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Issue

Vol 124 No 1344: 14 October 2011

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Issue Summary

SUMMARY

National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study)

Martin J Connolly, Timothy Kenealy, P Alan Barber, Peter Carswell, Janet Clinton, Lorna Dyall, Gerard Devlin, Robert N Doughty, Ngaire Kerse, John Kolbe, Ross Lawrenson, Allan Moffitt, Nicolette Sheridan

Chronic disease is the leading cause of illness, mortality, and inequitable health outcomes in New Zealand. This study aimed to identify extent of long-term conditions management evidence-based practices in stroke, heart disease, stroke and chronic lung disease in New Zealands District Health Boards (DHBs). In 2007/08, 15 DHBs completed two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing actual service provision. There was considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual service provision appeared to relate to DHB size.

SUMMARY

Contemporary sedation practice in a large New Zealand emergency department

Martyn Harvey, Grant Cave, Chris Betham

We have audited the sedation practice in a single large Emergency Department (ED) in New Zealand. Sedation to enable performance of painful procedures was commonly used with good effect. Such a technique may result in quicker, cheaper, and more efficient performance of many simple but painful tasks within the ED rather than requiring hospital admission.

SUMMARY

Emergency nurse practitioners: do they provide an effective service in managing minor injuries, compared to emergency medicine registrars?

Margaret Colligan, Caroline Collins, Bernard Foley, Peter Jones, Jennifer Miles, Irene Zeng

The introduction of the Emergency Nurse Practitioner (ENP) role to Auckland Hospital Emergency department has impacted on the waiting times for patients with minor injuries. Currently the ENP role focuses primarily on patients with minor injuries who normally would wait the longest to be seen. This research study found that the ENP role does reduce waiting times and length of stay for patients. ENPs appear to see minor injury patients faster than Emergency Medicine Registrars and this may account for the reduced length of stay for patients. In the current environment in New Zealand with the 6-hour target this role proves to beneficial to meeting this goal.

SUMMARY

Project RED—a successful methodology for improving emergency department performance

Michael W Ardagh, Angela M Pitchford, Anne Esson, Heather Manson, Brian Dolan

Emergency Department overcrowding is bad for patients and staff. Its causes are multiple and complex, and addressing it requires a comprehensive approach. The methodology of Project RED is pragmatic, innovative, comprehensive and prioritised. It incorporates clinical leadership, management support and project facilitation and is a useful structure for addressing the large and complex problem of ED overcrowding.

SUMMARY

Outcomes from out-of-hospital cardiac arrest in the Wellington region of New Zealand. Does use of the Fire Service make a difference?

Andrew H Swain, Tasmin Barry, Sarah R Hoyle, Grant Haywood, Hayley Cameron, Peter D Larsen

The survival rate from cardiac arrest (cessation of heart activity) in the Wellington region compares favourably with that reported from major cities overseas. Although the Fire Service often responds to cardiac arrest calls and arrives in advance of the Ambulance Service, no improvement in survival has been shown to result from this practice. When a cardiac arrest is witnessed, emergency services can respond more rapidly and the more likely it is that the heart will respond to treatment and the patient survive.

SUMMARY

Improving acute patient flow and resolving emergency department overcrowding in New Zealand hospitals—the major challenges and the promising initiatives

Michael W Ardagh, Gary Tonkin, Clare Possenniskie

All New Zealand hospitals were visited to determine the main challenges and the promising initiatives in relation to achieving the Shorter Stays in the Emergency Department Health Target. Access to hospital beds, inpatient team delays and access to diagnostics are the biggest challenges.

SUMMARY

Manipulation of simple paediatric forearm fractures: a time-based comparison of emergency department sedation with theatre-based anaesthesia

Chris Betham, Martyn Harvey, Grant Cave

Manipulation of childhood forearm fractures is traditionally done in the operating theatre. We have shown setting of simple fractures may be achieved in the Emergency Department under sedation with comparable outcome, but with significant savings in time both before and after the procedure thus enabling early discharge.

ALL ARTICLES
SUMMARY

National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study)

Martin J Connolly, Timothy Kenealy, P Alan Barber, Peter Carswell, Janet Clinton, Lorna Dyall, Gerard Devlin, Robert N Doughty, Ngaire Kerse, John Kolbe, Ross Lawrenson, Allan Moffitt, Nicolette Sheridan

Harold Thomas

Response to article “Spinal manipulation: an update of a systematic review of systematic reviews”

Dusty Quinn; on behalf of The New Zealand Manipulative Physiotherapists Association Inc

Contemporary sedation practice in a large New Zealand emergency department

Martyn Harvey, Grant Cave, Chris Betham

Emergency nurse practitioners: do they provide an effective service in managing minor injuries, compared to emergency medicine registrars?

Margaret Colligan, Caroline Collins, Bernard Foley, Peter Jones, Jennifer Miles, Irene Zeng

Unwarranted variation in healthcare organisation and practice for long-term conditions

Sue Wells, Rod Jackson

Softball injury causing haemoperitoneum due to ruptured Meckel’s mesodiverticular band

Julie Woodfield, Mark Barnett, Peter Shapkov

Procedural sedation in the emergency department: good medicine or flirting with danger?

Benjamin van der Griend, Ross Kennedy

Project RED—a successful methodology for improving emergency department performance

Michael W Ardagh, Angela M Pitchford, Anne Esson, Heather Manson, Brian Dolan

Ernst response to Poelsma regarding spinal manipulation

Nick Wilson, George Thomson, Richard Edwards

Outcomes from out-of-hospital cardiac arrest in the Wellington region of New Zealand. Does use of the Fire Service make a difference?

