Emergency Department data to reduce alcohol-related harm

Associate Professor Diana Egerton-Warburton

Reducing alcohol-related injury using emergency department (ED) data is the aim of a collaborative project including researchers and clinicians at Monash University and Monash Health.

Monash University’s Clinical Adjunct Associate Professor Diana Egerton-Warburton is a member of the research team awarded an NHMRC partnership grant for the important public health project.

Based on an international model, the intervention has already shown to substantially reduce violent crimes, street assaults and hospital admissions related to alcohol.

“Our project aims to reduce ED attendances related to risky drinking, based on the Cardiff model, which has been introduced in more than 80% of emergency departments in the UK,” said Associate Professor Egerton-Warburton, Director of Emergency Medicine Research at Monash Health.

Building on the international evidence and pilot data from Australia, the team will oversee and evaluate an intervention that aims to reduce alcohol-related injury in the community through a randomised trial in eight emergency departments in Victoria, NSW and the ACT.

“In the UK, this public health project has demonstrated to have a payback of 83 pounds per 1 pound spent—and has significantly reduced emergency department injury presentations and police work,” said Associate Professor Egerton-Warburton.

A key aspect will be the introduction of mandatory “last-drinks” data collection within existing hospital IT systems for triage/clinician follow-up.

Associate Professor Egerton-Warburton said this project gives emergency clinicians the opportunity to become part of the solution, not just mop up the end result of alcohol harm.

“This project has the potential to lead to improved practices in emergency departments across Australia—helping to reduce the national incidence of alcohol-related harm.”

Led by Professor Peter Miller from Deakin University’s Centre for Social and Early Emotional Development, the project team will work with colleagues at St Vincent's Hospital Australia (Melbourne and Sydney), the Australasian College for Emergency Medicine, Australian National University, Barwon Health, Calvary Health Care ACT, Monash Health, University of New South Wales, South West Health Care, and Cardiff University.

Monash Health will contribute $430,000 to run the project for 5 years.

Monash medical students enable emergency department research

Fourth year students Mariam Hassan, Neda So
and Eliott with her mother in ED

Monash University medical students worked tirelessly last week to undertake a research study to help determine why parents bring their children to the Emergency Departments (EDs) at Monash Health.

The first of its kind, the study will link the advice sought prior to ED presentation, triage categories, reasons for presenting and the outcomes of ED attendance.

Led by Monash Paediatric Emergency Department’s Associate Professor Simon Craig, the study was carried out over one week from 15 to 22 June in the EDs at Monash Medical Centre (MMC) and Casey Hospital.

“Thanks to the hard work and commitment of our medical students, more than 950 patient surveys were completed in just one week.  Without their help, we couldn’t have done this study,” said Associate Professor Craig.

Final year medical student Scott McNeil
with Lucia and her father in ED

Coordinated and rostered by final year medical student Scott McNeil, 48 students volunteered to work a combination of day, evening and night shifts to ensure 24/7 coverage of the two hospitals for the whole study period—and in their holidays no less!

“Our students did a fantastic job, entering the data pretty much in real time,” said Associate Professor Craig.  “We hope that this sort of research model may be useful for future studies, not only in the ED but in the rest of the hospital as well.”

Participation in the study was 100% voluntary, and all medical students were recruited through the Monash University Paediatric Promotion, Interest and Training Society (MUPPITS) Facebook page.

“Student involvement was vital to the project,” said MUPPITS Chair Scott McNeil.

“In order to gain the required study participants, we had 24 hour presence in both emergency departments at MMC and Casey, allowing us to get real-time data.“
“Without the large number of students sacrificing their holidays, we couldn’t have achieved it,” said Scott.

Most medical students don’t have time to complete a full research project from beginning to end and Associate Professor Craig was keen to give the students a taste of research.

“The students experienced how data is collected in ‘real life’, with all of the challenges of approaching patients and families, asking questions and data entry,” said Associate Professor Craig.

“They were also exposed to a large amount of time in the ED—a great opportunity to see how the department really works.”

Fourth year medical student Mariam Hassan said being involved in the study was a terrific opportunity to see first-hand how research works. Mariam and fellow student Neda So volunteered to cover the ED for the project from 11pm to 8am, their first night shift experience.

“It was really interesting to see the patient experience and how ED operates at night,” said fourth year medical student Neda.

“As well as contributing to this research and helping Associate Professor Craig with the project, we’re getting great clinical and teaching experience.”

The results of the study will be used to plan future services at Monash Children’s Hospital.