and drew on international policy and legislative analysis to recommend alternative approaches. These viable alternatives were utilised by Anglicare and the HomeStretch Campaign to lobby state and territory governments. This research has now supported the successful introduction of extended care policies and trials across Victoria, Western Australia, South Australia and Tasmania. In November 2020, the Victorian State Government announced $64.7 million in funding to invest in Home Stretch for every Victorian child, guaranteeing ongoing support to this group until 21 years.
The policy and legislative analysis can be found on the HomeStretch website.
Susan has also conducted research into older offenders, the largest Australian study of its kind, demonstrating a high policy impact. Its findings form the basis of the Victorian Department of Justice Corrections Ageing Prisoner and Offender Policy Framework (2015-20), directing current practice with older people across the Victorian corrections system.
This research resulted in Susan’s invitation to speak to Victorian and NSW senior correctional and governmental bodies.
Our falls prevention research has demonstrated to the world what does and does not work in the prevention of falls amongst hospitalised older adults.
Falls are commonly the most frequent adverse event that impacts on the safety of people being treated in hospitals. Correspondingly, great effort and expense is accrued trying to prevent hospital falls. However, this does not mean these resources are well spent.
Professor Terry Haines's research has led the world in
- Mapping and costing falls prevention activities - We have identified that each year, approximately $590 million is consumed across Australia in the provision of falls prevention practices that do not have evidence indicating that they reduce falls in hospitals.
- Generating evidence to show which falls prevention practices do not work - We have conducted trials demonstrating that routinely provided falls prevention practices such as use of falls risk screening tools, low-low beds, and multifactorial targeted intervention programs do not reduce falls.
- Developing and demonstrating an approach that does work - The Safe Recovery patient education program has been tested in three trials. The most recent trial involved rolling the Safe Recovery program out across geriatric rehabilitation wards in Western Australia leading to a 40% reduction in falls, 35% reduction in falls with injury, and 45% reduction in the proportion of patients who fell.
This body of work is impacting falls prevention practices internationally. eg. The UK National Audit of Inpatient Falls – Audit Report 2017 identified that “Many trusts and local health boards have stopped using ‘falls risk screening/prediction tools’, a drop from 74% in 2015 to 34% in 2017. These tools do not sufficiently predict who will fall in hospital and are not recommended by the National Institute for Health and Care Excellence. Where they are in use, it is likely that clinical staff are missing some at‐risk patients.
Development of patient-reported outcome measure
Our Physiotherapy research initiated the development of measuring patient reported outcomes, which can improve the quality and effectiveness of healthcare interventions.
Dr Sze-Ee Soh developed the “Monash University cardiac PROM (MC-PROM)” to assess recovery of patients following a percutaneous coronary intervention. The MC-PROM was subsequently included in a composite measure for the Victorian Cardiac Outcomes Registry to assess post-intervention outcomes.
Using Rasch analysis, five items were identified in being reliable and valid measures of patient-reported outcomes following percutaneous coronary interventions. It was also established that the MC-PROM has robust measurement properties including good structural validity and acceptable internal consistency.
The MC-PROM has been incorporated into the Victorian Cardiac Outcomes Registry (VCOR) to capture the patient’s perspective of their recovery 30 days following their procedure. The methods of this validation study are also novel and Sze-Ee has since been invited to replicate the study in other registry projects including the Victorian Lung Cancer Registry (VLCR) and the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).
Humanity and compassion training in healthcare workers
Our Social Work research has resulted in the development of compassion training to health care workers.
This research investigated the relationship between the perception of common humanity and compassion in healthcare workers. Common humanity has been proposed as the prerequisite for unbiased universal compassion. There is an absence of empirical research in this area.
There were two aspects to the research conducted by Dr Debbie Ling. First, a pre/post intervention was conducted to investigate the impact of viewing common humanity scenarios on healthcare workers’ level of compassion. Validated scales were used for perspective taking, common humanity and compassion. There was a statistically significant increase in levels of compassion for healthcare workers. This was the first study in the world to produce empirical evidence that viewing common humanity scenarios can increase healthcare worker compassion.
The second part of the research involved developing, trialling and evaluating a single session compassion training session focusing on common humanity.
The compassion training has been delivered to healthcare workers at Monash Health, Epworth HealthCare, Royal Australasian College of Physicians (RACP), Mercy Health and Perth Children’s hospital.
There have also been requests for the compassion training curriculum from NHS Pennine Care Trust (UK), Mount Sinai Health Network (US) and Southern District Health Board (New Zealand).
Common humanity training sessions are being trialled on paramedicine, occupational therapy and physiotherapy students at Monash University. Debbie is also leading a pilot randomised controlled trial investigating the impact of common humanity training on doctor well-being, sense of connection and compassion.
Our Occupational therapy research has resulted in recognition within the National Disability Insurance Agency (NDIA) executive of the value of a systematic approach to evidence.
Associate Professor Lisa O’Brien joined the Research and Evaluation within the NDIA to set up the Evidence Synthesis team. Lisa’s team has delivered rapid systematic reviews that have been incorporated into service re-design and evidence-informed policy including:
- Intermediary services to assist people with disabilities to implement individualised funding plans (including reviews of impact of Local Area Coordinator and Support Coordinator roles)
- National Community connectors program (for difficult to reach communities, such as indigenous peoples)
- Analyses of Psychometric properties of assessment tools for Independent Functional Assessment pilots
- Sexual supports for people with disability
Development of tool to diagnose condition
Our research has led to the development of a tool that is now used around the world.
Associate Professor Cylie Williams developed a tool to diagnose a children’s gait condition called Idiopathic Toe Walking (ITW) during her PhD. This condition impacts one in twenty children. Toe walking gait can also frequently be present in more serious conditions, like Cerebral Palsy, Muscular Dystrophy or Autism.
Since publication, the tool has been translated into Turkish, Spanish and German. In the past five years, it has been referenced as the inclusion tool for eight ITW clinical studies. The tool questions, and its exact question wordings are used on the Mayo Clinic ITW assessment information webpage.
Cylie was invited to teach about this tool and associated ITW research at the College of Podiatry Annual Conference Bournemouth (UK), Combined Sections Meeting American Physical Therapy Association (UK), Atlanta Children’s Hospital Orthopedics Grand Round (UK), and Woodruff School of Mechanical Engineering, Georgia Institute of Technology (USA).
Cylie was also the senior author in research developing a standardised assessment proforma, called the Gait And Lower Limb Observation in Paediatrics (GALLOP). The research utilised Delphi methodology to gain consensus and agreement of valid and reliable assessments for children presenting with foot and leg conditions to physiotherapy and podiatry services. This proforma is now embedded in undergraduate podiatry courses at eight of nine Australian universities, and three of 13 UK universities.
The research article has over 18,000 downloads (including a customisable word proforma template), made free to clinicians. It has annually been in the top 10 most downloaded journal articles since 2016.
This research resulted in invitations to run workshops for clinicians and podiatry students. To date, over 6000 podiatrists internationally have participated in ~2 hours of training on the GALLOP’s clinical applicability and use. In particular, the Cylie and the co-authors have run workshops at the University of Brighton, New Zealand Podiatry Conference Auckland, Glasgow Caledonian University UK, College of Podiatry Annual Conference, Bournemouth UK, and as keynote speaker at the College of Podiatry Annual Conference, Harrogate UK, opening the conference with relevance of the standardising assessment to ensure health professionals all collect similar information.