Novel solutions sought as hospitals grapple with patient flow issues

With demand for emergency department (ED) services in Australia growing rapidly and wait times increasing, a $1.3 million research boost has been granted that aims to improve patient care in a medical emergency.

Emergency Medicine Foundation (EMF) Chair Professor Hugh Grantham said demand for ED services in Australia had outpaced population growth since 2011-12, resulting in more than 8.8 million ED patient presentations in 2022-2023.

“Without research and novel solutions to this complex issue, our hospitals will continue to struggle under increasing pressure and patients will suffer,” Prof Grantham said.

In addition to the EMF-funded major investigation into barriers to effective patient flow in Queensland’s public hospitals, 22 new emergency medicine projects will be launched at EMF Grants Award Ceremony.

These projects will include innovative ways to improve pain management in children, treating diabetic patients and optimising treatment for patients who call an ambulance for nausea or vomiting.

EMF-funded research projects have proved both effective and wide-reaching, with a recent mental health study projected to save the Australian health system $30 million.

The SAFE STEPS project aims to prevent mental health patients reaching crisis point and requiring a visit to ED with possible hospital admission.

Associate Professor Manaan Kar Ray, Divisional Director (Mental Health), Princess Alexandra Hospital said busy EDs were ill-suited for patients with mental health challenges, but during a crisis there were few alternatives for rapid assessment and support.

“Each year, an increasing number of mental health patients receive better support in the community and have been successfully diverted away from EDs,” A/Prof Kar Ray said.

“Without early detection and enhanced community support, a large proportion of these patients would have needed an inpatient stay.”

While demand is a contributing factor, EDs are currently being impacted by various factors across the entire healthcare system.

Prof Grantham said bottlenecks triggered by uneven patient flow often caused delays in hospital admissions, but long wait times for hospital beds did not begin and end in the ED.

“Ambulance ramping and ED overcrowding are symptoms of complex whole-of-health issues,” Prof Grantham said.

“The issue of system-wide delays from triage to admission to treatment and discharge is one of the Australian healthcare system’s most challenging problems and it severely impacts vulnerable patient groups, including aged care and mental health patients.”

Early results from EMF’s flagship patient flow project show obstacles to efficient treatment and discharge are caused by bottlenecks throughout the system.

The Study on Patient Flow in Queensland’s Public Hospitals project is conducted by a research team comprising experts from CSIRO – Australia’s national science agency, Queensland Health, University of Queensland, and Queensland Ambulance Service. Researchers are analysing data from 25 of Queensland’s largest public hospitals over six years.

“These issues result in long ED wait times and new research shows improving patient flow requires whole-of-system solutions,” Prof Grantham said.

“Researchers have found most efforts to improve patient flow focused on ED efficiencies but interventions for the remainder of the patient journey were largely neglected. We need to ensure there are initiatives to improve patient flow pre-ED, within-ED, and post-ED.”

Ritchelle Drilon

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Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.

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