The role of emotional intelligence on the resolution of disputes involving the electronic health record

Numerous authors have expressed concerns that the introduction of the Personally Controlled Electronic Health Record (PCEHR) will lead to an escalation of disputes. Some disputes will concern the accuracy of the record whereas others will arise simply due to greater access to health care records. Online dispute resolution (ODR) programs have been successfully applied to cost-effectively help disputants resolve commercial, insurance and other legal disputes, and can also facilitate the resolution of health care related disputes. However, we expect that health differs from other application domains in ODR because of the emotional engagement patients have with their health and those of loved ones. In this study we will be looking at whether the success of an online negotiation is related to how people recognise and manage emotions, and in particular, their Emotional intelligence score.

Validation of de-identified record linkage to ascertain hospital admissions in a cohort study

Background Cohort studies can provide valuable evidence of cause and effect relationships but are subject to loss of participants over time, limiting the validity of findings. Computerised record linkage offers a passive and ongoing method of obtaining health outcomes from existing routinely collected data sources. However, the quality of record linkage is reliant upon the availability and accuracy of common identifying variables. We sought to develop and validate a method for linking a cohort study to a state-wide hospital admissions dataset with limited availability of unique identifying variables.

Methods A sample of 2000 participants from a cohort study (n = 41 514) was linked to a state-wide hospitalisations dataset in Victoria, Australia using the national health insurance (Medicare) number and demographic data as identifying variables. Availability of the health insurance number was limited in both datasets; therefore linkage was undertaken both with and without use of this number and agreement tested between both algorithms. Sensitivity was calculated for a sub-sample of 101 participants with a hospital admission confirmed by medical record review.

Results Of the 2000 study participants, 85% were found to have a record in the hospitalisations dataset when the national health insurance number and sex were used as linkage variables and 92% when demographic details only were used. When agreement between the two methods was tested the disagreement fraction was 9%, mainly due to "false positive" links when demographic details only were used. A final algorithm that used multiple combinations of identifying variables resulted in a match proportion of 87%. Sensitivity of this final linkage was 95%.

Conclusions High quality record linkage of cohort data with a hospitalisations dataset that has limited identifiers can be achieved using combinations of a national health insurance number and demographic data as identifying variables.

Record of the deep marine Clinocythereis australis Ayress and Swanson, 1991 (Ostracoda) from the upper Miocene Tambo River Formation, Gippsland Basin, Australia : Palaeo-oceanographic and biostratigraphic implications

Fossils of the deep marine ostracod, Clinocythereis australis Ayress & Swanson, 1991 occur within the Tambo River Formation, Gippsland Basin, southeastern Australia and record an approximately 6 Ma phase of late Miocene coastal ocean upwelling within this region. The presence of deep marine faunal elements within late Miocene Mitchellian strata is in contrast to the absence of such faunal elements in latest Miocene Cheltenhamian and younger marine strata of the Bass Strait hinterland. The absence of deep marine faunal elements in post-Mitchellian onshore strata is due to the Kosciusko Uplift, which transformed Bass Strait into a wholly shallow seaway placing adjacent coastal regions beyond the reach of ocean upwelling influences.

Unfair punishment : when criminal record checks lead to discrimination

Applying for a job is stressful enough, but if you have a criminal record, even if it’s not relevant to the job you’re applying for, it can be a nightmare.

Employers in Australia regularly discriminate on the grounds that a person has an irrelevant criminal record and checking criminal records is on the increase. The number of criminal record checks undertaken in Victoria have risen by almost 6,000% since 1993.

It is concerning then that the few laws that prohibit discrimination on the basis of irrelevant criminal record lack real teeth.

Implementing scanned medical record systems in Australia : a structured case study on envisioned changes to elective admissions process in a Victorian hospital

In recent years, influenced by the pervasive power of technology, standards and mandates, Australian hospitals have begun exploring digital forms of keeping this record. The main rationale is the ease of accessing different data sources at the same time by varied staff members. The initial step in this transition was implementation of scanned medical record systems, which converts the paper based records to digitised form, which required process flow redesign and changes to existing modes of work. For maximising the benefits of scanning implementation and to better prepare for the changes, Austin Hospital in the State of Victoria commissioned this research focused on elective admissions area. This structured case study redesigned existing processes that constituted the flow of external patient forms and recommended a set of best practices at the same time highlighting the significance of user participation in maximising the potential benefits anticipated. In the absence of published academic studies focused on Victorian hospitals, this study has become a conduit for other departments in the hospital as well as other hospitals in the incursion.

“Giving Dracula the keys to the blood bank? Interrogating the Fifth Crown Casino Licensing Regulatory Review

Drawing on narrative analysis, this paper analyses the 2013 Fifth Regulatory Review of the license of an Australian casino as a case study focused on the framing and articulation of ‘responsible gambling’ (RG) in the Review. Part 1 sets out the policy and regulatory context for the licensing review of Melbourne’s Crown Casino. Part 2 overviews the structure/content of the Review; the key messages of the Reviewers’ narrative and its main recommendations. In reflecting on the Review in Part 3, analysis focuses on the investigation and recommendations regarding Responsible Gambling, which has gained recent policy priority. The analysis interrogates the Review’s findings, narratives, processes and evidentiary base in relation to how it presents and assesses casino performance on RG. In doing so, it focuses on the Victorian Commission for Gambling and Liquor Regulation’s Review’s framing of RG; sources of evidence drawn on by the Review; an assessment of the casino’s loyalty club feature ‘Play Safe’, as an RG measure; the Review’s assessment of casino performance on RG and its Code of Conduct in particular; and the Review’s framing of RG recommendations. It concludes with reflections on governance issues raised by the Review, the need for more focus on the neglected area of regulatory licensing and enforcement (OECD, 2011; 2012; OECD & European Commission, 2009) and the need for independent regulatory reviews that address conflicts of interest on the part of both Government and the Regulator.

