Qld symposium examines ED blockages and more

Emergency medicine experts including physicians, nurses, paramedics, allied health professionals, administrators and patient advocates gathered in Brisbane last week to discuss the critical issues exacerbating emergency department (ED) wait times.

Close to 100 delegates travelled from across Queensland to attend the 2024 Emergency Medicine Foundation (EMF) Symposium, which showcased the latest research tackling ED congestion. EMF Chair Professor Hugh Grantham said the forum provided a rare opportunity for medical staff and managers from the state’s public hospitals to get together and discuss vital issues impacting patient care.

“EDs are the canary in the coalmine, where the coalmine is the whole health system,” Grantham said.

“The problem of blockages shows up in ambulance ramping and long wait times, but this is a complex issue requiring whole-of-health system solutions.

“One of the biggest concerns for emergency medicine is how to enhance patient flow from arrival at an emergency department to treatment, potential admission and, finally, discharge from hospital.

“There are also out-of-hospital factors, including access to GPs and the need for more community care of vulnerable patient groups such as aged care and mental health patients.”

Headlining the symposium was the $600,000 multi-agency patient flow project, supported by EMF and Queensland Health, which is expected to reveal unprecedented insights into patient flow impediments. Researchers are analysing data from 25 of Queensland’s largest public hospitals over six years, conducting interviews with staff and patients, and carrying out a comprehensive review of published literature. The research covers the whole health system, including out-of-hospital influences and factors impacting on the patient journey in hospital.

Early results of the study show that solutions must come from hospital-wide and health system-wide reforms. Recommendations are expected to target issues such as discrepancies between peak demand for admissions and the timing of patient discharges, and alternative care for long-stay patients.

Symposium speaker Associate Professor Manaan Kar Ray, an EMF clinician-researcher, meanwhile showcased the EMF-funded SAFE STEPS project that aims to decrease demand on emergency services by designing and assessing systems of care in the community. According to Kar Ray, “We are confident these systems can proactively identify and support deteriorating mental health patients before they reach ED.”

“We saw a 66% decrease in ED presentations from patients engaged by the Acute Care Team in 2023 compared to the previous year,” he continued.

“In January this year, the Mental Health section of Princess Alexandra Hospital’s Emergency Department clocked an impressive 1 hour 12 minutes average length of stay,” Kar Ray said. SAFE STEPS will help researchers understand how this was achieved and provide a blueprint for other EDs to replicate the success of Princess Alexandra Hospital.

Finally, a new EMF research investment of $1.3 million to fund 22 projects was revealed on the day. Projects include innovative ways to improve pain management in children, improving management of prisoners with minor orthopaedic injuries, treating diabetic patients, and optimising treatment for patients who call an ambulance for nausea or vomiting. EMF Board Director Associate Professor Luke Lawton said the Foundation’s mission to improve the way people were cared for in a medical emergency underpinned the flavour of its research investment.

“Every day, emergency medicine staff face challenges that need to be overcome to improve patient experiences and outcomes,” Lawton said.

“EMF prioritises research which delivers demonstrable benefits to patients, staff and hospitals, and we educate and support emergency department staff to translate research outcomes into practice.”

Image credit: iStock.com/skynesher