Department of Health & Human Services

2014 Evidence-based care project – Emergency Care Clinical Network

Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. © State of Victoria, February, 2015. Except where otherwise indicated, the images in this poster show models and illustrative settings only, and do not necessarily depict actual services, facilities or recipients of services. This publication may contain images of deceased Aboriginal and Torres Strait Islander peoples. Printed by Digital House, Port Melbourne (1412013)

Project leads: Sue Jackson and Gail Van Summermen

Project team: Jess Hall and Melissa Brosche

In February 2014 the Emergency Care Clinical Network began its sixth round of evidence-based improvement projects in emergency departments. The aim of these projects is to enhance the use of evidence-based care, reduce unwarranted variation in clinical practice and improve consistency of care within emergency departments.

Why this project was important to our emergency department• Increasing number of paediatric patients

• No local pathway in place to guide junior medical and nursing staff in clinical decision making

• Variation in clinical practice

• To develop a consistent approach to the management of fever in children

• To build staff confidence in managing fever in children.

What we did• Consulted with the medical director of the emergency department and the paediatric consultant at

Pennisula Health

• Gained information from parents about their child’s recent presentation to the emergency department

• Developed and implemented a traffic light tool and pathway

• Developed and displayed posters about the project in the department

• The Medical director provided education to new and existing medical staff on a regular basis

• Provided education to 28 staff members through four formal education sessions.

Our results • The proportion of children with fever managed according to a local pathway increased from

0 per cent to 100 per cent

• The proportion with a formal risk assessment did not change

• The proportion with one full set of vital sign observations did not change

• The proportion without an identified focus referred for early review increased significantly from 11 per cent to 78 per cent.

What we learnt about improving quality of care • Engaging clinical staff in the project contributed to its success

• Frequent education, ward meetings and posters were great reminders for all staff

• The chart was initially not very user friendly, which meant additional time was needed between updating the chart and reintroducing it

• Keeping pace with changes in the evidence is important during the project

• Frequent changeover of staff increases the need for constant education.

Impact on patients, staff and the health system • Patients receive evidence-based care

• Increased staff confidence in managing children with fever

• Use of the tool and pathway increased consistent care for children

• Local improvement spread and has been implemented at the other hospital in our health service.

Rosebud Hospital Emergency Department

Improving the management of fever in children aged five years or under

A2 Rosebud (fever in Children) ECCN storyboard poster V1.indd 1 16/02/2015 12:15 pm