Mapping workforce configuration and operational models in Australian emergency departments: a national survey

Gardner, G; Gardner, A; Middleton, S; Considine, J; Fitzgerald, G; Christofis, L; Doubrovsky, A; Adams, M; O'Connell, J

Mapping workforce configuration and operational models in Australian emergency departments: a national survey

Gardner, G Gardner, A Middleton, S Considine, J Fitzgerald, G Christofis, L Doubrovsky, A Adams, M O'Connell, J

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Publisher:: CSIRO Publishing
Publication Type:: Journal Article
Citation:: Australian Health Review, 2018, 42 (3), pp. 340 - 340
Issue Date:: 2018

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Field	Value	Language
dc.contributor.author	Gardner, G	en_US
dc.contributor.author	Gardner, A	en_US
dc.contributor.author	Middleton, S	en_US
dc.contributor.author	Considine, J	en_US
dc.contributor.author	Fitzgerald, G	en_US
dc.contributor.author	Christofis, L	en_US
dc.contributor.author	Doubrovsky, A	en_US
dc.contributor.author	Adams, M	en_US
dc.contributor.author	O'Connell, J	en_US
dc.date.issued	2018	en_US
dc.identifier.citation	Australian Health Review, 2018, 42 (3), pp. 340 - 340	en_US
dc.identifier.issn	0156-5788	en_US
dc.identifier.uri	http://hdl.handle.net/10453/134330
dc.description.abstract	<jats:p> Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs. Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study. Telephone interviews were conducted with nursing or medical department managers to collect data related to hospital characteristics, ED workforce and training and ED service and operational models. Results Surveys were completed in 87% of the population sample (n = 135). Metropolitan EDs were significantly more likely to retain higher full-time equivalents (FTEs) in several medical (staff specialist, registrar, resident and intern) and nursing (nurse practitioner (NP), nurse educator, nurse unit manager and registered nurse) positions. NPs were employed by 52% of Australian EDs overall, but this ranged from 40% to 75% depending on jurisdiction. The most commonly used operational models were FastTrack teams (72% of EDs), short-stay/observational unit (59%) and patient liaison models for aged care (84%) and mental health (61%). EDs that employed NPs were significantly more likely to use FastTrack (P = 0.002). Allied health services most frequently available within these EDs were radiology (60%), social work (69%), physiotherapy (70%) and pharmacy (65%). Conclusions The present study has established a baseline measure of the staffing configuration and organisational characteristics of Australian EDs. What is known about the topic? EDs are overcrowded due, in part, to the combined effect of increased service demand and access block. Innovative service and workforce models have been implemented by health departments aiming to improve service and performance. National uptake of these service and workforce innovations is unknown. What does this paper add? The present study is the most comprehensive to date profiling Australian EDs covering hospital characteristics, workforce configuration, operational models and NP service patterns and practice. What are the implications for practitioners? Information from the present study will assist health service planners to evaluate workforce and service reform models, and to monitor trends in emergency service development. </jats:p>	en_US
dc.language	en	en_US
dc.publisher	CSIRO Publishing	en_US
dc.relation.ispartof	Australian Health Review	en_US
dc.relation.isbasedon	10.1071/ah16231	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.title	Mapping workforce configuration and operational models in Australian emergency departments: a national survey	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	42	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1605 Policy and Administration	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.consider-herdc	false	en_US
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	42	en_US

Abstract:

Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs. Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study. Telephone interviews were conducted with nursing or medical department managers to collect data related to hospital characteristics, ED workforce and training and ED service and operational models. Results Surveys were completed in 87% of the population sample (n = 135). Metropolitan EDs were significantly more likely to retain higher full-time equivalents (FTEs) in several medical (staff specialist, registrar, resident and intern) and nursing (nurse practitioner (NP), nurse educator, nurse unit manager and registered nurse) positions. NPs were employed by 52% of Australian EDs overall, but this ranged from 40% to 75% depending on jurisdiction. The most commonly used operational models were FastTrack teams (72% of EDs), short-stay/observational unit (59%) and patient liaison models for aged care (84%) and mental health (61%). EDs that employed NPs were significantly more likely to use FastTrack (P = 0.002). Allied health services most frequently available within these EDs were radiology (60%), social work (69%), physiotherapy (70%) and pharmacy (65%). Conclusions The present study has established a baseline measure of the staffing configuration and organisational characteristics of Australian EDs. What is known about the topic? EDs are overcrowded due, in part, to the combined effect of increased service demand and access block. Innovative service and workforce models have been implemented by health departments aiming to improve service and performance. National uptake of these service and workforce innovations is unknown. What does this paper add? The present study is the most comprehensive to date profiling Australian EDs covering hospital characteristics, workforce configuration, operational models and NP service patterns and practice. What are the implications for practitioners? Information from the present study will assist health service planners to evaluate workforce and service reform models, and to monitor trends in emergency service development.

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http://hdl.handle.net/10453/134330