The 2017 NSW Rural Health & Research Congress includes four themed Concurrent Streams:

I) Rural Workforce – Sustain, Maintain, Gain
workforce development, health and safety, wellbeing and resilience

I) Healthy Rural Communities
equity and access to health care, primary health care, health promotion and prevention, integrated health services

III) Rural Health Journeys – Design, Deliver, Experience
clinical practice, person centred care, consumer experiences, patient safety system redesign, integrated care, clinical improvement, digital health

IV) Culture and Health
cultural, environmental and social determinants of rural health

Below are the presentation summaries for the sessions held in each theme:
Please email for more information.

I) Rural Workforce – Sustain, Maintain, Gain

Session Title:
Defining “rural Health”: exploring GPs perceptions of what constitutes rural health
Speaker: Christopher Wilson, Medical Student, University of Notre Dame, Australia
Co-presenter: Associate Professor Catherine Harding

Presentation Summary: Definitions of rural and remote health have typically taken a geographical or a practice-based approach. There is also an implied rural culture within the rural health literature that potentially has implications for health and health behaviour.
This study was aimed to gain an understanding of GPs’ perspectives of what constitutes rural health and rural medicine. The approach involved semi-structured interviews with thematic analysis and a systematic review of the literature around the definitions of rural health.

Session Title: Overcoming the “too busy, too poor…. too rural” perception: organisational strategies for rural research training
Speaker: David Schmidt, PhD Candidate, School of Public Health, University of Sydney

Presentation Summary: Rural areas offer tremendous research opportunities but clinicians are often too busy to consider attempting research projects. Lack of resources, competing priorities and perceived skill gaps can all be barriers for rural research. This qualitative study explored these issues within a rural local health district, garnering the views of clinicians and key informants within the organisation’s leadership. This presentation provides a deeper understanding of ‘where, how, who, what and why’ research training could be implemented.

Session Title: Impact of a remotely delivered, writing for publication ‘Bootcamp’ program on publication outcomes of novice researchers
Speaker: Kerith Duncanson, Rural Research Program Manager, NSW Health Education and Training Institute

Presentation Summary: Increasing publication of clinician-led health research is important to improving patient care and health outcomes. In this presentation, the outcomes of the writing for publication ‘Bootcamp’ for graduates of the Rural Research Capacity Building Program will be compared with previously reported writing for publication interventions. Novice researchers respond to similar intervention features as experienced researchers when engaging with writing for publication, and publication outcomes can be increased substantially with modest investment of funding and resources.

Session Title: A collaborative approach to increasing access to diabetes education in the bush
Speaker: Narelle Mills, Manager Quality and Pathways, Murrumbidgee Primary Health Network

Presentation Summary: The Murrumbidgee region experiences a high rate of people with chronic disease and has a distinct shortage of credentialed diabetes educators resulting in a significant lack of access to best practice primary health management. The primary health network offered scholarships to primary health providers to support completion of credentialed diabetes educator training and have partnered with the local health district to help build a community of practice to support their training and credentialing process.

Session Title: Sustaining a rural midwifery caseload program in Broken Hill
Speaker: Alison Isaacs, Maternity Unit Manager, Broken Hill Health Service
Co-presenter: Chelsea Anderson & Danielle Toigo, Broken Hill Health Service

Presentation Summary: A presentation on Broken Hill Midwifery Group Practice (BHMGP), 2 years after its launch with a focus on how it has evolved and how we are planning to sustain it for the future. We will demonstrate how rural maternity services have a unique opportunity to be able to provide gold-standard maternity care, meet the needs of their community, and be flexible and innovative to accommodate and support the needs of their local workforce.

Session Title: Establishing a casual pool to fill Allied Health vacancies in a rural LHD
Speaker: Sarah Dowe, Allied Health Project Officer, Hunter New England Local Health District
Co-presenters: Sherida Coleman & Clare Daley, Hunter New England Local Health District

Presentation Summary: Service gaps created from short term vacancies during leave and recruitment episodes mean reduced access to services for the community, and increased waitlists and demands on services, which have a flow on effect to patient outcomes. District Allied Health established a Casual Pool of employees as a local solution to address Allied Health workforce issues in the District. Evaluation was undertaken through surveying Allied Health managers and casual pool employees. The evaluation findings from surveys completed by managers and casual employees showed overwhelming support for the continuation of the Allied Health Casual Pool.

