Reema Harrison

UNSW Sydney | UNSW · School of Public Health and Community Medicine

Background: Mentorship has been identified as a beneficial practice for doctors and may be particularly valuable for newly appointed consultants. It is associated with a number of potential clinical and non-clinical gains, such as enhanced job satisfaction and well-being. Despite strong support, many formalised schemes fail to launch or gain moment...

This paper summarises the current integration of quality improvement, implementation and managing change in nursing curricula, and outlines strategies for addressing this to enable nurses to better lead and support change for healthcare improvement.

Background Clinicians’ experiences of providing care constitute an important outcome for evaluating care from a value-based healthcare perspective. Yet no currently available instruments have been designed and validated for assessing clinicians’ experiences. This research sought to address this important gap by developing and validating a novel ins...

Background: Consumer engagement in health care is recognized as a critical strategy to minimize healthcare-associated harms, however, little research has focussed on strategies to engage young people in healthcare safety. This study explores the suitability of commonly used engagement strategies, such as brochures, interactive bedside charts or ap...

Introduction: Although it is widely accepted that the physical environment can impact health quality and care outcomes, its impact on consumer engagement with health services has not been examined. Currently, no tools exist that assess the opportunities for consumer engagement offered within the physical environment. We aimed to develop and valida...

Aim To understand what constitutes a good experience of care for inpatient children and young people with intellectual disability as perceived by nursing staff. Design Interpretive qualitative study. Methods Focus groups with clinical nursing staff from speciality neurological/neurosurgical and adolescent medicine wards across two specialist tert...

Objective: Ovarian cancer has the highest mortality of all gynaecological cancers. This study aimed to identify the extent to which women across New South Wales experienced variation in their care in diagnosis and initial treatment for ovarian cancer against the national optimal care pathway for ovarian cancer. Method: Clinical audit methodology...

Objectives and importance of study: We report the evaluative findings from the first stage of a project designed to co-produce strategies which improve the safety of culturally and linguistically diverse (CALD) patients in cancer care. Co-leadership is developed via training and supporting consumers, multilingual fieldworkers and researchers to co-...

Background: Making a medical error is a uniquely challenging psychosocial experience for clinicians. Feelings of personal responsibility, coupled with distress regarding potential or actual patient harm resulting from a mistake, create a dual burden. Over the past 20 years, experiential accounts of making an error have provided evidence of the ass...

Background Clinicians’ experiences of providing care constitute an important outcome for evaluating care from a value-based healthcare perspective. Yet no currently available instruments have been designed and validated for assessing clinicians’ experiences. This research sought to address this important gap by developing and validating a novel ins...

Objective Ethnic minority populations are often exposed to healthcare-associated harm. There is little evidence about whether current patient engagement interventions are relevant. We conducted a national analysis of existing approaches amongst stakeholders in cancer care. Methods Five online focus groups were conducted with 24 participants from c...

Continual innovation to address emerging population needs necessitates health service ongoing redesign and transformation worldwide. Recent examples include service transformations in response to Covid‐19, many of which were led and managed by nurses. Ensuring change readiness is central to delivering these transformative changes yet has been ident...

Despite the requirement for continual change and development, change failure is omnipresent in health care, ranging from small technical errors within new systems, processes or technologies, through to breakdowns and large-scale disaster. Despite decades of research investment, consultancy and initiatives, creating a healthcare context that promote...

People with intellectual disability have unmet health needs and experience health inequalities. There is limited literature regarding cancer care for children, adolescents, and young adults (AYA) with intellectual disability despite rising cancer incidence rates in this population. This systematic review aimed to identify the psycho-social and info...

Co-design as a participatory method aims to improve health service design and implementation. It is being used more frequently by researchers and practitioners in various health and social care settings. Co-design has the potential for achieving positive outcomes for the end users involved in the process; however, involvement of diverse ethnic mino...

