Emergency medicine conference highlights

Media release
Emergency medicine conference highlights

Thursday 24 November, Millennium Hotel, NZ

From tragedy to telehealth – one NZ doctor’s journey

An event 16 years ago changed Dr Ruth Large’s life forever.

She was working as a young doctor in a remote settlement in Far North Queensland when a very sick infant was brought into her clinic.

“She needed specialist emergency treatment but we couldn’t give it to her,” Dr Large says. “Very sadly, she died.”

The event drove Dr Large to become an emergency medicine physician. It also prompted her to begin exploring the potential of telehealth, which uses technology to deliver medical care and education over long distances.

Today Dr Large is Clinical Director for Virtual Health at Waikato District Health Board (DHB). She will be chairing a virtual healthcare session at 1.30pm on Thursday 24 November, looking at where the field stands currently in Australia and New Zealand and how it might develop in the future.

For Dr Large, two main benefits of telehealth have emerged.

“The first is that telehealth can help address the shortage of qualified emergency medicine doctors in remote areas, both in NZ and Australia,” she says. “The other is that telehealth eliminates the need for a trainer to be physically present with the students, so it can make it much easier to deliver medical education.”

Both these areas – and others – are developing rapidly because the technology has reached a tipping point, she says.

“Audio visual (AV) platforms now are cheap and easy to use,” Dr Large says, “Combine this with the spread of broadband and the opportunity to do things like access a patient’s notes digitally and the potential for telehealth is obvious.”

Dr Large is currently involved with a number of pilot studies in Waikato, including a virtual acute clinic and a smartphone app that links patients and medical staff with specialists.

“We’ve set a target of having 30% of our patient contact be virtual by mid-2017,” Dr Large says. “It’s an ambitious target but thanks to strong support and financial investment from the DHB we’re on our way.”

When leadership counts – EM training in the Pacific

Emergency medicine in the Pacific took a huge step forward in June of this year.

That was when the first dedicated regional Emergency Medicine Leadership Workshop was held in Fiji.

At 11.30am on Thursday 24 November Melbourne-based emergency medicine physician Dr Georgina Phillips will tell the conference why this event was so significant.

“This was the first time that new and experienced emergency medicine leaders from Fiji, PNG, Solomon Islands, Kiribati, Samoa and Tonga – along with visiting Fellows of the Australasian College for Emergency Medicine (FACEMs) – had come together,” says Dr Phillips.

Using the ACEM Leadership Framework, participants learnt new skills, enhanced their knowledge and began the creation of a regional EM support network.

“This was a momentous event for EM in the Pacific, but it was also just the beginning,” says Dr Phillips.

Six-hour hospital target associated with fewer deaths in emergency departments

New research shows that New Zealand’s six-hour emergency department target was associated with a reduction in crowding in emergency departments by half.

The target – which aims to limit the amount of time people stay in hospital emergency departments – was also associated with hundreds of fewer patients dying, compared to predictions if pre-target trends had continued.

Director of Emergency Medicine at Auckland City Hospital, Dr Peter Jones, and University of Auckland researcher Linda Chalmers co-led an investigation into the effects of the mandatory six-hour national target on patient outcomes with the support of a $1.1 million project grant from the Health Research Council of New Zealand (HRC).

The study examined various indicators of quality of patient care in 18 of New Zealand’s 20 district health boards (DHBs) over a period of seven years (2006–2012), and included an in-depth investigation of four hospitals.

“We found that the introduction of the six-hour target was associated with a substantial 50 per cent reduction in the number of patient deaths in emergency departments,” said Dr Jones, “That’s about 700 fewer deaths than predicted if pre-target trends had continued. This result mirrors the 50 per cent reduction in emergency department crowding,”

“There was also no increase in deaths on the wards, so there was no evidence that the observed reduction was due to ‘shifting’ deaths to elsewhere in the system.”

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