Research projects
MERC researchers are clinicians, scientists and academics. They work on ground-breaking research while providing emergency care services across the Emergency Departments of Monash Health sites. Currently, the following research projects are being undertaken:
Geriatrician led model of care for high COVID-19 risk older patients in the Emergency Department
Aim:
- to evaluate the impact of a geriatrician embedded in the ED, on outcomes of admission, diversion, management of delirium and falls risk, medication review and communication with families and carers of older patients who are managed as high risk of COVID-19
- to evaluate patient, carer and ED staff satisfaction on having targeted geriatric assessment early in the patient journey.
Investigators: Dr Helen Psihogios, Dr Sumitha Bhaskaran, Prof Barbara Workman
Has covid-19 pandemic lock-down in Melbourne affected overdose and mental health problem presentation rates, severity and epidemiology in adolescents presenting to Monash Health EDs? A retrospective audit
Aim: to compare overdose and mental health presentation rates, severity and epidemiology in adolescents presenting to MH EDs in two comparable periods in 2019 and 2020.
Investigators: Dr Nicola Rodd, Prof Andis Graudins
Has covid-19 pandemic lock-down in Melbourne affected overdose and mental health problem presentation rates, severity and epidemiology in older adults (> 60 years), presenting to Monash Health EDs? A retrospective audit
Aim: to compare overdose and mental health presentation rates, severity and epidemiology in older adults (>60 yo) presenting to MH EDs in two comparable periods in 2019 and 2020.
Investigators: Dr Joel Kuan, Prof Andis Graudins
An evaluation of using high physical resemblance PPE in training health care workers to ensure task fidelity
Aim: to evaluate the feasibility and logistics of a trial crowd sourcing of high physical resemblance PPE for use in training health care workers (HCW) in the application and removal of PPE. If the product received is approved for use, the efficacy of the use of the high resemblance PPE in training will be compared with training using no equipment.
Investigators: Prof Diana Egerton-Warburton and Suzanne Bumpstead
Audit of PPE Application and Removal
Aim: i) to evaluate the efficacy of translation of the PPE training provided (both standard and high physical resemblance PPE) into correct practice of application and removal of PPE in the workplace, ii) to identify any areas of risk in emergency department HCW practice of applying and removing PPE in the workplace.
Investigators: Prof Diana Egerton-Warburton and Suzanne Bumpstead
Audit of COVID-19 Infections: Clinical Characteristics and Outcomes at PREDICT Sites
Aim: to describe the clinical features and outcomes of patients with COVID-19 and those tested for the virus.
Investigator: Prof Simon Craig
COVID-19: Increased COVID related stressors and overdose presentations to Monash Health
Aim: to review the medical records of patients presenting to Monash Health with drug overdose and determine if the ingestion was precipitated by COVID-19 related stressors.
Investigator: A/Prof Anselm Wong
Use of Lung Ultrasound for Diagnosis and Prognostication of COVID-19 Lung Disease in the Emergency Department: A prospective cohort study
Aim: to evaluate the prognostic value of clinician-performed lung ultrasound for suspected COVID-19 disease in the Emergency Department.
Investigator: Dr Gabriel Blecher
Vulnerable Paediatric ED Presentations during COVID
Aim: to compare trends in patient presentations from January 2019 to April 2020 for all ED presentations with presentations of neonates (<28 days) and those with a Mental Health discharge diagnosis.
Investigator: Prof Simon Craig
Audit of COVID-19 Infections: Clinical Characteristics and Outcomes at PREDICT Sites
Aim: to describe the clinical features and outcomes of patients with COVID-19 and those tested for the virus.
Investigators: Prof Simon Craig, Prof Franz Babl
KIDS THRIVE Trial: Trans-nasal Humidified Rapid-Insufflation Ventilatory Exchange in Children Requiring Emergent High Intubation
Aim: to assess the effectiveness of THRIVE as a method for prolonging apnoeic oxygenation during the emergency intubation of children to reduce the proportion of adverse events (specifically, oxygen desaturation) and increase the proportion of first attempt success for endotracheal intubation.
Investigator: Prof Simon Craig
NACSTOP 2 trial – Shorter treatment course for patients at low risk liver toxicity
Aim: to determine if low risk paracetamol overdose patients can be treated with a shorter course of acetylcysteine.
