Australasian Emergency Care最新文献

{"title":"Barriers and facilitators to paramedics use of referral pathways as alternatives to emergency department presentation: A scoping review.","authors":"Brianna Gray, Meena Gupta, Robbie King","doi":"10.1016/j.auec.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.auec.2026.03.002","url":null,"abstract":"<p><strong>Background: </strong>An increasing proportion of patients attended by paramedics are more suitable for referral to health and social services in the community rather than attendance at hospital emergency departments. Despite the growing number of referral pathways available to paramedics, they often remain underused.</p><p><strong>Aims: </strong>To describe the depth of literature, synthesise data, and to provide an enhanced understanding of the barriers and facilitators that impact paramedics' use of referral pathways.</p><p><strong>Methods: </strong>A scoping review was performed by applying the Joanna Briggs Institute (JBI) methodology. The search strategy was translated and conducted in five databases: CINAHL Complete, MEDLINE Complete, APA PsycInfo from the EBSCOhost interface, Web of Science Core Collection from the Clarivate Interface and Scopus.</p><p><strong>Results: </strong>Thirty-five articles, mostly of qualitative design, from six countries were included. Key barriers included lack of access to pathways, fear of consequences, inability to access patient records, and paramedic role perception intersecting with perceived time pressures. Core facilitators included enhanced paramedic education for non-emergency presentations, positive rather than punitive feedback, and improved satisfaction from being empowered to provide person-centred care.</p><p><strong>Conclusions: </strong>To improve use of referral pathways, emergency medical services and local health systems need to consider collaboration on referral processes, increase the number of pathways, provide paramedics education on primary and urgent care presentations, and shift paramedic culture. Due to the heterogeneity of studies and settings, to inform improved referral processes, further investigation is required at local system level.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789584","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":"Urgent care centres and their role in metropolitan healthcare systems in high-income countries: A scoping review.","authors":"Nicole W Carter, Judith Finn, Janie A Brown","doi":"10.1016/j.auec.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.auec.2026.03.003","url":null,"abstract":"<p><strong>Background: </strong>Urgent care centres are expanding within high-income metropolitan healthcare systems as an accessible option for non-life-threatening conditions. Understanding their service scope, patient profiles, and system impacts is critical to informing policy and care delivery.</p><p><strong>Methods: </strong>A scoping review was conducted using the JBI methodology. MEDLINE, EMBASE, CINAHL, and Web of Science were searched up to September 2025. Studies published in English between 1970 and 2025 were included. Two independent reviewers screened all citations, and data were extracted using a standardised template covering patient demographics, service characteristics, and health system outcomes.</p><p><strong>Results: </strong>Twenty-two studies were included, mostly from the United States. Urgent care centres primarily served younger adults, especially women, presenting with minor injuries, infections, and musculoskeletal conditions. Services were disproportionately located in higher-income metropolitan areas. Staffing models ranged from physician-only to multidisciplinary teams, and workforce reporting outside North American studies was limited. Some evidence suggests that reductions in low-acuity emergency department visits occurred when urgent care centres were located near hospitals, although overall effects on emergency department and primary care utilisation were mixed. UCCs reduce per-visit costs, but total system expenditure may increase due to induced demand. Where reported, patient outcomes and satisfaction were generally favourable.</p><p><strong>Conclusions: </strong>Urgent care centres offer value in managing acute, non-emergent care but require policy alignment in workforce, funding, and integration to maximise impact.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724919","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":"A comparative analysis of emergency department key performance indicators across Australia: Metrics over meaning?","authors":"Viet Tran, Simone A Page, Lauren Thurlow, Giles Barrington","doi":"10.1016/j.auec.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.auec.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>The adoption of key performance indicators (KPIs) in healthcare has transcended fiscal objectives, now seen as a symbol of commitment to high quality and safe patient care. Our objective was to describe and compare Australian Government state and territory-based Emergency Department (ED) KPIs.</p><p><strong>Methods: </strong>Summative content analysis of all Australian Government state and territory health performance frameworks for 2024-2025 and supplementary documents describing ED KPIs.</p><p><strong>Results: </strong>ED KPIs varied widely in number and categories across Australia. The proportion of patients seen on time was the only KPI used across all jurisdictions. All jurisdictions aside from Western Australia used ED length of stay as a KPI. Ambulance offload time was used in four jurisdictions. Only Tasmania measured 'did not wait' and only South Australia measured unplanned reattendance as a KPI. Both New South Wales and Tasmania used ED specific patient experience measures in their KPIs. KPIs measuring safety were reported across all jurisdictions but were not specific for ED. There were no KPIs measuring quality standards.</p><p><strong>Conclusions: </strong>Wide variability in ED KPIs and types of measures limit the ability to benchmark ED care nationally. This variability is shared internationally. It is important that policy makers, clinicians and the public also remain vigilant of the limitations of current KPIs and what they measure.