NSW Emergency Department workforce research project and workforce analysis tool
1
Conference Abstracts 137 Hold onto your seats as I explore the machina- tions behind dealing with those few ‘Difficult’ Emer- gency/Medical/Surgical Doctors the Emergency team have to deal with on a regular basis. I will look at how to manage a lack of Medical leadership and how to stop repeat offend- ers. I will suggest who you need to report issues to resolve ongoing issues. This is not a Doctor bashing session, but a look at how to deal with these stressful events. I will leave the audience with some strategies for these ‘‘infrequent’’ events.... Keywords: Leadership; Emergency Department; Coping strategies doi:10.1016/j.aenj.2010.08.264 Descriptive analysis of Emergency Department oxygen use in acute exacerbation of COPD Julie Considine , Mari Botti b,c , Shane Thomas d a Deakin University-Northern Health Clinical Partnership, c/- School of Nursing, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125, Australia b School of Nursing, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125, Australia c Epworth-Deakin Centre for Clinical Nursing Research, Aus- tralia d Primary Health Care Research Unit, Monash University, Clayton 3168, Australia E-mail address: [email protected] (J. Considine). Inconsistencies in oxygen therapy recommendations in acute exacerbation of COPD may result in variability in ED oxygen management of patients with COPD. The aim of this study was to describe oxygen management in the first 4 h of emergency department (ED) care for patients with exacerbation of COPD. A retrospective medical record audit was conducted at four public and one private ED in Mel- bourne, Australia. Participants were 273 adult ED patients with COPD presenting with a primary complaint of shortness of breath from July 2006 to July 2007. Outcome measures were physiological data including oxygen saturation (SpO2), oxygen delivery devices and flow rates on ED arrival, 1 h and 4 h. Oxygen was used in 82.0% of patients. Patients who required oxygen had higher incidence of ambulance transport (p < 0.001), triage category 2 (p = 0.006), home oxygen use (p < 0.001), and increased work of breathing on ED arrival (p < 0.001), and higher median respiratory rate (p < 0.001) and heart rate (p = 0.001). SpO2 > 90% occurred in the majority of patients (87.5%; 96.4%; 95.6%) however a considerable number of patients with SpO 2 < 90% were not given oxygen (61.8%; 30%; 45.5%). A number of patients with documented hypoxaemia were not given oxygen and there may be variables other than oxygen saturation may influ- ence oxygen use. Future research should focus on increasing the evidence-base supporting oxygen use and better under- standing of clinicians’ oxygen decision making in patients with COPD. Funding: This project funded by a Deakin University Fac- ulty Research Grant. doi:10.1016/j.aenj.2010.08.265 NSW Emergency Department workforce research project and workforce analysis tool Jenny Morris , Anne Hawkins b , Antoinette Borg c a WDI Branch, NSW Health Department, Locked Mail Bag 961, North Sydney, NSW 2059, Australia b Greater Southern Area Health Service, 22 Gormly Ave, Wagga Wagga, NSW 2650, Australia c St George Hospital, Gray St, Kogarah, NSW 2217, Australia E-mail addresses: [email protected] (J. Morris), [email protected] (A. Hawkins), [email protected] (A. Borg). Introduction: As demand for emergency services grows worldwide, access to sufficient, appropriately skilled peo- ple to deliver care and provide the needed support to the patient journey is central to delivering services to meet demand. NSW Health undertook an Emergency Department Workforce Research Project with the aim of providing an evidence-based process to address ED skill mix. Methodology: The project was undertaken in several phases. The diagnostic phase included a national and inter- national literature review, data collection from a sample of 13 NSW EDs through structured interviews, activity mapping, and reviewing staff profiles and state-wide ED data analy- sis. The solution-design phase developed a set of ED staffing skill mix principles and guidelines (P&Gs) based on results of the diagnostic phase. The P&G were tested and applied in 4 NSW EDs. The final implementation phase will begin 2010/11. Results: A scenario framework was developed to iden- tify ED profiles and assist in building staffing profiles. The key components of the framework included identified drivers of ED characteristics (remoteness, activity and com- plexity), education, models of care and skills profile. To support the framework, skill mix P&Gs were created and tested through a Workforce Analysis Tool. The tool is a practical guide which enables EDs to apply the P&Gs inde- pendently and develop a workforce plan to address any variances. Conclusions: The project has provided NSW EDs with a tool that can provide a consistent approach to analy- sis of current workforce and facilitate application of the evidenced-based P&Gs at a local level. Keywords: ED skill mix; Models of care; Workforce analysis doi:10.1016/j.aenj.2010.08.266 Presented on behalf of NSW Health Department, Pricewater- houseCoopers and the Emergency Department Workforce Reference Group.
-
Upload
jenny-morris -
Category
Documents
-
view
215 -
download
1
Transcript of NSW Emergency Department workforce research project and workforce analysis tool
u
d
Na
J
a
Nb
Wc
EAA
wpttDpm
pn1assoi2
tTdpstppv
asevidenced-based P&Gs at a local level.
