Emergency Medicine Australasia最新文献

{"title":"Rate, Mode, Reasons and Factors Associated With Re-Presentation in People Diagnosed With Musculoskeletal Conditions at a Single Emergency Department: A Cross-Sectional Exploratory Study","authors":"Patricia Slapp,&nbsp;Linda Spencer,&nbsp;Rob Waller,&nbsp;Karen Richards,&nbsp;Anne Smith,&nbsp;Nic Saraceni,&nbsp;Piers Truter","doi":"10.1111/1742-6723.70128","DOIUrl":"https://doi.org/10.1111/1742-6723.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the rate, mode, and reasons for re-presentations for emergency department (ED) patients with musculoskeletal diagnoses and examine factors associated with increased odds of re-presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cross-sectional audit of re-presentation patterns for patients with musculoskeletal diagnoses presenting to the study ED in 2023.</p>\u0000 \u0000 <p>The study ED was in a secondary hospital in Perth, Western Australia, which operates a diversion pathway (daily, 10 am–6 pm) for patients with musculoskeletal diagnoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2023, 3677 patients with musculoskeletal diagnoses were diverted from the ED, 972 provided research consent and of those, 143 (14.7%) re-presented. Importantly, 10 (1.0%) patients re-presented to the ED itself, and 133 (13.7%) re-presented to the physiotherapy outpatient diversion clinic.</p>\u0000 \u0000 <p>There were 65 scheduled and 78 unscheduled re-presentations, with telehealth the preferred mode of contact (<i>n</i> = 86, 60.1%). Clinician diagnostic uncertainty, identified patient psychosocial issues, and concern that the patient would re-present to the ED most commonly resulted in scheduled re-presentation (<i>n</i> = 31, 47.7%). Unscheduled re-presentations focused on administrative inquiries (e.g., hospital referrals, medical certificates) (<i>n</i> = 31, 39.7%) and concern for symptoms (<i>n</i> = 25, 32.1%).</p>\u0000 \u0000 <p>Older age, high pain severity, and lower limb affected body region were associated with increased odds of re-presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ED clinicians may reduce re-presentation by employing targeted strategies such as shared decision-making about pain management, ensuring a shared understanding of the diagnosis, or stage of the diagnostic process and likely course of symptoms. Further, a follow-up plan that is clinically indicated and patient acceptable may be critical for those with increased odds of re-representation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Factors Could Create a More Comfortable Waiting Experience for Patients on Emergency Department Ramps? A Scoping Review","authors":"Vicki Binnie,&nbsp;Robert Eley,&nbsp;Andrew Staib","doi":"10.1111/1742-6723.70125","DOIUrl":"https://doi.org/10.1111/1742-6723.70125","url":null,"abstract":"<div>\u0000 \u0000 <p>Ambulance ramping is the situation where patients who arrive by ambulance are forced to queue for access to an emergency department (ED) cubicle. Despite efforts to address the problem of ambulance ramping, it continues to present a ubiquitous challenge for health services. While facility guidelines consider general healthcare and ED environments, evidence is lacking regarding necessary requirements to provide patient-centred care within the ramp environment. This scoping review identifies current research regarding characteristics of waiting environments that provide better experiences for consumers that may be transferable to the ambulance ramp. It utilises sources from both health and non-health literature to support outcomes. A systematic search of five electronic databases was conducted, reference chaining was undertaken, and grey literature was searched. Levels of evidence were assessed using the Mixed Methods Appraisal Tool. No study was found that specifically addressed the spatial layout of the ED ramp environment in relation to patient experience. Fifty-nine papers were included in the review. Papers underwent an inter-rater assessment regarding translatability of the outcomes to the ramp environment, including perceived complexity and cost. Outcomes with high inter-rater agreement were then discussed according to the domains of psychological, self-efficacy, social and functional. Elements categorised within these domains include privacy, availability of external views and natural elements, proximity of staff and communication, aspects of the physical environment, elements of hospitality, preferred furniture and environmental temperature. This review identifies environmental elements that may support person-centred care while on the ED ramp and informs future facility planning.