</p>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461055","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":"Drowning in research? A scoping review of the emergency response to medical emergencies occurring in water-based environments","authors":"Derek Collings-Hughes ,&nbsp;Ashlea Smith ,&nbsp;Stephen Ball","doi":"10.1016/j.auec.2025.08.003","DOIUrl":"10.1016/j.auec.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>The water-based environment presents challenges to emergency services responding to medical emergencies. These include logistical difficulties, interagency response requirements, and knowledge of unique clinical conditions. Understanding which water-based incidents need emergency response, their locations, and resource needs is essential for preparing paramedics and other emergency service personnel.</div></div><div><h3>Objective</h3><div>To describe the existing literature examining the prehospital response and management of patients who experience an emergency in a water-based environment.</div></div><div><h3>Review methods</h3><div>This review used a scoping review methodology following JBI guidance. Five databases were searched: Ovid Medline, EMCARE, CINAHL, SPORTDiscus, and Web of Science. Two independent reviewers screened articles against predefined inclusion criteria. Data were extracted using a structured form, in accordance with JBI guidance.</div></div><div><h3>Results</h3><div>The search identified 6122 articles, of which 101 were included in the review. Eight emergency service types were described. A broad range of medical emergencies were reported, although most studies focused on fatal drowning. Research on non-fatal drowning and interagency coordination was limited, and reported outcome varied considerably across studies.</div></div><div><h3>Conclusions</h3><div>Much of the prehospital research on water-based emergencies reports only on fatal drowning, with limited attention to other incident types or agency interoperability. Further research is needed to improve understanding of emergency response, patient outcomes, and interoperability of emergency services in the context of water-based emergencies.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 54-64"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979887","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":"Understanding paramedic attrition: A scoping review exploring why paramedics are leaving the profession","authors":"Rachael Middleton,&nbsp;Tanya Capper,&nbsp;Robbie King,&nbsp;Scott Devenish","doi":"10.1016/j.auec.2025.07.002","DOIUrl":"10.1016/j.auec.2025.07.002","url":null,"abstract":"<div><div>Over the past decade, health care and ambulance organisations worldwide have reported increasing paramedic attrition rates, with many of these leavers exiting the profession entirely. Retaining experienced paramedics is necessary to improve patient outcomes, decreasing onboarding costs, and to continue the progression of the profession. Understanding paramedic attrition has gained more interest in the literature; however, studies have mainly focussed on paramedics leaving their place of employment rather than the profession altogether. It is important that this distinction is made as the influencing factors likely vary, requiring different retention strategies. This scoping review aimed to determine the main factors influencing paramedics to leave the profession and identify areas for further research. A total of 1026 articles were screened, of which 28 were included in the final review. Content analysis of their key findings led to the identification of three main themes and 14 subthemes that illustrate the main factors influencing paramedics’ decisions to leave the profession. This review found that paramedic attrition is driven by a complex combination of organisational, occupational, and personal factors. More research, especially from outside the United States, is needed to better understand why paramedics are leaving the profession and to identify targeted retention strategies.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 22-29"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805349","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":"Parent experiences and psychosocial needs during critical paediatric emergencies: A thematic network analysis","authors":"Alys-Marie Manguy ,&nbsp;Ed Oakley ,&nbsp;Rob Gordon ,&nbsp;Lynette Joubert","doi":"10.1016/j.auec.2025.08.002","DOIUrl":"10.1016/j.auec.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Family presence during critical paediatric emergencies is increasingly accepted practice in paediatric emergency departments, within Australia and internationally. However, limited research explores parent experiences in high-acuity, resuscitation-level presentations.</div></div><div><h3>Methods</h3><div>This qualitative study used Attride-Stirling’s thematic network analysis methodology to identify key themes. Semi-structured telephone interviews were undertaken with 20 parents whose child received care during a critical paediatric emergency at the Emergency Department of The Royal Children’s Hospital, Melbourne, Australia.</div></div><div><h3>Results</h3><div>Thematic network analysis identified 136 unique themes relating to parent experiences and self-identified psychosocial care needs, resulting in the two organising themes of ‘Parent perspectives’ and ‘Emergency system interventions’, and the global theme of ‘Family responsive service protocols’. These findings highlight the value of family-centred care approaches in paediatric emergency settings, emphasising the importance of staff communication skills and peri-event psychosocial support throughout the episode of care.</div></div><div><h3>Conclusions</h3><div>Recommendations for practice include enhancing communication strategies, improving pre-arrival preparation, optimising the physical environment, and implementing dedicated family support roles.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 45-53"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862736","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":"In-service training needs and expectations of junior nurses in Chinese emergency departments: A qualitative study based on the COM-B model","authors":"Qiqi Liu ,&nbsp;Lijin Zhou ,&nbsp;Yuanyuan Tang ,&nbsp;Wenlin Cheng ,&nbsp;Yifan Zhang ,&nbsp;Yanjie Ma ,&nbsp;Yanhong Liu ,&nbsp;Rui Li","doi":"10.1016/j.auec.2025.08.001","DOIUrl":"10.1016/j.auec.2025.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the in-service training needs and expectations of junior nurses in Chinese emergency departments, using the Capability-Opportunity-Motivation-Behaviour (COM-B) model to inform the development of targeted training strategies.