Keywords: ED skill mix; Models of care; Workforce analysis
doi:10.1016/j.aenj.2010.08.266
Conference Abstracts
Hold onto your seats as I explore the machina-tions behind dealing with those few ‘Difficult’ Emer-gency/Medical/Surgical Doctors the Emergency team haveto deal with on a regular basis. I will look at how to managea lack of Medical leadership and how to stop repeat offend-ers. I will suggest who you need to report issues to resolveongoing issues.
This is not a Doctor bashing session, but a look at how todeal with these stressful events.
I will leave the audience with some strategies for these‘‘infrequent’’ events. . ..
Keywords: Leadership; Emergency Department; Copingstrategies
doi:10.1016/j.aenj.2010.08.264
Descriptive analysis of Emergency Department oxygen usein acute exacerbation of COPD
Julie Considine, Mari Botti b,c, Shane Thomasd
a Deakin University-Northern Health Clinical Partnership,c/- School of Nursing, Deakin University, 221 Burwood Hwy,Burwood, Victoria 3125, Australiab School of Nursing, Deakin University, 221 Burwood Hwy,Burwood, Victoria 3125, Australiac Epworth-Deakin Centre for Clinical Nursing Research, Aus-traliad Primary Health Care Research Unit, Monash University,Clayton 3168, Australia
E-mail address: [email protected] (J. Considine).
Inconsistencies in oxygen therapy recommendations inacute exacerbation of COPD may result in variability in EDoxygen management of patients with COPD. The aim ofthis study was to describe oxygen management in the first4 h of emergency department (ED) care for patients withexacerbation of COPD. A retrospective medical record auditwas conducted at four public and one private ED in Mel-bourne, Australia. Participants were 273 adult ED patientswith COPD presenting with a primary complaint of shortnessof breath from July 2006 to July 2007. Outcome measureswere physiological data including oxygen saturation (SpO2),oxygen delivery devices and flow rates on ED arrival, 1 hand 4 h. Oxygen was used in 82.0% of patients. Patientswho required oxygen had higher incidence of ambulancetransport (p < 0.001), triage category 2 (p = 0.006), homeoxygen use (p < 0.001), and increased work of breathing onED arrival (p < 0.001), and higher median respiratory rate(p < 0.001) and heart rate (p = 0.001). SpO2 > 90% occurredin the majority of patients (87.5%; 96.4%; 95.6%) howevera considerable number of patients with SpO2 < 90% were notgiven oxygen (61.8%; 30%; 45.5%). A number of patients withdocumented hypoxaemia were not given oxygen and there
may be variables other than oxygen saturation may influ-ence oxygen use. Future research should focus on increasingthe evidence-base supporting oxygen use and better under-standing of clinicians’ oxygen decision making in patientswith COPD.hG
137
Funding: This project funded by a Deakin University Fac-lty Research Grant.
oi:10.1016/j.aenj.2010.08.265
SW Emergency Department workforce research projectnd workforce analysis tool�
enny Morris, Anne Hawkinsb, Antoinette Borgc
WDI Branch, NSW Health Department, Locked Mail Bag 961,orth Sydney, NSW 2059, AustraliaGreater Southern Area Health Service, 22 Gormly Ave,agga Wagga, NSW 2650, AustraliaSt George Hospital, Gray St, Kogarah, NSW 2217, Australia
-mail addresses: [email protected] (J. Morris),[email protected] (A. Hawkins),[email protected] (A. Borg).
Introduction: As demand for emergency services growsorldwide, access to sufficient, appropriately skilled peo-le to deliver care and provide the needed supporto the patient journey is central to delivering serviceso meet demand. NSW Health undertook an Emergencyepartment Workforce Research Project with the aim ofroviding an evidence-based process to address ED skillix.Methodology: The project was undertaken in several
hases. The diagnostic phase included a national and inter-ational literature review, data collection from a sample of3 NSW EDs through structured interviews, activity mapping,nd reviewing staff profiles and state-wide ED data analy-is. The solution-design phase developed a set of ED staffingkill mix principles and guidelines (P&Gs) based on resultsf the diagnostic phase. The P&G were tested and appliedn 4 NSW EDs. The final implementation phase will begin010/11.
Results: A scenario framework was developed to iden-ify ED profiles and assist in building staffing profiles.he key components of the framework included identifiedrivers of ED characteristics (remoteness, activity and com-lexity), education, models of care and skills profile. Toupport the framework, skill mix P&Gs were created andested through a Workforce Analysis Tool. The tool is aractical guide which enables EDs to apply the P&Gs inde-endently and develop a workforce plan to address anyariances.
Conclusions: The project has provided NSW EDs withtool that can provide a consistent approach to analy-
is of current workforce and facilitate application of the
� Presented on behalf of NSW Health Department, Pricewater-ouseCoopers and the Emergency Department Workforce Referenceroup.
