Centre for Healthcare Resilience and Implementation Science

A Centre undertaking research of national and international standing with a core interest to investigate health sector issues of policy, culture, systems, governance and leadership.

Identity

We are :

• The people who look at sustainable health systems and make them meaningful
• World class systems researchers
• Experts in understanding and developing models of improvement for healthcare
• Promoting exciting cross-disciplinary research with multiple internal and external partners, in Australia and across the world.

Principles

Our principles for projects:

• Utility and usefulness
• Highest quality results
• Feasible and realistic
• Propriety - conducted ethically
• Accurate reporting and faithful interpretation of results
• Pursuing inclusivity.

Six CHRIS objectives

The Centre has six main objectives. These are:

• To undertake internationally recognised inter-disciplinary research and development projects on clinician led approaches to organising and managing clinical work across the full spectrum of care.
• To provide a focal point for initiating and managing collaborative research and development projects on clinician led approaches to the organisation and management of clinical work. involving partners drawn from other groups within the Faculty of Medicine, Health and Human Sciences, other departments within the University, Federal, State and Area health authorities and potential collaborators in other universities both within and external to Australia.
• To provide a supportive environment for developing research skills of young health researchers from both clinical and social science disciplines.
• To develop an international research reputation not simply in health but also in the base disciplines from which Centre members are drawn viz., policy studies, multi-disciplinary teamwork, improvement studies, discourse analysis, sociology, organisational behaviour, social theory, anthropology, health informatics and clinical studies.
• To be an internationally recognised reservoir of knowledge and expertise on clinical work management issues with a capacity to respond to requests for advice and consultation.
• To facilitate the development of education and training activities both within and outside the University in support of clinical governance.

Patient safety and appropriateness of care

With a suite of unique projects examining the level of appropriate care delivered to patients in Australia, we are in a strong position to identify areas for improvement and to recommend effective and practical interventions to optimise care for all Australians. Read more.

Complex systems and implementation science

Healthcare is increasingly recognised as a complex adaptive system, comprised of multiple levels of interacting agents, including diverse organisations (e.g., hospitals, not-for-profits, governments, professional bodies), groups (e.g., medical teams, online patient communities) and individuals (e.g., doctor, nurse, patient, carer, pharmacist). All of this interconnection leads to nonlinearity, making understanding, influencing and improving the healthcare system a challenge of the greatest magnitude. Read more.

Health and societal outcomes

Improving estimates of the burden of injury and disease is integral for priority-setting and to evaluating the impact of preventive strategies. Examining health outcomes following the provision of healthcare can also be instrumental in guiding where improvements need to be made in health service delivery and health policy. The health outcomes stream is conducting large-scale, population-based studies in the areas of paediatric trauma, dementia and care transitions, unwarranted clinical variation, and a case-control study of adult injury and health service use. Read more.

Health System Sustainability

Globally, healthcare systems face numerous challenges that test their ability to provide safe, high quality care. These challenges encompass ageing populations, rising prevalence of chronic and complex diseases, escalating cost pressures due to advancements in medical technologies and medications, spending on low-value care, inefficiencies resulting from system fragmentation, and limited utilisation of data and evidence to drive reform. The Health System Sustainability research stream endeavours to investigate these and other challenges to ensure the sustainability of health systems. We provide research evidence and strive to formulate and assess a range of practical interventions that align with clinical, patient, and economic perspectives. Read more.

Human factors and resilience

While the rate of medical error remains stubbornly high at around 10 percent in modern hospital systems, there are considerable untapped opportunities to improve care by turning our attention to what healthcare systems do well. Instead of focussing on why systems sometimes fail, resilience science engineering seeks to understand how dynamic and highly complex organisations and systems, like healthcare, usually get things right. Read more.

International healthcare reform

Professor Jeffrey Braithwaite brings his international reputation for health services and systems research to uniquely focus on comparative international health reform efforts. He has published widely on health policy, management and systems reform and co-edits two book series in this field: one, on international efforts to understand resilient healthcare, and another on 152 different countries’ reform activities. The books, used to inform future policy direction, include many low-, middle- and high-income countries and their efforts to make systems improvements. Read more.

• Achieving behaviour change for management of lynch syndrome and prevention of cancer
• Behavioural and attitudinal responses to Cochlear implantation in Australia and the United Kingdom
• Better evidence for earlier identification and surgical intervention for refractory epilepsy
• CareTrack Aged
• CareTrack Australia
• CareTrack Kids
• Centre for research excellence in implementation science in oncology
• Communities of practice and social-professional networks
• Creating a culture of safety and respect
• Creating safe, effective systems of care: The translational challenge
• Dementia and injury rehabilitation
• Dementia and injury-related hospitalisations
• Dementia and residential aged care
• DUQuA
• ED Cognitive Work Analysis
• Genomics in Primary Care
• Genomics translational activities
• Identification and referral for surgical intervention of refractory epilepsy patients
• Impact of child and placement characteristics, carer resources and perceptions, and life stressors on care giving
• Impact of chronic health conditions and injury on school performance
• Implementation of genomic medicine into clinical practice
• Implementation and Complexity Science in Mental Health - various projects
• International healthcare reform
• Keeping Australians out of hospital
• Melanoma Centre of Research Excellence
• MQ-Minds cohort study
• MyEd -  Working together - Innovation to improve emergency department (ED) performance and patient outcomes and experience for five complex consumer cohorts
• NHMRC Partnership Centre for Health System Sustainability
• National Paediatric Applied Research Translation Initiative (N-PARTI)
• Observatory on the Future of Healthcare
• Organisational resilience at Townsville hospital
• Patient safety
• Rouse Hill Hospital  Development Project
• Stocktake of data sources for childhood injury in NSW
• The ACCREDIT project
• Zero Childhood Cancer

Methods

• Methods for analysing ‘work-as-done’ including Functional Resonance Analysis Method (FRAM)
• Methods for analysis of linked population data collections
• Methods for assessing health outcomes
• Methods for assessing the appropriateness of healthcare
• Methods for soft systems

Models and approaches

• Complexity science approaches to problem solving
• Improvement models for enhancing organisational culture
• Models for sustainable health systems
• Social network analysis
• Study designs for examining health systems at scale