Patient demand on Emergency Departments (EDs) is rising by over 3% per annum contributing to congestion. ED congestion is known to be associated with poor health outcomes and reduced efficiency; the latter is characterised by increased waiting time, length of stay and ambulance diversion. Even though the National Emergency Access Target (the four-hour rule) has reduced the level of access block, initiatives to reduce ED demands have not had significant effect to date.
Previous research undertaken by the emergency health research group at QUT has described in detail the increases in demand and has identified some contributing factors. Our research highlighted reduced access to primary healthcare is one important factor associated with increased ED demand.
The aim of this project is built on our earlier work investigating factors that influence the choice made by patients between ED and primary healthcare for acute illness, and to thus identify viable primary healthcare alternatives for diverting ED patients so as to reduce ED demand. This project will provide the necessary evidence base to subsequently develop a NHMRC grant application to trial a national model of expanded primary healthcare practice to reduce ED demand. Importantly, this project will facilitate better integration and knowledge exchange between existing primary and secondary health sectors in Queensland through the stakeholder involvement.READ MORE
The increasing demand on emergency health care in Australia has seen recent emphasis on clinical redesign initiatives that are focused on time-based performance measures and activity-based funding. While congestion in emergency departments continues, and emphasis is placed on reaching these time targets, the quality of care that patients receive when presenting with non-life threatening injuries is potentially compromised.
To date, there is a lack of high-level evidence surrounding the type of quality indicators (QIs) that should be used in EDs to measure quality of care. This project will develop QIs for care of patients who present to EDs with musculoskeletal injuries under appropriate expert review. The final QI set will allow application across EDs and will contribute to comparison and optimisation of emergency care for patients in ED with musculoskeletal injuries.READ MORE
Acute respiratory disease is the leading cause for infants and children needing hospital admission. The main focus of hospital treatment is oxygen therapy beside disease specific treatment like inhalers for asthma or antibiotics for pneumonia. 10 to 20% of these infants or children need higher level of care at some point of their illness and will be transferred to a children’s hospital intensive care unit. This is not only expensive and imposes a huge burden on health care costs but more importantly is very stressful for these children and families because they are taken out of their familiar environment. Recent research suggests that with early optimal respiratory support the need for transfer can be significantly reduced and many of these patients could be cared in their regional hospital allowing the family to be the main support group. This concept of “keeping the patients in their regional centre” is not only from a psychosocial aspect of advantage but will have as well a great impact on health care costs. Our research group has recently investigated the role of high flow therapy in infants with bronchiolitis and we were able to demonstrate a 40% reduction in intensive care admission. Early respiratory intervention is a fundamentally new approach, which has the potential to prevent progression and deterioration of respiratory illness. The aim of this study is to investigate the role of high flow therapy in infants with bronchiolitis, but future research and trials will also include other conditions such as asthma and pneumonia.READ MORE
The aims of this research are to link best practice ED workforce models to available ED funding under an activity-based funding (ABF), while contributing to the development of an improved national activity and outcome-based ED funding model. This research will identify the current status of funding of EDs, identify and critically appraise models for funding of EDs and identify the workforce implications of those funding models and propose a State-wide ED clinical workforce framework.READ MORE