An ED avoidance strategy outside the walls of a busy ED; emergency health care delivery for a planned mass gathering

Tonya Donnelly1, Dr Amy Johnston2, Nerolie Bost1, Dr Michael Aitken1, Cary Strong3, Jo Timms1, Kate Gilmore1, Professor Julia Crilly2

1Dept Emergency Medicine, Gold Coast Health , Southport, Australia, 2Dept Emergency Medicine Gold Coast Health And Menzies Health Institute Qld  , Southport, Australia, 3Gold Coast LASN, Queensland Ambulance Service, Ormeau, Australia

You’re off to great places, but why do you go? So you’ve set up a tent – but what does it show?

Background: Emergency department (ED) crowding and ambulance transportation rates are known to be increasing annually. The implementation of ED avoidance strategies during events such as mass-gatherings can be an important. One such strategy, the ‘Schoolies week’ health tent has been in operation for 10+ years. Evidence in support of its use for ED avoidance has been primarily anecdotal.

Methods: This was a retrospective observational study.  The study sample included all 16-18 years old patient presentations made to the ED over a three week period (pre, during, post Qld Schoolies week) and to a temporary medical tent (during Qld Schoolies week) in 2014. Patient information from the ED and ambulance service databases were linked. Descriptive and inferential statistics were used for analysis.

Results: A total of 1,028 patient presentations were made by the 16-18 year age group to the ED and/or health tent over the three week study period ( (120 pre, 684 during, 224 post Qld Schoolies week). During the schoolies week, a total of 420 presentations were made to the health tent with an average of 60 per night. The majority (n=394) were seen and discharged from the tent while some (n=26) required further ED care.

Conclusions: The results suggest that a temporary facility for one week during the Schoolies mass-gathering event was a useful ED avoidance strategy for young adult school leavers. Pressure on the hospital EDs and ambulance services was relieved, and access by local residents maintained, because the on-site tent diverted young people away from the local EDs. Given the increase in ED crowding and pressures on ambulance services, such care models may be worth considering for mass gathering events in other locations.


Biography:

Tonya Donnelly is a highly experienced award-winning ED CNC, who has held the disaster/mass gathering portfolio at Gold Coast Health Service for ~10 years. She is committed to developing and implementing evidence-based ED avoidance strategies that really reduce patient load and enhance care delivery in local EDs. She is passionate about the establishment of hospital avoidance programs particularly around mass gatherings.

Amy Johnston is a conjoint research fellow in Emergency Care, based between Gold Coast Health and Menzies Health Institute Queensland/School of Nursing and Midwifery Griffith University, seconded from a senior lecturer position at Griffith University. She is deeply committed to bringing research skills and outcomes to emergency staff. She is a widely published and cited academic and registered nurse with experience in a range of research techniques. Her love of clinical research is heartfelt and (hopefully) infectious. She is involved in HDR student supervision and onsite development of ED staff research skills.