Investigator: A/Prof Anselm Wong
Double NAC Trial: Investigation of Increased N-Acetylcysteine Dosing in Patients Treated for Paracetamol Overdose
Aim: to determine if an increased acetylcysteine dose can decrease liver injury in high risk paracetamol overdose patients.
Investigator: A/Prof Anselm Wong
Being Your Best - an innovative, co-designed approach to frailty and care transitions from hospital to home, in people aged 65 years or more
Aim: to build resilience in older adults to overcome the vulnerabilities that arise from frailty.
Investigators: A/Prof Alison Hutchinson
The effect of digital transformation on compensable billings recovery
Aim: to examine the effect of an Australian health service’s digital transformation on the 14th October 2019 on its Emergency Department compensable billings accuracy.
Investigator: Dr Andy Lim
Description of the impact of flow, junior doctor supervision, and pandemic preparation on the ability of Emergency Physicians to provide direct patient care
Aim: to build an explanatory model to investigate Emergency Physician productivity at a metropolitan adult emergency department.
Investigator: Dr Andy Lim
Econometric forecasting of monthly flu season presentation to anticipate health service demand
Aim: to engage time series analysis techniques to inform data-driven decision making for this and future influenza seasons.
Investigator: Dr Andy Lim
The MS-Home Pathway – Safety of a Minor Stroke Imaging-Guided Outpatient Model of Care
Aim: to evaluate the safety of the MS-Home minor stroke pathway. Our group have experience with designing novel pathways, resulting in safe discharge of patients with transient ischemic attack.
Investigator: Dr Andy Lim
Management of indwelling urinary catheters in the Emergency Department: A retrospective audit
Aim: to describe the management approaches of urinary catheters within emergency departments.
Investigator: A/Prof Alison Hutchison
Broader state-wide data quality evaluation project funded by the Australian Government as part of the VAHI ‘Health Data Integrity Program’.
Aim: to improve the accuracy and completeness of injury surveillance items in the Victorian Emergency Minimum Dataset.
Investigators: Dr Dianne Sheppard, A/Prof Janneke Berecki-Gisolf
The Kids are not ok: Protocol for a Delphi study to identify consensus research priorities and core outcome sets in paediatric emergency departmental mental health presentations
Aim: to ask patients, parents, carers, and healthcare workers about what is most important to them when children and young adults (<18 years old) with mental health concerns attend Emergency Departments, and use this information to guide in deciding where more research is needed, and to understand the best ways of working out how to tell whether the treatment we provide is helpful.
Investigators: Prof Simon Craig, Dr Frank Muscara, Prof Franz Babl, Dr Meredith Borland, Dr Vicki Anderson, Dr Harriet Hiscock, Prof Bruce Tonge, A/Prof Kylie Gray, Dr Katherine Lee, Dr Glenn Melvin, Dr Amit Kochar, Dr Rohan Borschmann, Dr Emma Tavender, Dr Michael Gordon , Dr Richard Haslam, Catherine Wilson
Exploring Stress Resilience in Emergency Service Personnel
Aim: to explore whether physical activity can promote stress resilience for emergency department nurses
Investigator: Ms Samantha Armstrong (Federation University)
Behavioural Disturbance in Elderly Patients in the Emergency Department
Aim: to assess and describe prevalence of the behavioural disturbance symptoms amongst elderly patients presenting to Emergency Departments.
Investigators: Dr Gabriel Blecher, Dr Chhavi R. Bhatt, A/Prof Lisa Kuhn
Utility of lumbar puncture in Emergency department
Aim: to retrospectively analyse a cohort of patients presenting with headaches concerning for SAH, over a period of 5 years (2013-2018) whom underwent a non-contrast CTB +/- LP
Investigator: Dr Pourya Pouryahya
Hypertension in children presenting to a tertiary care paediatric emergency department
Aim: to understand hypertension in children presenting to a tertiary care paediatric emergency department
Investigator: Dr Sheena Kaul
Driving Change Project –Using Emergency Department Data To Reduce Alcohol-related Harm
Aim: to reduce alcohol-related harm in communities and reduce the impact on EDs and ED staff, by using data collected in Emergency Departments to target the sources of the most alcohol-related harm.
