Over 28,000 students will descend on the Gold Coast for the start of Schoolies this week, and while the party may be chaos, emergency departments on the Gold Coast already know how many patients will be coming through the door.
Music plays and text appears: Patient Admission Prediction Tool]
[Image changes to Dr James Lind, Director of Access and Patient Flow, Gold Coast Hospital]
Dr James Lind: The Patient Admission Prediction Tool is a tool to look at exactly what it says, it predicts to about 95% accuracy which patients are coming in and when.
[Music plays and image changes to an outside shot of Robina Hospital, then to the Emergency Department with ambulances parked out the front]
We know today that there are 12 people coming in with broken arms and legs. Only one of them has come in up to date, but we know there's another 11 out there, so what we've been able to do is set aside emergency theatre time for these people already, so we know that they're coming, and we know we can treat them.
[Image changes to show a patient being wheeled through the hospital corridors in a bed] [Image changes to show a patient seated on a bed]
[Image has changed back to Dr Lind]
Patient: At the moment I walked in I spoke to the person and I sat there for ten minutes, and the doctor called me in, and so here I am. So it was like less than half an hour I'm waiting to have my cast put on.
Dr James Lind: It was difficult at first because many people didn't believe the tool could do what we said it could do.
[Image changes to show a cast being applied to the arm of a patient and then moves back to Dr Lind]
Up til recently a fallacy existed that all hospitals had to be at 85% occupancy for optimal patient flow. Using the mathematics of CSIRO we've actually dispelled that rumour, and we can actually show categorically that that's not true, and we've actually worked out optimal occupancies for not just our hospital but other hospitals. Now people trust in the tool and it actually informs our strategy. The performance of this hospital, compared to the data from 2010, has actually increased its four hour score by 20%. We now run above the federal target, and we're one of the largest HHS's that actually is able to do that. The impact for staff is that this can be done within hours, so that it actually minimises the amount of overtime. It also minimises the amount of stress because it's done in a well ordered fashion, and everyone knows their jobs and responsibility, and where the actual problems that we need to address are.
[Image changes to show Dr Lind and colleagues discussing graphs and information that's displayed on a monitor]
One of the key points with the partnership with CSIRO is that we provide the clinical input, and the mathematics resource optimisation etcetera does come from the CSIRO expertise, but it's marrying these two important areas together. You couldn't do it without either one, and that's where the partnership has been fantastic. The proof of the pudding really of this tool is we're in the middle of winter; it's the worst point for an emergency department because of the winter surge that occurs. Up til recently you would have seen pictures of ambulances queuing outside to get into emergency, and all the beds being full. If we look today, on one of our busiest winter's day, you can see there are still free beds in the emergency department, and there's only one ambulance outside, which has managed to offload its stretcher.
[Camera pans over the Emergency ward beds and staff and then moves to show the stationary ambulance parked outside]
What we're able to do with this tool is show people that actually what happens in health care is very predictable on a day by day basis.
[Music plays and the CSIRO logo appears with the text: Big ideas start here www.csiro.au]
Thanks to CSIRO technology hospitals will also know how serious the cases will be and if they will be admitted to hospital.
Dr James Lind, Director of Access and Patient Flow at Gold Coast Health said using CSIRO’s Patient Admission Prediction Tool (PAPT) had been crucial for dealing with big events such as Schoolies, helping to reduce waiting times and ensure schoolies get the best treatment where and when they need it.
“We know in this first week of the Schoolies festival there will be around 2700 presentations to our emergency department in total and around 20 per cent of these will be schoolies,” Dr Lind said.
“Having this information about admissions allows us to plan the staff, medical supplies and beds needed to care for those schoolies and manage waiting times for our other patients who are still arriving with other serious injuries.”
Some of the most common injuries among 17-19 year olds turning up to emergency departments during Schoolies include:
- Mental and behavioural disorders due to intoxication from alcohol (90/wk)
- Grazes or cuts to the head (30/wk)
- Grazes and cuts on the ankle and foot (18/wk)
- Grazes and cuts on the wrist and hand (19/wk)
- Sprain and strains to the ankle and foot (18/wk)
- Drug poisoning (18/wk).
Estimates derived from 2009-2012 schoolies presentation data from Queensland Health.
“We know the majority of presentations during Schoolies are from alcohol intoxication and cuts to the feet from broken glass," Dr Lind said.
"Our safety message to all Schoolies is to party responsibly and don’t walk on the beach without footwear and most importantly look after your mates.
"For the past few years we’ve been working with Queensland Ambulance Service at the designated medic tent for the first week of Schoolies. We aim to treat as many of these patients on the ground and free up beds in our hospital emergency department for more serious cases, using PAPT we know this is making a real difference."
CEO of CSIRO’s Australian E-Health Research Centre David Hansen said the PAPT software was currently available in 31 hospitals across Queensland and had the potential to save $23 million/per annum in improved service efficiency for the health system if implemented in hospitals across Australia.
“Large events like Schoolies really demonstrate the predictability of emergency departments throughout the year," Dr Hansen said.
"Our software gives hospitals the information they need to make informed decisions to put in place plans to help them work towards emergency targets even during these peak periods whilst delivering the best care to patients.”
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