March 2018

The HCF Research Foundation has awarded a total of $1 million in research grants to six successful Australian researchers who are tackling key healthcare issues including palliative care and mental health care, as well as how health systems can best use registry data to directly improve health systems and patient outcomes.

HCF Research Foundation Chair, Lisa McIntyre, says that this year’s grants – which range in value from $80,000 to $240,000 – highlight the increasingly prominent issues impacting health and patient outcomes for all Australians.

“We’re pleased the recipients of this year’s grants are tackling pervasive healthcare issues. Our funded researchers have identified opportunities to improve end-of-life care and communication, support the mental health of Australian health professionals, and optimise clinical registry data to improve patient outcomes. These topical healthcare issues present an opportunity for us to work collaboratively to find solutions that will benefit not just HCF members, but patients and health professionals across Australia.”

Improving quality of end-of-life care for young and old

Ensuring that those who will benefit from palliative care are referred early enough for the service, and enabling health professionals to navigate conversations about palliative care with young and old, helps to meet patients’ end-of-life needs.

People with heart failure have a high symptom burden, reduced quality of life and poor prognosis which is comparable with cancer patients. Dr Peter Allcroft from Southern Adelaide Local Health Network will use his HCF Research Foundation grant to explore how early referral of patients with severe heart failure to palliative care services can improve their quality of life, reduce symptom burden, and reduce their healthcare utilisation.

Dr Cardona-Morrell’s team from UNSW Sydney will assess records from over 500 general practitioners (GPs) in five States to see if there is sufficient information to characterise the profile of older people at risk of death. The team will then investigate GP views on barriers and enablers for end-of-life discussions at primary care, to ultimately support GPs in their key role of recognising and discussing the end of life needs and preferences of an ageing population.

Without clinical guidance, end-of-life conversations occur for less than 3 per cent of adolescents and young adults (AYAs). Dr Ursula Sansom-Daly from UNSW will use her HCF Research Foundation grant to support medical professionals to communicate with young Australians with life-limiting illnesses such as cancer and cystic fibrosis.

Due to the developmental complexity of the AYA years, without age-appropriate interventions this cohort is at risk of poor quality-of-life outcomes, such as greater anxiety, inadequate pain management, dying in a state of ‘emotional isolation’ and dying in hospital against their wishes. In an Australian first, Dr Sansom-Daly’s research will evaluate an internationally developed tool called ‘Voicing My CHOiCES’  to ensure its appropriateness, feasibility and ability to meet the psychosocial needs of young Australians. Dr Sansom-Daly’s research will also investigate barriers and facilitators to best-practice end-of-life communication in hospital settings, and will work towards developing training to equip clinicians with the skills and confidence to have these challenging end-of-life conversations with young people.

Liz Callaghan, CEO of Palliative Care Australia recognises the value of early end-of-life conversations and palliative care for Australians of every age.

“I’m very pleased to see these palliative care researchers being supported by the HCF Research Foundation. We know that talking about your wishes with your loved ones and accessing palliative care services early after being diagnosed with a life-limiting condition can really improve your quality of life. Any research that looks to increase these conversations and early referrals are a great step in the right direction.”

Enhancing resilience and mental health in Australia’s doctors

Previous research from Dr Michael Ireland of the University of Southern Queensland shows Australian doctors experience high burnout (>50%) and ‘severe’ anxiety (>60%). In turn, burnout and poor mental health negatively impact patient care provided by these doctors.

In response, Dr Ireland’s team has designed ‘Working Well’, an online resilience training program based on the best available evidence. With their HCF Research Foundation grant, the team is collaborating with Queensland Doctors' Health Programme with the aim of establishing the efficacy and acceptability of ‘Working Well’ amongst doctors, ultimately helping to achieve better mental health outcomes for doctors and more efficient health service delivery.

Royal Australian College of General Practitioners President Dr Bastian Seidel said that the RACGP welcomes research that investigates the mental health of Australian doctors, with the aim of identifying solutions to improve their mental health outcomes:

“Supporting the mental health of Australian doctors, so they do not experience burnout and anxiety, will protect their patients. Doctors deserve to receive the same level of mental healthcare that they provide their own communities.”

Optimising clinical registry data to directly improve patient outcomes

Both Professor Belinda Gabbe of Monash University in Victoria and Professor Kei Lui from UNSW are focused on maximising clinical registry data to identify knowledge gaps, capture variances in outcomes and benchmark performance and best practices that will improve outcomes for patients.

The degree of scarring and reconstructive surgery needed in burn patients, and the functional, social and quality-of-life outcomes for patients is largely determined by acute management. Professor Gabbe will leverage data in the Burns Registry of Australia and New Zealand to address the lack of in-depth clinical trials into efficacy of burn treatments. She hopes to improve the evidence gap surrounding best practices and treatment protocols, which currently result in a high-variation in patient outcomes.

Similarly, Professor Lui will strengthen the evaluation process for very premature babies born before 32 weeks who are at greater risk of mortality, major morbidities and life-long impacts, such as cerebral palsy, cognitive delay, blindness and deafness. Using the clinical registry data from the Australian and New Zealand Neonatal Network, Professor Lui’s research will implement quarterly data analyses of mortality and major morbidities from data submitted at hospital discharge, with the goal of aligning best practices for children in neonatal intensive care units to reduce adverse events that may have life-long consequences.

The health care industry is facing challenges across a number of key areas, and the HCF Research Foundation continues to explore ways to improve our health care system and drive optimal outcomes for patients. Results of these projects will be published on the HCF Research Foundation website once the studies have been completed.