Co-investigators: Prof Diana Egerton-Warburton
Bell's Palsy in Children: A Multi-centre. Randomised, blinded, placebo-controlled trial to determine whether prednisolone improves recovery at 1 month
Aim: to determine whether treatment with oral prednisolone for 10 days increases the proportion of children who have complete recovery at 1 month,
Co-investigator: Dr Adam West
Quality Assurance Title: What is the time to theatre of neck of femur (NOF) fractures within Monash Health? And are there any adverse outcomes related to this?
Investigators: Julian Lim, Suong Le & Marion Waldsley
Escalating Deteriorating Patients' Care in the ED: Characteristics and Safety Cultures
Aim: To examine the organisation's safety culture to escalate care of the deteriorating patients
Investigator: Dr Cliff Connell
Anaphylaxis management in Emergency Department presentations
Investigator: Nadishani Ratnayake
Companion participation in the care of the older person in the emergency department: A mixed method study
Aim: to explore and describe companion perceptions of their participation in the care of an older person discharged home from the ED (including the Short Stay Unit)
Investigator: A/Prof Bernice Redley
Corneal foreign body in emergency department
Aim: to find the incidence and outcome of patients presenting to emergency department with corneal foreign body
Investigator: Dr Pourya Pouryahya
Diagnostic yield of computed tomography scan in the emergency department
Aim: to describe the indications, clinical categories and positive yield rates of patients receiving CT scans in the ED.
Investigator: Dr Pourya Pouryahya
Assessment of adult eating disorder in ED
Aim:
- to evaluate the parameters measured and investigations carried out in the emergency department for patients presenting with an eating disorder (anorexia nervosa or bulimia nervosa) being the key issue, as compared to the parameters recommended in the RANZCP Clinical Practice Guidelines for treatment of eating disorders when considering weather patients require inpatient admission
- to use this data to identify possible gaps in the assessment of adult eating disorder patients, and allow this to guide education of emergency department staff, and potentially develop of a local guideline for health service.
Investigator: Dr Georgina Tuck
Emotional Support in the Monash Health Emergency Department
Aim: to elicit the perceptions of patients, family members and/or carers regarding the provision of emotional support in the emergency department setting.
Investigators: Prof Alison Hutchinson, A/Prof Bernice Redley
How effective is the Monash Health SHRFV family violence education for helping staff to identify, respond and refer patients experiencing family violence?
Aim: to review education from September 2017 and to the end of May 2019, 3097 Monash Health employees received family violence training.
Investigators: Glenda Bawden, Jessica Bermudez
DeFining Lumbar Extension, FleXion And Rotation in the workplace (FLEXAR)
Aim: to undertake real time monitoring of low back movement with motion sensor equipment to quantify lumbar movements of nurses working in intensive care and the emergency department within a teaching hospital. A secondary aim is to ascertain the prevalence of low back pain within the cohort.
Investigator: A/Prof Julia Morphet
Hospital healthcare professional perceptions and experiences of emergency readmissions of older people- The PEER review
Aim: to explore the perceptions and experiences of health professionals working in the hospital setting, regarding the identification and management of older patients (aged 65 years and over) who are at the highest risk of early, unplanned hospital readmission (within 28 days of discharge) following an inpatient stay.
Investigators: Josephine McGuiness, A/Prof Julia Morphet, Dr Kelly-Ann Bowles, Dr Mehmet Özmen
Appendicitis but not appendicitis
Aim: to identify patients underwent unnecessary investigation that might delay diagnosis.
Investigator: Dr Pourya Pouryahya
Are vital signs really vital to suspect pulmonary embolism?
Aim: to assess variation of vital signs in patients with confirmed pulmonary embolism.
Investigator: Dr Pourya Pouryahya
Incidence of PE in pregnancy and post-partum
Aim: to examine the incidence of pulmonary embolism during pregnancy and in post-partum.
Investigator: Dr Pourya Pouryahya
Hi, Is It Me You’re Looking For
Aim: to observe the practices of the ED consultants/clinicians in charge (CIC) with respect to answering the phone. Informal observations have suggested that callers often do not know to whom they spoke with over the phone, which can become problematic if there is information that needs to be followed up.
