Mental health is a nationally recognised priority area and significantly contributes to the burden of illness in the Australian community, with almost 50% of people aged over 16 experiencing a mental illness at some point in their life. Coordinating treatment and support for people with mental illness is a key priority area in the Fifth National Mental Health and Suicide Prevention Plan and is a key priority indicator.
Over the last decade several models of mental health service delivery have evolved in response to the need for specialised mental health assessment and care in EDs as client numbers and acuity increases. Research has shown that these models are effective at supporting staff and increasing consumer satisfaction. However, little is known about how well the services integrate into ED service delivery and the way in which these MH services augment ED care and processes or their cost. Nor is there any research that summarises the salient features of the various models in a way that health services may integrate them to improve service delivery.
This research project is in two parts. The first phase aims to describe and explore the structures and processes required to sustain an ED physician championed. By understanding the structure and process required and through identifying its salient features, it may allow health services to implement the model or redesign, or adapt, current practice to improve the care received by patients presenting to EDs with a mental illness. The second phase will involve three quantitative studies that will examine the performance of the model.READ MORE
As the population of Australia grows the percentage of those aged >65years is expected to double over the next 30 years. This will lead to more patients presenting to emergency of which a significantly larger portion will be frail and/or from residential care facilities (RCF). This vulnerable population is at significant risk of hospital acquired complications including acute confusion, falls, and infections if they suffer prolonged stays in the emergency department (ED) or on admission to hospital.
The GEDI program is an innovative nurse led intervention designed to improve emergency care of frail older persons who develop an acute medical problem. GEDI's are trained in geriatrics and have excellent communication skills liaising with RCF staff, families, general practitioners, ED medical officers/nurses and inpatient teams. Their role also involves patient centred geriatric risk assessment and management to minimise the negative impact of the older person’s emergency visit. The program has already been shown to led to a decrease in ED and hospital length of stay, improved patient and staff satisfaction and decrease in overall cost of care.
In this research project, we will evaluate the structures, processes and outcomes of the GEDI intervention relevant to the RCF cohort. This study will look specifically at the RCF dwelling cohort as they have often been excluded from previous studies. We hope to use the outcomes of this research to gain a greater understanding of the problems faced by our frail ED RCF population and with this knowledge develop innovative evidenced based healthcare solutions.READ MORE