Library News June 2021

What is in this issue

Topic focus: NSQHS-Standard 5.2 : Applying quality improvement systems
New to the Library
Topic of interest: Vehicle emissions and population health
CME/CPD Tracking
Research Review Australia

NSQHS - Standard 5.2: Applying quality improvement systems

Quality Improvement (QI) is the intentional process of making system-level changes in clinical processes with a continuous reassessment to improve the delivery of a product. If you are planning to make changes to support the delivery of care, you will need to concider strategies to improve care, and how you will review, measure, and assess the effectiveness.  Here are some articles to support you thinking about Standard 5.2:

Braithwaite, J., Clay-Williams, R., Taylor, N., Ting, H. P., Winata, T., Hogden, E., Li, Z., Selwood, A., Warwick, M., Hibbert, P., & Arnolda, G. (2020). Deepening our Understanding of Quality in Australia (DUQuA): An overview of a nation-wide, multi-level analysis of relationships between quality management systems and patient factors in 32 hospitals. International Journal for Quality in Health Care32(Supplement_1), 8–21.

Crowl, A., Sharma, A., Sorge, L., & Sorensen, T. (2015). Accelerating quality improvement within your organization: Applying the Model for Improvement. Journal of the American Pharmacists Association : JAPhA55(4), e364–e376.

McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve Plan-Do-Study-Act cycle fidelity: a retrospective mixed-methods study. BMJ Quality & Safety28(5), 356–365.

McQuillan, R. F., Silver, S. A., Harel, Z., Weizman, A., Thomas, A., Bell, C., Chertow, G. M., Chan, C. T., & Nesrallah, G. (2016). How to measure and interpret quality improvement data. Clinical Journal of the American Society of Nephrology : CJASN11(5), 908–914.

For board and senior managers, understanding the board's role in quality healthcare and how we convey quality reports to them -  Brown A. (2020). Communication and leadership in healthcare quality governance. Journal of Health Organization and Management34(2), 144–161. 

There are also some new books about the topic of quality improvement avaliable in the Library. 

Topic of interest: Vehicle emissions and population health

Human health is dependent upon environmental health. Air pollution is a leading cause of morbidity and mortality globally, and climate change has been identified as the single greatest public health threat of the 21st century (Eckelman, 2018). A positive outcome of the COVID-19 lockdowns is that there has been a substantial reduction in asthma and Chronic Obstructive Lung Disease (COPD) emergency presentations in part due to the reduction in air pollution (Alsallakh, 2021, Davies, 2021). 

Air pollution in Australia and New Zealand comes primarily from motor vehicle emissions, electricity generation from fossil fuels, heavy industry, and home heating using wood and coal. In Australia and New Zealand we see a ‘massification’ of our vehicles. On both sides of the Tasman the average car, like the average person, has put on weight (Woodward, 2019). These bigger cars have not helped with our average fuel economy and emissions.

What can we do as individuals?
We can improve public health by participating in and promoting active transport (e.g. cycling, scooting, walking) around town and the use of zero emission vehicles. Did you know that SWH's Warrnambool Base Hospital has bike parking and shower/change rooms in both underground care parks? 

What can hospitals and health care staff do?
Vehicle fleet Optimize fleet size and vehicle use
Promote car pooling
Promote electric vehicles (e-cars and e-bikes)
Ensure suitable infrastructure (e.g. charging points)
Active transport Promote walking and cycling as alternatives to vehicle use, for example bike share schemes, subsidies for e-bikes for staff
Provide facilities (safe bike parking, lockers and showers)
Telemedicine Use home-based care or telemedicine where possible
Public transport Work with local government to ensure accessible connections to public transport
Public transport Provide free fares for patients attending hospital appointments
Subsidize bus and train fares for staff  
  Table of suggestions from Woodward, 2019.
In May the Victorian Government announced it was incentivising Victorians to choose to buy an ZEV sooner through the Zero Emissions Vehicle Subsidy Program, saving people up to $3,000 on the purchase of a ZEV and driving Victoria’s transition to a net-zero emissions future. (Quickly compare vehicle emissions, fuel consumption, and noise pollution here).
If you are considering buying an electric vehicle and would like a bonus 1,500km of supercharging you can use my referral link:
  • Eckelman, M. J., Sherman, J. D., & MacNeill, A. J. (2018). Life cycle environmental emissions and health damages from the Canadian healthcare system: An economic-environmental-epidemiological analysis. PLoS Medicine, 15(7), e1002623.  (This article also includes a comparison to the environmental emissions of the Australian healthcare system.)
  • Gunn L. D. (2020). Can a liveable city be a healthy city, now and into the future?. Internal Medicine Journal, 50(11), 1405–1408.
  • Hime, N. J., Marks, G. B., & Cowie, C. T. (2018). A Comparison of the Health Effects of Ambient Particulate Matter Air Pollution from Five Emission Sources. International Journal of Environmental Research and Public Health15(6), 1206.
  • Kjellstrom, T. E., Neller, A., & Simpson, R. W. (2002). Air pollution and its health impacts: the changing panorama. Medical Journal of Australia, 177(11-12), 604–608.
  • Woodward A. (2019). Climate change and the surgeon: what is the problem? Why is it so hard? What can be done?. ANZ Journal of Surgery, 89(11), 1358–1363.
Declaration of conflict of interest: I like riding bikes, they are fun, and I own an EV. 

CME/CPD Tracking

Many professionals need documentation of time spent reading clinical resources to demonstrate they are keeping their knowledge and skills current and learning about the latest, evidence-based developments. Continuing medical education (CME) or continuing professional development (CPD) hours can be easily reported with the help of these Library resources:

Did you know that time spent reviewing books, journals and clinical overviews within ClinicalKey ( and is automatically tracked as time based CME credits ready for claiming with an easily generated certificate? Ensure you create a personal account to unlock this as well as remote access and many more features. 

UpToDate also tracks your CME if you remember to login while searching for clinical answers. For Australian doctors make sure your credit type is changed to Time-based tracking (ACD, ACRRM, ANZCA/FPM, Inpractice (NZ), RACP, RACGP, RANZCOG, RNZCGP, RNZCUC) in the CME settings. 

Research Review Australia

Have you heard of Research Review Australia?  Research Review publications "bring the best of 10,000 global medical journals" to your email inbox every issue, with commentary from Australian experts. There are over 40 areas including Cardiology, Dentistry, Diabetes, Oncology, Obstectrics and Psychiatry. Specialist opinions on guidelines, medicines and conferences. All Research Review publications are free to receive. The reviews are a summarised interpretation of the published studies and are aimed at assisting the process of clinical reading.


In last month's newsletter the PRISMA2020 update was mentioned. PRISMA is a way to transparently report how a systematic review was conducted. This month we share some tools that make this reporting easier and can be used for literature review assignments also. 
PRISMA 2020 Checklist

PRISMA Flow Diagram -helps to generate your own flow diagram. 
See Past Newsletters Here
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