IMPROVING EMERGENCY TRAINING

AND QUALITY ASSURANCE CAPACITY

USING http://www.alphastudy.com

Category 5 – Making Smart Choices

Michael Dinh, Jon Hayman, Kendall Bein,

David Dinh, Timothy Tan

RPAH Emergency DepartmentNSW Institute of Medical Education and Training

Aims

� Demonstrate an online Web 2.0 collaborative learning

and quality management tool

� Design and develop

� Implement

� Evaluate� Evaluate

� Improve training and quality assurance capacity in an

emergency department

The problem – quality & knowledge

management capacity

� Large mobile workforce

� Secondments

� Shift work

� Staff turnover� Staff turnover

� Training networks

� State-wide Emergency training networks

� Training capacity in Regional NSW

� Quality assurance capacity

� Surveys, audit tools

� Research

� E-learning

Strategic importance

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Planning & implementing solutions –

http://www.alphastudy.com

• Easy to use online Web 2.0 tool

– Independent workspaces within secure

domain

– Content management– Content management

– Surveys, audits, research

– Online learning modules

– Discussion forums

– Networking

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OUTCOMES – a better way to integrate

knowledge and quality managementknowledge and quality management

Uses at Royal Prince Alfred Hospital Emergency

Department

• E-learning modules

• Protocol audits

• Virtual Journal Club

• Research studies

Clinical handover assessments• Clinical handover assessments

• Triage credentialing

• CME assessments

• Fellowship exam resources

• ED activity dashboard

• Stream online presentations

Audit: Clinical Handover

� Assess clinical handover

� 1:7 patients significant issues not handed over

� Implementation of integrated handover

� 73% decrease in incidence of handover/ward transfer

IMMS 2008-2009IMMS 2008-2009

National Research Surveys

� Ultrasound use and credentialing in Australian

Emergency Departments

Knowledge sharing – current VJC users

� Royal Prince Alfred

Hospital

� Canterbury Hospital

� Bankstown Hospital

Liverpool Hospital

� Gosford Hospital

� John Hunter

� Lismore Base

The Canberra� Liverpool Hospital

� St George Hospital

� St Vincents Hospital

� Westmead Hospital

� The Canberra

� Shoalhaven

� Royal Melbourne

� Nambour

� Tweed Heads

Closing the evidence-practice gap using quality

management approach

� Code crimson adopted and implemented 2008

� Critical incident April 2009

� Audit: Knowledge of key protocols = 67%

� E-learning module – improved to 90% (p=0.002)

When would you contact the consultants on call?

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40

60

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100

120

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Use

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ts

(%) Before

After

Real time quality management – the ED

activity dashboard

� AO shift handover report

� Automated messaging

PROLONGED STAY

ICU PT

5%

ADMISSION

DECISION

6%

INTERESTING

CASE

6%

EQUIPMENT/SUP

PLY

11%

RADIOLOGY

11%

ACCESS

BLOCK

IMPAIRING ED

FUNCTION

17%

PATIENT

ABSCONDING

22%

MENTAL HEALTH

22%

Breakdown of issues identified

n=18

Evaluation – the lessons learnt

� Formal evaluation conducted October 2009-2010

� Usage, usability analysis

� 54 site users

Evaluation – the lessons learnt

88% agreed or strongly agreed that

alphastudy had improved education and

training at RPAH emergency department

Evaluation – the lessons learnt

Benefits

�Improved QA/research capability

�Improved outcomes

Knowledge sharing and networks�Knowledge sharing and networks

�Low cost/low maintenance

�Scalable

�In house development

Transferability and Future Scope

� System enhancements

� Semantic search engine and ranking algorithm

� Better surveys and quiz templates

� Easier use

� Live video streaming, web conferencing� Live video streaming, web conferencing

� NSW IMET

� Digital Regions Initiative/National Broadband Network

� Emergency online training and simulation

� Streaming presentations and sharing case discussions

� Improve medical training in regional NSW

Emergency Training Networks – local hubs,

knowledge sharing and live feeds

http://www.alphastudy.com

Instant sign-up�Instant sign-up

�Web enabled online service

�Low cost affordable solution

�Instant learning & knowledge portals

�Fast and simple to use