Exploring beliefs of the four major ethnic groups in Melbourne regarding healthcare and treatment.

Objectives: To explore and compare beliefs about healthcare and treatment of four ethnic groups attending a Melbourne emergency department (ED), and the corresponding perceptions held by emergency clinicians.

Method: Prospective survey of ED doctors and patients from Greek, Italian, Vietnamese and Anglo-Saxon backgrounds.

Results: Vietnamese patients were least likely to believe their ethnic group received the best available care but less likely to believe in the existence of ethnic healthcare disparities.

Verbal dyspnoea score predicts emergency department departure status in patients with shortness of breath.

Objectives: We examined whether a previously validated verbal dyspnoea rating scale, and/or other demographic and clinical parameters, could predict ED departure status, among ED patients presenting with shortness of breath.

Methods: In this prospective observational study, a convenience sample of patients presenting to an inner urban adult tertiary hospital ED with shortness of breath were assessed at triage using objective and subjective breathlessness parameters. These included respiratory rate, oxygen saturation, heart rate, systolic blood pressure and verbal dyspnoea scores.

Health smart cards: differing perceptions of emergency department patients and staff.

An analytical, cross-sectional survey of 270 emergency department patients and 92 staff undertaken in three tertiary referral hospital emergency departments was completed to compare the perceptions of patients and staff regarding the use of health smart cards containing patient medical records. The study recorded data on a range of health smart card issues including awareness, privacy, confidentiality, security, advantages and disadvantages, and willingness to use. A significantly higher proportion of staff had heard of the card.

Gamma-hydroxybutyrate: a 30 month emergency department review.

Objectives: To describe epidemiology, symptomatology, resource use and complications in patients attending the ED following gamma-hydroxybutyrate (GHB) ingestion.

Methods: Retrospective chart review of GHB-related emergency attendances over 30 months.

Results: One hundred and seventy emergency attendances attributed to GHB ingestion occurred.

Australasian emergency physicians: A learning and educational needs analysis. Part six: differences in confidence, exposure to learning and expressed learning needs by subgroups of Australasian emergency physicians.

Objective: To determine differences in the confidence and learning needs between subgroups of Fellows of the Australasian College for Emergency Medicine (FACEM), according to sex, type of hospital of principal employment, region of practice in Australasia, year of obtaining the fellowship and percentage of hours worked clinically.

Method: Mailed survey of all FACEM with multiple Likert scale options.

Results: Male emergency physicians (EP) more often expressed confidence in 14 of 58 tasks, but female EP more often expressed a strong desire for continuing professional development (CPD) in 8.

Triage presenting complaint descriptions bias emergency department waiting times.

Objectives: The authors aimed to determine whether certain emergency department (ED) triage "presenting complaint" descriptions are associated with shorter or longer waiting times, when compared with matched controls.

Methods: This was a retrospective, analytical study in three tertiary referral EDs. Data relating to adult patients with Australasian National Triage Scale (NTS) Category 3-5 complaints, who presented over 1 year, were accessed.

An observational study of emergency department intern activities.

Objectives: To describe how intern time is spent, and the frequency of activities performed by interns during emergency department (ED) rotations.

Design And Setting: Prospective observational study of 42 ED interns from three Melbourne city teaching hospitals during 5 months in 2006. Direct observations were made by a single researcher for 390.

Barriers to continuing medical education in Australian prevocational doctors.

To determine perceived barriers to continuing education for Australian hospital-based prevocational doctors, a cross sectional cohort survey was distributed to medical administrators for secondary redistribution to 2607 prevocational doctors from August 2003 to October 2004. Four hundred and seventy valid questionnaires (18.1%) were returned.

Emergency clinician-delivered screening and intervention for high-risk alcohol use: a qualitative analysis.

Objectives: To evaluate qualitative feedback from patients who received opportunistic screening and brief intervention for harmful alcohol use during an ED attendance; to evaluate emergency staff attitudes to performing alcohol screening and delivering opportunistic brief intervention; and to document process issues associated with the introduction of routine clinician-initiated opportunistic screening and training and administration of brief intervention.

Methods: Structured and semi-structured interviews with emergency staff and recipients of brief intervention.

Results: Sixty-nine patients were interviewed 3 months after an ED attendance where they received emergency clinician-delivered brief intervention for high-risk alcohol use.

Opportunistic screening and clinician-delivered brief intervention for high-risk alcohol use among emergency department attendees: a randomized controlled trial.

Objective: To evaluate the feasibility and efficacy of routine opportunistic screening and brief intervention (BI) by ED staff to reduce high-risk alcohol consumption.

Methods: This was an open, randomized controlled trial with allocation blinding performed over 12 months. Using the Paddington Alcohol Test, adult patients were screened for high-risk alcohol use.

Handover from paramedics: observations and emergency department clinician perceptions.

Objectives: 1. To evaluate emergency clinician attitudes towards handover from prehospital paramedics. 2.

Australasian emergency physicians: a learning and educational needs analysis. Part one: background and methodology. Profile of FACEM.

