Emergency department (ED) waiting times are a significant predictor of the patient experience.
Simple prediction methods, such as rolling average, are used by hospitals in Australia to predict waiting time for patients. Although this approach is inexpensive to implement, the forecasts have limited accuracy and consequently most Australian hospital EDs do not report expected waiting times to the public.
A solution that is capable of sourcing data from ED information systems and feed it into prediction models to generate waiting time forecasts would bring practical benefits for staff and patients. There is also potential to assist clinicians and nurses to estimate demand for care and calibrate workflow.
For patients, the knowledge may reduce anxiety associated with uncertainty about the waiting time and reduce the number of patients who leave before treatment.
This project aims to use advanced statistical models and machine-learning algorithms to capture dynamic fluctuations in waiting time, to implement and validate the prediction performance of these models. The project will also build ED research capacity by educating staff on forecast modelling and data management techniques.READ MORE
Global estimates suggest that approximately 5 million people die from infection each year. Research into improved management and treatment for patients with infection is essential for reducing mortality.
Patients presenting to the emergency department with severe infections are treated with fluids in the vein to maintain optimal blood volume, to keep the heart working properly and tissues well oxygenated. Fluids administered to patients include crystalloids (water-based fluids that include salts and other water-soluble molecules), and albumin (a fluid manufactured from human plasma). Crystalloids are most commonly used by emergency physicians in standard care however initial evidence indicates that albumin may result in better outcomes for patients with severe infections, but further quality trials are required for validation.
In this study, researchers will randomise emergency department patients with severe infection to receive either albumin or crystalloids. The aim of the study is to provide emergency doctors with important information about how to best treat patients with infections to improve blood pressure, prevent organ failure, reduce the need for intensive care and potentially reduce the number of deaths.READ MORE
In the acute phase of police detention, health concerns can emerge for detainees, especially around drug dependence, mental health conditions, and physical injury. In addition are system complexities including crowding.
In the event of an infectious disease outbreak (such as COVID-19), crowded conditions amongst a population with greater underlying burden of disease than the general population creates significant public health and economic concern. Furthermore, access to resources and expertise to manage health concerns in this environment can be challenging, especially in rural areas.
Researchers will interview key stakeholders involved with the care delivery and decision making of detainees, to identify innovative strategies to delivering healthcare in watch-house settings. This research will consider the decision making processes and costs associated with the delivery of healthcare in police watch-houses that may reduce the need for transfer to hospital emergency departments or reduce the potential for deaths in custody.
This research addresses the World Health Organisation’s (WHO) recommendation to understand how evidence-based health services can be provided for those requiring treatment, care and illness prevention whilst in police custody. It also identifies ways in which the need for expensive hospital stays can be minimised.
The expected impact of this research is the capability to identify and inform joined-up approaches so that cost-effective, safe, quality emergency care can be provided to detainees in police watch-house settings.READ MORE
Patient flow in emergency departments (ED) is impeded when the number of patients exceed physical and/or staffing capacity. This is often referred to as crowding, and is common problem for EDs across the country, adversely impacting patients, staff and the healthcare system.
While many strategies have been reported and trialled to mitigate the consequences of crowding and address its causes, there is no one solution that fits all EDs.
Researchers propose to develop and test a computer model to mimic the ED, simulating patient flow to provide forecasts that can inform policy makers. This is especially important in periods of anticipated high demand for emergency services such as in the current COVID-19 pandemic.
Emergency doctors will team-up with academic researchers to model patient flow in the emergency department to consider operational changes and provide knowledge to guide decision-making for improvement strategies that will lead to faster, more effective patient care, better outcomes and more effective, economical choices.
This innovative collaboration between doctors and university researchers aims to solve real-life system-level problems affecting patient care. The research will generate practical outcomes that improve clinical practice at a system level so that we can better care for our patients.READ MORE
Queenslanders living in regional, rural and remote areas have a higher incidence of traumatic injury and poorer access to health services than their urban counterparts.
Researchers propose to undertake a first-of-its-kind study to classify and characterise trauma patients from these areas serviced by Townsville, Cairns, Mt Isa, and Mackay Hospitals over the three-year period 2016-2018. Using patient records, researchers will examine the clinical therapies and interventions used and patient outcomes from point-of-injury through to hospital discharge.
