Healthcare Improvement and Implementation

Healthcare Improvement and Implementation science is a growing and vitally important field of applied healthcare delivery research. It has developed in response to the recognised need that systems established for the delivery of front-line clinical care need to be continually strengthened and adapted to clinical needs. This has arisen in the light of the remarkable success of clinical medicine, nursing, midwifery, and allied health that has in turn spawned issues such as safety, ethics, cost and policy pressures to achieve greater system efficiency and effectiveness globally, combined with rising public expectation of high quality, safe and patient-centered service delivery.

Theme Lead

Professor Helen Skouteris is a developmental and health psychologist with a strong track record in longitudinal multi-factorial research, randomised controlled trials, implementation research and higher degree research supervision. Her research since 2010 has predominantly focused on building agency/capacity in ‘the consumer' to make healthy lifestyle choices across preconception, pregnancy, preschool, and childhood, including adolescence, to reduced the burden of obesity.

Theme Research Areas

Implementation and Healthcare Improvement

The Healthcare Improvement and Implementation topics undertaken in this theme include:

  1. Implementation and Healthcare Improvement
  2. Healthcare Systems of the Future
  3. Evaluation Methods in Implementation Research
  4. Centre of Clinical Effectiveness

Our Team

  • Professor Helen Skouteris
  • Professor Helena Teede
  • Associate Professor Jacqueline Boyle
  • Associate Professor Lisa Moran
  • Dr Bengianni Pizzirani
  • Dr Briony Hill
  • Dr Cate Bailey
  • Dr Cheryce Harrison
  • Dr Grace Xie
  • Dr Heather
  • Dr Lauren Bruce
  • Dr Lauren Stafford
  • Dr Melanie Gibson-Helm
  • Dr Siew Lim
  • Dr Alex Hu
  • Ms Claire Blewitt
  • Ms Julie Avery
  • Ms Madelaine Smales
  • Ms Rachel Breman
  • Ms Tracy Taylor

Major Collaborations

  • Department of Health and Human Services (DHHS) (HEALing Matters for Residential Out-of-Home Care)
  • Baptcare  (HEALing Matters for Foster Care and Kinship Care)
  • Bestchance Child Family Care (Fostering positive mental health in pre-schoolers)
  • The Australian Prevention Partnership Centre (Health in Preconception, Pregnancy and  Postpartum – HIPPP)
  • MacKillop Family Services (The Sanctuary Model)

Major Current Projects

HEALing Matters for Residential Out-of-Home Care

The Victorian Department of Health and Human Services will work with Monash University to implement the Healthy Eating Active Living Matters (HEALing Matters). The objectives of implementing the state-wide healthy eating and active living program in residential Out-of-Home Care (OoHC) are to: embed the HEALing Matters program principles and practices and resources in residential OoHC guidelines, policies and strategies and align to changes in the OoHC sector; provide opportunities for young people living in residential OoHC to learn positive healthy lifestyle skills related to healthy eating and active living; support residential OoHC staff to create a healthy home like environment which promotes healthy eating and provides opportunities to be active and connected to the community;  evaluate the translation of the program from a research pilot into a system-wide initiative, using a pragmatic iterative approach (based on real-time stakeholder feedback) to inform sustainable program delivery and build the rigorous evidence-base for work in this area.

Project Lead: Professor Helen Skouteris
Project Manager: Bengianni Pizzirani
Team Members: Dr Lauren Bruce, Ms Madelaine Smales

Website: https://hm.erc.monash.edu
Email: MCHRI.Healingmatters@monash.edu

HEALing Matters for Foster Care and Kinship Care

This research will involve a partnership between Baptcare and Monash to revise the HEALing Matters program (developed by Professor Skouteris and her team) for Residential Out-of-Home Care to be relevant, meaningful and applicable for Foster Care and Kinship Care.

Project Lead: Professor Helen Skouteris
Project Manager: Dr Lauren Stafford
PhD Student: Rachel Breman

Fostering positive mental health in pre-schoolers

Bestchance Early Years, The Cheshire School and Monash University are partnering to develop a toolkit of resources, that build positive behaviours and resilient mental health in young children, into the early childhood environment, where prevention and early intervention offers greatest benefit.

Project Lead: Professor Helen Skouteris
PhD Student: Claire Blewitt
Associate Supervisor: Dr Heather Morris

Health in Preconception, Pregnancy and Postpartum (HIPPP)

This program of research is funded by the Medical Research Future Fund’s Boosting Prevention program, through The Australian Prevention Partnership Centre. The research is led by the HIPPP Collaborative, a multi-disciplinary national/international network led from the Monash Centre for Health Research and Implementation. Its primary aim is to improve lifestyle, improve health and prevent maternal obesity. This work is underpinned by partnership, research, capacity building and knowledge translation.