Objective: Fellows of the Australasian College for Emergency Medicine (FACEM) have opportunities to participate in a range of continuing professional development activities. To inform FACEM and assist those involved in planning continuing professional development interventions for FACEM, we undertook a learning needs analysis of emergency physicians.

Method: Exploratory study using survey methodology.

Australasian emergency physicians: a learning and educational needs analysis. Part two: confidence of FACEM for tasks and skills.

Objective: To determine the degree of confidence perceived by Fellows of the Australasian College for Emergency Medicine for a variety of procedural, patient management, educational and research skills, and tasks that may be required of them.

Method: Mailed survey with Likert scales and grouped qualitative responses.

Results: More than 90% of emergency physicians (EP) feel usually or always confident of their skills for peripheral vascular access, procedural sedation, fluid resuscitation, tube thoracostomy, managing patients with altered conscious state, cardiac emergencies, behavioural disturbance, and interpreting acid base and other blood tests.

Australasian emergency physicians: a learning and educational needs analysis. Part three: participation by FACEM in available CPD: what do they do and do they like it?

Objective: To determine the participation of Emergency Physicians (EP) in currently available continuing professional development opportunities (CPD), their perception of the usefulness of available CPD and their preferred format or method of CPD desired in the future.

Method: A mailed survey of Fellows of the Australasian College for Emergency Medicine with 17 Likert type options on educational methods and qualitative analysis grouping volunteered free text responses.

Results: The most frequent learning methods reported by EP are on the job contact with other clinicians, formal ED based teaching and reading journals, which were also perceived as useful or very useful learning methods by more than 90% of EP.

Australasian emergency physicians: a learning and educational needs analysis. Part Four: CPD topics desired by emergency physicians.

Objective: To report the preferences of Fellows of the Australasian College for Emergency Medicine for topics they would desire for their continuing professional development (CPD).

Method: A mailed survey of Fellows of the Australasian College for Emergency Medicine asked for Likert type responses on the desirability of CPD on 15 procedural skills, 13 management skills, 11 clinical emergency topics, 9 topics related to teaching, 7 related to diagnostics and 5 evidence based practice topics.

Results: CPD in procedural skills of advanced and surgical airways, ED ultrasound, ventilation, skills, plastic procedures and regional anaesthesia were nominated as desirable by 85% of emergency physicians (EP).

Australasian emergency physicians: a learning and educational needs analysis. Part five: barriers to CPD experienced by FACEM, and attitudes to the ACEM MOPS programme.

Object: To determine the barriers to continuous professional development (CPD) perceived by Fellows of the Australasian College for Emergency Medicine (FACEM), their opinions on the maintenance of professional standards programme (MOPS), and other aspects of education.

Method: Mailed survey offering 12 factors that could prevent them from participating in CPD. FACEM were asked to rate the items on Likert from 1, no barrier, through to 5, insurmountable barrier.

Can medical admission and length of stay be accurately predicted by emergency staff, patients or relatives?

Objectives: To determine the accuracy of predictions of the need for hospital admission and, if admitted, length of stay (LOS) made early in an emergency attendance by emergency department (ED) doctors, nurses, patients and relatives, and the characteristics of ED presentations predictive of admission and short stays (
Methods: Prospective collection of predictions by medical and nursing staff, patients and relatives of ED departure status and LOS (1 day, 2-3 days, 4-7 days or longer) of a convenience sample of adults presenting with medical symptoms. Predictions were made before full medical assessment and matched against actual departure status and LOS.

The effect of multidisciplinary case management on selected outcomes for frequent attenders at an emergency department.

Objective: To evaluate the effects of multidisciplinary case management (CM) on emergency department (ED) utilisation and psychosocial variables for frequent attenders at the ED.

Design: Retrospective cohort analysis, with the study population as historical controls and data analysed 12 months before and after CM intervention in the period 1 January 2000 - 31 December 2004. Subgroup analyses were performed according to primary problem categories: general medical, drug and alcohol, and psychosocial.

Learning opportunities for Australian prevocational hospital doctors: exposure, perceived quality and desired methods of learning.

Objective: To survey prevocational doctors working in Australian hospitals on aspects of postgraduate learning.

Participants And Setting: 470 prevocational doctors in 36 health services in Australia, August 2003 to October 2004.

Design: Cross-sectional cohort survey with a mix of ordinal multicategory questions and free text.

Patient perceptions of privacy infringements in an emergency department.

Objective: To identify the nature, severity, impact, frequency and risk factors for patient perceived privacy infringements in the ED of St Vincent's Health Melbourne with 32,000 emergency attendances per annum.

Methods: Patients 18 years and older attending emergency over a 2-week period were offered a nine-item questionnaire using a Likert scale. A privacy incident was defined as: (i) overhearing medical or personal information; (ii) being overheard; (iii) having private body parts exposed or (iv) seeing others' body parts.

The heaviest repeat users of an inner city emergency department are not general practice patients.

Objective: To test the hypothesis that frequent attenders to the ED are suitable for diversion to general practice.

Methods: A retrospective review of a computerized database for the top 500 frequent presenters to an inner city adult teaching hospital ED.

Results: Five hundred patients presented 12,940 times, an average of 26 times per patient, accounting for (8.