Emergency Department Management Conference

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CONFERENCE DAY ONE: Wednesday 20 July 2016
8:30 Registration & Coffee
9:00 Opening Remarks from the Chair
A/Professor Ian Scott, Director, Internal Medicine & Clinical Epidemiology, Princess Alexandra
Hospital, Brisbane; Associate Professor of Medicine, University of Queensland
9:10 Developing the New Australian Emergency Care Classification
 Work completed so far
 Early results on national costing study
 Development plan & timeline
James Downie, Acting CEO, Independent Hospital Pricing Authority (IHPA)
9:50 INTERNATIONAL ADDRESS | The 'Left to Right, Over & Under' Concept - A Comprehensive
Approach to Improving Patient Flow in Hospitals
 The problem - Demand & capacity mismatch, queues, overcrowding & the 'spiral of doom'
 The solution - A well governed, comprehensive & prioritised programme of work
 A model solution - The 'Left to right, over & under' concept, incorporating the patient journey,
an overarching governance & an underpinning operation structure
Professor Michael Ardagh, Professor of Emergency Medicine, University of Otago; Specialist in
Emergency Medicine, Christchurch Hospital
10:30 Morning refreshments and networking
11:00 In Search of the Most Efficient & Safest Patient Flow for Acute Patients Presenting to ED
A/Professor Ian Scott, Director, Internal Medicine & Clinical Epidemiology, Princess Alexandra
Hospital, Brisbane; Associate Professor of Medicine, University of Queensland
11:40 Clinical Governance & The Art of Clinical Decision-Making - Are We as Clinicians Losing
Perspective in Modern Patient Management?
Dr Dewald Behrens, Emergency Physician, Modbury Emergency Department, Modbury Hospital
12:20 Lunch and networking break
1:20 Who Do We Need in ED? Who Can Tell Us?
 ED staffing models are historical which creates a "resource lag phenomenon & may not produce
best fit"
 National & international workforce guidelines are difficult to translate to individual departments
 Australian Guidelines now available allows increased potential tailored solutions using concepts
such as workforce output & integration of queueing theory
 This will be reviewed, explored & discussed
Dr Neil Grant, Clinical Director, The Prince Charles Hospital Adult Emergency
2:00 Developing a Supportive New Graduate Program for Newly Registered Nurses in the ED
Penny Kooyman, Nurse Educator, Nurse Education & Development Centre, St Vincent's Hospital

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2:40 A Clean Sheet - Or Is It?
 Opening a new ED
 Managing change
 Evolving solutions
 Investigating innovations
 What can you learn from our experience?
Dr Matt Summerscales, Head of Department, Emergency Department, St John of God Midland Public
& Private Hospitals
Dr Michèle Geneviève MBBS FACEM, Head of Department, Emergency Department, St John of God
Midland Public & Private Hospitals
3:20 Afternoon Tea & Networking
3:50 The Aged Care Rapid Response Team (ARRT) - A Review of Hospital Avoidance Programs for
Older People
 Discussion of the risks of hospitalisation for older people
 A review of the evidence for hospital in the home services for older people
 Description of the ARRT model of care operating in Northern Sydney Local Health District
Dr James Hardy, Staff Specialist Geriatrician, Aged Care Department, Royal North Shore Hospital
4:30 GEDI - Overcoming the Discombobulation
Dr Elizabeth Marsden, Emergency Staff Specialist, Consultant lead Geriatric Emergency Department
Intervention (GEDI), Nambour General Hospital, Sunshine Coast Hospital & Health Service
Queensland
Andrea Taylor, Clinical Nurse GEDI, Nambour General Hospital, Sunshine Coast Hospital & Health
Service Queensland
5:10 Closing Remarks from the Chair followed by Networking Drinks

