BACKGROUND:Equitable access to health care is supported as families experience cultural safety, reducing inherent power imbalances. Current measures of cultural safety focus on First Nations Peoples; no framework or measure has been identified for families of multicultural background who access children's health services. AIM:To identify how culturally safe care is assessed, measured, and monitored for families of multicultural background who access children's hospital services. METHOD:This scoping review followed Joanna Briggs Institute Manual for Evidence Synthesis. The search included terms for: 'population' of multicultural families of children aged birth to 17 years; 'concept' of experience of cultural safety; and 'context' of hospital-based care. Databases included PubMed, Cochrane, Epistemonikos, Cumulative Index to Nursing and Allied Health Literature, MedLine, PsychINFO, Scopus, Proquest, and secondary search of references from included studies. Data were evaluated using thematic analysis, and narrative discussion aligned with the World Health Organization Framework for improving the quality of paediatric care. RESULTS:Seven manuscripts were included, and four themes identified: 'Resources', 'Effective communication', 'Shared decision making', and 'Feeling supported'. Central to experience of multicultural safety is respectful verbal and nonverbal communication, supported through self-reflection by staff, allocation of extra time for families to seek clarity, and availability of interpreters. IMPLICATIONS:Most important to families was an experience of being respected as nurses and care providers listened carefully and showed interest in family culture. We will translate findings by partnering with families to develop a tool to measure experience of multicultural safety in hospital-based care for children and families.
BACKGROUND:National health systems evaluate hospital safety and quality by incentivizing or mandating the reporting of both hospital-acquired complications (HACs), which are potentially preventable iatrogenic conditions, and sentinel events, which are potentially preventable but severely harmful incidents. The objective of this study was to describe the landscape of currently reported hospital quality measures across countries. METHODS:The authors compared HACs and sentinel events across five well-developed national reporting systems (Australia, Canada, New Zealand, England, and the United States) and collated publicly reported rates and/or event counts. Reported measures were first categorized using existing Australian groupings, with additional categories added by consensus. RESULTS:Per country, the number of unique HACs ranged from 7 to 43. The United States, Australia, New Zealand, and Canada have measures in the categories of Pressure injuries, Falls and in-hospital injuries, Healthcare-associated infections, and Thromboembolism. The United Kingdom England system reports aggregated counts under broader categories. Per country, the number of unique sentinel events ranged from 5 to 17 measures. "Unintended retention of a foreign body after a surgery" and "transfusion of incompatible blood" are a HAC, a sentinel event, or both depending on national definitions. CONCLUSION:Hospital quality reporting varies considerably across countries, which may complicate comparisons and sharing of successful improvement strategies. Targets for harmonization were identified.
General practitioners (GPs) worldwide face increasing cognitive demands, especially in after-hours and voluntary primary care, where urgent decision-making and resource constraints exacerbate workload pressures. Studies across North America, Europe, and Asia indicate that GPs encounter similar challenges globally, with administrative burdens and patient complexity contributing to high cognitive loads. While prior research has examined technological interventions, workflow optimization, and cognitive assistance independently, an integrated, actionable framework tailored to GPs' needs remains lacking. This study employs a design science approach to develop and evaluate a Neural Assistant for Optimized Medical Interactions (NAOMI), a prototype AI agent designed to support triage and clinical decision-making in after-hours and voluntary care settings. Through 80 simulated consultations and clinician feedback, we identify three key design principles: Comprehensive Data Collection and Analysis, Clinical Reasoning Transparency, and Adaptive Triage and Risk Assessment. These design principles provide a structured foundation for developing AI-driven solutions that reduce cognitive burden, enhance clinical workflows, and improve healthcare equity. By advancing AI integration in primary care, this study offers a scalable roadmap for AI-driven healthcare research and innovation, addressing systemic workforce challenges while optimizing patient outcomes.
OBJECTIVE:All Australian residential care facilities are recommended to have access to a medication advisory committee (MAC) to provide governance of medication management. The objective was to explore the structure and function of Australian MACs. METHODS:A national 43-item survey of MACs was conducted from November 2023 to January 2024. The survey was adapted from the Australian Government Department of Health and Aged Care Audit Tool and Checklist for a Medication Advisory Committee (Audit Tool). All MAC representatives were recruited using a comprehensive and purposive strategy including the Department of Health and Aged Care newsletter, professional organisations, social media and professional contacts. Outcomes included self-reported MAC structure and function across four key roles as per the Audit Tool, including policy development, risk management, education and quality improvement. RESULTS:Responses were received from 120 MACs covering 642 residential care facilities (24% of Australian residential care facilities) in all Australian states and mainland territories. The MACs provided oversight to a median (IQR) 116 (61-196) beds/residents and a median (IQR) 1 (1-4) facilities. Over half (58%) of MACs were multidisciplinary (nursing, pharmacist and prescriber representation). More than half of MACs reported performing all functions listed in the Audit Tool relating to policy development (59%) and risk management (53%). Only 41% and 28% of MACs reported they performed all functions in the Audit Tool related to education and quality improvement, respectively. CONCLUSION:There is extensive heterogeneity in the structure and function of MACs with scope for MACs to become more multidisciplinary, identify staff training needs and proactively lead quality improvement.