</p>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital Trauma Care","authors":"John Glasheen","doi":"10.1111/1742-6723.70115","DOIUrl":"https://doi.org/10.1111/1742-6723.70115","url":null,"abstract":"","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Presentations for Low Back Pain by Remoteness and Socioeconomic Status in New South Wales: A Population-Based Study","authors":"Jacqueline North,&nbsp;Zoe A. Michaleff,&nbsp;Michael Lee,&nbsp;Christopher Williams,&nbsp;Alexandre S. Stephens","doi":"10.1111/1742-6723.70127","DOIUrl":"https://doi.org/10.1111/1742-6723.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the patterns of emergency department (ED) presentations for low back pain (LBP) by remoteness and socioeconomic status (SES) in New South Wales (NSW).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective, population-based study of deidentified data was undertaken with data sourced from the NSW Emergency Department Data Collection (EDDC). The study population comprised NSW residents who presented to an NSW public hospital ED in 2013–2019 for LBP and were registered in the NSW EDDC. Total LBP ED presentations, quasi-Poisson regression modelled annual changes in LBP ED presentations over 2013–2019, and age and sex-standardised rates of ED presentations in 2019 were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, between 2013 and 2019, LBP ED presentations increased in both metropolitan and rural NSW, with mean annual percentage increases of 3.5% (95% CI 2.9–4.0) and 4.7% (95% CI 3.6–5.9), respectively. Rates of LBP ED presentations increased with decreasing SES in both metropolitan and rural areas. Rates of LBP ED presentations were higher in rural areas compared to metropolitan NSW across all SES quintiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Remoteness and SES were independently associated with rates of LBP ED presentations. Further research on the underlying causal mechanisms linking rates of LBP to each of these key sociodemographic factors is warranted. Elucidating these mechanisms would provide crucial information to inform strategies to reduce the rates and impacts of LBP presentations in EDs and help counteract social determinants of health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Evaluating the Introduction of Humidified High-Flow Nasal Cannula Therapy Into an Australian Aeromedical Service Within a Paediatric Population: A Retrospective Cohort Study”","authors":"","doi":"10.1111/1742-6723.70124","DOIUrl":"https://doi.org/10.1111/1742-6723.70124","url":null,"abstract":"<p>C. Yap, A. Withers, N. Ghedina, and E. O'Connell, “Evaluating the Introduction of Humidified High-Flow Nasal Cannula Therapy Into an Australian Aeromedical Service Within a Paediatric Population: A Retrospective Cohort Study,” <i>Emergency Medicine Australasia</i> 37, no. 4 (2025): e70105, https://doi.org/10.1111/1742-6723.70105.</p><p>In Paragraph 4 of the Introduction section, the citations are incorrect. The paragraph should read as follows:</p><p>For context, this study has taken place in Western Australia (WA). WA's population was 2.7 million in 2021 and covers over 2.5 million square kilometres, making it the second largest country subdivision in the world [14]. There is one tertiary paediatric centre in WA, Perth Children's Hospital (PCH). Perth Children's Hospital is relatively new, replacing Princess Margaret Hospital in 2018. PCH has a 298-bed capacity and sees 30,000 admissions per year [15]. The Royal Flying Doctor Service (RFDS) is a 24-hour health service that delivers healthcare to those that live in rural and remote Australia. In 2022, RFDS completed 9771 aeromedical transfers (including both adult and paediatric population) [16].</p><p>The references [14], [15] and [16] are shown below:</p><p>14. Australian Bureau of Statistics. Snapshot of Western Australia: High level summary data for Western Australia in 2021. 2022.</p><p>15. Australian Institute of Health and Welfare. Perth Children's Hospital Admissions 2021–2022. 2023.</p><p>16. Royal Flying Doctor Service: Western Operations. Annual Report 2022. Royal Flying Doctor Service, 2022.</p><p>Therefore, the citations throughout the article that come after this paragraph should be corrected to [17], [18], [19].</p><p>Paragraph 1 of section 2.2, should be referenced as follows:</p><p>A manual chart review of aeromedical manifests and inpatient notes was used to collect data. The subset was extracted by three reviewers. Study data were collected and managed using REDCap electronic data capture tools hosted at Child and Adolescent Health Service, Perth, WA [17, 18].</p><p>17. P. A. Harris, R. Taylor, B. L. Minor, et al., “The REDCap Consortium: Building an International Community of Software Platform Partners,” Journal of Biomedical Informatics 95 (2019): 103208.