Preparing for reopening: An emergency care perspective

Abstract

Australia is rapidly moving towards ‘living with COVID‐19’, with relaxation of some public health measures. The number of severe cases of COVID‐19 may be mitigated by vaccination, but ‘living with COVID‐19’ will be associated with higher number of patients seeking emergency care. This impending impact on the emergency care system requires recognition, monitoring and co‐ordinated management. Current challenges include a lack of emergency care monitoring systems, staff shortages and patient flow processes that are quickly overwhelmed by large numbers, particularly in a system already operating at capacity. Effective monitoring systems are required for health systems to proactively detect and respond to stresses. Additional solutions include public health messaging and clinical innovation to facilitate care of the right patient in the right place at the right time. Optimising staff numbers and morale, and efficient patient flow, are integral steps to increasing capacity within the emergency care system.

Lessons from the frontline: The value of emergency care processes and data to pandemic responses across the Pacific region

“…The study findings are broadly in keeping with the lessons learnt from other EC settings and regions during the pandemic. 12 , 13 , 14 , 23 , 36 , 37 , 38 For instance, the value of dynamic strategies for triage and screening for COVID-19 was recognised early on by West African clinicians with recent experience of Ebola virus disease (EVD), 37 and has been reinforced by experiences in North Africa. 36 A recent consensus statement from a consortium of global critical care experts has also confirmed the role of simple triage instruments and clinical processes in responding to the pandemic.…”

“… 12 , 13 , 20 , 22 For example, placing high transmission risk patients in negative pressure and/or individual rooms is a recommended strategy for HICs. 38 , 42 However, this is not a practical solution for most resource-limited EDs, which rarely have individual cubicles (or equipment) and rely on open ward models to maximise the visibility of patients to clinical staff. 43 …”

Optimising Access to Healthcare for Patients Experiencing Homelessness in Hospital Emergency Departments

“…As noted in a recent systematic review by Vohra et al [15], the ED is an urgent care and resource-intensive environment, and it is challenging in this setting to care for patients with a multitude of diagnosed and undiagnosed health conditions, compounded by poor social circumstances. The COVID-19 pandemic has further added extraordinary pressure on strained hospital services, including EDs [29,30].…”

Disposition of patients utilising the virtual emergency department service in southeast region of Melbourne (SERVED‐1)

“…The pandemic has exacerbated pressure with staff shortages, ward closures, disruption to community services and isolation and infection control procedures. 2,3 It is now recognised a substantial proportion of presentations could be safely and efficiently managed outside of EDs, 4,5 if appropriate alternatives were available to access care. This approach is supported by The Australian Commission for Safety and Quality in Healthcare charter of rights, which emphasises that consumers must get the right care, in the right place, at the right time.…”

“…A persistent increase in ED attendances above population growth 1 has contributed to overcrowded EDs, limiting capacity to provide optimal emergency care for consumers. The pandemic has exacerbated pressure with staff shortages, ward closures, disruption to community services and isolation and infection control procedures 2,3 …”