Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2019
Aligning ambulance dispatch priority to patient acuity: A methodology.
In Victoria, Australia, Emergency Medical Service (EMS) demand has increased almost 5% per annum over the past 5 years. This may adversely affect response times to time-critical patients. Additionally, >55% of cases have received Code 1 (lights/sirens) responses. Primary telephone triage occurs using the Medical Priority Dispatch System (MPDS); however, MPDS is reported to be highly sensitive, with common over-triage. The present study describes the methodology applied to better align the response allocated to MPDS determinant codes with patient acuity. ⋯ Analysis of a large EMS dataset supported changes to the EMS response priority for a number of MPDS determinant codes. Such changes should improve the alignment between EMS response and patient acuity, and improve response times to time-critical patients. Other EMS with electronic data could consider testing this methodology.
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Emerg Med Australas · Jun 2019
Observational StudyExamining emergency department inequities: Do they exist?
Ethnic inequities in health outcomes have been well documented with Indigenous peoples experiencing a high level of healthcare need, yet low access to, and through, high-quality healthcare services. Despite Māori having a high ED use, few studies have explored the potential for ethnic inequities in emergency care within New Zealand (NZ). Healthcare delivery within an ED context is characterised by time-pressured, relatively brief, complex and demanding environments. When clinical decision-making occurs in this context, provider prejudice, stereotyping and bias are more likely. The examining emergency department inequities (EEDI) research project aims to investigate whether clinically important ethnic inequities between Māori and non-Māori exist. ⋯ The present study will provide the largest, most comprehensive investigation of ED outcomes by ethnicity to date in NZ.
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Emerg Med Australas · Jun 2019
Observational StudyImpact of acutely behavioural disturbed patients in the emergency department: A prospective observational study.
The present study describes patients with acute behavioural disturbance presenting to the ED, the impact they have on the department and any complications that occur. ⋯ Patients with acute behavioural disturbance often have a history of mental illnesses and are commonly intoxicated. These patients have impacts on healthcare resources and pose risks to staff safety, but significant complications to patients do not occur frequently.
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Emerg Med Australas · Jun 2019
The Sydney Triage to Admission Risk Tool (START2) using machine learning techniques to support disposition decision-making.
To further develop and refine an Emergency Department (ED) in-patient admission prediction model using machine learning techniques. ⋯ Machine learning methods demonstrate similar performance to logistic regression for ED disposition prediction models using basic triage information. This should be investigated further, especially for larger data sets with more complex clinical information.
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Emerg Med Australas · Jun 2019
Effective triage in the Pacific region: The development and implementation of the Solomon Islands Triage Scale.
The ED at the National Referral Hospital in Honiara, Solomon Islands, receives approximately 50 000 patients per year. A 2014 review of ED functioning identified deficiencies in triage processes. Placement of Australian volunteer advisors provided an opportunity to develop and implement a purpose-designed triage system. ⋯ Solomon Islands Triage Scale is the first three-tier triage scale to be implemented in the Pacific region and appears to have adequate validity and reliability. The partnership between Australian volunteers and local clinicians is a positive example of capacity development and represents a model that could be implemented in other resource-limited settings.