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A realist case study of a regional hospital's response to improve emergency department access in the context of Australian healthcare reforms

Reddy, Sandeep, Carey, Timothy A. and Wakerman, John 2016, A realist case study of a regional hospital's response to improve emergency department access in the context of Australian healthcare reforms, Health services research and managerial epidemiology, vol. 3, pp. 1-8, doi: 10.1177/2333392816631101.

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Title A realist case study of a regional hospital's response to improve emergency department access in the context of Australian healthcare reforms
Author(s) Reddy, SandeepORCID iD for Reddy, Sandeep orcid.org/0000-0002-5824-4900
Carey, Timothy A.
Wakerman, John
Journal name Health services research and managerial epidemiology
Volume number 3
Start page 1
End page 8
Total pages 8
Publisher Sage Publications
Place of publication London, Eng.
Publication date 2016
ISSN 2333-3928
Keyword(s) national health-care reforms
emergency department access
realist evaluation
case study
regional hospital
Summary Introduction: Major health-care reforms have extended across all Australian public hospitals in recent years. Improving emergency department (ED) access has been a focus of these reforms.

Objective: This study evaluates how the national reforms have led to improvement in ED access in a regional hospital in remote Australia.Methods: Assessing a complex scenario such as national reforms and the challenges faced by the regional hospital to implement these reforms requires in-depth analysis. A realist evaluation theory-based approach was employed, allowing investigation of what, how, why, and for whom change occurred. A case study mixed methods design was adopted within the realist framework to answer these questions about change.

Results and Conclusion: The study identified moderate improvement in ED access as a result of the reforms (investment in infrastructure and workforce and the introduction of ED targets). Clinical leadership and support from management were essential for the improvement. Without ongoing investment and clinical redesign activities, however, sustainability of the improvement may prove difficult.
Language eng
DOI 10.1177/2333392816631101
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085512

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.