This program of research is based on the prehospital patient journey: beginning with the emergency ‘000’ call and appropriate determination of patient priority; exploration of alternative pathways for non-urgent cases; investigation of the clinical effectiveness of paramedic-initiated clinical interventions; and development and validation of indicators of quality of care for use by Ambulance Services.
Path to 000 Accessing Emergency Care
- Investigate the optimal community based utilisation of ‘000’ and research alternative clinical pathways that maximise access for time critical emergencies
- Impact of campaigns (e.g. stroke and heart attack)
- Epidemiology of demand
- Public’s perception of the role of ambulance
- Listen to calls of critical events not identified in the calls
Triage and alternative pathways
- Survey services –referral pathways in place and monitoring
- Call taker experience –influence diagnostic accuracy
- Epi profile elderly, high level care –EMS-ED-hospital
- Prospective follow-up of patients not transported (subsequent admissions, GP)
Building an Evidence Base Clinical Trials
- High Priority Areas
- Pain – Assess the current practice for management of pain by the ambulance services (in metropolitan and rural areas) and patient outcomes. Undertake prospective studies using the most promising combinations of analgesic drugs, based on observational data.
- Patients with behavior of concern – describe the size and nature of the issue within the ambulance services. Examine current practice and outcomes, including the safety of staff and patients. Trial alternate therapeutic regimens based on current Australian and overseas practice.
- Sepsis – model the feasibility of using clinical characteristics of patients prehospital to predict severe sepsis. Trial early interventions including use of broad spectrum antibiotics.
- Translating what is known to improve patient outcomes into clinical practice and maintaining adherence to evidence based guidelines is the “holy grail” of medical system improvement.
- Survey Emergency Medicine Services
- Identify differences in the key Clinical Practice Guidelines
- Compare benchmarks of service looking at Key Performance Indicators