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Emergency department (ED) overcrowding and subsequent impacts on patient safety and quality of care is a global public health challenge. Capacity measurement and risk assessment tools play a vital role in capturing and communicating ED overcrowding to trigger escalation strategies, mitigate risk and facilitate patient safety and flow. Currently, there is no universal definition of ED crowding and tools developed to measure crowding and quality of care in paediatric EDs are largely based on research undertaken in the adult setting.
The Queensland Children’s Hospital (QCH) ED currently use the Staffing Acuity Physical Transfer/Disposition Environment (SAPhTE) tool, manually calculated by the Emergency Flow Coordinator (EFC) and designed to assess and escalate ED capacity, access block and departmental risk. Audits and staff surveys have identified challenges in the SAPhTE tool including timely completion especially during peak ED activity, inter-operator variability in interpretation and scoring, limited central visibility and poor shared understanding around escalation. QCH ED have co-designed the Acuity Level and Flow Report - Emergency Department (ALFRED) dashboard which provides near real-time capacity metrics from FirstNet to provide an automated and visual report of ED capacity, patient flow challenges and risk assessment. As a measure of overcrowding, ALFRED incorporates the single-site validated Pediatric Emergency Department Overcrowding Scale (PEDOCS). Further research is required to evaluate the acceptability, feasibility and efficacy of the ALFRED tool in a paediatric ED. This will facilitate potential translation to other pediatric centers and mixed emergency departments to promote a proactive approach to capacity risk assessment and improve patient flow.
READ MOREIntravenous lines are placed in the majority of patients admitted to hospital. Unfortunately they often fall out, become infected, cause irritation & pain or become blocked. Occasionally this can cause a life threatening illness. Blood can leak from the intravenous line onto the patient’s skin, clothing or bed linen. This causes patient distress. It can also be dangerous for hospital staff if they accidentally come into contact with the blood.
The insertion of a replacement intravenous line is generally regarded as an unpleasant experience that would be nice to avoid. The IVL-GONE research team are researching the use of common skin glue (think super-glue) to ‘stick-on’ the intravenous line. Other benefits are thought to include keeping the bugs out, improving patient comfort & helping to protect hospital staff from blood. If the skin glue works as well as preliminary studies indicate, this could be a simple solution for a worldwide problem; Queensland research leading the world.
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