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  • Gruen, Russell L.  (11)
  • PMC (PubMed Central)  (11)
Type of Medium
Language
Year
  • 1
    Language: English
    In: BMC Health Services Research, 01 May 2004, Vol.4(1), p.8
    Description: Abstract Background The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist...
    Keywords: Public Health
    ISSN: 1472-6963
    E-ISSN: 1472-6963
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  • 2
    In: PLoS ONE, 2016, Vol.11(2)
    Description: Background The Neurotrauma Evidence Translation (NET) Trial aims to design and evaluate the effectiveness of a targeted theory-and evidence-informed intervention to increase the uptake of evidence-based recommended practices for the management of patients who present to an emergency department (ED) with mild head injuries. When designing interventions to bring about change in organisational settings such as the ED, it is important to understand the impact of the context to ensure successful implementation of practice change. Few studies explicitly use organisational theory to study which factors are likely to be most important to address when planning change processes in the ED. Yet, this setting may have a unique set of organisational pressures that need to be taken into account when implementing new clinical practices. This paper aims to provide an in depth analysis of the organisational context in which ED management of mild head injuries and implementation of new practices occurs, drawing upon organisational level theory. Methods Semi-structured interviews were conducted with ED staff in Australia. The interviews explored the organisational context in relation to change and organisational factors influencing the management of patients presenting with mild head injuries. Two researchers coded the interview transcripts using thematic content analysis. The “model of diffusion in service organisations” was used to guide analyses and organisation of the results. Results Nine directors, 20 doctors and 13 nurses of 13 hospitals were interviewed. With regard to characteristics of the innovation (i.e. the recommended practices) the most important factor was whether they were perceived as being in line with values and needs. Tension for change (the degree to which stakeholders perceive the current situation as intolerable or needing change) was relatively low for managing acute mild head injury symptoms, and mixed for managing longer-term symptoms (higher change commitment, but relatively low change efficacy). Regarding implementation processes, the importance of (visible) senior leadership for all professions involved was identified as a critical factor. An unpredictable and hectic environment brings challenges in creating an environment in which team-based and organisational learning can thrive (system antecedents for innovation). In addition, the position of the ED as the entry-point of the hospital points to the relevance of securing buy-in from other units. Conclusions We identified several organisational factors relevant to realising change in ED management of patients who present with mild head injuries. These factors will inform the intervention design and process evaluation in a trial evaluating the effectiveness of our implementation intervention.
    Keywords: Research Article ; Medicine And Health Sciences ; Medicine And Health Sciences ; People And Places ; Medicine And Health Sciences ; Medicine And Health Sciences ; People And Places ; People And Places ; Biology And Life Sciences ; Biology And Life Sciences ; Social Sciences ; Biology And Life Sciences ; Computer And Information Sciences ; Social Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences
    E-ISSN: 1932-6203
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  • 3
    Language: English
    In: BMC Medical Research Methodology, 01 June 2011, Vol.11(1), p.92
    Description: Abstract Background Evidence mapping describes the quantity, design and characteristics of research in broad topic areas, in contrast to systematic reviews, which usually address narrowly-focused research questions. The breadth of evidence mapping helps to identify evidence gaps, and may guide...
    Keywords: Medicine
    ISSN: 1471-2288
    E-ISSN: 1471-2288
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  • 4
    Language: English
    In: PLoS ONE, 01 January 2018, Vol.13(6), p.e0198676
    Description: OBJECTIVE:To appraise the currency, completeness and quality of evidence from systematic reviews (SRs) of acute management of moderate to severe traumatic brain injury (TBI). METHODS:We conducted comprehensive searches to March 2016 for published,...
    Keywords: Sciences (General)
    E-ISSN: 1932-6203
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  • 5
    Language: English
    In: Bismark, Marie M., Andrew J. Gogos, Richard B. Clark, Russell L. Gruen, Atul A. Gawande, and David M. Studdert. 2012. Legal disputes over duties to disclose treatment risks to patients: a review of negligence claims and complaints in Australia. PLoS Medicine 9(8): e1001283.
    Description: David Studdert and colleagues identified disputes over informed consent among malpractice claims and serious health care complaints in Australia and provide an analysis of disagreements between patients and doctors over whether particular clinical risks should have been disclosed before treatment.
