Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2021
ReviewReview article: Has the implementation of time-based targets for emergency department length of stay influenced the quality of care for patients? A systematic review of quantitative literature.
Time-based targets (TBTs) for ED stays were introduced to improve quality of care but criticised as having harmful unintended consequences. The aim of the review was to determine whether implementation of TBTs influenced quality of care. Structured searches in medical databases were undertaken (2000-2019). ⋯ The evidence for associations was mostly low certainty and confidence in the findings is accordingly low. Quality of care generally improved after targets were introduced and when compliance with targets was high. This depended on how targets were implemented at individual sites or within jurisdictions, with important implications for policy makers, health managers and clinicians.
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Emerg Med Australas · Jun 2021
Credentialing of emergency medicine trainees in point-of-care ultrasound: An effective, efficient and enjoyable model.
The Australasian College for Emergency Medicine Curriculum Framework contains numerous mentions of point-of-care ultrasound (PoCUS). However, obtaining formal PoCUS credentials is often problematic. The Fiona Stanley Hospital ED PoCUS training programme was devised to assist emergency medicine trainees to meet the credentialing requirements of the Australasian College for Emergency Medicine and the Australasian Society for Ultrasound in Medicine. ⋯ The Fiona Stanley Hospital ED model is effective in assisting emergency medicine trainees to gain formal PoCUS credentials. As it requires relatively little organisation, time and staffing, it could be adopted in many EDs around Australia and New Zealand.
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Emerg Med Australas · Jun 2021
Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland.
Chronic obstructive pulmonary disease (COPD) patients commonly have frequent visits to the ED. Consequently, COPD has a significant effect on total healthcare expenditure. The objective was to measure the frequency of ED presentation and hospitalisation among COPD patients and to estimate the costs resulting from such care utilisation. ⋯ COPD patient presentation to ED and admission to hospital is an expensive method of providing healthcare to manage this chronic condition. Clinical practitioners and policy makers need to develop and implement optimal integrated care management systems to reduce this hospitalisation rate and reduce the societal costs associated with COPD patient management.
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Emerg Med Australas · Jun 2021
Displaying emergency patient estimated wait times: A multi-centre, qualitative study of patient, community, paramedic and health administrator perspectives.
EDs have the potential ability to predict patient wait times and to display this to patients and other stakeholders. Little is known about whether consumers and stakeholders would want this information and how wait time predictions might be used. The aim of the present study was to gain perspectives from consumers and health services personnel regarding the concept of emergency wait time visibility. ⋯ Consumers and paramedics want wait time information visibility. They would use the information in a variety of ways, both pre-hospital and while waiting for care.