Session Title: Effectiveness of Rural Mobile Simulation Education: A program logic evaluation
Speaker: Tod Adams, Manager, Rural Mobile Simulation Centre, NSW Health Education and Training Institute

Presentation Summary: The NSW Rural Mobile Simulation Centre (MSC) was established to provide a safe environment and education resource for rural and remote clinicians to practice clinical and team based skills in a safe experiential learning environment. The purpose of this evaluation is to measure and compare the implementation of program services, education provided and the access and reach of the MSC. The MSC offers rural and remote health workforces with a crucial means of bridging the disparity in available clinical training opportunities.

Session Title: Sustaining Murrumbidgee Local Health District physiotherapy rural generalist training program
Speaker: Emily Farquhar, Physiotherapy Advisor, Murrumbidgee Local Health District
Co-presenter: Teala Stephens, Murrumbidgee Local health District

Presentation Summary: Murrumbidgee Local Health District has employed three Rural Generalist Training Program Physiotherapists located in outer regional towns and supported by a Senior Physiotherapist. The training positions focus on the priorities of Physiotherapy service development, extended scope of practice, use of Allied Health Assistants and use of telehealth. The Physiotherapists have 20 percent of their time allocated to professional and service development activities to be able to meet the needs of the community.

Session Title: Practical benefits of the introduction of a district medication safety pharmacist to rural health facilities without on-site pharmacy
Speaker: Kirstin Berry, Medication Safety and Quality Manager, Hunter New England Local Health District
Co-presenter: Cathy Martin, Hunter New England Local Health District

Presentation Summary: The lack of medication safety processes at thirty district remote and rural hospitals without on-site pharmacy departments was considered a risk to patients and the organisation. We aim to describe the impact of a single pharmacist addressing medication safety activities at remote and rural hospitals without face-to-face access to pharmacy department resources.

II) Healthy Rural Communities

Session Title:
“Swap to Stop” Supporting pregnant Aboriginal women in making changes to their smoking behaviours
Speaker: Belinda Tully, Aboriginal Population Health Trainee, Hunter New England Local Health District Population Health

Presentation Summary: Engaging smokers initially through a “Swap to Stop” model which focuses on reducing Carbon Monoxide readings using NRT rather than focussing on Quitting may lead to increased engagement and uptake of support by clients attending rural Aboriginal Maternity and Child Health services and in turn increased quit rates in this vulnerable population.

Session Title: Alcohol and other drug prevention for Indigenous youth: What works?
Speaker: Brianna Lees, Research Assistant, National Drug and Alcohol Research Centre

Presentation Summary: This presentation will discuss the results of a systematic review on alcohol and other drug prevention programs for Indigenous youth. The most effective programs were: 1. Non-cultural programs that are culturally adapted; 2. Included strong partnerships between Indigenous members and researchers; and 3. Incorporated cultural knowledge enhancement, alcohol and other drug education, and skill development. Evaluations conducted in Australia were consistently identified as poor quality, highlighting the need for an evidence-based high-quality intervention.

Session Title: Rural student led paediatric speech pathology clinics improving access and outcomes
Speaker: Claire Brunero, Speech Pathology Academic, Lecturer, Broken Hill University Department of Rural Health

Presentation Summary: Since 2009, supervised speech pathology (SP) students have provided speech, language and communication screening, and therapy services to primary school children in a rural Australian town, in response to limited service availability and socioeconomic disadvantage. SP student-led clinics are an effective model for delivering services to primary school children in communities with limited service availability and high need.

Session Title: “Swap to Stop” Medical consults via telehealth in rural emergency departments: a systematic review
Speaker: Dot Hughes, Nurse Manager Initiatives and Projects, Southern NSW Local Health District
Co-presenters: Tania Dufty, Registered Nurse & Ingrid Evans, Epidemiologist, Southern NSW Local Health District

Presentation Summary: Rural and remote populations experience poorer health outcomes, and equitable access to health care is limited by geography, time and distance. Workforce shortages in rural health services are common, and a number of patients who require a medical consult will present to small rural emergency departments (ED) when no doctor is available. The provision of a medical consult via telehealth could provide safe and cost-effective health care for the patient as close to their home as possible, and maintain the viability of small rural hospitals.

Session Title: Using telehealth to bridge the rural gap: a dietetics example
Speaker: Jenny Griffiths, HSM - Nyngan Health Service, Western NSW Local Health District

Presentation Summary: This is a well-established gap in access to Allied Health Services in rural and remote areas. Technology is one tool that can bridge the gap and allow rural and remote older people access to services close to home.

