Sydney, 6 March 2018 – The HCF Research Foundation has today announced six recipients of over $1 million in research grants, with funded projects addressing key healthcare issues including palliative care, mental health care and the optimisation of registry data to directly improve patient outcomes.

The HCF Research Foundation grants range in value from $80,000 to $240,000 and will drive improvements to the quality, safety, appropriateness and cost effectiveness of health care in Australia.

HCF Research Foundation Chair, Lisa McIntyre, says that this year’s grants 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 practictioners (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.

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.

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.

-Ends-

Notes to editors

HCF Research Foundation Grant Recipients:

Dr Peter Allcroft, Southern Adelaide Local Health Network
RCT: Early referral to palliative care in patients with severe heart failure

• People with heart failure have a high symptom burden, reduced quality of life, poor prognosis, and care needs which are comparable to patients with cancer. The prognosis of patients with heart failure is poor, and repeated admissions to hospital in the last 12 months of life are very common. Caregivers of patients with heart failure struggle to provide the complex care required for this ‘progressive and relentless’ disease.
• Dr. Allcroft’s team’s research aims to find out whether referral of patients with heart failure to a palliative care service will improve quality of life, symptom burden and reduce healthcare utilisation.
• The research aims to show that the involvement of the palliative care team will enable patient goals of care to be met, including the preferred site of dying. They also hope to show that caregivers will have an improved quality of life, and be able to cope better with the bereavement period due to their involvement in palliative care.

Dr Magnolia Cardona-Morrell, UNSW
Optimising early end-of-life (EOL) conversations and advance care planning (ACP) in general practice

• For elderly people admitted to the intensive care unit, the outcome is usually death within months and poor quality end-of-life.
• Conversations about end-of-life preferences are not common in the emergency room setting – rather, communication of medically-driven decisions is the predominant culture. But many of these elderly patients do not see improvement of prognosis in hospital – and could potentially be treated outside acute in-patient settings if they can be identified in general practice as suitable for an end-of-life pathway of care in agreement with the patient and their caregiver.
• Dr Cardona-Morrell and team’s research will introduce the concept of screening for high risk of death and support holding end-of-life (EOL) discussions at primary care level.
• The research aims to assess whether there is sufficient information in the routinely collected GP records to characterise the profile of older people at risk of death, and to help GPs understand their important role in recognising and managing these patients.

Dr Ursula Sansom-Daly, UNSW
Difficult decisions: Helping adolescents and young adults to voice their choices at end-of-life

• Most adolescents and young adults with life-limiting illnesses such as cancer and cystic fibrosis want to die at home, however delayed end-of-life communication often prevents this possibility. This can be due to medical professionals’ lack of experience in communicating with adolescents and young adults, or concerns about causing undue distress.
• However, when patients are not provided an opportunity to have these conversations, they are at risk of poor outcomes such as greater anxiety, inadequate pain management, dying in a state of ‘emotional isolation’ and dying in hospital.
• There is no research documenting the experiences and needs of young Australians at end-of-life, and no gold-standard protocol to ensure that their psychosocial needs are met.
• Dr Sansom-Daly’s research aims to ultimately assist more seriously-ill young Australians to die at home, by formally evaluating this tool will ensure its appropriateness, feasibility and utility across all Australian young adults with life-limiting illness.

Dr Michael Ireland, University of Southern Queensland
Working well: Enhancing resilience and mental health of doctors

• Dr Ireland’s team’s own research reveals high burnout (>50%) and ‘severe’ anxiety (>60%) in Australian doctors which is consistent with recent national and international studies. Burnout and poor mental health negatively impacts patient care provided by doctors.
• Dr Ireland’s systematic literature review found there was an absence of well-controlled studies examining psychological interventions to assist doctors and no interventions could be considered validated by observation.
• Dr Ireland’s team has designed ‘Working Well’, an online resilience training program based on the best available evidence.
• Through this research, the team is aiming to establish the efficacy and acceptability of Working Well amongst doctors.

Professor Belinda Gabbe, Monash University
Burn Quality Improvement Program: the use of clinical registry data to directly improve patient outcomes

• Burn injuries are associated with substantial treatment and rehab costs, but acute management of burn injury can positively impact the degree of scarring, the need for reconstructive surgery and the functional, social and quality-of-life outcomes for patients.
• Clinical trials of the efficacy of burn treatments are few, have been limited by small sample sizes in single-centre studies, focused on unrepresentative patient populations, and have been of poor methodological quality. Therefore, treatment protocols and guidelines for serious burns are variable and best practice for burns care is largely unknown.
• Professor Gabbe’s research will aim to quantify variation in practice in the management of serious burn injury between burn units in ANZ, establish whether practice variation has significant impact on clinical and patient outcomes, and use data from the the Burns Registry of Australia and New Zealand (BRANZ) to drive quality improvement initiatives and establish clinical care pathways for implementation and evaluation in ANZ burns units.

Professor Kei Lui, UNSW
Using clinical registry to reduce variation in clinical outcomes in Neonatal Intensive Care Units

• Infants born very pre-term (at less than 32 weeks) are at high risk of mortality and major morbidities and life-long impacts, such as cerebral palsy, cognitive delay, blindness and deafness.
• The Australian and New Zealand Neonatal Network (ANZNN) clinical registry collects, audits, and standardises, de-identified patient clinical data to produce annual benchmarking reports for each NICU’s performance. There is consistent evidence that benchmarking by feedback of outcomes and practice variations to clinicians drives improvement.
• Professor. Lui’s research aims to strengthen the evaluation process by introducing data acquisition at hospital discharge, allowing quarterly feedback based on rapid, high-quality analysis.
• The team’s research will establish quarterly data analyses of mortality and major morbidities from the data submitted at the time of hospital discharge, so that the team can provide quick feedback to individual NICUs; to monitor, feedback and correlate neonatal units’ adherence to agreed evidence-based clinical practice with outcome trends; and to facilitate ongoing collaborative learning across the network.

About the HCF Research Foundation

Now in its 17^th year, the HCF Research Foundation’s mission is to encourage the examination and improvement of the provision, administration and delivery of health services to effect positive changes to the health of all Australians. This is achieved by funding research projects that consider the most effective ways to organise, manage, finance and deliver high-quality care; reduce the number of errors; and improve patient safety.

The HCF Research Foundation was originally established with a donation from The Hospitals Contribution Fund of Australia Limited (HCF). While HCF has generously donated money to establish the Foundation’s current corpus of $50 million, the HCF Research Foundation operates independently and with specific focus on funding health services research that can benefit all 24 million Australians.

Visit the HCF Research Foundation website.

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ABOUT HCF

HCF, Australia’s largest not-for-profit health fund protecting people since 1932, covers around 1.5 million members with health and life insurance, community care, travel and pet insurance. On average over the last five years, HCF has paid out more cents in every dollar in premiums to members as benefits than the industry average. With over 35,000 specialists participating in its Medical Gap Cover Scheme and approximately 10,000 providers participating in its 100% back More for You programs, HCF gives members access to quality healthcare with no gaps or minimal costs compared to non-participating providers. To empower members to put their health first, HCF also offers a range of health and lifestyle services including its My Health Guardian health management program, mobile Victor Chang Heart Health Checks and My Global Specialist second opinion service. HCF’s national network of retail outlets and Australian-based call centres have earned multi-award winning status. HCF members also have access to low cost, high quality services at HCF Dental Centres. Having contributed $50 million to support the health services research funded by the HCF Research Foundation, HCF is devoted to investing in the future of Australia’s health. To learn more about HCF go to hcf.com.au/about-us