Reducing avoidable COPD emergency presentations: An integrated cross-health service initiative

Almost 3% of consumers of healthcare services in the Darling Downs, West Moreton and Gold Coast (Including Robina) regions are estimated to have Chronic Obstructive Pulmonary Disease (COPD); which is somewhat higher than the state average of 2.4%. COPD is the second leading cause of avoidable hospital admissions. Anecdotal evidence indicates continued over-utilisation of frontline resources (e.g., Emergency Department [ED]), and potential gaps in outreach services (e.g. underutilised services).

This project will inform the implementation and evaluation of referral treatment initiatives (e.g., anxiety management, smoking cessation referral, and quality intra-professional care [IPC] programs), based on identified causal factors.

Patients transfers from rural hospitals – are we getting it right?

The aim of this research was to provide preliminary data on patients transferred to Toowoomba Hospital from 18 rural hospitals within the Darling Downs Hospital and Health Service. The data was collected via a retrospective audit in order to identify transfers where quality and safety may not have been optimal.

There has been no clear indication of the magnitude of the potential problems with patient transfers and no validated method for obtaining this information.

Outcomes in Transfers of Head and Neck Trauma Patients for Neuroimaging to Toowoomba Base Hospital Emergency Department.

Patients from Dalby and Kingaroy Hospitals are transferred to Toowoomba Hospital, for CT Scanning and advanced Radiology, when CT and Advanced Radiology services are not available locally. Dalby and Kingaroy Hospitals only have these services during business hours, Monday to Friday, and advanced Radiology when the trained Radiologist is working. This means on weekends and after-hours, patients need to be transferred to Toowoomba for these services.

It is hypothesised that a percentage of transfers from rural hospitals for head and neck imaging following minor trauma do not meet ACEM guidelines. Our aim is to investigate the reasons for transfer for CT Head and Neck scanning or advanced radiology, to see if any identifiable patterns or concerns emerge around decision making which led to the transfer. The secondary aim is to evaluate adherence to evidence based clinical practice guidelines on diagnostic imaging by ACEM.

Results of this research will include identification of transfers that were not made according to current guidelines. These results would allow education opportunities to better facilitate evidence-based decision making in transferring head or neck trauma patients for diagnostic imaging when services are not available.