Advancing leadership in Australasian emergency medicine: Taking stock and looking ahead.

Since 2018, the Australasian College for Emergency Medicine has collaborated with the Swinburne University of Technology on a research project to understand and enhance the leadership capacity of emergency physicians, beginning with Australasian Directors of Emergency Medicine (DEMs). Over the last 3 years, this research programme has revealed the complexity of leadership in emergency medicine, illuminating the strengths and limitations of extant research and suggesting promising new directions for emergency medicine leadership and leadership development research. This programme has also shed new light on the knowledge, skills and abilities that DEMs need to develop to catalyse change in the systems where DEMs practice both medicine and leadership.

Early lessons from COVID-19 that may reduce future emergency department crowding.

The COVID-19 pandemic has produced significant changes in emergency medicine patient volumes, clinical practice, and has accelerated a number of systems-level developments. Many of these changes produced efficiencies in emergency care systems and contributed to a reduction in crowding and access block. In this paper, we explore these changes, analyse their risks and benefits and examine their sustainability for the future to the extent that they may combat crowding.

Management of adult cardiac arrest in the COVID-19 era: consensus statement from the Australasian College for Emergency Medicine.

Introduction: The global pandemic of coronavirus disease 2019 (COVID-19) has caused significant worldwide disruption. Although Australia and New Zealand have not been affected as much as some other countries, resuscitation may still pose a risk to health care workers and necessitates a change to our traditional approach. This consensus statement for adult cardiac arrest in the setting of COVID-19 has been produced by the Australasian College for Emergency Medicine (ACEM) and aligns with national and international recommendations.

Safer coalmines, happier, healthier and more engaged canaries.

Addressing and limiting burnout and its significant impacts on emergency physicians is an important and ongoing challenge, requiring much more than a focus on individual resilience. This is a key understanding which guides and informs the Australasian College for Emergency Medicine's holistic approach and advocacy efforts when it comes to the wellness of emergency physicians and the health systems in which they operate.

ICare-ACS (Improving Care Processes for Patients With Suspected Acute Coronary Syndrome): A Study of Cross-System Implementation of a National Clinical Pathway.

Background: Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals.

Emergency and stroke physician combined consensus statement on thrombolysis for acute stroke.

The New Zealand Faculty of the Australasian College for Emergency Medicine (ACEM) is the professional body representing the specialist emergency medicine physicians who work in and lead emergency departments of New Zealand. The National Stroke Network Leadership Group represents New Zealand stroke clinicians including stroke physicians and neurologists who work within and lead district health board (DHB) stroke services. In an effort to promote their shared goal of ensuring patient safety while striving to achieve improved stroke outcomes, the two communities have set up a consensus group to develop this combined emergency physician and neurologist/stroke physician consensus statement on the use of intravenous alteplase in stroke ('stroke thrombolysis').

Meningococcal disease deaths and the frequency of antibiotic administration delays.

Objective: Meningococcal disease (MCD) remains a medical emergency and a frequent cause of death in previously healthy individuals. We aimed to determine the frequency and cause of delays in antibiotic administration in a cohort of deaths.

Methods: A retrospective chart review was undertaken on 140 hospitalised MCD deaths within New Zealand's serogroup B epidemic (1993-2004).