Background: It has been widely acknowledged that refugees are at risk of poorer health outcomes, spanning mental health and general well-being. A common point of access to health care for the migrant population is via the primary health care network in the country of resettlement. This review aims to synthesize the evidence of primary health care...

Background Multidisciplinary cancer care to facilitate the provision of patient centred and evidence-based care is considered best practice internationally. In 2016 multidisciplinary care measures were developed for all local health districts across NSW. The aim of this study was to identify system-level changes and quality improvement activities a...

Aim To investigate if there are inequities in quality and safety outcomes for children with intellectual disability admitted to two tertiary paediatric hospitals. Method A cross-sectional study of 1367 admissions for 1018 randomly selected patients admitted for more than 23 hours to one of two tertiary children’s hospitals in Sydney, Australia (1s...

Co-design is increasingly employed as a user-centric method to create healthcare change. In healthcare co-design, small groups of consumers and healthcare workers come together to identify processes, policies or service elements that require improvement and to design solutions. Multiple frameworks have emerged to guide the health work force and hea...

Background: Patients are increasingly being asked for feedback about their healthcare and treatment, including safety, despite little evidence to support this trend. This review identifies the strategies used to engage patients in safety during direct care, explores who is engaged and determines the mechanisms that impact effectiveness. Methods:...

Introduction Consumer engagement is central to high-quality cancer service delivery and is a recognised strategy to minimise healthcare-associated harm. Strategies developed to enhance consumer engagement specifically in relation to preventing healthcare harm include questioning health professionals, raising concerns about possible mistakes or risk...

Background: Engagement frameworks provide the conceptual structure for consumer engagement in healthcare decision making, but the level to which these frameworks support culturally and linguistically diverse (CALD) consumer engagement is not known. Objective: This study aimed to investigate how consumer engagement is conceptualised and operation...

Background Family-based ‘informal’ caregivers are critical to enable sustainable cancer care that produces optimal health outcomes but also gives rise to psychological burdens on caregivers. Evidence of psychosocial support for caregivers does not currently address the impacts of their role in providing clinical and health-related care for their lo...

Background Clinicians’ delays to identify risk of death and communicate it to patients nearing the end of life contribute to health-related harm in health services worldwide. This study sought to ascertain doctors, nurses and senior members of the public’s perceptions of the routine use of a screening tool to predict risk of death for older people....

Background Family-based ‘informal’ caregivers are critical to enable sustainable cancer care that produces optimal health outcomes people who are living with or have lived with cancer worldwide. The present study sought to explore the experiences of family-based caregivers for people with cancer, their role in providing clinical care for their love...

An amendment to this paper has been published and can be accessed via the original article.

Background: The increasing prioritisation of healthcare quality across the six domains of efficiency, safety, patient-centredness, effectiveness, timeliness and accessibility has given rise to accelerated change both in the uptake of initiatives and the realisation of their outcomes to meet external targets. Whilst a multitude of change management...

Rationale, aims and objectives: Consistent data demonstrates negative psychological effects of caregiving on front-line health professionals. Evidence that psychological resilience factors can help minimize distress and the potential for low-cost interventions have created interest in resilience-based development programmes; yet evidence of percei...

Background In the context of the volume of mixed- and multi-methods studies in health services research, the present study sought to develop an appraisal tool to determine the methodological and reporting quality of such studies when included in systematic reviews. Evaluative evidence regarding the design and use of our existing Quality Assessment...

Objective: The aim of the study was to determine from patient-reported data the relationships between patients' experiences of adverse events (AEs), the disclosure of the events, and patients propensity for complaints or legal action. Methods: A cross-sectional survey was administered to 20,000 participants randomly chosen from the 45 and Up Stu...

Background: It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torre...

Purpose: As the cost of healthcare continues to rise, healthcare organizations internationally are seeking long-term solutions to eradicate inefficiency, achieve value-based healthcare, and minimize hospital inpatient services. This requires transformational change in healthcare organizations, and associated change management and leadership capabil...

Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progre...

Introduction: Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient...

Children with intellectual disability are susceptible to poor experiences of care and treatment outcomes and this may compound existing health inequities. Evidence to date indicates three priority areas that must be addressed in order to reduce these inequities in the safety and quality of care for children with intellectual disability. Firstly, we...

Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progre...

Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progre...

Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progre...

High-quality teaching is central to the higher education sector. Its pursuit has become heightened with increasing competition across institutions and opportunities to study globally through various modes. This systematic meta-review provides a synthesis of evidence relating to the methods used to assess and enhance the quality of teaching practice...

Background: Assessment of clinical variation has attracted increasing interest in health systems internationally due to growing awareness about better value and appropriate health care as a mechanism for enhancing efficient, effective and timely care. Feedback using administrative databases to provide benchmarking data has been utilised in several...

Background: Effective patient engagement has been associated with high quality health care. There is a dearth of evidence around effective engagement with consumers from ethnic minority backgrounds; specifically in relation to the role of cultural competence amongst healthcare professionals in effective engagement with consumers from ethnic minori...

Background: In the context of an effective consumer engagement framework, there is potential for health-care delivery to be safer. Consumers from culturally and linguistically diverse (CALD) backgrounds may experience several barriers when trying to engage about their health care, and they are not acknowledged sufficiently in contemporary strategi...

Objective: To systematically identify and synthesize peer-reviewed qualitative evidence of the parental experience of hospitalization with a child with Intellectual Disability. Search strategy: Key words, synonyms and MeSH subject headings that related to the three key concepts of parental experience, children with Intellectual Disability and ho...

Background: The psychological and professional impact of adverse events on doctors and nurses is well-established, but limited data has emerged from low- and middle-income. This article reports the experiences of being involved in a patient safety event, incident reporting and organisational support available to assist health professionals in Viet...

Purpose: Socially assistive robots are emerging as a method of supporting the rehabilitation of children with physical disabilities. To date there has been no in-depth analysis of parent and child perspectives regarding the use of socially assistive robots for pediatric rehabilitation. The purpose of this study was to capture the experiences of par...

Background Health systems are complex and continually changing across a variety of contexts and health service levels. The capacities needed by health managers and leaders to respond to current and emerging issues are not yet well understood. Studies to date have been country-specific and have not integrated different international and multi-level...

Background: Clinical variation in ovarian cancer care has been reported internationally. Using Wennberg's classification of clinical variation as effective care we can conceptualise variation through deviation from clinical guidelines. The aim of this review was to address knowledge gaps in the effectiveness of attempts to reduce unwarranted clini...

Background: Mentorship has been identified as a beneficial practice for doctors and key aspect of continuing professional development, associated with a number of potential clinical and nonclinical gains. The likely contribution of mentorship to enhancing patient safety is acknowledged, but there is a dearth of empirical studies that attempt to ma...

Background Globally, health service leaders and managers have a critical role in strengthening health systems. Competency frameworks for health service managers are usually designed to describe expectations of good performance of a health manager within a country-specific health sector context. However, a growing number of health service management...

Purpose The aim of this study was to explore the service and policy structures that impact open disclosure (OD) practices in New South Wales (NSW), Australia. Participants and methods An explorative study using semi-structured interviews was undertaken with 12 individuals closely involved in the implementation of OD in hospitals at policy or pract...

Background As older adults approach the end‐of‐life (EOL), many are faced with complex decisions including whether to use medical advances to prolong life. Limited information exists on the priorities of older adults at the EOL. Objective This study aimed to explore patient and family experiences and identify factors deemed important to quality EO...

Effective interprofessional collaboration is critical for sustaining high quality care in the context of the increasing burden on primary healthcare services. Despite this, there is limited understanding of the factors contributing to effective collaboration between general practitioners and community pharmacists. The aim of this systematic review...