Session Title: Challenges in research into links between periodontal and systemic health
Speaker: Barbara Taylor, Periodontist, Murrumbidgee Local Health District

Presentation Summary: The Murrumbidgee Local Health District population has higher levels of major health risk behaviours that increase the chance of developing conditions such as cardiovascular disease, diabetes, cancer and respiratory disease. We have shown associations between poor oral health and various systemic conditions but observational studies do not prove whether the relationship is casual or causal. We therefore conducted clinical trials to determine the relationship between periodontal disease and cardiovascular risk. Our studies showed that periodontal treatment had a systemic effect, causing statistically significant changes in levels of various cardiovascular risk markers. The direction of these changes indicated that periodontal treatment reduced cardiovascular risk in these particular study populations. The conduct of clinical trials, and the subsequent translation of research findings into policy and practice in rural Australia, present interesting challenges that can be overcome to provide a rational basis for health service policy, planning and delivery.

Session Title: Scale up of a multi-strategic intervention to increase implementation of a mandatory state-based healthy canteen policy across both urban and rural schools
Speaker: Kathryn Reilly, Project Officer / PhD Candidate, Hunter New England Local Health District, Population Health

Presentation Summary: Despite the popularity of school healthy eating policies across all Australian jurisdictions, the implementation of such policies is poor, particularly in rural schools. A non-controlled before and after study involving a multi-strategic intervention to support school implementation of a healthy canteen policy was delivered across 173 schools. Results indicate that an evidence-based implementation intervention can be effective in increasing school canteen compliance with healthy food canteen policies, including rural schools.

Session Title: “Better rural city park planning to improve older people’s health and well-being
Speaker: Rachel Whitsed, Senior Lecturer, Spatial Sciences, Charles Sturt University
Co-presenter: Rosemary Black, Charles Sturt University & Alexandra Knight, Charles Sturt University

Presentation Summary: Research shows that access to well-planned parks as safe sites for leisure, engagement with nature and community activities will improve older people’s health and well-being. In the Better Parks for People project we collected data on how people view and use parks in a rural city, and developed a spatial modelling tool to identify gaps in provision and highlight parks where changes could have an impact on the health and wellbeing of the local aged community.

Session Title: UV exposure: mixed messages
Speaker: Catherine Harding, Head of Clinical School, Wagga Campus, School of Medicine Sydney, University of Notre Dame Australia
Stephanie Blake, RMO, St George Hospital, Sydney

Presentation Summary: UV (Ultraviolet) radiation and its link to skin cancer has been seen as a particular problem for rural areas. The popular ‘Slip, Slop, Slap’ skin cancer prevention message of the 1980s has been complicated by a newer discourse relating to need for measured exposure to sunshine for healthy living, and for appropriate levels of Vitamin D. This study explored the discourses around these two conflicting messages.

III) Rural Health Journeys – Design, Deliver, Experience

Session Title:
Transforming the experience of rural residential aged care: a collaborative improvement process
Speaker: Jenny Preece, Rural Health Network Manager, Agency for Clinical Innovation
Co-presenters: Jessica Drysdale & Jennifer Parkin, Agency for Clinical Innovation

Presentation Summary: The ACI rural health network has worked with 25 MPS across NSW to improve the experience of residential aged care so that residents are cared for as residents in their own home rather than patients in hospital, with associated choices, freedom and attitude to risk. The Collaborative methodology used has been successful at creating and expediting change across rural sites with distant sites learning from each other’s successes and failures.

Session Title: “Walk and Talk”: weekend walks with MPS residents, a small act achieving large impacts
Speaker: Karen Burn, Enrolled Nurse, Grenfell Multipurpose Health Service
Co-presenters:Karen Hancock & Pauline Tregenza

Presentation Summary: Grenfell Multipurpose Service (MPS) has been working to adopt person-centred care for their residents’ who call MPS “home”. Partnering with The Agency for Clinical Innovation (ACI) in the Living Well in MPS project, Grenfell MPS undertook a collaborative approach to implement principles of care strategies through small plan-do-study-act (PDSA) cycles. Selected residents were taken on walks with staff on weekend days. Staff report learning more about residents, enabling improved provision of person-centred care and enhancing the resident experience.

Session Title: Geriatrician in the Practice: an integrated model of care for people with dementia
Speaker: Jeremy Christley, Head of Aged Care and Rehabilitation Department, Shoalhaven Hospital
Co-presenter: Tabitha Hartwell, Dept of Aged Care and Rehabilitation, Shoalhaven Hospital, Nowra

Presentation Summary: This program aims to provide integrated, patient centred care for people with dementia by providing joint specialist / general practice clinics in the primary care setting. Patient and service outcome data of the first 18 months of the service will be presented.

