Showing papers by "Megan Bohensky published in 2007"

Under-reporting of deaths to the coroner by doctors: a retrospective review of deaths in two hospitals in Melbourne, Australia.

Abstract: Background. ‘Under-reporting’ of deaths to the coroner has significant implications for the identification and investigation of preventable deaths. In extreme cases, it may even be a symptom of the system failures that allowed cases such as Harold Shipman, Australia’s King Edward Memorial Hospital, the alleged incidents at the Bundaberg Hospital and the Bristol Royal Infirmary to persist. Several initiatives in Australia and the UK are currently reviewing the coroner’s system in light of the recommendations made by the Luce report and the Bundaberg Hospital inquiry to consider whether the coroner’s system effectively meets the needs of our society, including the healthcare sector. Reporting of deaths to the coroner is a key issue for consideration in this debate. Objective. This study’s primary aim is to identify the number of deaths in the hospital setting that meet the reporting criteria set out by the coroner’s Act, Victoria 1985 (‘reportable deaths’). Method. This study utilized a method of retrospective structured medical record review of in-patients who died between 1 January 2002 and 30 June 2003 at two major public hospitals in Victoria, Australia. Results. In total, 229 cases (95.4% of records requested) were included in this review (120 from Hospital A and 109 from Hospital B). The number of cases at both hospitals meeting the coroner’s reporting criterion was 58, of which, 22 (37.9%) were reported to the coroner. Conclusion. This study provides the first experimental evidence of significant ‘under-reporting’ of deaths to the coroner by hospitals. This is an important consideration for the reform initiatives currently underway. Better communication channels need to be fostered between doctors and coroners if coronial investigations are to be used effectively for reviewing deaths in hospitals.

Drivers with visual field loss in one Australian licensing jurisdiction

Abstract: In Australia, the presence of a visual field deficit condition requires assessment by an optometrist or ophthalmologist before an individual can be considered fit-to-drive. However, there are currently limitations in the validity of tests and criteria used for assessing vision for safe driving. This paper examines the scope of the problem in one Australian jurisdiction by identifying the prevalence of visual field loss (VFL) amongst drivers referred for medical review and describing the current practices for managing their licence review. A random sample of medical review cases was extracted from the VicRoads Medical Review database to identify cases involving VFL conditions: glaucoma, age-related macular degeneration, diabetic retinopathy, hemianopia/quadrantanopia and retinitis pigmentosa. Data on demographic information, visual field loss conditions and the referral process were collected for all identified cases. (a) For the covering entry of this conference, please see ITRD abstract no. E216178.

Some options for assessing older driver fitness to drive for licensing purposes

Abstract: The proposed Australasian older driver licensing model incorporates a screening assessment of older drivers identified as being at-risk by health or other authorities. Some drivers are either failed or passed with drivers whose test performance has been inconclusive, being referred for further in-depth assessment. The useful field of view (UFOV) screening test has been extensively evaluated over the past decade or so, with results commonly confirming a statistically significant association between test performance and various measures of crash risk. An Austroads project currently being conducted in Western Australia involves a case-control study to assess the usefulness of UFOV and other assessment options to licensing authorities when assessing older drivers. Preliminary results based on 39 cases and 39 controls indicate that several measures have a statistically significant association with recent crash involvement. Once all testing has been completed, more sophisticated statistical analyses (e.g. a regression analysis, diagnostic accuracy testing) will be undertaken to evaluate the effectiveness of using these tests for screening older drivers. This paper explores the different ways in which UFOV and other measures of fitness to drive might assist in the assessment of older drivers generally and within the Australasian licensing model, specifically. (a) For the covering entry of this conference, please see ITRD abstract no. E216178.