Modified national versions of the WHO’s International Statistical Classification of Diseases, current version ICD-10 with ICD-11 coming into effect in January 2022, have become the standard in many countries for diagnosis and procedure coding to facilitate the submission of medical billing and reimbursement by health insurers. The WHO ICD-10 exists purely as a coded classification of disease. It has no related classification of procedures and lacks the clinical level of diagnostic specificity necessary for the documentation of individual clinical cases and the associated prescribed therapies and interventions, particularly surgical cases. Historically, the US clinical modification of ICD-9, known as ICD-9-CM, established the trend. Australia adopted ICD-9-CM, later adapted it to Australian clinical specifications, and after the launch of the WHO ICD-10 produced the current Australian modification ICD-10-AM, used under license by many other countries. This paper examines a work in progress, rather than offering an academic critique, to illustrate the evolution of national clinical modications with particular reference to those of the United States, Australia and Thailand. The selection is based on the historical ICD-9-CM connection of the US and Australia, and the fact that Thailand is a more advanced developing nation like Saudi Arabia. The study parameters include the Saudi national healthcare system which has not previously employed a classification clinical coding, despite the wealthy developing healthcare system. Nations using their own modification face the burden of upgrading. Saudi Arabia plans to implement the national Australian modification, rather than creating a Saudi national modification.

Internationally the agenda for healthcare reform has moved rapidly. In Australia, the health care system has recently undergone significant structural changes to target sustainable improvements to the performance of health service delivery. Throughout this process there has been growing attention to the importance that leadership and management can play in the ultimate success of improved health service delivery. The quality of the management and leadership education within the health services and state health authorities has been shown to be crucial to better patient outcomes. Despite leadership being integral to the success of reform, the national strategies have failed to address the leadership and management education, development and training needed at the health care and health services level. The Australian health service reforms ignore the critical issues of planning and investment towards the education and development required for a system targeting management and decision making at the hospital level. The two prominent professional bodies which nationally promote health management education, research and professional development are the Society for Health Administration Programs in Education (SHAPE) and the Australasian College of Health Service Management (ACHSM). Both groups have recently sought commitment from the government, health departments and healthcare providers to invest in health management education through supporting the continuing professional development and training of the health management workforce.

Introduction: The Australian Government recently announced major reforms to the health system - A National Health and Hospitals Network for Australia's Future. The national health reform plan involves substantial structural change which the Government expects will deliver 'better health and hospitals' for future generations. Approach: A review is undertaken of the proposed set of reforms to determine whether its frame of reference can contribute to the effective achievement of the desired health and hospitals outcomes. Findings: The national health reform plan was found to have two striking weaknesses. Firstly, it fails to account for the political, cultural, behavioural and professional aspects of change. Secondly, it fails to position leadership and health management as central to the implementation of reform. Conclusion: The complexity of major structural change is such that major health reform strategies need to incorporate proper assessment of organisational behaviour aspects within a system which values the central roles of leadership and health management. A new leadership model for introducing health reform is presented.

Introduction: A recently released report, the National Survey of Pathology Workforce 2011, has painted a bleak future for clinical pathology services in terms of a looming major workforce shortage. Approach: A review is undertaken of the current pathology workforce situation to determine the key contributing issues, future demands, workforce needs and strategic solutions. Findings: A workforce crisis in pathology is upon us, with approximately a third of the total workforce expected to leave within the next five years. This represents a real threat to the future capacity of the workforce to sustain quality services at current levels and the likely growth of demand for pathology testing into the future. Conclusion: Four strategies are recommended to address the future pathology workforce needs in Australia through leadership and workforce development. These are; increasing supply of the workforce; redistributing the workforce from areas of lower to higher demand; improving productivity; and reducing demand for pathology services.

A study was undertaken to identify the causes of unnecessary repeated medical imaging examinations. The repeat analysis study investigated repeated medical imaging examinations at two medium sized hospitals in Sydney, Australia. The analytical part of the study was conducted jointly by a radiologist and a radiographer. Overall there were 9.3% and 7.2% of total films repeated respectively at the two hospital sites. Unnecessary repeats were found to have been caused by numerous factors including: poor technical judgement, the adoption of unconventional techniques, non availability of radiologist for advice, patient movement or motion, equipment mishandling, disorganised practice and poor supervision of students. At both of the sites, senior radiographers were associated with 70.2% and 84.5% respectively of dark and light film errors, and 59.7% and 85.5% respectively of the repeated cases had students' involvement. On the other hand, junior radiographers were involved with 70.3% and 86.1 % respectively of positioning errors. It was recommended that major changes be introduced to radiographer practice including, quality control, radiological techniques, training, supervision and continuing professional development. It was also recommended that the radiologist takes a more active role in future guidance and training of radiographers.

