PhD Opportunities in the Centre for Research Excellence in Reducing Healthcare Associated Infection

[Nicholas Graves]

Dear AICALIST,
Please forward this to anyone who might be interested, or think about applying.
Best Wishes
Nick Graves

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PhD Opportunities in the Centre for Research Excellence in Reducing Healthcare Associated Infection
The NHMRC funded Centre for Research Excellence in Reducing Healthcare Associated Infection aims to generate new knowledge about how scarce resources should be used to reduce healthcare associated infection in Australia and which strategies should be used to ensure effective transfer of research outcomes into health policy and practice.
It has major emphasis on collaboration and capacity building and offers exciting opportunities for undertaking postgraduate research in the areas of epidemiology, public health, biostatistics, decision making, health economics, health services research and more.
We are offering full-time PhD scholarships which are tenable at Queensland University of Technology. Scholarships are available for highly motivated and appropriately qualified students to commence a PhD, developing their own original studies, in the following research programs:

A. Improving the surveillance of healthcare acquired infection

B. Modelling the cost-effectiveness of infection control strategies

C. Applying advanced methods for meta-analyses and evidence synthesis

D. Improving knowledge of antimicrobial stewardship

E. Finding out how decisions are made about infection control programmes

F. Developing an intervention for environmental cleaning in acute hospitals
We are inviting applications for PhD projects in programs A, D and F to start in 2012.

Eligibility details
An appropriate University level qualification, with Honours or Masters level qualification useful
A background in a health-related field such as medicine, public health, epidemiology, health services research, or a generic field such as economics, biochemistry, statistics or psychology.

What you receive
AUD $32,860 per annum for living expenses, tax exempt for up to 3 years (the equivalent of the full-time APA stipend rate currently AUD $22,860 per annum in 2011, plus a CRE top-up of AUD $10,000 per annum).
an additional AUD $1,500 per annum available for research related costs.
access to support, expertise and mentoring from Australia-wide and international research investigators including: David Paterson; Tom Riley; Nicholas Graves; Graeme Nimmo; Ben Cooper; Andrew Wilson; Jenny Doust; Kerrie Mengersen; Martin Wolkewitz; Wayne Hall and Jan Beyersmann.
access to a strong group of technical and research support staff
opportunities for national and international travel and collaboration

Application details
Expressions of interest remain open for scholarships. There is no specified closing date and applications for PhD admission and CRE scholarships will be received at any time until all positions have been filled. Submit to megan.campbell@qut.edu.au an up-to-date CV together with a statement about your professional research interests to allow initial consideration of your suitability for the scholarship. We are currently seeking students to work on three PhD projects described next.
Project 1 is in Program G: Developing and implementing an environmental cleaning intervention for acute hospitals.
The cleanliness of hospitals attracts attention from the media, patients and politicians. And for good reason, the hospital environment has many separate components that pose a risk of infection for patients if not cleaned appropriately. There are published studies that document outbreaks of multiresistant organisms which have had serious consequences for patients and health services. Improving the management of the environment to minimise the chance of cross-colonisation and infection is an emerging focus of policy and research in HAI prevention. Environmental cleaning is a complex area, with variations in the type, frequency, product used and auditing methods in place. There are gaps in the evidence base, and gaps observed between evidence, policy and practice. A comprehensive programme of environmental cleaning, that is reproducible in different health care settings, cost-effective and easy to disseminate and manage would be a valuable addition to health services.
The overall goal of this research is to develop the theory for, and implement in a pilot study an environmental cleaning intervention that will ideally become the new standard for a modern acute hospital. The successful candidate will:

1. Interact with and collect data from relevant health services professionals to design an evidence-based intervention.

2. Pilot the intervention and then in an iterative process improve and refine the intervention.

3. Develop outcome measures that will show whether the intervention is effective and will enable an assessment of cost-effectiveness.

4. Design and prepare the materials for a cluster randomised controlled trial to test the effectiveness of the intervention.

Project 2 is in Program A: Improving the surveillance of healthcare associated infection in Australian hospitals.
Surveillance of HAI is a cornerstone of infection prevention. The data are used for quality improvement within hospitals, and performance monitoring by decision makers. Effective surveillance systems provide the impetus for change and make it possible to evaluate the effectiveness of interventions. Traditionally surveillance has been a time consuming, manual process, requiring clinical staff to examine data from a range of sources and apply a suite of definitions. In recent years electronic surveillance systems have been developed to streamline processes, save costs and allow clinical staff to spend more time on prevention efforts. There is potential for these systems to increase quality, improve timeliness and reduce costs by making surveillance more accurate, timely and simpler.
This major task for this PhD project will be to apply innovative statistical methods to existing retrospective and prospective clinical and surveillance data sets to answer two research questions:

1. What factors and clinical data best predict the likelihood of an event being classified as a healthcare associated bloodstream or surgical site infection?

2. Can this information be used to refine electronic surveillance systems, leading to an improvement in surveillance practices and data quality?
There will be a large set of retrospective surveillance data available for this project, and this might be linked to laboratory and hospital activity data to generate a powerful source of information. We hope to improve prospective methods for data collection, and generate information in real time that can lead to enhanced decisions. There may also be an opportunity to apply “machine learning” methods such as Bayesian networks to determine what refinements could be made to surveillance data.

Project 3 is in Program D: Quantifying the health and economic impact of antimicrobial stewardship programs in Australian hospitals.
A STUDENT HAS BEEN FOUND FOR PROJECT 3
Antimicrobial resistance has huge economic implications in terms of the costs associated with its existence and the costs associated with its containment. Antimicrobial stewardship is an important strategy to contain the emergence of resistance. The aim is to optimise the benefits from use of antimicrobials now whilst maintaining the benefits of antimicrobials for future use. National hospital accreditation standards now require all facilities to have a policy for antimicrobial stewardship. Programs are currently being implemented based around national guidance, however, implementing the wide range of recommendation these contain under conditions of scarce resources is a major research challenge.
http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/Antimicrobial-Stewardship
Although there is a theoretical framework for considering the cost-effectiveness of antimicrobial stewardship activities, empirical estimates of the cost of resistance are often crude and limited in perspective and there is only limited evidence for the cost or effectiveness of stewardship programs.
The overall goal of this research is to evaluate the cost-effectiveness of antimicrobial stewardship programs in Australian hospitals. The successful candidate will:

1. Evaluate the cost-effectiveness of antimicrobial stewardship programs from a short-term healthcare perspective.

2. Utilise existing economic frameworks to design a more comprehensive economic evaluation for antimicrobial stewardship that includes the long term health and economic impact of these programs from a societal perspective.

3. Specify the data required to evaluate this comprehensive model and identify if this is currently available, and if not, if it is possible to collect.
A STUDENT HAS BEEN FOUND FOR PROJECT 3

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Nicholas Graves PhD (econ.)
Professor of Health Economics
Academic Director – Australian Centre for Health Services Innovation (AusHSI)
School of Public Health and Institute for Health & Biomedical Innovation,
Queensland University of Technology, 60 Musk Avenue, QLD, 4059, Australia.
tel +61(0)7 3138 6115; fax +61(0)7 3138 6030; mobile +617 (0)412 058051

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