The study will capture, collate and compare patient data from Queensland Health, Retrieval Services Queensland (RSQ), LifeFlight Retrieval Medicine (LRM) and the Royal Flying Doctor Service (RFDS) to assess the current state of emergency trauma care in the Queensland Tropics, and any potential gaps in aeromedical healthcare delivery. The results will also provide a springboard for a wider system and processes assessment of emergency trauma care for the benefit of patients in North Queensland.READ MORE
Currently in Australia, children with suspected neck injuries undergo neck scans such as x-rays, computed tomography (CT) or magnetic resonance imaging (MRI). However these scans may carry risks from radiation exposure, and are often associated with discomfort and distress for young patients and the need for sedation.
Considerable emergency department time and costs are also associated with these scans and it is unclear when it can be safely avoided. Rules and tools can help doctors decide when scans are necessary. The SONIC study aims to look at whether existing rules for adults are also appropriate for use in children, and to develop and test a specific tool to help doctors decide which children need a neck x-ray or scan. The study will involve a large number of children across multiple hospitals in Australia and New Zealand. The research is expected to help researchers learn more about looking after children with neck injuries and hopefully allow us to safely limit the number of scans that need to be done.READ MORE
COVID-19 has impacted healthcare provision in Australian emergency departments (EDs). Infection control precautions, including isolation of patients with respiratory symptoms and methodical use of Personal Protective Equipment (PPE), are of paramount importance to reduce the risk of transmission within the healthcare setting.
Patients presenting to Australian EDs with epidemiological or clinical features suggesting risk of COVID-19 illness are isolated into a physically separate, high risk-zone (HRZ) within the ED. Entry into HRZ is restricted to essential staff wearing appropriate personal PPE. Consequently, interactions between patients and clinicians, particularly allied health, are limited.
Mobile robotic telepresence (MRT) has the potential to maintain quality of care while facilitating contactless communication between patients and staff in the HRZ and the external multidisciplinary team. MRT is a wifi-enabled wheeled devices with audio-video capabilities controlled remotely by a clinician. This study aims to determine the feasibility of using MRT to support clinical care in the HRZ of the ED.READ MORE
Health workers are at increased risk of exposure and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). The implications of healthcare worker infection are wide-reaching and impact not only the worker, but also have implications for nosocomial spread in the pre-symptomatic phase and depletion of the skilled workforce required to manage an increased volume of presentations.
Front-line health care workers represent a unique cohort to follow for trends in SARS-CoV-2 infection, immune response and antibody production as well as monitoring for re-infection. Understanding the implications of staff infection on the potential for long-lasting immunity is of key significance to staff and leaders of EDs. Equally, understanding of asymptomatic staff infection can inform policy regarding routine screening of staff to minimise the risk of nosocomial spread to other staff and patients.READ MORE
Since COVID-19 was declared a pandemic by the World Health Organization (WHO), the elderly population globally have been identified as a vulnerable group, yet there is limited literature exploring the effect of pandemics on Emergency Department (ED) presentations in this cohort.
Healthcare systems have rapidly adapted and made changes to prepare for a potential healthcare crisis that has largely targeted our frail older population. The impact of the pandemic and changes in health care delivery need to be evaluated, to ensure the measures taken did not have unforeseen negative consequences and subsequent positive consequences.
This research aims to describe the clinical profiles, patterns of presentations and factors associated with outcomes of patients, aged 60 years and over, presenting to Queensland EDs before, during and after the COVID-19 pandemic. The results of this study will assist clinicians and policymakers to better respond to the challenges of acute care provision for this complex population during future pandemics.READ MORE
COVID-19 is an infectious respiratory pathogen with significant capacity to spread within the healthcare environment which has been highlighted by the number of healthcare staff internationally that have died or suffered significant morbidity through transmission while caring for patients. Guidelines recommend distancing between healthcare staff and patients and the need for personal protective equipment (PPE).
The majority of hospitalised and unwell patients with COVID-19 will receive some type of respiratory support, however very little is known in regard to how differing devices mitigate or exacerbate spread of respiratory droplets during coughing. Inadequate information has led to restrictions on certain types of therapies being offered to patients at risk for COVID-19. This study aims to clarify the extent of environmental contamination from droplet spread during coughing and the effect of different types of standard respiratory support on this.READ MORE