Evaluation of ECI Leadership Forum – 9 August 2013 On 9 August 2013 the Emergency Care Institute NSW (ECI) held the sixth Emergency Department Leadership Forum. 76 registered and 68 attended on the day (89% of those registered). 41% of attendees were Medical and one half (50%) were Nursing. Of the Medical staff attending 79% registered as ED Directors, and 65% of Nurses registered as Managers. 43 attendees completed the feedback form (63% response rate). Most attendees were from the Sydney area. 9 August 2013 Forum: Location of attendees Sydney LHD Northern Sydney LHD Western Sydney LHD Western NSW LHD Other Illawarra Shoalhaven LHD SW Sydney LHD Southern NSW LHD HNE LHD St Vincent's & Mater Health Network SE Sydney LHD Murrumbidgee LHD Sydney Children's Hospital network Central Coast LHD Northern NSW LHD Nepean Blue Mountains LHD Mid North Coast LHD Far West LHD Network with Vic 8 8 6 6 6 6 4 4 4 3 3 3 2 2 1 1 1 0 0 0 5 Number of attendees 10 General rating for the day overall The “general rating for the day overall’ for August 2013 was close to ‘Very Good’. 9 August 2013 Forum: Overall event rating December 2012 February 2013 2.6 2.7 May 2013 August 2013 Poor 3.1 2.9 Fair Good Very Good Excellent Feedback on main sessions The feedback ratings are presented as single average scores, plotted within the five‐level ranking Excellent to Poor. An aggregate ‘benchmark’ rating is included which is the combined ratings for all previous events. Key findings are:   Four out of the six presentations scored approximately ‘Very Good’ In a separate evaluation form question (not plotted) ‘Activity based funding’ was classed as the most relevant session (15 votes) followed by humidified nasal prong oxygen (9 votes). ‘Severe burns’ was the third most relevant (5 votes). 9 August 2013 Forum: Main session and benchmark (average and SD range) HARD and difficult airway… Humidified nasal prong oxygen General rating General rating for the day ECI update Activity based funding The severe burns patient ICU/HDU outcomes and the future Benchmark Forum Presentations* Poor Fair Good Very Good Excellent *Benchmark values are the combined average ratings for all Leadership Forums Feedback on facilities Attendees felt facilities were close to “Very Good”, and the ratings for catering and venue are higher than the benchmark (see plot overleaf). The venue used for the last two Forums appears popular. However, there were comments about poor acoustics, not being able to follow speakers and hot/stuffy room: “Poor acoustics, ‘echeoy’, poor PA system” “Difficult to hear speakers most of the time” “Poor audio ‐ particularly at the back” “Too hot, bad audio ‐ people mumbling” “Room quite warm and stuffy after lunch” 9 August 2013 Forum: Facilities Catering Venue Benchmark Forum Facilities* Poor Fair Good Very Good Excellent *Benchmark values are the combined average ratings for catering and venue for all Leadership Forum Would attendees come to a future Forum?  100% of attendees stated they would come to a future forum. The reasons why were to network and stay up‐to‐date. Key findings/ideas for ongoing ED Leadership Forum   Overall, a successful Forum. A return to the group‐table format was well received However, there were some acoustic issues – people found it hard to hear at times or follow clearly what was being said  Some audience members would like opportunities to develop topics and conduct reviews: o “Given burns estimation is so poorly done, education on this or discussion of a model on how to improve estimation” o “Review evidence for top 10 ED presentations (not usually) addressed ‐ have we got these right and are we consistent. e.g. anaphylaxis” o “Would be good to have more time for questions on ABF” Future agenda suggestions Managerial/administrative          NEAT, comparison of ED care models, pros/cons, different ideas. Impact of NEAT on workforce retention and satisfaction National standards ‐ Australian Commission on Safety, Quality in Healthcare NSW SAGO Chart, policies coming from the Ministry Firstnet and State‐wide ED data comparisons RCA process ‐ how to? Standardised drug administration guidelines ED workforce, staffing models, senior streaming model, staff performance benchmarking, medical/nursing to patient ratios for safe care delivery Successful quality projects in ED or new innovations in ED. Quality project outcomes. Impact of NP role in ED Clinical              Spinal injury, brain injury Paediatric emergency (shock, fever), new paediatric sepsis guidelines Resistant arrhythmia Pulmonary embolism in pregnancy What to do with paediatric patients too sick for the ward, but not sick enough for transfer/NETS? Psychotic patient presentations, mental health management in ED, especially discussion of medical clearance Headaches Advance care directives, EOL Therapeutic hypothermia Chest pain pathways Misuse of troponins in ED Anaphylaxis Organophosphate poisoning