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CONFERENCE DAY TWO: Thursday 21 July 2016
8:30 Registration & Coffee
9:00 Opening Remarks from the Chair
Dr Dewald Behrens, Emergency Physician, Modbury Emergency Department, Modbury Hospital
9:10 National Standards & Patient Safety – Are We on the Right Track?
 The National Standards have grown from the patient safety movement & promised huge
reductions in patient harm which has not been delivered
 It is time to reframe our approach & medical staff need to be involved
 This is a look at the Standards from a resilience engineering perspective & an introduction to
safety II concepts
 How do we apply this to the ED?
Dr Stephen Gourley, Director Emergency Medicine, Alice Springs Hospital ED, Central Australia
Health Service, Northern Territory Government
9:50 Risk Insights & Patient Safety Issues in Emergency Medicine
 Major challenges in ED which contribute to patient harm & adverse events include – Missed/
delayed diagnosis, poor communication, traditional structure/ culture, human factors, junior
clinicians supervision & poor discharge planning
 What are the innovations & patient safety strategies which could assist administrators &
clinicians identify & work together to address these failings & improve patient safety in ED
 How can a State Insurer such as the VMIA support a health service or services around patient
safety issues in ED
Ursula Harrisson, Risk Advisor – Medical Indemnity, Victorian Management & Insurance Authority
10:30 Morning Tea & Networking
11:00 Improving ED Flow & Safety with a Multimodal Hospital-Wide Intervention
Professor Drew Richardson, Staff Specialist in Emergency Medicine, Canberra Hospital & Health
Services; Chair of Road Trauma & Emergency Medicine, Australian National University Medical
School
11:40 Towards Zero Harm in the Emergency Environment – A Challenge in the Face of a Dynamic
Ever Changing Acute Care Model
 How safe is your ED?
 Where are your risks?
 What are the tools?
 Getting the right data
 What resources are needed?
 Who leads the journey towards a safer ED?
Kylie Stark, Nurse Manager Emergency, Sydney Children's Hospital Randwick
12:20 Lunch & Networking

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1:20 Initiatives for Managing Aggression within ED's
 Collaboration between departments with ED/ Protective Services Liaison Roles for efficient
communication & interaction
 Flexible occupational violence prevention training & ongoing support from Occupational
Violence Prevention Services
 Utilising technologies to track, record & prevent aggression within the ED
Lita Olsson, Clinical Nurse Consultant, Department of Emergency, Metro North Hospital & Health
Service
Craig Roudenko, OVP Officer, Occupational Violence Prevention Services, Metro North Hospital &
Health Service
2:00 A New Integrated Model of Care for ED Mental Health Patients
 The model is ED based with Mental Health Liaison based in ED
 All medical staff undergo mental assessment training (created by us)
 Patients are primarily seen by ED staff, risk stratified, basic mental health & medical screen
 Patients not needing mental health review are managed by ED
 Improvements in DNWs & NEAT
Dr Chris May, FACEM, Eminent Staff Specialist, Redland Hospital
2:40 Afternoon Tea & Networking
3:00 Improving Mental Health ED Flow - A Partnership Approach
 Working with frontline staff we designed, piloted & implemented strategies to manage peak
demand & improve the way patients move through our acute service, during winter in 2015
 Over 20 initiatives were rolled out & embedded in inpatient & community mental health teams,
resulting in a reduction in overall average length of stay, mental health patients waiting more
than 24 hours & the number of mental health patients staying on an acute ward for longer than
35 days
 Explore how these partnerships expedite & create sustainable improvement
Dr Kathryn Zeitz, Director Strategic Operations, Mental Health Directorate, Central Adelaide Local
Health Network - SA Health
Dr Tim Fontaine, Partner, McKinsey & Company
3:40 PARTS - Police Acute Response & Triage Service - "Leading Mental Health Services in a New
Direction"
 Providing a more timely response
 Reducing ED presentations
 Providing MH assessments & immediate referral
 Reframing police interventions
 Increasing emergency services capacity for mental health
 Building community trust & alliance
Cathy Cooper, Senior Mental Health Clinician, Eastern Health
4:20 Closing Remarks from the Chair
4:30 Close of the Conference