Research Translation Fellow, Eastern Health and La Trobe University
Research focus: Demand management, reducing waitlists and improving access to outpatient, ambulatory and community health services.
Dr Annie Lewis is a recipient of a 2024 Early and Mid-Career Researcher Award for excellence in an implementation project. This award recognises early and mid-career researchers for excellence in their field. Monash Partners spoke to Annie upon accepting this award.
Can you tell us about yourself, your research and career journey to date?
I graduated as an occupational therapist a very long time ago and fairly late in my career made a sideways step into research, initially as a project officer. The project was led by two brilliant researchers who have become my mentors, PhD supervisors and friends: Professors Katherine Harding and Nick Taylor. They were working on demand management in non-bed-based healthcare using the STAT model and I have extended and contributed to this field of health services research. The model we have developed, evaluated and implemented in a range of settings requires a change in thinking to do away with waitlists as a way to manage demand.
Can you tell us about your achievements in the category of excellence in an implementation project?
My doctoral and postdoctoral work in the area of health services research has tackled the gnarly problem of waiting for healthcare. It is an issue that urgently needs to be addressed due to the increasing demand on our health services. Outpatient services are often overlooked, with timely access for an ambulance or emergency department care more often in the spotlight. However, if operating well, outpatient care can prevent emergency presentations and hospital admissions, support General Practitioners to provide care for chronic conditions, and improve the condition and quality of life of thousands of patients.
I conducted a systematic review that showed that delayed care for people with epilepsy matters in terms of seizure outcomes and quality of life. I applied the STAT model to reduce waiting to an epilepsy clinic that had 600 people of a waitlist pre-intervention. With minimal resources, the intervention reduced the number on the waitlist to around 50 and this has been sustained for more than three years. This is important in that intervention studies and those that evaluate sustainability in the area of demand management and patient flow are rare. There is a lot of literature defining the problem but minimal evidence contributing to solving the issue in a pragmatic, uncontrolled health services environment.
Why is support of early and mid-career researchers so important?
Working in research is completely different from clinical or health leadership work! It can feel like another universe – ethics applications, understanding research methodology, doing statistics, writing for journals, applying for funding… Stepping into a research career requires support from experienced and encouraging senior researchers as there is so much unknown territory to cover. Having organisations and mentors to provide guidance, training and even small grants can make all the difference. I’d go so far to say that it’s near impossible to make the move to research without formal and informal support from generous seniors who are in your corner.
What kind of support was the most beneficial to you/or you felt you needed as an early and mid-career researcher and what did it mean to you?
I’m in an incredibly fortunate position where I am physically located at Eastern Health, but my team (and I) are in conjoint roles with La Trobe University. This provides a structural link between academia and the hands-on business of delivering public healthcare. The formal partnerships between health services and universities, strengthened and broadened by organisations such as Monash Partners is central to developing early to mid-career researchers.
At the team level, there is no possibility of doing research alone in my experience. My work has built upon and contributed to that done by those who have gone before. An essential ingredient for me has been the encouragement, mentorship and help from senior researchers who have generously shared their experience and time.
Why do you think awards like this are important for Early and Mid-Career Researchers?
It’s hard not to feel like an imposter in the early days of becoming a researcher. Being recognised with awards, publications and opportunities to present helps to build confidence and a track record. Receiving an award from Monash Partners provided me an opportunity to showcase our work and network with people beyond the day-to-day circle of colleagues. I anticipate there will be opportunities for collaboration that have arisen from the event.
What are your future aspirations for your research/career?
My aspiration is to revolutionise the delivery of public outpatient healthcare. A fundamental shift in attitude where healthcare providers think differently about their role in managing demand is required. It is possible to reorganise our healthcare to provide the greatest good to the most people in our community, with the resources that we have. I’d like to be involved in that.
Listen to Annie speak on her research: https://www.rrr.org.au/shared/broadcast-episode/31652/2269000
