The state of our Emergency Departments: Tasmanian trends and perspectives

Ms Maria Unwin1,2, Ms Claire Morley1, Dr Jim Stankovich3, Mr Scott Rigby2, Prof Gregory  Peterson3, Dr Elaine Crisp1, Prof Leigh  Kinsman1,2

1University Of Tasmania, School of Health Sciences, Launceston & Hobart, Australia, 2Launceston General Hospital, Tasmanian Health Service, Launceston, Australia, 3Health Services Innovation Tasmania, Faculty of Health, University of Tasmania, Hobart, Australia

Introduction: Tasmania has the oldest population of all Australian states and territories, and the second highest proportion of residents living in the most disadvantaged quartile of the Socio-Economic Indexes for Areas (SEIFA), with the whole state classified as regional or remote. These factors are all known to increase the probability of attending an emergency department (ED). Faced with this challenging profile, it is essential for future planning to characterise the drivers behind ED utilisation in Tasmania. This presentation will detail a program of research seeking to understand why, where and when people attend EDs in Tasmania.

Method: A retrospective analysis of ED presentation data to Tasmania’s four public hospital EDs over a four-year period (July 2010 to June 2014) was undertaken.  Also, a waiting room survey of non-urgent (triage categories 4 and 5) patients was conducted to identify factors influencing decision making processes to attend the ED.

Results: There was a 3.4% increase in state-wide presentations with a 6.8% increase in high acuity (triage categories 1 to 3) presentations, over the studied time-frame. Variations in regional ED presentations included a 16% increase in the South (with a significant increase in the elderly), a 5.1% increase in the North and a 3.9% decrease in the North-West. The waiting room survey established that 39% of patients had attempted to access alternative health care options before attending the ED, 31% would have preferred to be managed by their own general practitioner and 29% were referred to ED by a healthcare professional.

Discussion: This research identified regional variations in ED attendances and demonstrated the preferences of non-urgent patients to be managed outside the ED. A summary of ongoing work focusing on the drivers behind the increased presentations in the South and service requirements of non-urgent patients presenting to ED will also be presented.


Biography:

Maria is a registered nurse with clinical experience in paediatric and emergency nursing. Over the past 24 years she has observed a continued increase in the demand for healthcare services and is acutely aware of the impact this has on her local hospital. In 2015 this led to an Honours research project focusing on patients’ perspectives for accessing the emergency department with non-urgent complaints. Maria has commenced a PhD, further focusing on this issue and aiming to identify what services would best suit this patient group.  In her spare time Maria enjoys time with family, travelling, camping, bush-walking.

Claire is a registered nurse with clinical experience in both Australia and the UK. She has worked in diverse clinical settings, including: emergency, occupational health, cardiology, cardiac intensive care and paediatric intensive care. She has also held positions in both research and education. Claire is passionate about effecting change in the Tasmania healthcare system to ensure all Tasmanian’s receive the right care, at the right time, in the right place. In her spare time Claire, along with husband Geoff, cares for their three school-aged children, skis and gets into the Tasmanian bush whenever time allows.