First do no harm: how minimal intervention is benefitting patients, staff and the system

Less can be more when it comes to medical intervention, according to Prof Gerben Keijzers, Senior Staff Specialist and emergency physician, Gold Coast University Hospital.

Prof Keijzers says the EMF-funded Conservative Management of Primary Spontaneous Pneumothorax Trial shows just how effective “doing nothing” can be in benefitting patients, staff and the hospital system.

“Doing nothing, just observing patients with moderate to large pneumothorax, actually ended up being as good in terms of re-expanding the chest at eight weeks as the original guideline-based treatment which was putting a drain in,” Prof Keijzers said.

“Doing nothing, just observing patients with moderate to large pneumothorax, actually ended up being as good in terms of re-expanding the chest at eight weeks as the original guideline-based treatment which was putting a drain in.”

“Interestingly, all the things patients care about such as how long they are in hospital ended up being better when they were getting conservative treatment, so observation alone.

“That’s now led us to propose an implementation grant together with Monash University and we will try to get multiple sites in Australia to implement these findings because publishing evidence that something is better doesn’t always lead to translating it in real practice.”

Prof Keijzers was co-lead of the EMF-supported Queensland arm of the study, with 10 Queensland EDs participating.

The team plans to develop new work practice recommendations to encourage other practitioners and hospitals to follow the evidence for avoiding unnecessary intervention and care.

Prof Diana Egerton-Warburton, emergency physician and Professor at the School of Clinical Sciences at Monash Health, Monash University agrees translation of the research is vital.

“The role of EMF funding was absolutely pivotal to securing further NHMRC funding and it’s that sort of seed funding for a big project that can really give translation leg up,” Prof Egerton-Warburton said.

“When you’ve got pilot data that you can take into the next grant application it’s hugely helpful and so the EMF grant was a linchpin in getting the NHMRC grant.”

As the team seeks further funding for implementation, she says the clinician-researchers are grateful for EMF funding and support.

 


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