This document provides an agenda for a two-day conference on emergency department management. Day one focuses on developing new models for patient classification and costing, improving patient flow, workforce planning, and programs to avoid hospital admissions. Speakers will discuss the International concept of "Left to Right, Over and Under" to improve patient flow, and developing graduate nurse programs. Day two focuses on improving safety, managing overcrowding and aggression, integrating mental health services into emergency departments, and new models of police response for mental health crises. The conference aims to explore innovations and partnerships to enhance patient safety, flow and outcomes in emergency care.

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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