Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2023
What factors help and hinder efforts to address incivility in Australasian emergency departments? A modified Delphi study of FACEM perspectives.
Workplace incivility is a global challenge for healthcare and a major leadership challenge facing emergency physicians. However, little is known about emergency physicians' understanding of the factors that help and hinder attempts to address incivility, or what emergency physicians believe are the priority factors to address. The present study makes a novel contribution to research in this area by examining the perceived enablers of, and barriers to, efforts to address incivility in Australian and Aotearoa New Zealand EDs. ⋯ The causes of incivility in Australian and Aotearoa New Zealand EDs are complex and highlight incivility in EDs as a key adaptive leadership challenge of emergency physicians. Fundamentally, the results underscore the need to foster a workplace culture of respect, inclusion and civility in Australasian hospitals.
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Emerg Med Australas · Jun 2023
What can coronial cases tell us about the quality of emergency healthcare for prisoners in Australia?
This research aimed to examine the legal and regulatory obligations of authorities and healthcare professionals in the provision of prison emergency health services and to identify problems in the provision of emergency care to prisoners by using case examples from coronial findings. ⋯ Coronial findings and royal commissions have repeatedly identified deficiencies in the emergency healthcare provided to prisoners in Australia. These deficiencies are operational, clinical and stigmatic and not limited to a single prison or jurisdiction. Applying a health quality of care framework focussed on prevention and chronic health management, appropriate assessment and escalation when urgent medical assistance is requested, and a structured audit framework could avoid future preventable deaths in prisons.
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Emerg Med Australas · Jun 2023
Reducing diagnostic errors in the emergency department at the time of patient treatment.
The purpose of the present study was to compare and combine the radiographic interpretation accuracy of emergency clinicians and radiographers in clinical practice. ⋯ This is the first study to directly compare and combine the accuracy of an emergency clinician's radiographic interpretation with a radiographer's interpretation within clinical practice. The present study demonstrated that with the addition of a radiographer's interpretation, an emergency clinician's interpretation can be more accurate than the emergency clinician's interpretation in isolation. This highlights the value of a radiographer's interpretation that can complement an emergency clinician's interpretation when a radiologist's report is unavailable.
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Emerg Med Australas · Jun 2023
'Burr holes in the bush': Clinician preparedness for undertaking emergency intracranial haematoma evacuation surgery in rural and regional Queensland.
Delayed inter-hospital transfers of deteriorating neurotrauma patients from rural and regional hospitals to tertiary centres have seen the need for non-neurosurgeons to undertake emergency intracranial haematoma evacuation surgery locally. In the present study, the authors contributed to the paucity in the literature regarding the widespread availability of cranial access equipment in non-tertiary centres and patient outcomes in Queensland. ⋯ The availability of cranial access equipment outside Queensland tertiary centres has been limited. Inter-hospital transfers are likely to persist in Queensland and haematoma evacuation surgery has been a life-saving endeavour, so improving access to cranial access equipment in hospitals where it is currently lacking is highly warranted.
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Emerg Med Australas · Jun 2023
New bed configurations and discharge timing policies: A hospital-wide simulation.
Optimising patient flow is becoming an increasingly critical issue as patient demand fluctuates in healthcare systems with finite capacity. Simulation provides a powerful tool to fine-tune policies and investigate their impact before any costly intervention. ⋯ ED access performance for admitted patients can be improved by modifying downstream capacity or inpatient discharge times. The simulation model was able to quantify the potential impacts of such policies on patient flow and to provide insights for future strategic planning.