Search

The health landscape has changed enormously since the introduction of Medicare 40 years ago. Not only have population health needs changed, the provision of health care has also evolved. A wider range of health practitioners with enhanced skills and competencies are ready and able to provide high‐quality primary health care. However, expecting the funding model introduced 40 years ago to be fit for purpose to support this expanded workforce may be unrealistic. Whilst optimising person‐centred team care might be the vision, currently missing is the systems thinking approach required to realise the synergistic benefits of health care teams. [ABSTRACT FROM AUTHOR]

In this paper, we discuss a rapid‐fire study involving Indigenous and non‐Indigenous stakeholders from the urban Indigenous health sector who collaborated to produce an "Urban COVID‐19 Systems Map." The map outlines the behaviours, actions and responses that stakeholders identified as mitigating or exacerbating COVID‐19 risks in urban Indigenous communities. Data were collected and analysed during the height of the pandemic in 2021. We begin by introducing the characteristics of system thinking—the methodology that informed our research—and consider its use in Indigenous health research more broadly. We then outline our utilisation of system thinking and discuss how it was applied to the three workshops. System thinking contributes to collaboration and collective debate amongst stakeholders and aims to produce holistic understandings of complex problems, such as pandemics. This article provides a reflective overview of the benefits and challenges of applying system thinking in Indigenous health research whilst also sharing some of the research findings. We argue that centralising the voices of stakeholders, particularly Indigenous stakeholders, is critical to developing and implementing effective and culturally appropriate responses to pandemics and is equally as important to the preparedness for future pandemics. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to demonstrate through practical application how a system dynamics (SD) patient flow model of an emergency department (ED) can show which levers effectively reduce backlogs to improve access to care. Overcrowded EDs are struggling to meet demand and access targets. In 2016 and 2017, in the UK and Australia, respectively, 15% and 28% of arrivals waited longer than the targeted 4‐hr treatment time. Historically, simulation models that have informed access to emergency care have ignored the wider systems impacts. There is a growing awareness of the value of systems analysis tools for informing interventions and policy. In this study, we constructed a pilot system dynamics patient flow model, where the scope was the ambulatory and ambulance patient arrivals, the ED processes for acute and fast‐track pathways, pathology and radiology services, the ED short‐stay unit, and the Medical Assessment Planning Inpatient Unit. Patients queued to access constrained ED resources (doctors and beds) and diagnostic services (pathology and X‐ray). The model was tested on actual data from five separate historical periods spanning 3 years. The resultant daily pattern of peaks and troughs in patient flow and system delays accurately replicated patterns in actual patient flows, resource use, and the location of delays. "What if" scenario analysis (b) simulated how access would have looked in the sample weeks with different intervention strategies, (b) simulated system limits on the basis of current resources, (c) accurately identified levers that historically have been most effective at minimizing ambulance ramping, and (d) identified when additional staffing would fail to improve flow. [ABSTRACT FROM AUTHOR]

The article focuses on countering conspiracies and misinformation within Indigenous Communities in Australia. It mentions vaccination rates in some Indigenous communities, however, remain stubbornly low, with hesitancy coinciding with the spread of misinformation and amplification of conspiracy theories. It also mentions removal and institutionalisation of Aboriginal children, now known as the Stolen Generations, or the disproportionate rates of policing.