Examining the Time to Diagnosis in Idiopathic Intracranial Hypertension Presentations in a Specialist Eye Emergency Department.

Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by chronic headaches, cognitive difficulties, reduced quality of life, and rarely irreversible visual loss. Community diagnosis is often challenging due to unfamiliarity with current guidelines and a lack of clinical experience, leading to misdiagnosis and treatment delays, which can negatively impact visual recovery and quality of life. Our study examined the time to diagnosis and investigated the barriers to timely diagnosis in adults with newly diagnosed IIH.

Conjunctivitis: A review.

Background: General practitioners (GPs) face the challenge of diagnosing conjunctivitis accurately and confidently. Conjunctivitis and red eye are common presentations that confer diagnostic uncertainty. GPs are pivotal in diagnosing and managing conjunctivitis-like symptoms, making them a critical first port of call for patients.

Addressing diagnostic uncertainty and excellence in emergency care-from multicountry policy analysis to communication practice in Australian emergency departments: a multimethod study protocol.

Introduction: Communication failings may compromise the diagnostic process and pose a risk to quality of care and patient safety. With a focus on emergency care settings, this project aims to examine the critical role and impact of communication in the diagnostic process, including in diagnosis-related health and research policy, and diagnostic patient-clinician interactions in emergency departments (EDs).

Methods And Analysis: This project uses a qualitatively driven multimethod design integrating findings from two research studies to gain a comprehensive understanding of the impact of context and communication on diagnostic excellence from diverse perspectives.

Ocular trauma in badminton: A 5-year review of badminton-related eye injury emergency department presentations.

Objective: To examine the nature and severity of badminton-related ocular injuries in Melbourne, Australia.

Methods: This is a retrospective chart review. A search of the medical records was conducted for patients presenting to the ED at The Royal Victorian Eye and Ear Hospital, with badminton-related eye injuries from June 2018 to May 2023.

Vital signs monitoring in Australasian emergency departments: Development of a consensus statement from ACEM and CENA.

Background: Emergency Department (ED) care is provided for a diverse range of patients, clinical acuity and conditions. This diversity often calls for different vital signs monitoring requirements. Requirements often change depending on the circumstances that patients experience during episodes of ED care.

An organisational approach to improving diagnostic safety.

Diagnostic error affects up to 10% of clinical encounters and is a major contributing factor to 1 in 100 hospital deaths. Most errors involve cognitive failures from clinicians but organisational shortcomings also act as predisposing factors. There has been considerable focus on profiling causes for incorrect reasoning intrinsic to individual clinicians and identifying strategies that may help to prevent such errors.

Communication of Diagnostic Uncertainty in Primary Care and Its Impact on Patient Experience: an Integrative Systematic Review.

Background: Diagnostic uncertainty is a pervasive issue in primary care where patients often present with non-specific symptoms early in the disease process. Knowledge about how clinicians communicate diagnostic uncertainty to patients is crucial to prevent associated diagnostic errors. Yet, in-depth research on the interpersonal communication of diagnostic uncertainty has been limited.

Sports-related ocular injuries at a tertiary eye hospital in Australia: A 5-year retrospective descriptive study.

Objective: To describe the demographics and outcomes of sports-related ocular injuries in an Australian tertiary eye hospital setting.

Methods: Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow-up.

Diagnostic statements: a linguistic analysis of how clinicians communicate diagnosis.

Objectives: To investigate from a linguistic perspective how clinicians deliver diagnosis to patients, and how these statements relate to diagnostic accuracy.

Methods: To identify temporal and discursive features in diagnostic statements, we analysed 16 video-recorded interactions collected during a practice high-stakes exam for internationally trained clinicians (25% female, n=4) to gain accreditation to practice in Australia. We recorded time spent on history-taking, examination, diagnosis and management.

'More than words' - Interpersonal communication, cognitive bias and diagnostic errors.

During the diagnostic process, clinicians may make assumptions, prematurely judge or diagnose patients based on their appearance, their speech or how they are portrayed by other clinicians. Such judgements can be a major source of diagnostic error and are often linked to unconscious cognitive biases - faulty quick-fire thinking patterns that impact clinical reasoning. Patient safety is profoundly influenced by cognitive bias and language, i.

Developing critical thinking skills for delivering optimal care.

Healthcare systems across the world are challenged with problems of misdiagnosis, non-beneficial care, unwarranted practice variation and inefficient or unsafe practice. In countering these shortcomings, clinicians must be able to think critically, interpret and assimilate new knowledge, deal with uncertainty and change behaviour in response to compelling new evidence. Three critical thinking skills underpin effective care: clinical reasoning, evidence-informed decision-making and systems thinking.

Implementing a pandemic roster in a specialty emergency department: Challenges and benefits.

Objective: To create a roster that eliminated unnecessary cross-staff exposure to ensure the hospital had sufficient staff to run the ED in the event that a group of staff are affected by COVID-19. This roster was aimed at providing staff with 'manageable shift lengths, down-time between shifts, regular breaks and access to refreshments' as dictated by the Victorian Department of Health and Human Services.

Methods: Creating six fixed teams in our ED.

Diagnostic error in an ophthalmic emergency department.

Background Diagnostic error is a major preventable cause of harm to patients. There is currently limited data in the literature on the rates of misdiagnosis of doctors working in an ophthalmic emergency department (ED). Misdiagnosis was defined as a presumed diagnosis being proven incorrect upon further investigation or review.

Topical anaesthetic in the treatment of corneal epithelial defects: What are the risks?

Background: Recent publications have suggested that  topical anaesthetic eye drops can be used safely and are effective in providing pain relief for the treatment of corneal abrasions. Complications resulting from the injudicious prescribing of topical anaesthetic eye drops are seen with some frequency in the Royal Victorian Eye and Ear Hospital's (RVEEH's) emergency department.

Objective: The aim of this article is to review the literature and provide a clinical perspective to challenge the safety of topical anaesthetic eye drops for corneal abrasions.

Virtual Reality for Pediatric Needle Procedural Pain: Two Randomized Clinical Trials.

Objective: To assess the efficacy and safety of a virtual reality distraction for needle pain in 2 common hospital settings: the emergency department (ED) and outpatient pathology (ie, outpatient laboratory). The control was standard of care (SOC) practice.

Study Design: In 2 clinical trials, we randomized children aged 4-11 years undergoing venous needle procedures to virtual reality or SOC at 2 tertiary Australian hospitals.

Epidemiology of uveitis in urban Australia.

Importance: Few prior studies have described the epidemiology of uveitis in the Australian population.

Background: To report the incidence and period prevalence of active uveitis in Melbourne and detail their subtypes and aetiologies.

Design: Cross-sectional study using retrospective medical record review in a tertiary hospital.