Investigator: Dr Pourya Pouryahya
PRimary health and Aged Care Translation and Interpreting Services (PRACTIS)
Aim: to evaluate the relationship between linguistic discordance and avoidable ED admissions for limited English proficiency residents of aged care homes.
Investigator: Prof Suresh Sundram
Clinical Audit of Restrictive Interventions in the Emergency Department
Aim: to contribute to the growing evidence base to gradually reduce the use of restrictive practice not only in the emergency department but also to other areas of the mental health service.
Investigator: Dr Al-amin Hoque
SNOTWATCH: Mapping real-time respiratory microbiology information to inform health outcomes
Aim:
- to examine and describe organism specific epidemiology of respiratory and gastrointestinal positive tests from all participating laboratories
- to describe the association of organisms in time and place with health service utilization and presentations.
Investigator: Prof Jim Buttery
Emergency Department Nurses Perceptions of Working with Substitute Decision Makers
Aim: to explore and understand how ED nurses work with Substitute Decision Makers within the emergency department setting.
Investigators: A/Prof Susan Lee, A/Prof Cheryle Moss
Empiric antibiotic management of UTI in paediatric patients presenting to Monash Health
Aim: to review current empiric prescribing in paediatric UTI and assess changes post implementation of an antibiogram
Investigators: Kaman Cheung, Prof Jim Buttery
Acute behavioural disturbance in paediatric health services: retrospective observational study of Code Grey incidents
Aim: to examine recent code grey incidents occurring at Monash Health sites to develop an understanding of how acute behavioural disturbances arise and are managed in these paediatric health services.
Investigator: Prof Simon Craig
How are we managing acute asthma in children? A PREDICT study
Aims:
- to determine current management practices for children with severe acute asthma and/or wheeze across Australia and New Zealand
- to determine the incidence of (and complications relating to) severe acute asthma requiring IV bronchodilator therapy or ventilator support across Australia and New Zealand
- to determine where differences in therapy exist between states / regions across Australia and New Zealand given our previous research.
Investigator: Prof Simon Craig
Acute behavioural disturbance in paediatric health services: retrospective observational study of Code Grey incidents
Investigator: Prof Simon Craig
Treatment decisions for children with acute severe exacerbations of asthma: interviews with clinicians. A Pediatric Emergency Research Networks (PERN) study.
Investigators: Prof Simon Craig, Erin Mills
A Multicentre Randomized Controlled Trial Comparing Epinephrine (Epinephrine (Adrenaline)) And Dexamethasone to Placebo in the Treatment of Infants with Bronchiolitis. BIPED
Investigator: Prof Simon Craig
Nasal High Flow Therapy for Children with Acute Hypoxemic Respiratory Failure – a Randomised Controlled Trial – PARIS II Trial
Aim: To investigate in a randomised controlled trial performed in children aged 1-4 years presenting with acute hypoxemic respiratory failure if the early use of NHF therapy reduces the hospital length of stay when compared to standard oxygen therapy.
Investigators: Prof Simon Craig, Rhiannon Barrow
The utility of blood and urinary ketones in the assessment of abdominal pain (KIAPP Study)
Aim: to determine Whether blood and urinary ketones can be used to assist in the diagnosis of appendicitis, and
If ketone measurements assist with discriminating between simple and complex appendicitis in children prior to operation.
Investigator: Prof Simon Craig
Factors affecting parental experience of investigations for suspected sepsis in neonates
Investigator: Prof Simon Craig
Nasal High Flow Therapy for Children with Acute Hypoxemic Respiratory Failure – a Randomised Controlled Trial – PARIS II Trial
Aim: To investigate in a randomised controlled trial performed in children aged 1-4 years presenting with acute hypoxemic respiratory failure if the early use of NHF therapy reduces the hospital length of stay when compared to standard oxygen therapy.
Investigators: Prof Simon Craig and Rhiannon Barrow
Equity of allergy resource distribution in Victoria
Aim:
- to assess the geo-temporal distribution of allergy services compared to the apparent prevalence of allergy in Victoria
- to characterise the allergy burden and needs of the Monash Health catchment areas to inform the establishment of an allergy immunology service at Monash Health.
Investigators: Prof Simon Craig, Prof Jim Buttery