We conducted a cross-sectional online survey of members of the Australian and New Zealand College of Anaesthetists to investigate their experiences of adverse patient safety events and near misses, including their use of incident reporting systems and the organisational support available. There were 247 respondents. Of the 243 anaesthetists whose p...

Objective Since Australia initiated national open disclosure standards in 2002, open disclosure policies have been adopted in all Australian states and territories. Yet, research evidence regarding their adoption is limited. The aim of the present study was to determine the frequency with which patients who report an adverse event had information d...

Objective: Evidence of the patient experience of hospitalization is an essential component of health policy and service improvement but studies often lack a representative population sample or do not examine the influence of patient and hospital characteristics on experiences. We address these gaps by investigating the experiences of a large cohor...

Purpose Adults and children with intellectual disability (ID) are vulnerable to preventable morbidity and mortality due to poor quality healthcare. While poor quality care has been commonly identified among children with ID, evidence of the patient safety outcomes for this group is lacking and therefore explored in this review. Data sources System...

Background To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. Methods Systematic review and narrative synthesis. Key words, syno...

Unanticipated patient adverse events can also have a serious negative impact on clinicians. The term second victim was coined to highlight the experience of health professionals with these events and the need to effectively support them. However, there is some controversy over use of the term second victim. This article explores terminology used to...

Introduction Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of system...

Background: Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. Objectives: To assess the impact of practice-based interventions designed to improve interprofessional c...

Adverse events (AEs) are common, estimated to occur in around 10% internationally. Although preventable harm can be minimized, when AEs occur it is important that they be managed appropriately. AEs can be traumatic not only for patients, their friends, and relatives, but also for the involved clinicians, who have been referred to as "second victims...

Background: Understanding a patient's hospital experience is fundamental to improving health services and policy, yet, little is known about their experiences of adverse events (AEs). This study redresses this deficit by investigating the experiences of patients in New South Wales hospitals who suffered an AE. Methods: Data linkage was used to i...

Background: Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurse...

Perceptions of failure have been implicated in a range of psychological disorders, and even a single experience of failure can heighten anxiety and depression. However, not all individuals experience significant emotional distress following failure, indicating the presence of resilience. The current systematic review synthesised studies investigati...

Objective Patients are uniquely positioned to provide insightful comments about their care. Currently, a lack of comparable patient experience data prevents the emergence of a detailed picture of patients' experiences in Australian hospitals. The present study addresses this gap by identifying factors reported in primary research as relating to pos...

Background Reasoned action approach (RAA) includes subcomponents of attitude (experiential/instrumental), perceived norm (injunctive/descriptive), and perceived behavioral control (capacity/autonomy) to predict intention and behavior. PurposeTo provide a meta-analysis of the RAA for health behaviors focusing on comparing the pairs of RAA subcompone...

Background Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a ‘no-report’ country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals. Methods This project was undertaken in Bach Mai National General...

Objective To explore the applicability of a patient complaint taxonomy to data on serious complaint cases. Design Qualitative descriptive study. Setting Complaints made to the New South Wales (NSW) Health Care Complaints Commission, Australia between 2005 and 2010. Participants All 138 cases of serious complaints by patients about public hospita...

Healthcare professionals work in emotionally charged settings; yet, little is known about the role of emotion in ensuring safe patient care. This article presents current knowledge in this field, drawing upon psychological approaches and evidence from clinical settings. We explore the emotions that health professionals experience in relation to mak...

Background: High profile safety failures have demonstrated that recognising early warning signs of clinical and physiological deterioration can prevent or reduce harm resulting from serious adverse events. Early warning scoring systems are now routinely used in many places to detect and escalate deteriorating patients. Timely and accurate vital si...

Background Patients are uniquely positioned to provide insightful comments about their care. Currently, a lack of comparable patient experience data prevents the emergence of a detailed picture of patients’ experiences in Australian hospitals. This review addresses this gap by identifying factors reported in primary research as relating to positive...