</p><p>18. P. A. Harris, R. Taylor, R. Thielke, J. Payne, N. Gonzalez, and J. G. Conde, “Research Electronic Data Capture (REDCap)—A MetadataDriven Methodology and Workflow Process for Providing Translational Research Informatics Support,” Journal of Biomedical Informatics 42, no. 2 (2009): 377–381.</p><p>Lastly, paragraph 1, sentence 4 of Section 5.1 should read as follows:</p><p>Although neonatal transfers on HHF have been described as successful by multiple studies [12, 19].</p><p>19. B. Muniyappa, G. Honey, and B. A. Yoder, “Efficacy and Safety of Nasal High-Flow Therapy for Neonatal Transport,” Air Medical Journal 38, no. 4 (2019): 298–301.</p><p>We apologise for this error.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Scan Rates and Outcomes in Children Risk-Stratified Using the PREDICT Guideline Algorithm for Risk Stratification of Mild and Moderate Head Injuries","authors":"Stephen J. C. Hearps,&nbsp;Emma Tavender,&nbsp;Meredith L. Borland,&nbsp;Ed Oakley,&nbsp;Anneke Grobler,&nbsp;Vicki Anderson,&nbsp;Karen M. Barlow,&nbsp;Stuart R. Dalziel,&nbsp;Natalie Phillips,&nbsp;Amit Kochar,&nbsp;Sarah Dalton,&nbsp;Jeremy Furyk,&nbsp;Jocelyn Neutze,&nbsp;Amanda Williams,&nbsp;Franz E. Babl,&nbsp;Paediatric Research in Emergency Departments International Collaborative (PREDICT)","doi":"10.1111/1742-6723.70111","DOIUrl":"https://doi.org/10.1111/1742-6723.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Since 2021, the PREDICT Guideline for Mild to Moderate Head Injuries in Children has been widely implemented across Australia and New Zealand. We set out to describe the application of the guideline's risk stratification using an existing database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary analysis of a large multicentre prospective data set of paediatric patients with head injuries. We stratified the sample into high, intermediate, low, and very low risk categories per the PREDICT Guideline algorithm. Rates and 95% confidence intervals (CI) of computed tomography (CT), abnormal CT, and clinically important traumatic brain injury (ciTBI) were determined within these categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 20,137 patients, 1847 were excluded from risk stratification as requiring immediate CT scans (GCS ≤ 13) or as special conditions. 18,290 (90.8%) were stratified into risk categories: 542 (2.9%) high, 4843 (26.0%) intermediate, 2138 (11.5%) low, and 10,767 (57.9%) very low. CT rates were 59.2% (95% CI 55.0%–63.4%) and 18.9% (17.8%–20.1%) in high and intermediate risk groups, with subsequent abnormal CT rates of 42.1% (95% CI 36.6%–47.7%) and 17.6% (95% CI 15.1%–20.2%), and ciTBI rates of 8.9% (95% CI 6.6%–11.6%) and 1.3% (95% CI 1.0%–1.6%), respectively. CT rates were 7.1% (95% CI 6.1%–8.3%) and 1.8% (95% CI 1.6%–2.1%) for low and very low risk groups, with ciTBI rates of 0.4% (95% CI 0.2%–0.8%) and 0.01% (95% CI 0.0002%–0.1%). 9 low and 1 very low risk patient had a ciTBI (2 required neurosurgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PREDICT Guideline algorithm risk stratifies head injuries into high, intermediate, low, and very low risk patients. Two of the missed lower risk patients required neurosurgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia”","authors":"","doi":"10.1111/1742-6723.70120","DOIUrl":"https://doi.org/10.1111/1742-6723.70120","url":null,"abstract":"<p>\u0000 <span>O'Reilly, G. M.</span>, <span>Afroz, A.</span>, <span>Curtis, K.</span>, et al. <span>2025</span>. “ <span>The Incidence and Determinants of Traumatic Brain Injury Deaths Occurring Outside Hospital in Australia</span>.” <i>Emergency Medicine Australasia</i> <span>37</span>: e70051. https://doi.org/10.1111/1742-6723.70051.\u0000 </p><p>The abstract contains one statement that is inconsistent with the analysis results and another statement that is ambiguous in its interpretation of the findings. To address this, the second sentence in the Results section of the Abstract should read as follows:</p><p>“The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), <b>higher for</b> penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in <b>Tasmania, followed by</b> the Northern Territory <b>and</b> Queensland.”</p><p>We apologize for this error.</p>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serendipity, Flexibility, Calling and Commitment: How Clinicians Navigate the Path to Clinician-Coach","authors":"Andrew Rixon,&nbsp;Victoria Lister,&nbsp;Lee Yung Wong,&nbsp;Elizabeth Elder,&nbsp;Samuel Wilson","doi":"10.1111/1742-6723.70122","DOIUrl":"https://doi.org/10.1111/1742-6723.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the practice-related changes that occur as emergency physicians contemplate and navigate the path from clinician to clinician-coach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were interviewed about how they made sense of their coaching roles and coaching practice within the emergency department.