The Medical journal of Australia
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This article reports the experience of the Victorian Department of Health in seeking clinician engagement in the testing of 11 quality-of-care indicators in 20 health services in Victoria. The Department previously developed a suite of 18 core indicators and seven subindicators known as the AusPSI set. We used routinely collected administrative data from the Victorian Admitted Episodes Dataset to produce variable life-adjusted display (VLAD) control charts for 11 selected indicators. ⋯ Although using readily available and inexpensive routinely collected administrative data to measure clinical performance has a certain appeal, the use of administrative data and VLADs to identify apparent variations has posed significant challenges due to concerns about the quality of the data and resource requirements. When clinicians at a major Melbourne hospital were engaged, it resulted in an improvement in clinical practice. Investigating apparent variation in patient care provides an ideal opportunity for emerging clinical leaders to take local ownership and develop expertise in investigating apparent variation in processes of care and implementing change as required.
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Whether pilots with insulin-dependent diabetes should be allowed to fly has long been a controversial issue. Hypoglycaemia remains a significant threat to flight safety, and a barrier for pilots with insulin-dependent diabetes to overcome. Some countries allow recreational pilots to fly while treated with insulin under strict conditions. Recent changes in aeromedical certification in Australia will give pilots with diabetes more freedom to exercise the privileges of their licence, while adopting mechanisms to ensure the safety of air navigation.
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Currently available data can be used to focus clinical quality, patient centredness and safety of care in hospitals.
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To assess emergency department (ED) doctors' knowledge of radiation doses associated with diagnostic imaging and to describe their practice with regard to informing patients of risk. ⋯ Emergency doctors in our sample had a varied knowledge of the risks from radiation exposure, but overall knowledge was poor. Staff should receive education, and the diagnostic imaging request process may need to include information on radiation doses and risks.