    Keywords: Medicine ; Public Health ; Behavioral And Social Aspects Of Health ; Surgery ; Social And Behavioral Sciences ; Law ; Medical Law
    ISSN: 1549-1277
    E-ISSN: 15491676
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  • 6
    Language: English
    In: World Journal of Surgery, 2015, Vol.39(4), pp.842-853
    Description: Byline: Prasit Wuthisuthimethawee (1), Samuel J. Lindquist (2), Nicola Sandler (3), Ornella Clavisi (4), Stephanie Korin (6), David Watters (5,6), Russell L. Gruen (2,4) Abstract: Background Few guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where resources and facilities are also often limited, and clear appropriate guidance is needed for early wound management. Methods We undertook a systematic review focusing on the nature of wounds in disaster situations, and the outcomes of wound management in recent disasters. We then presented the findings to an international consensus panel with a view to formulating a guideline for the initial management of wounds by first responders and subsequent healthcare personnel as they deploy. Results We included 62 studies in the review that described wound care challenges in a diverse range of disasters, and reported high rates of wound infection with multiple causative organisms. The panel defined a guideline in which the emphasis is on not closing wounds primarily but rather directing efforts toward cleaning, debridement, and dressing wounds in preparation for delayed primary closure, or further exploration and management by skilled surgeons. Conclusion Good wound care in disaster settings, as outlined in this article, can be achieved with relatively simple measures, and have important mortality and morbidity benefits. Author Affiliation: (1) Department of Emergency Medicine, Songklanagarind Hospital, Prince of Songkla University, Hatyai, Songkhla, Thailand (2) The Alfred Trauma Service, Melbourne, VIC, Australia (3) Royal Perth Hospital, Perth, WA, Australia (4) National Trauma Research Institute, The Alfred Hospital, Monash University, Level 4, 89 Commercial Road, Melbourne, VIC, 3004, Australia (5) Department of Surgery, Barwon Health Geelong, Barwon Health and Deakin University, Geelong, VIC, Australia (6) Royal Australasian College of Surgeons, Melbourne, VIC, Australia Article History: Registration Date: 04/06/2014 Online Date: 02/08/2014
    Keywords: Medical Personnel – Health Aspects ; Wound Care – Health Aspects ; Emergency Medicine – Health Aspects;
    ISSN: 0364-2313
    E-ISSN: 1432-2323
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  • 7
    Language: English
    In: 2014, Vol.11(2), p.e1001603
    Description: Julian Elliott and colleagues discuss how the current inability to keep systematic reviews up-to-date hampers the translation of knowledge into action. They propose living systematic reviews as a contribution to evidence synthesis to enhance the accuracy and utility of health evidence.
    Keywords: Policy Forum ; Medicine
    ISSN: 15491277
    E-ISSN: 1549-1676
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  • 8
    Language: English
    In: Health Research Policy and Systems, 01 December 2009, Vol.7(Suppl 1), p.S9
    Description: Abstract This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Differences between health systems may often result in a policy or programme option that is used in one setting...
    Keywords: Public Health
    ISSN: 1478-4505
    E-ISSN: 1478-4505
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  • 9
    In: Medicina, 2019, Vol.55(10)
    Description: Background and objectives: Prompt identification of patients with acute traumatic coagulopathy (ATC) is necessary to expedite appropriate treatment. An early clinical prediction tool that does not require laboratory testing is a convenient way to estimate risk. Prediction models have been developed,...
    Keywords: Review ; Acute Traumatic Coagulopathy ; Prediction Model ; Pre-Hospital ; Bleeding ; Trauma
    ISSN: 1010-660X
    E-ISSN: 1648-9144
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  • 10
    Language: English
    In: Implementation Science, 01 January 2019, Vol.14(1), pp.1-16
    Description: Abstract Background Evidence-based guidelines for management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available; however, clinical practice remains inconsistent with these guidelines. A targeted, theory-informed implementation intervention (Neurotrauma...
    Keywords: Mild Traumatic Brain Injury ; Cluster Trial ; Effectiveness ; Emergency Department ; Implementation Science ; Clinical Practice Guideline ; Public Health
    E-ISSN: 1748-5908
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