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:

  1. 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
  2. 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:

  1. 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
  2. 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:

  1. to examine and describe organism specific epidemiology of respiratory and gastrointestinal positive tests from all participating laboratories
  2. 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:

  1. to determine current management practices for children with severe acute asthma and/or wheeze across Australia and New Zealand
  2. to determine the incidence of (and complications relating to) severe acute asthma requiring IV bronchodilator therapy or ventilator support across Australia and New Zealand
  3. 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:

  1. to assess the geo-temporal distribution of allergy services compared to the apparent prevalence of allergy in Victoria
  2. 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