Emergency medicine Australasia : EMA
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Emerg Med Australas · Dec 2019
Knowledge, attitude and practices of clinical quality and performance assessment among emergency medical services personnel in South Africa: A mixed methods study.
Deficits in healthcare quality are becoming an increasing concern globally. Within the low- to middle-income country (LMIC) setting insufficient quality has become a bigger barrier to reducing mortality than insufficient access, where 60% of deaths from conditions amenable to healthcare, are due to poor quality care. Measuring quality is key towards improving the effectiveness of healthcare in this setting. ⋯ Within EMS, quality systems are in their infancy. It could be argued that this is somewhat more pronounced in the LMICs, where knowledge of organisational quality systems was found to be poor. Despite this, there was a strong general understanding of the importance of quality systems, and the role they have to play in this setting.
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Emerg Med Australas · Dec 2019
The Pacific Emergency Medicine Mentoring Program: A model for medical mentoring in the Pacific region.
To describe the development and implementation of a Pacific medical mentoring programme and to evaluate the programme after the first year. ⋯ The present study suggests a new model of Pacific mentoring that recognises the centrality of the mentoring relationship, and allows for flexible communication, shared responsibility of mentors and mentees as co-drivers and a broad understanding of goals and timelines. Future programmes should incorporate funding for in-person meetings and educational opportunities to enhance contextual and cultural understanding. These lessons can inform future medical mentorship programmes across the Pacific.
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Emerg Med Australas · Dec 2019
Gaming National Emergency Access Target performance using Emergency Treatment Performance definitions and emergency department short stay units.
To evaluate potential gaming of the 4 h ED length of stay metric known as the National Emergency Access Target (NEAT) in Australia and Emergency Treatment Performance (ETP) in New South Wales (NSW). ⋯ The opportunity of NEAT may be squandered unless gaming of the definitions and use of ED short stay beds is addressed. We argue that the longstanding issue of 'departure time' should be defined as 'physically leaving' the department, in accordance with the Australasian College for Emergency Medicine (ACEM) definition. Patient occupancy is a real measure of ED resource use and NSW and national recommendations should be adjusted. ACEM accreditation of EDs should include review of their application of NEAT definitions to ensure they truly reflect patient flow processes.
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Emerg Med Australas · Dec 2019
Role and impact of brain computed tomography in the management of drug overdoses and guideline recommendations.
Patients presenting with overdoses commonly receive computed tomography brain (CTB) scans in their assessment. There is no current guideline or validated decision support tool for neuroimaging in overdose patients. We investigated the proportion of overdose patients who received a CTB scan and its impact on management. ⋯ A high proportion of overdose patients received CTB scans. There was only a low yield in terms of management alteration. We propose that clinicians adopt a guided approach using a decision support tool to minimise unnecessary CTB scans.
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Emerg Med Australas · Dec 2019
Impact of electric scooters to a tertiary emergency department: 8-week review after implementation of a scooter share scheme.
A retrospective audit of presentations to a tertiary trauma centre reviewing the demographics of electric scooter injuries in the first 2 months of the scooter-share scheme, which was commenced in Brisbane in November 2018. ⋯ The findings characterised injury patterns and costs associated with electric scooters in our ED. Given the increasing popularity of electric scooters as an alternate form of transportation, our study may help to inform public policy for future injury prevention.