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

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.

Assessment of nationwide emergency systems in Thailand, a middle‐income country setting with UHC

“…This study provides rare evidence at national scale profiling hospital emergency system in Thailand, a middle‐income country with UHC. ED size in our study (50 000 visits per year; Table ) is roughly similar to that of a national survey in Australia, 36.3% with less than 30 000 ED visits per year …”

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Nursing service innovation: A case study examining emergency nurse practitioner service sustainability

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“…This questionnaire was developed following the examination of Australian emergency department nurse practitioner workforce (Gardner et al., ). Participants were asked to provide information related to distribution of work across service models and limitations to practice (Gardner et al., ). For example, question 3.1 asked, Do you have a pharmaceutical benefits scheme number?…”

Assessment of Time-Series Machine Learning Methods for Forecasting Hospital Discharge Volume

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