Emergency Department Models of Care 2012 - NSW Health

Executive SummarySince the publication in 2006 of the ‘Emergency Models ofCare’ document for NSW Hospitals, the acceptance andimplementation of emergency care models have broadened.This has been coupled with the creation of new models toassist Emergency Departments (ED) to provide safe andtimely access to emergency care. Six years later,PricewaterhouseCoopers has been engaged to, inconsultation with the NSW Ministry of Health (NSW Health),the Emergency Care Institute and the community of thoseinvolved in Emergency Care, revise this document.■Complete a self-assessment of each relevant MOC toidentify opportunities for improvement within their ownhospitals, as well as to identify key areas that requireongoing monitoring for their effectiveness.After considering the components of each model, the EDand hospital should have a clear understanding of how themodel works, what data is required to demonstrate a needfor the model, key factors required to implement the modeland measures to assess the model’s effectiveness.In 2011, NSW Health carried out a review to discover whatcurrent models of care (MOC) are in place in EDs and theeffectiveness of these models for managing demand fortheir services. The review identified challenges faced by EDsin the operation of current models, key principles requiredfor models to operate effectively and monitoring measuresfor ongoing review and quality improvement. The reviewalso aimed to create a standardised suite of models of careto assist hospitals to provide access to timely, safe andquality emergency care and to meet the NationalEmergency Access Target.Based on this review and our consultations, this revisedModels of Emergency Care Document (the Document)includes ten Emergency Department models of care and anumber that are external to the ED and support thehospital in managing demand for emergency care. Eachmodel has been designed to facilitate the ideal patientjourney through ED.The Document includes models that are likely to be in placein EDs currently and require revision, as well as those thathave been newly developed in NSW. It is intended thatHospital Executives and the ED use the Document to:■■Assess the current Models of Care in their EmergencyDepartments using the given criteriaAssess the potential to introduce models to theirhospitals that may improve patient care and flow, thepatient experience and clinical outcomesThe Document also describes the benefits and challengesexperienced by EDs who have previously introduced theseModels of Care. Reflecting on these lessons, the hospitaland ED can plan accordingly for a model’s implementationin their own location. A ‘case for implementation’ is givenfor each MOC which will enable the ED and hospital toaddress key questions related to the need forimplementation, and hence improve decision-making forplanning and implementation.Created to support this document is a self-assessment toolfor each Emergency Model of Care. The purpose of the toolis to allow Local Health Districts to assess if a MOC isappropriate for their ED or if an implemented MOC isfunctioning to its utmost potential. The tool is intended tobe used at an ED level in a collaborative approach with allkey stakeholders.The Self-Assessment tool rates the effectiveness of eachmodel. Results of the self-assessment are then linked toresponses based on the key principles described for eachMOC. A robust evaluation of each model can be used togenerate an action plan for an ED to improve thefunctioning of current Models of Care being used, or toconsider the implementation of new models.It is recognised that not all of the Models of EmergencyCare are applicable for all NSW Emergency Departments.Decisions to implement them will be made based on thestaff, patient presentations and space available in the ED tooperate each model.PAGE 2 NSW HEALTH Models of Emergency Care