Session Title: “Swap to Stop” The utilisation of electronic consultations within remote general practice
Speaker: Dennis Nguyen, Medical Student, Wagga Wagga Rural Clinical School, University of Notre Dame Australia

Presentation Summary: E-consultations (e-consults) can reduce the administrative workload for GPs (result notifications, repeat scripts) and improve efficiency. OzDocsOnline is a web-based program that facilitates e-consults and currently used by Gorge Health General Practice in Katherine, Northern Territory. A retrospective audit was conducted from July 2012 to April 2017 to identify the age, gender, type and frequency of use.

Session Title: Using a time and motion study to assess the efficiency of telehealth services
Speaker: Emily Saurman, Research Fellow-Rural Health, Broken Hill University Department of Rural Health

Presentation Summary: Telehealth services are about improving access and supporting patient-centred care in the right place, at the right time, and come in many different forms. But are they value for money? With the increasing use and application for telehealth services, we need to be vigilant to evaluate and ensure these services are both effective and efficient. Using a time and motion study design within our research strategies may help to improve future evaluations of telehealth services by assessing their efficiency and demonstrating their value for money.

Session Title: Improving access to cardiovascular screening technology in rural communities
Speaker: Joseph Suttie, Clinical and Research Director of Cardiac CT and MRI, Murrumbidgee Local Health District
Co-presenters: Hannah Kempton, Research Masters Student, Notre Dame University Australia & Dr Jacqui Stumpel, Regional Imaging Riverina

Presentation Summary: The implementation of the cardiovascular CT imaging service in the Riverina has resulted in improved access to the gold standard of atherosclerotic disease detection. Additional benefits include the reduction in unnecessary invasive procedures and better targeting of medical and interventional therapy. We provide a guide to the safe and effective implementation of this new technology in a rural setting.

Session Title: Supporting rural nurses to undertake medication reconciliation processes
Speaker: Kate Roper, Medication Safety and Quality Officer, Clinical Excellence Commission

Presentation Summary: Standardised medication reconciliation processes have been recognised internationally as a strategy to improve patient safety. Traditionally pharmacists have taken on the tasks associated with medication reconciliation, however in rural areas where there are very low numbers of pharmacists, and limited medical workforce, involvement of nursing staff is essential in reducing medication errors associated with poor communication of medicines information. This project aimed to provide specific training to nurses in how to undertake medication reconciliation processes.

Session Title: “Be audit you can be: optimisation through automation
Speaker: Samantha Fraser, District Quality Use of Medicines Pharmacist, Hunter New England Local Health District
Co-presenter: Kirstin Berry, Hunter New England Local Health District

Presentation Summary: HNE District Pharmacy Services has strived for medication excellence and has increased its function of supporting HNELHD rural and remote facilities through the implementation of electronic tools. The outcome is a reduction in the occurrence of medication incidents, and improved safety and quality use of medicine in accordance with national standards. Our services continue to expand and commensurate with our ever-increasing knowledge and experience.

Session Title: Grin and Grow health pathway: preventative oral health care for children in out of home care
Speaker: Angela Rankin, Clinical Leader, Oral Health Promotion and Prevention, Southern NSW and Murrumbidgee Local Health Districts
Co-presenter: Angela Masoe, NSW Centre for Oral Health Strategy NSW

Presentation Summary: The Grin and Grow project was initiated when a service gap was identified around trauma focused service provision for children in Out of Home Care (OOHC). OOHC children have traumatic backgrounds which can lead to poor oral health outcomes. The project solutions developed and implemented included a uniform referral pathway, trauma focused service provision, an optimal preventive focused oral health model of care and improved communication between Oral Health and Out of Home Care Services.

IV) Culture and Health

Session Title:
Culturally respectful health care and findings from participant evaluations
Speaker: Denise Hampton, Acting Community Development/ Health Education Officer, Broken Hill University Department of Rural Health

Presentation Summary: Providing culturally appropriate services is critical in enhancing healthcare accessibility and acceptability for Aboriginal people in rural and remote Australia. Significant State and Federal investments have been made to support the provision of cultural education for practising health professionals and pre-registration health students undertaking clinical placements within this context. Aboriginal Staff across the University Departments of Rural Health contribute significantly to the provision of culturally respectful healthcare.

Session Title: Reducing bacterial skin infections by incorporating Aboriginal ways of knowing and doing as part of best practice
Speaker: Kristy Crooks, Aboriginal Program Manager, Population Health, Hunter New England Local Health District C
Kylie Taylor, Aboriginal Health Education Officer, HNE Population Health, Wallsend, NSW

Presentation Summary: Bacterial skin infections are common in Aboriginal families in rural NSW. Current clinical guidelines may not incorporate the sociocultural factors or Aboriginal ways of knowing, doing, and living as important elements. We conducted focus groups and individual interviews were conducted and in keeping with cultural protocols in place. Findings from the qualitative study formed the basis for the development of a culturally responsive appropriate and acceptable treatment model for treating and managing bacterial skin infections. Skin infections are common but incorporating Aboriginal ways can support better models of care.