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A combination of inductive and deductive qualitative analytic approaches explored the initiation and evolution of the coaching practices of emergency medicine (EM) physicians as they navigated the path from clinician to clinician-coach. Enablers of and barriers to the initiation and development of coaching practices were identified, along with four overarching experiential qualities<b>—</b>serendipity, calling, flexibility, and commitment<b>—</b>that attend and support the process of becoming and being a clinician.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The stages of practice evolution and the notions of serendipity, calling, flexibility, and commitment offer a framework for understanding how EM physicians successfully embark on and navigate the path from clinician to clinician-coach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Examination of Job Satisfaction in Emergency Medicine From the Perspective of Physicians Also Working in Prehospital and Retrieval Medicine","authors":"J. A. Myers,&nbsp;S. Aldington,&nbsp;D. M. C. Powell","doi":"10.1111/1742-6723.70121","DOIUrl":"https://doi.org/10.1111/1742-6723.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Low job satisfaction amongst emergency physicians is a significant risk to career sustainability. Anecdotal evidence suggests that prehospital and retrieval medicine (PHARM) physicians experience relatively high job satisfaction. The objective of this qualitative study was to explore the research question: ‘What influences job satisfaction and sustainability for emergency physicians who maintain dual roles in PHARM and the emergency department?’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible emergency physicians from Australia and New Zealand were interviewed in-depth about their experiences and perceptions of job satisfaction and sustainability. The research team applied experiential knowledge and an inductive analytic approach to construct a conceptual understanding of the physicians' job satisfaction from the data, including factors contributing to career sustainability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our sample included 11 participants, six from Australia and five from New Zealand. We identified six key themes influencing job satisfaction: workload, job factors, personal factors, focus on well-being, culture and management and bureaucracy. These are explored in detail, along with ideas on career sustainability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The nature of emergency medicine work remains inherently satisfying for participants in this study but is influenced by the culture and current working conditions found in many emergency departments, particularly when these factors impact the standard of clinical care physicians feel they can provide. Our findings offer practical guidance on protective factors for job satisfaction and sustainability, including fractional appointments, diversity and flexibility of practice, continuous professional development and access to professional supervision or peer support. Preserving career longevity in emergency medicine requires the implementation of evidence-based, sustainable initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Implementing Clinical Pathways for Acute Care in Tasmania (IMPACT) Project","authors":"Viet Tran,&nbsp;Amanda Neil,&nbsp;Sarah Prior,&nbsp;Emma Tavender,&nbsp;Maria Unwin,&nbsp;Simone Page,&nbsp;Jan Radford,&nbsp;James E. Sharman,&nbsp;Biswadev Mitra,&nbsp;Jim Stankovich,&nbsp;Giles Barrington,&nbsp;Ashley Loughman,&nbsp;Simon Brown,&nbsp;Graeme Zosky,&nbsp;Anthony J. Lawler,&nbsp;Simon Craig","doi":"10.1111/1742-6723.70119","DOIUrl":"https://doi.org/10.1111/1742-6723.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Implementing research findings into clinical practice remains a significant challenge. This manuscript outlines the Implementing Clinical Pathways for Acute Care in Tasmania (IMPACT) project. IMPACT will co-design and evaluate implementation strategies for four clinical pathways—suspected stroke, suspected sepsis, chest pain and fractured neck of femur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods design will include evaluation of practice, focus group exploration of factors contributing to variation, co-designed implementation strategies, and evaluation of their adoptability, implementability, sustainability and economic value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IMPACT will conceptualise and evaluate the framework for implementing clinical pathways across Tasmania.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12624001066572</p>\u0000 </section>\u0000 </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}