Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2017
Impact of an education session on clinical handover between medical shifts in an emergency department: A pilot study.
To evaluate the impact of a medical education session on the implementation of a new change of shift medical clinical handover format in an urban hospital ED. ⋯ Time pressures need to be taken into consideration when introducing changes to current processes. Also, it is recommended that, in addition to ongoing education, senior clinicians are engaged during the planning and execution stages of changes to practice.
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Emerg Med Australas · Jun 2017
The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.
Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. ⋯ The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes.
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Emerg Med Australas · Jun 2017
Establishing a dedicated toxicology unit reduces length of stay of poisoned patients and saves hospital bed days.
This study evaluates the effect on the average length of stay (LOS), relative stay index (RSI), bed days and costs saved following the establishment of a dedicated clinical toxicology unit in an Australian tertiary referral hospital. ⋯ The reduction in average LOS is similar to results previously published by two Australian toxicology units over 15 years ago. Despite changes in healthcare delivery since this time, these results continue to support the efficiency and associated cost saving of a dedicated toxicology unit in managing poisoned patients.