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design and inductive thematic analysis were used. Semi-structured face-to-face interviews were conducted with 16 emergency department (ED) staff between January and February 2025.</div></div><div><h3>Results</h3><div>The training needs and expectations of junior ED nurses can be summarised into four themes: capability, the depth of mental and physical needs; opportunity, the two-way construction of physical and social opportunities; motivation, the synergy of self-motivation and reflective motivation; and training management: diversified training forms, scientifically reasonable training time, composite team of lecturers, and multidimensional assessment and evaluation.</div></div><div><h3>Conclusion</h3><div>In developing in-service training program, nursing managers should pay attention to the needs of nurses in terms of competence, motivation, opportunity and training management, and design training content and forms that meet actual needs, in order to enhance the professionalism and clinical competence of junior ED nurses, strengthen professional identity and work motivation, reduce the willingness to leave, and promote sustainable development.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 36-44"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884342","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":"“In from the Beginning” – Evaluation of a framework to improve the experience of nurses commencing in the emergency department","authors":"Anna O’Hare ,&nbsp;Geoffrey Melville ,&nbsp;Brenton Ritchie ,&nbsp;Ryan Kloger ,&nbsp;Barb Crawford ,&nbsp;Kate Curtis","doi":"10.1016/j.auec.2025.07.001","DOIUrl":"10.1016/j.auec.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Australia has a nursing shortage. Emergency Departments (EDs) are particularly affected, necessitating interventions to support and retain new emergency nurses. This study evaluates \"In from the Beginning,\" a framework designed to improve the experience of new emergency nurses.</div></div><div><h3>Methods</h3><div>A 12-month longitudinal study was conducted in 2023–2024 at three Australian EDs with 72 nurses. Surveys administered at baseline, six and 12 months were used to assess ascent to competence and belonging. Differences between groups were assessed using nonparametric tests, changes over time with linear mixed-effects models and content analysis for free text.</div></div><div><h3>Results</h3><div>All 72 nurses participated, 15 received the intervention, 50 (70 %) completed 12 m follow-up. Participants reported high levels of feeling welcomed (median 26.5/30). The intervention group reported lower baseline self-confidence, but greater rate of improvement compared to control group (β=8.95, SE=3.75, p = 0.019). There were no differences in belonging, learning and competency. Qualitative data emphasised importance of mentorship. Retention at 12 months was 87 % in the intervention group and 65 % in control group (Χ²₍₁₎ = 1.72. p = 0.19).</div></div><div><h3>Conclusion</h3><div>The \"In from the Beginning\" framework provided support to new emergency nurses and resulted in improved self-confidence. Future research will explore long-term impacts on retention.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 14-21"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746124","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":"RESCUE – Rapid, Effective, Safe Communication in Emergency Departments: A cross-sectional e-survey","authors":"Syeda Kashaf Batool ,&nbsp;Syed Sarim Naqvi","doi":"10.1016/j.auec.2025.06.011","DOIUrl":"10.1016/j.auec.2025.06.011","url":null,"abstract":"","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Page 1"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577043","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":"So close, yet so far: Understanding the relationship between ambulance mobilisation times and survival from out-of-hospital cardiac arrest in rural Western Australia","authors":"Ashlea Smith BSc ,&nbsp;David Majewski PhD ,&nbsp;Gavin Pereira PhD ,&nbsp;Jason Belcher MPhil ,&nbsp;Karen Stewart ,&nbsp;Judith Finn PhD ,&nbsp;Stephen Ball PhD","doi":"10.1016/j.auec.2025.06.010","DOIUrl":"10.1016/j.auec.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Internationally, rural areas tend to have prolonged emergency medical service (EMS) response times, associated with a lower survival from out-of-hospital cardiac arrest (OHCA). We examined how the components of EMS response time to OHCA vary according to rurality in Western Australia (WA), and estimated the effect that reducing rural mobilisation times might have on OHCA survival.</div></div><div><h3>Methods</h3><div>Using a retrospective cohort of medical OHCAs in WA with EMS-resuscitation attempted, from 2015 to 2022, we compared the components of response time (Triage, Mobilisation, Travel to the scene and Total Response), stratified by regional remoteness and proximity to nearest town. Using only the rural subgroup, we then used counterfactual simulation methodology to estimate the number of 30-day survivors if response times were reduced in rural areas.</div></div><div><h3>Results</h3><div>Total EMS response time increased with increasing regional remoteness. Mobilisation time also increased with regional remoteness, even among OHCAs occurring within towns; in rural areas, median mobilisation time was 3.32 mins (1.43, 10.00) (mean 6.24, sd 6.61), with metropolitan areas having a median of 0.97 mins (0.63, 1.48) (mean 1.43, sd 2.65). If rural areas had the same mean mobilisation time as metropolitan areas, the relative increase in the estimated number of rural survivors (16.9 %) was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Mobilisation times were significantly longer in rural areas of WA than metropolitan. These results demonstrate that the effects of rurality on OHCA response time are not simply due to rural patients having increased distance from emergency services. Efforts to improve rapid bystander interventions may be particularly beneficial in rural towns for the crucial minutes before EMS personnel arrive.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 4-13"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555923","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}