Emergency medicine Australasia : EMA
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Emerg Med Australas · Feb 2015
Predicting the number of emergency department presentations in Western Australia: A population-based time series analysis.
To predict the number of ED presentations in Western Australia (WA) in the next 5 years, stratified by place of treatment, age, triage and disposition. ⋯ ED demand in WA will exceed population growth. The highest growth will be in patients with complex care needs. An integrated system-wide strategy is urgently required to ensure access, quality and sustainability of the health system.
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Emerg Med Australas · Feb 2015
Redesigning emergency patient flow with timely quality care at the Alfred.
The 4 h National Emergency Access Target was introduced in 2011. The Alfred Hospital in Melbourne implemented a hospital-wide clinical service framework, Timely Quality Care (TQC), to enhance patient experience and care quality by improving timeliness of interventions and investigations through the emergency episode and admission to discharge in 2012. We evaluated TQC's effect on achieving the National Emergency Access Target and associated safety and quality indicators. ⋯ TQC resulted in improvement in timeliness of care for emergency patients without compromising safety and quality. Success is attributed to effective engagement of stakeholders with a hospital-wide approach to redesigning the care pathway and establishing a new set of principles that underpin care from the time of ED arrival.
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Understanding the reasons patients decide to attend a particular acute care service, and their expectations of that service, is important in providing optimal patient care. The present study aimed to determine factors influencing patient decisions to attend a private Australian ED, an issue that has not been previously addressed in the literature. ⋯ Patients chose to use the private ED because of prior experience, proximity, and an expectation they would be seen promptly and be provided with competent care.
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Emerg Med Australas · Feb 2015
Measuring the effectiveness of a revised clinical practice guideline for the pre-hospital management of supraventricular tachycardia.
To evaluate the effect of changes to the pre-hospital management of patients with supraventricular tachycardia (SVT) following intervention with a revised Clinical Practice Guideline (CPG). The major CPG revisions were removal of verapamil, addition of adenosine and an emphasis on Valsalva manoeuvre. ⋯ The revised CPG improved pre-hospital SVT reversion success. This expansion of practice has not demonstrated improvements to utilisation or effectiveness of the Valsalva manoeuvre. Adenosine is effective and safe for pre-hospital use.