Session Title: “Whatchya gonna do?” Increasing Aboriginal community awareness through an immunisation music video
Speaker: Leanne Saunders, Aboriginal Immunisation Health Worker, Murrumbidgee and Southern Local Health Districts
Co-presenter: Barbara Wilson, Albury Public Health Unit

Presentation Summary: In consultation with elders, students, Aboriginal Medical Services and Aboriginal Education Officers it appears that there is a lack of awareness of vaccine preventable diseases and immunisation. High school students would be more likely to attend the school immunisation clinics if they had more information on vaccine preventable diseases. Adolescents are more likely to respond to messages delivered via visual arts and social media.

Session Title: Improving health outcomes through increased acceptability of digital health services for rural and remote Australians
Speaker: Michael Araco, Medical Advisor, Health Direct Australia

Presentation Summary: E-consultations (e-consults) can reduce the administrative workload for GPs (result notifications, repeat scripts) and improve efficiency. OzDocsOnline is a web-based program that facilitates e-consults and currently used by Gorge Health General Practice in Katherine, Northern Territory. A retrospective audit was conducted from July 2012 to April 2017 to identify the age, gender, type and frequency of use.

Session Title: Aboriginal Health Practitioners role in a rural opioid substitution treatment program
Speaker: Monica Murray, Project Manager, Integrated Care, Western NSW Local Health District

Presentation Summary: Sharing early positive results and resources developed with our experience of a trial of Aboriginal Health Practitioner role as witness to administration of schedule eight opioid substitutes (Methadone, Suboxone and Buprenorphine) in WNSW Local Health District. Guidelines, education package and competency have been approved by relevant external industrial bodies and ratified at executive level for further implementation in other health facilities

Session Title: Respect-Ed: preventing relationship violence
Speaker: Danielle Allen, Social Worker, Cowra Community Health
Co-presenters: Desley Johnson, Womens Health Nurse, Cowra & Donna Middleton, NUM Sexual Health Oarnge

Presentation Summary: In line with best practice recommendations for relationship violence prevention, the aim of Respect –Ed was to increase health promotion and healthy relationships education in local schools. The Health team led and collaborated with local schools and services to run an education campaign, involving 4 primary and 2 secondary schools, teachers, parents and local services. The project included arts based education activities over 2 terms including culminating in the ‘Respect Ed’ event which showcased student learning. Resources were developed for the community. Media coverage, improved access to services for youth, strengthened service networks and schools seeking Health involvement for ongoing health promotion activities were additional results. This project will be a bi annual event for our regional town. Respect -Ed is currently a finalist in the Western NSW Health Quality and Innovation Awards 2017.

Session Title: Can changing the environment in which we work change the attitudes of those who work there?
Speaker: Elizabeth Worboys, Health Service Manager, Boggabri Multi-Purpose Service

Presentation Summary: Standardised medication reconciliation processes have been recognised internationally as a strategy to improve patient safety. Traditionally pharmacists have taken on the tasks associated with medication reconciliation, however in rural areas where there are very low numbers of pharmacists, and limited medical workforce, involvement of nursing staff is essential in reducing medication errors associated with poor communication of medicines information. This project aimed to provide specific training to nurses in how to undertake medication reconciliation processes.

Session Title: Birth of the Henty Heirlooms – a co design approach to MPS residential living
Speaker: Nerida Hodges, Nurse Manager, Murrumbidgee Local Health District
Co-presenter: Annie Williams, Murrumbidgee Local Health District

Presentation Summary: The Birth of the Henty Heirlooms is an innovative approach to improving a residents lifestyle whilst in care which has a resident led approach. Making their experience more home-like and enjoyable. Fulfilling the twilight years and sharing worthwhile memories.

Session Title: Mapping the health and health needs of Western NSW
Speaker: Daniel Belshaw, Domestic Violence Project Officer, Western NSW Local Health District

Presentation Summary: The development of a multi-agency approach to mapping and understanding the health and service issues needs in regional and remote context. The use of shared data and resources from two LHDs, PHN and Aboriginal Community Controlled Health Organisations allowed for a whole of health approach in understand health behaviours/factors, health status, the role of remoteness in health status and the a market gap analysis of health services. The Health Needs Analysis supports the strategic direction and resource focus of health agencies in western NSW.