The ECI and NSW Emergency Care - Emergency Care Institute

8Australian trends in ED utilisation and bed availability(2002‐2007). 2007)76543213.462.656.744.76433 4.334.103.802.43 2.47 2.60 2.60 2.6001998-99 2002-03 03 2003-04 04 2004-05 05 2005-06 06 2006-0707ED presentations per year (in millions)Beds available per 1000 pop

Emergency Care InstituteActivities (cont):• Establishing exec and advisory committees,(clinical, research and incident)• Network launch• Web page up; interactive website live nextweek• Partner in Sepsis project• Provision of expert input, advice andguidance on NSW ED‐related projects• Establishing research partnershipsp

MINISTER OF HEALTHACI/CEC BOARDDIRECTOR GENERALECIEXECUTIVE COMMITTEEITTEECLINICAL AD DVISORY COMMIRESEARCH AD DVISORY COMM MITTEEWorking GroupWorking GroupWorking GroupWorking GroupWorking GroupITTEEINCIDENT AD DVISORY COMMNSW Emergency Departments

Emergency Care InstituteAdvisory committees• Clinical: focus on emerging issues, variation ofcare• Incident: rich data available• Research: harness and foster activity• Multidisciplinary, geographically diverse• Co‐chairs appointed• Wider reference groups

Who took part in the ECI survey?Medical Nursing Allied Health Administrative Other5%3%7%33%52%

120010008006004002000To what extent do you agree with the following aims for theECI?Foster communication across all key stakeholdersincluding NSW Health, expert groups, clinicians andconsumers at a state, national and international level.Promote evidence based care and disseminate thisappropriatelyResearch and promote newinnovative solutions tocurrent and future challenges to emergency careincluding new models of care and system developments.Provide a forum for the systematic analysis andassessment of information regarding the quality of care inNSW Emergency Departments.Provide strong leadershipto interest groups andemergency staff on the future direction of emergencycare in NSW.Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree

What respondents felt was missing from the ECI statement ofaims by whether the respondent works in an EDYesNo0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Equitable and adequate resource allocationProvide support and foster staff developmentOtherEnhanced interprofessional and organsiational communication and relationshipsTransparent and meaningful benchmarking e.g resources, staffing, KPIs, standards of careEstablish an interface with the public on role and remit of EDs incl. Alternatives to ED attendancePromote and enhance quality of care and patient experience

Please rate in order of importance the listed challenges below asthey apply to your ED. Please indicate by numbering from 1-5(where 1 is the most important and 5 is the least important)Staff shortages2.29Access block and overcrowding239 2.39Inconsistent clinical expertise of staff2.78Difficulties in getting patients accepted fortransfer3.25Lack of access to education or informationfor clinicians3.790.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0

What respondents believed to be the biggest challenge facingemergency care in NSW at the momentLack of staffAccess blockLack of resourcesLack of access to primary/community careIncreasing demand for servicesLack of education/professional developmentPatient & Public expectationsKPIsHealth bureaucracyInefficient hospital systems/poor communication between …Ageing populationLack of senior cliniciansRural issuesMental HealthVariations in careV&ATransfer of patientsR&RWaiting timesOvercrowdingeMRSuport services only 9-5Poor data/information0 50 100 150 200 250Number of respondents

Oh Other comments provided dby the respondents4%4%4%Positive feedback about establishment ofECI5%28%OtherRegional and rural focus essential8%Stating prioritiesFeedback about actual surveyClarification about involvement10% Highlighting concerns that ECI is notneeded15%Importance of working with otherorganisationsListen to those working in emergency care11%Risk of duplication11%

200180160140120100806040200NSW ED Incident data 2010 for SAC levels 1‐4 by weekNumber of incidents

1200NSW ED Incident data 2010 for SAC levels 1‐4 by day of the week1000800600SAC4SAC3SAC2SAC1No SAC4002000Monday Tuesday Wednesday Thursday Friday Saturday Sunday

1000NSW ED Incident data 2010 for SAC levels 1‐4 by age900800700600500400300SAC4SAC3SAC2SAC1No SAC2001000

300NSW ED Incident data 2010 for SAC levels by time of day250200Axis Title150100No SACSAC1SAC2SAC3SAC4500

30NSW ED Incident data 2010 for SAC levels 1 and 2 by time of day2520Axis Title1510SAC1SAC250

2500NSW ED Incident data 2010 for SAC levels 1‐4 ‐ categorisation200015001000500SAC4SAC3SAC2SAC1No SAC0

NSW: opportunities for EDs• A new approach: all EDs involved with the ECI• A new structure:• Devolution of responsibility to LHDs• The BHI and clinical networks of the ACI• More clinical leadership• Federal access targets• Funding towards Emergency clinical trainingand supervision

Opportunities with ECI• Get involved• Tell us what you want• Collaborate with ihcolleagues across the stateand system• Research and quality projects• Drive the ED agenda

Sally McCarthyMedical Directorsally.mccarthy@aci.health.nsw.gov.auVanessa EvansNetwork Managervanessa.evans@aci.health.nsw.gov.auSophie BaughManager Special Projectssophie.baugh@aci.health.nsw.gov.au