EMET improves regional, rural and remote patient care
There are more than 600 emergency departments (EDs) and urgent care centres across Australia, but just 25 percent are currently staffed by FACEMs.
Hospitals without FACEMs are typically located in rural locations with clinical staffing models that include general practitioners, medical officers, nurses, paramedics and allied health workers.
To help regional, rural and remote hospitals and health services across Australia deliver the best possible patient care – even when they don’t have permanent access to a senior emergency medicine specialist – ACEM’s Emergency Medicine Education and Training (EMET) provides education, training and supervision to doctors and other health professionals who are not specifically trained in emergency medical care.
At a recent EMET session held in Wangaratta, in regional Victoria, Registered Nurse Rachel Holmes said the training ‘gives you the skills for more specific interventions and more contemporary ideas about how to manage patients’.
What it also provides, she said, is improved confidence.
“‘With better education and confidence, there is better patient care.’”
Being in a smaller, regional ED, Holmes said that, without the same exposure and knowledge ‘around certain interventions’, attending the training ‘helped me feel much more skilled’.
‘Reading about things in books can only get you so far,’ she said. ‘It’s definitely changed my practice in lots of ways.’
She came to EMET after hearing ‘people rave’ about the quality of ‘evidence-based and more contemporary’ knowledge it offered.
‘I got a lot from it,’ she said. ‘There were lots of little nuggets of information.’
She said that when you have the opportunity to ‘hear from specialist clinicians who deal with serious critical cases all the time, it’s very valuable.’
‘With better education and confidence, there is better patient care.’
Learning how to accurately calculate the amount of fluids to give paediatric patients, at a recent EMET session in Wangaratta, Victoria.
“‘The training helped me feel much more skilled and have lots of evidence-based knowledge about why I should do something a certain way.’”
Holmes has worked in the ED at Northeast Health Wangaratta (NHW) for more than three years, after 18 years as a nurse in the mental health sector. Before going into the EMET experience for the first time, Holmes said she looked forward to enhancing her critical care studies by specifically upskilling in key areas of patient care.
‘To be a critical care nurse in ED who does resuscitation and triage, I want to be more skilled and confident when it comes to paediatric patients,’ she said.
It was a hope that she said EMET delivered, with the training providing her with a number of practical and helpful ways to better engage with young patients.
Holmes said that, although some of the insights shared during the EMET session she attended might have seemed subtle, they were ‘really key’ – including tips on how to communicate with paediatric patients and their families or carers when they present for medical attention and how to make it easier for treating medical staff to undertake whatever intervention is needed for the young person’s unique health care needs.
‘When there’s less trauma for the patient and their family, there are potentially better outcomes for everyone involved,’ she said.
‘If you’re an anxious clinician who doesn’t have experience in something, you’re not going to perform as well. Exposure is the best teacher.
‘The training helped me feel much more skilled and have lots of evidence-based knowledge about why I should do something a certain way.’
“‘Personally, I get confidence in leading the team that I work with every day. I always make it a priority to go when it’s on.’”
Leading a cohesive local team
Dr Elizabeth Brewer is a Clinical Medical Officer (CMO) at Macksville District Hospital.
It has a 28-bed acute inpatient unit and a 24-hour Emergency Department with medical coverage and telehealth capabilities to connect into Coffs Harbour Health Campus’ Emergency Department, which is around 40 minutes away.
‘Personally, I get confidence in leading the team that I work with every day,’ she said, of the benefits the EMET sessions offer her. ‘I always make it a priority to go when it’s on.’
Sharing practical tips about effective ways to care for young patients (and their families) at times of emergency presentations helps boost the skill level and confidence of participants in the EMET sessions.
Currently, the EMET program supports 59 Hubs to deliver training and supervision to hospitals and health services with EDs or emergency services within their region. This training is delivered to more than 540 health services nationally.
Dr Brewer said that ‘a valuable part of in-hospital EMET is staying current with the ventilator machinery specific to our service’.
‘What’s great about EMET is that it’s very relevant to your workplace. It’s very site-specific. We don’t have to travel, it’s free, so it’s family-friendly, it’s work-friendly, it’s team-focused. I think it’s an incredible education tool.’
With a young family and a busy workload in the under-resourced environment of a small, rural ED, Dr Brewer said that, if a lack of funding meant EMET was not accessible in the future, the added travel time and expense would make accessing the potentially life-saving training more problematic.
‘The funding helps us stay current because it enables access to senior clinicians whose experience and insights help us keep up-to-date,’ she said. ‘That’s a really important part of what EMET does for people working in regional and rural EDs.’
In addition to the benefits of the hands-on education that informs quality patient care, many EMET participants say they appreciate the way EMET helps create greater cohesion between team members.
The ability to upskill nursing staff in her ED is another vital benefit, Dr Brewer said.
‘We don’t always send medical escorts with our patients. The fact that we’ve upskilled the nurses has made a big difference. Now, a lot of nurses are quite confident to transfer patients – that’s a direct result of EMET, which is important for us because often there’s only one doctor on the floor.
“‘We would lose a lot of our sense of cohesion if we didn’t have access to EMET. I think it would definitely have an impact on patient care.’”
‘The results include faster inter-hospital transfer times because everybody knows the system and the process and what their role is.’
Providing improved patient care is important, but Dr Brewer said that building staff morale is another positive gained from EMET.
‘The nursing students and the medical students, we all do it together. We all come away from it with better knowledge, which means we’re all on the same path. That’s probably one of the best things about it,’ she said.
‘It really raises the morale in the ED. Going through the training together on-site helps bond us.
‘It’s very positive and confidence-building. It’s such a great program.
‘We would lose a lot of our sense of cohesion if we didn’t have access to EMET. I think it would definitely have an impact on patient care.’
EMET’s funding future is currently uncertain. ACEM has launched the ‘FundEMET’ campaign to support its call for the important funding to continue enabling regional, rural and remote health care workers to access this potentially life-saving training.
