About Flinders Centre for Clinical Change & Health Care Research

Executive Summary

The continuing ageing of the Australian population combined with the expanding costs of providing optimal health care reaffirm key strategic focus, research direction and collaborations of the Clinical Change ASRI. Members continue to undertake and publish high value research informing the effective and cost efficient delivery of clinical therapies, facilitating their translation into improved clinical practice and outcomes.

Current membership includes 102 clinicians and researchers, with the supervision of around 100 students, spanning a diverse array of disciplines including nursing, allied health, palliative care, rehabilitation and aged care medicine, sleep medicine, cardiovascular medicine, intensive care and health economics. Since 2004, members of this ASRI have attracted competitive grants in excess of $30m, including $6.6m in Category 1 grants and $17.4m in Category 2 grants.

Members of the Clinical Change ASRI: serve in key roles within high profile public health/health promotion organizations such as the Cancer Australia and the Heart Foundation; are advisors to State and Federal Government and the Pharmaceutical Benefits Advisory Committee; are principal investigators and steering committee members of international clinical trials; and are integral members of national clinical research collaboratives. Future directions of the ASRI include consolidation of membership to enhance opportunities for collaboration, while building on the strengths in health economic evaluation in order to define greater value in current and future health care interventions. Building a culture of grant success with strategic management of the grant application processes will be a key focus. 

Vision and Purpose

The Minister for Health, The Hon John Hill in his presentation to Flinders Medical Centre on 7 May 2009, reiterated that in South Australia and indeed throughout Australia, the population is ageing rapidly. By 2016 the overall population will increase by 4%; yet we will see a 9% growth rate in the 75+ age group. Minister Hill suggested that at the age of 65, a person is twice as likely to require a hospital bed. By the age of 85, they are four times more likely to require hospitalisation. The State Government is focusing on reducing demand and optimising efficiency of supply in order to prepare for and manage the health system for this demographic transition without breaking the health budget.

Australians 80 years and over are the most rapidly increasing segment of this population and are especially vulnerable to adverse health outcomes such as hospitalisation, disability, dependency and death. The collaborative research across 102 people in the Clinical Change ASRI brings together unique expertise to fill critical gaps in our knowledge on chronic disease management and later and end-of-life health care for older adults. A particular focus is the application of health economics to these issues.

Members of Clinical Change share a common goal: to efficiently develop and disseminate high value research and evidence to inform optimal decision making and implementation of cost effective health care interventions. Rigorous assessment of clinical and health system interventions and outcomes is complemented by original research to better understand and effect knowledge transfer.

Research is collaborative and involves medical specialists, allied health and nursing disciplines across a range of health care settings, including primary, acute, ambulatory, transitional, rehabilitation and residential aged care facilities.

The three key areas of research focus and performance are:

• Effective and Cost Effective Evidence-Based Clinical Practice: The delivery of modern medical care is informed by a substantial evidence-base. Often these data have been assimilated into clinical practice guidelines. Yet challenges in the translation of evidence remain. Factors contributing to this set of barriers include patient complexity, limited resources and health service contextual factors. This research theme seeks to evaluate the current disease specific barriers to care from the perspective of the patient, the clinician and the health care system. In addition it seeks to evaluate the clinical and cost effectiveness of current therapies for many of the common clinical conditions impacting our community. Through innovative clinical trial designs, as well as biostatistical and health economic techniques, this research agenda also evaluates the comparative effectiveness of current therapies in emerging indications and novel therapies among common clinical problems. This research theme is directed at informing the substantial future health policy needs by defining value in delivery of clinical care while identifying the facilitators of effective clinical care, hence enabling the effective translation of innovation to outcome.

• Implementation Research: Research findings cannot change health outcomes unless they are adopted. Implementation research centrally involves the study of changing behaviour and maintaining change. It is the “scientific study of methods to promote the systematic uptake of clinical research findings and evidence-based practice into routine practice and hence to improve the quality (effectiveness, reliability, safety, appropriateness, equity and efficiency) of healthcare”. In relation to health programs and innovation it is “research that focuses on the question ‘What is happening?’ in the design, implementation, administration, operation, services and outcomes of social programs”. Implementation research is focused on the process, not simply the impact, and seeks to answer questions about what is happening, whether it is what was expected and, importantly, why things are happening as they are. It may use both quantitative and qualitative methods, but is generally directed towards problems that do not have a simple, sharply focused numerical answer. It includes the study of any strategy that may influence healthcare professional, organisational or consumer behaviour. It is therefore relevant to all clinical contexts and all players in the healthcare environment (patients, healthcare workers, service providers and policy makers).

• Prevention and Management of Chronic Conditions: Chronic conditions refer to those people with long term medical (diseases), psychiatric disorders and disabilities or combinations of these in the one person. The primary aim of researchers engaged in this theme is to improve the health outcomes of people with chronic conditions. With many chronic conditions caused or exacerbated by individual behaviour and psychosocial factors, prevention and management of chronic conditions have considerable overlap. This theme focuses on the full range of research from underlying pathology, mechanisms or aetiology, prevention and clinical treatments and management by teams of health professionals from all health disciplines. Research focuses on both the individual with the condition and populations of people with chronic conditions. There is an emphasis on research into the role of the person with the chronic condition and their family or carer in the management of their condition(s) and an understanding of health system factors that influence health outcomes at the individual and population level.

The ASRI is led by Professor Derek Chew and governed by an Executive Committee.

Contact Us

For more information, please contact:

Anthea Williams - Research Development Officer
Telephone:       (08) 8275 2882
Facsimile:        (08) 8275 2854
Email: anthea.williams@flinders.edu.au

Last revised: 10 June, 2009