The objective of this study is to investigate job satisfaction amongst nurses in Saudi Arabian hospitals. In recent years, there has been considerable growth in the healthcare system in Saudi Arabia, yet little attention has been paid to improving the performance of healthcare professionals, by improving job satisfaction and retention of nursing staff. This paper reviews the research conducted on job satisfaction, and retention of Saudi nursing staff. This is an integrative review of previous studies on job satisfaction and retention of Saudi nursing staff. The electronic databases Google Scholar, CINAHL, PubMed, and Global Health were used to identify peer-reviewed literature published between 2009 and 2018. The literature review showed that the majority of nurses were satisfied in their job. However, there was a shortage of research in retention of nurses. The evidence from this study suggests that the hospitals need to ensure high level of job satisfaction and decent wages of nurses for maximum retention of nurses.

The Blacktown Mt Druitt Hospital Imaging Department wanted to find a clinical practice improvement solution to the escalating endemic and common public hospital problem of long waiting times for x-rays, Access Block, cancelled examinations, inefficiency and poor service capacity. A multi-disciplinary team was formed, the workflow analyzed, request form and patient flow were mapped from time of requesting the x-ray examination to final report delivery. After the main causes were identified the steps deemed unnecessary were eliminated to create a revised request pathway (arriving with patient instead of prior) and patient flow. Patients arriving with the request form were given immediate access. Radiographers from other modalities methods provided support to ensure streamlined patient flow within the department. Patient Services Assistant (PSA) roles were redefined and the referring ward became responsible for contacting the PSA when patient was ready to be transported. This new process was called 'Open Access'. The issues identified were receiving and distribution of the request form to imaging areas providing x-ray service and the excessive, uneven workflow demands of the PSA. As a result of original request form pathway and the patient flow system, radiographers were inefficient and underused, many examinations were cancelled, service capacity was poor and imaging contributed to hospital Access Block. Through implementation of 'Open Access', average ward x-ray availability reduced from 15 to 1 h, with 91.9% of all examinations completed in less than 3 h. Average Emergency Department x-ray availability reduced from 3 h to 30 min. Average of 80 cancelled x-ray examinations/month reduced to zero. Patients requiring x-ray have immediate access to services when they arrive with the request form. 'Open Access' has led to efficient patient flow, improved availability of images, assisted patient clinical management, discharge processes from hospital and bed availability. 'Open Access' has reduced Emergency Department Access Block, allows more effective use of staff resources and higher staff, patient and referring ward satisfaction.

At the Gold Coast 2006 AMZAME Conference, Jenny Graham, Leon Cowen and Paul Orrock conducted a session on hypnotherapy, attracting significant interest across the health professions. Many ideas and viewpoints were shared and many questions were raised. The current health climate (with strong public interest in natural and complementary medicine and governments keen to contain burgeoning costs of health delivery) seems conducive to serious examination of the place of hypnotherapy in the preparation and/or continuing development of health professionals. The benefit of hypnotherapy as an effective rapid drug free intervention and one which can be coupled with and enhance other interventions (Cognitive Behavioural Therapy or counselling) is being recognised. As reported in 2006, a wide range of health practitioners are seeking training in hypnotherapy and there is a need to identify core competencies.

Purpose: Activity in health services is expanding faster than population growth and that of the production of all goods and services in Australia. This paper is concerned with the number and characteristics of its managers in relation to the number of people employed and resources used. It also assesses different trends in hospitals and other medical and health services.
Methodology/Design: Design of the analyses follows specifications set by the authors for tabulations prepared by the Australian Bureau of Statistics (ABS) from the censuses of population conducted by ABS in 2006 and 2016.
Analysis: Assesses changes in the number and variations in the characteristics of managers of hospitals and medical and other health services, in relation to the number of people employed, contrasted with changes in all industries.
Findings: There are different trends in hospitals and medical and other health services, with a decline in the number of employees per manager in medical and other health services and a slight rise in hospitals. The older average age of health service managers continued to rise, similarly to that for all industries. The proportion of female managers in health services, below the average for all employees, increased somewhat during the decade. The distribution among the various fields of study remained about the same; but level of education, higher than the average for all industries continued to rise.The growth in average income of managers during the decade was somewhat lower than in all industries, due to a lower increase rate in medical and other health services. The proportion of managers of indigenous status rose substantially - almost double the proportion in all industries.
Implications: The findings are of relevance to those concerned with the management of health services and training of the growing number of managers of health services in Australia.