Australian health review : a publication of the Australian Hospital Association
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In January 2006 the Maryborough Base Hospital in Queensland faced imminent closure of its emergency department (ED) due to a shortage of senior medical staff. At the same time patient confidence in Queensland Health was low. ⋯ In search of a solution, the Fraser Coast District Health Service asked Maryborough general practitioners to work in the Maryborough Hospital ED and/or in the internal medicine ward as Visiting Medical Officers. While this represented a solution to the problem, there was much to be considered before such a plan could be put into place.
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High-reliability organisations are those, such as within the aviation industry, which operate in complex, hazardous environments and yet despite this are able to balance safety and effectiveness. Crew resource management (CRM) training is used to improve the non-technical skills of aviation crews and other high-reliability teams. ⋯ The purpose of this discussion paper is to examine the application of CRM to acute, ward-based multidisciplinary health care teams and more broadly to argue for the repositioning of health-based CRM to address effective everyday function, of which "crisis events" form just one part. It is argued that CRM methodology could be applied to evaluate ward-based health care teams and design non-technical skills training to increase their efficacy, promote better patient outcomes, and facilitate a range of positive personal and organisational level outcomes.
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To help develop criteria to identify older patients suitable for admission to medical short-stay units, by determining predictors of length of stay (LOS) of 3 days or less. ⋯ Preserved function, measured using the MBI and TUG, and the absence of delirium are strong predictors of short LOS. In conjunction with early, skilled clinical evaluation, these criteria could be used to select older patients presenting to the emergency departments for admission to short-stay units.