Effectiveness of an electronic inpatient medication record in reducing medication errors in Singapore

This study examined the effectiveness of an inpatient electronic medication record system in reducing medication errors in Singaporean hospitals. This pre- and post-intervention study involving a control group was undertaken in two Singaporean acute care hospitals. In one hospital the inpatient electronic medication record system was implemented while in another hospital the paper-based medication record system was used. The mean incidence difference in medication errors of 0.06 between pre-intervention (0.72 per 1000 patient days) and post-intervention (0.78 per 1000 patient days) for the two hospitals was not statistically significant (95%, CI: [0.26, 0.20]). The mean incidence differences in medication errors relating to prescription, dispensing, and administration were also not statistically different. Common system failures involved a lack of medication knowledge by health professionals and a lack of a systematic approach in identifying correct dosages. There was no difference in the incidence of medication errors following the introduction of the electronic medication record system. More work is needed on how this system can reduce medication error rates and improve medication safety. © 2013 Wiley Publishing Asia Pty Ltd.

Bushfire catastrophe in Victoria, Australia : public record, accountability, commemoration, memorialization and heritage protection

In Australia, 7 February 2009 has become known as ‘Black Saturday’ because of the bushfire catastrophe that took 173 lives and devastated communities in the central parts of the State of Victoria. The paper considers how the 2009 fires have been recorded, how the issue of accountability has been dealt with, particularly in relation to the State and its agencies but also individual residents in the fire-devastated areas, and how bushfire deaths and other losses have been commemorated through remembrance events and museum collection projects and memorialized through the creation of new monuments and the protection of remaining physical structures as official heritage. Despite the major impact of bushfires on the State, to date few bushfire-related places have been protected. The former Cockatoo Kindergarten, which acted as a community refuge during an earlier catastrophic Victorian bushfire on Ash Wednesday, 16 February 1983, is an exception. Inscribed in 2012, the former kindergarten is the only bushfire-related place inscribed on the Victorian Heritage Register, in this case for its historical and social value as a place resonating with other communities affected by other bushfires and helping the broader Victorian public to come to terms with bushfire catastrophe. But, while bushfire commemoration activities and physical memorials, like those relating to war, help many societies remember individual and community pain and suffering, they can divert attention from the more fundamental questions of why they were there in the first place and what must be done to ensure the same catastrophe does not recur in the future. In this regard, the paper questions the oft-cited claim that bushfires are embedded in the Australian psyche, seeing links between the rhetoric around bushfire survival and Australian myth-making and nation-building.

Holocene record of Tuggerah Lake estuary development on the Australian east coast: sedimentary responses to sea-level fluctuations and climate variability

We investigated the Holocene palaeo-environmental record of the Tuggerah Lake barrier estuary on the south-east coast of Australia to determine the influence of local, regional and global environmental changes on estuary development. Using multi-proxy approaches, we identified significant down-core variation in sediment cores relating to sea-level rise and regional climate change. Following erosion of the antecedent land surface during the post-glacial marine transgression, sediment began to accumulate at the more seaward location at ~8500. years before present, some 1500. years prior to barrier emplacement and ~4000. years earlier than at the landward site. The delay in sediment accumulation at the landward site was a consequence of exposure to wave action prior to barrier emplacement, and due to high river flows of the mid-Holocene post-barrier emplacement. As a consequence of the mid-Holocene reduction in river flows, coupled with a moderate decline in sea-level, the lake experienced major changes in conditions at ~4000. years before present. The entrance channel connecting the lake with the ocean became periodically constricted, producing cyclic alternation between intervals of fluvial- and marine-dominated conditions. Overall, this study provides a detailed, multi-proxy investigation of the physical evolution of Tuggerah Lake with causative environmental processes that have influenced development of the estuary.

Communication keys: understanding the importance of the early childhood teacher's role in children's language and literacy development within a holistic, integrative approach to child development

Early childhood is a critical period in children’s lives during which experiences and the quality of the interactions lay the foundation for their subsequent learning and behavior, impacting upon the their lives. In response to Early Years research that identifies the positive impact of quality early years education upon children’s future learning, governments worldwide are implementing changes in policy, processes, professional learning and practice and are pouring funds into early childhood education. A range of approaches and multiple strategies are being adopted in an effort to improve children’s health, education and overall well-being, including the holistic and integrative approach such as that undertaken in Indonesia. This paper argues that high quality Early Childhood teachers play an important role within these approaches and this is discussed in light of the research - policy - praxis nexus, with language and literacy development as a focus area.

An international observational prospective survey assessing the control of atrial fibrillation in Asia-Pacific: results of the record-AFAP registry

A prospective 1-year observational survey was designed to assess the management and control of atrial fibrillation (AF) in eight countries within the Asia-Pacific region. Patients (N = 2,604) with recently diagnosed AF or a history of AF ≤1 year were included. Clinicians chose the treatment strategy (rhythm or rate control) according to their standard practice and medical discretion. The primary endpoint was therapeutic success. At baseline, rhythm- and rate-control strategies were applied to 35.7% and 64.3% of patients, respectively. At 12 months, therapeutic success was 43.2% overall. Being assigned to rhythm-control strategy at baseline was associated with a higher therapeutic success (46.5% vs 41.4%; P = 0.0214) and a lower incidence of clinical outcomes (10.4% vs 17.1% P < 0.0001). Patients assigned to rate-control strategies at baseline had higher cardiovascular morbidities (history of heart failure or valvular heart disease). Cardiovascular outcomes may be less dependent on the choice of treatment strategy than cardiovascular comorbidities.