Andrew H Swain, Tasmin Barry, Sarah R Hoyle, Grant Haywood, Hayley Cameron, Peter D Larsen

Improving acute patient flow and resolving emergency department overcrowding in New Zealand hospitals—the major challenges and the promising initiatives

Michael W Ardagh, Gary Tonkin, Clare Possenniskie

Be wary of a mature adult, who presents with a parent

Syed H Ahmed, King S Leong

A policy of no pharmaceutical industry sponsorship: a case for health equity

Phillip Pinhao Chao

Bahrain health workers in danger: call to action

Brendon Gray, Paul Ockelford

Proceedings of the 209th Scientific Meeting of the Otago Medical School Research Society: Wednesday 28 September 2011

Potential dangers of chest drains: response to case report by Drs Jayathissa and Dee

Kyle Perrin

Dominion Notes: Good work by the Inspector-General

Medical image. Gigantic evidence for a microscopic disease

Anna Ashcroft, Gary J Lim

Medical image. Retinal macroaneurysm following a branch retinal vein occlusion

Andrew Bastawrous, Vineeth Kumar, Som Prasad

The ‘Shorter Stays’ target is a whole health system target, not an emergency department target

Peter Jones

Listeria rhomboencephalitis

Mohamed Ramadan, Nicole M McGrath

End-of-term brief review of the New Zealand Government’s actions on five major health risk factors

Nick Wilson, George Thomson, Richard Edwards

Manipulation of simple paediatric forearm fractures: a time-based comparison of emergency department sedation with theatre-based anaesthesia

Chris Betham, Martyn Harvey, Grant Cave

New Zealanders' favourite natural health products are ineffective

Shaun Holt, Sarah Jeffries, Andrew Gilbey

SUMMARY

National variability in provision of health services for major long-term conditions in New Zealand (a report from the ABCC NZ study)

Martin J Connolly, Timothy Kenealy, P Alan Barber, Peter Carswell, Janet Clinton, Lorna Dyall, Gerard Devlin, Robert N Doughty, Ngaire Kerse, John Kolbe, Ross Lawrenson, Allan Moffitt, Nicolette Sheridan

Chronic disease is the leading cause of illness, mortality, and inequitable health outcomes in New Zealand. This study aimed to identify extent of long-term conditions management evidence-based practices in stroke, heart disease, stroke and chronic lung disease in New Zealands District Health Boards (DHBs). In 2007/08, 15 DHBs completed two questionnaires: a generic component capturing perceptions of practice; and a disease-specific component assessing actual service provision. There was considerable variability in perceptions of long-term conditions management service provision across DHBs. In many instances variability in actual service provision appeared to relate to DHB size.

SUMMARY

Contemporary sedation practice in a large New Zealand emergency department

Martyn Harvey, Grant Cave, Chris Betham

We have audited the sedation practice in a single large Emergency Department (ED) in New Zealand. Sedation to enable performance of painful procedures was commonly used with good effect. Such a technique may result in quicker, cheaper, and more efficient performance of many simple but painful tasks within the ED rather than requiring hospital admission.

SUMMARY

Emergency nurse practitioners: do they provide an effective service in managing minor injuries, compared to emergency medicine registrars?

Margaret Colligan, Caroline Collins, Bernard Foley, Peter Jones, Jennifer Miles, Irene Zeng

The introduction of the Emergency Nurse Practitioner (ENP) role to Auckland Hospital Emergency department has impacted on the waiting times for patients with minor injuries. Currently the ENP role focuses primarily on patients with minor injuries who normally would wait the longest to be seen. This research study found that the ENP role does reduce waiting times and length of stay for patients. ENPs appear to see minor injury patients faster than Emergency Medicine Registrars and this may account for the reduced length of stay for patients. In the current environment in New Zealand with the 6-hour target this role proves to beneficial to meeting this goal.

SUMMARY

Project RED—a successful methodology for improving emergency department performance

Michael W Ardagh, Angela M Pitchford, Anne Esson, Heather Manson, Brian Dolan

Emergency Department overcrowding is bad for patients and staff. Its causes are multiple and complex, and addressing it requires a comprehensive approach. The methodology of Project RED is pragmatic, innovative, comprehensive and prioritised. It incorporates clinical leadership, management support and project facilitation and is a useful structure for addressing the large and complex problem of ED overcrowding.

SUMMARY

Outcomes from out-of-hospital cardiac arrest in the Wellington region of New Zealand. Does use of the Fire Service make a difference?

Andrew H Swain, Tasmin Barry, Sarah R Hoyle, Grant Haywood, Hayley Cameron, Peter D Larsen

The survival rate from cardiac arrest (cessation of heart activity) in the Wellington region compares favourably with that reported from major cities overseas. Although the Fire Service often responds to cardiac arrest calls and arrives in advance of the Ambulance Service, no improvement in survival has been shown to result from this practice. When a cardiac arrest is witnessed, emergency services can respond more rapidly and the more likely it is that the heart will respond to treatment and the patient survive.

SUMMARY

Improving acute patient flow and resolving emergency department overcrowding in New Zealand hospitals—the major challenges and the promising initiatives

Michael W Ardagh, Gary Tonkin, Clare Possenniskie

All New Zealand hospitals were visited to determine the main challenges and the promising initiatives in relation to achieving the Shorter Stays in the Emergency Department Health Target. Access to hospital beds, inpatient team delays and access to diagnostics are the biggest challenges.

SUMMARY

Manipulation of simple paediatric forearm fractures: a time-based comparison of emergency department sedation with theatre-based anaesthesia

Chris Betham, Martyn Harvey, Grant Cave

Manipulation of childhood forearm fractures is traditionally done in the operating theatre. We have shown setting of simple fractures may be achieved in the Emergency Department under sedation with comparable outcome, but with significant savings in time both before and after the procedure thus enabling early discharge.

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