Project Co-leaders: Professor Helena Teede and Professor Helen Skouteris
Project Manager: Tracy Taylor
Team Members: Associate Professor Jacqueline Boyle
Associate Professor Lisa Moran
Dr Cheryce Harrison
Dr Briony Hill
Dr Siew Lim
Dr Melanie Gibson-Helm
PhD student: Cate Bailey

Website: www.hippp.org.au

The Sanctuary Model

The aim of this program of research is to generate new knowledge and co-design an implementation blueprint and toolkit/resources ready for scale up to deliver a school-wide trauma-informed practice model, the Sanctuary Model, targeting Australia’s most disadvantaged and vulnerable children and families and the staff who work with them.

Project Lead: Professor Helen Skouteris
PhD student: Julie Avery
Associate Supervisor: Dr Heather Morris
Statistical Advisor: Dr Cate Bailey

Healthcare Systems of the Future

Overview

This is a three year, interdisciplinary research  project that will generate knowledge that supports the diffusion and scaling up of redesign and innovation initiatives within health care systems. The overall aim of the project is to enable hospitals and other health care organisations to develop capabilities that will ensure investments in redesign and improvement activities have ‘whole system’ economic and health care benefits.

Our Team

Evaluation Methods in Implementation Research

MCHRI is an internationally recognised leader in evaluation methods and implementation research. Guided by the MCHRI Knowledge to Action Framework we work on solution-focused research with industry partners to develop the evidence base needed to inform implementation, translation, and scale up of programs designed to improve the health and wellbeing of Australians.

Our Team and Students

Major Collaborations

  • Baptcare (MiCare Evaluation)
  • Anglicare (Parents Building Solutions Evaluation)
  • MacKillop Family Services (Cradle to Kinder Evaluation)

Major Current Projects

MiCare

Monash University has been commissioned by Baptcare to evaluate their MiCare Program. MiCare delivers individualised packages of care that integrate both mental health support and psychosocial outreach counsel for people aged 18-64 with a persistent and severe mental illness. The program has been implemented in North and South Tasmania for over four years.

Project Lead: Professor Helen Skouteris
Project Manager: Renee O’Donnell
Team Member: Melissa Savlaglio

Parents Building Solutions

The aim of the partnership between Anglicare and Monash University is to evaluate the Parents Building Solutions Program.  Monash will conduct this independent evaluation and will work collaboratively with Anglicare to ensure the evaluation is co-designed by all stakeholders so the findings and recommendations are relevant, meaningful and applicable to/for the beneficiaries of the program.

Project Lead: Professor Helen Skouteris
Project Manager: Dr Heather Morris

Cradle to Kinder

Cradle to Kinder (C2K) is a targeted antenatal and postnatal support service that provides intensive and longer-term family and early parenting support to vulnerable young mothers (aged less than 25 years) and their families.  Monash University has partnered with MacKillop and the Victorian Aboriginal Child Care Agency (VACCA) to provide an evaluation of the C2K program.

Project Lead: Professor Helen Skouteris
Project Manager: Renee O’ Donnell

Centre of Clinical Effectiveness

This program is integrated with the National Association of Diabetes Centres accredited Centre of Excellence, at Monash Health in diabetic research, education and clinical care.

Overview

Centre for Clinical Effectiveness (CCE) is an evidence-based practice support unit that partners with health professionals, managers and executive leadership to implement evidence-informed practice to improve healthcare. Currently, CCE represents a unique model of evidence-based support working within a health service.  In collaboration with Monash University and Monash Health, CCE is able to respond directly to the need for research translation with relevant and high quality reviews of the evidence conducted by a skilled and experienced team.

Our Team and Students

CCE supports the mobilisation of knowledge into practice which is a complex activity involving evidence, diverse stakeholders, contexts, teams with appropriate skills, mechanisms and processes. Facilitating one component of these broad ranging activities is that of knowledge synthesis.

This Centre partners with health service professionals, managers, and executive leadership to facilitate evidence informed decision-making by undertaking tailored and rapid knowledge synthesis. This Centre is embedded within a large health service and supports and informs clinical and operational decisions with diverse types of evidence. Embedded within a health service enables the mobilisation of evidence directly to the point of health service decision-making in a timely manner. This also provides a unique opportunity to develop ‘knowledge products’ and to evaluate the impact of both product and evidence on clinical and operational decisions in health service delivery.

The provision of different types of evidence synthesis reports are produced for different health service activities and processes which includes the development of practice guidelines, informing quality improvement initiatives, guidance about implementing evidence-based change, and program evaluation.

Reviews

Our information, expertise and resources guide health service personnel in using the best available evidence to inform decision-making throughout the organisation and in everyday clinical practice.
In 2015 CCE undertook the following reviews that have influenced organisation wide change:

The Weekend Effect: A literature review about the impact of day of week and time of day of presentation on patient outcomes
Effective strategies to manage prescribing errors in hospital patients with known medication allergies: A literature review
A rapid literature review about strategies to support healthcare delivery during the winter.
An overview on the clinical effectiveness and cost-benefit analysis of robot-assisted surgery compared to open or laparoscopic surgery
Effectiveness of intermittent pneumatic compression with/without pharmacological prophylaxis in addition to or in place of graduated compression stockings in Urology and Neurosurgery
Best practice for conducting morbidity and mortality reviews.