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A NEW ERA FOR EMERGENCY MEDICINE AT CABRINI

A new team at the helm of Cabrini’s Emergency Department (ED) is on a mission to make it the gold standard in emergency medical care in Australia.

There is a small room at Cabrini Malvern used to store wheelchairs. It is hard to believe that ten years ago, this room was set up to receive emergency patients in the absence of a fully-fledged ED. Back then, Cabrini had around 30 emergency presentations annually. Today, ten years after Cabrini first opened a dedicated ED at Malvern, the hospital has 25,000 emergency presentations per year.

While Cabrini’s ED sees the bumps, breaks and scrapes typical in a hospital ED, 45 per cent of presentations result in a hospital admission. This figure reflects the complexity of ED presentations at Cabrini, and is on a par with major tertiary hospitals such as Alfred Health.

“We do serious emergency medicine here,” says Dr Michael Ben-Meir, Clinical Director, Emergency Medicine, “and as we enter our second decade, we have big plans to make this ED the gold standard in emergency medical care.”

The ED is already a flagship for Cabrini – it is one of the few private emergency departments that cares for children and Cabrini’s expertise in areas such as oncology, cardiology and maternity draws people from as far afield as Albury to receive emergency medical care.

“We want to take something that is already excellent and raise it to the next level,” says Dr Ben-Meir.

Cabrini’s exciting vision has attracted some of the biggest names in emergency medicine, including Dr Debra O’Brien and Dr Trevor Jackson, who relocated from Perth to take up senior roles in the department in February. Dr O’Brien and Dr Jackson are Senior Fellows of the Australasian College for Emergency Medicine (ACEM).

Most recently, Dr O’Brien was Director of Emergency Medicine at Sir Charles Gairdner Hospital – a hospital with around 60,000 ED presentations annually – and she has a track record in leading significant change.

Dr Jackson, also from Sir Charles Gairdner Hospital, is an emergency medicine educator whose reputation draws doctors from around the world to train under him in Australia. Dr Jackson is leading the emergency medicine teaching program at Cabrini and, together with Drs Ben-Meir and O’Brien, has played a key role in securing ACEM accreditation to hold advanced training at Cabrini Malvern.

“This is an important milestone,” says Dr Ben-Meir. “To my knowledge, we are the first department that on its first inspection by the ACEM was granted a one-year training accreditation. For first-time applicants, it is usually a six-month licence. It is a testament to the quality of what we already do, as well as our plans for the future.”

 

Vision for Cabrini’s ED
  • You will be seen by a doctor quickly, but a senior nurse with specialist training will have begun your care (for example, by ordering blood tests or x-rays), so that there are no unnecessary delays for the doctor diagnosing you or starting a course of treatment.
  • The first doctor you see will be a senior doctor. In public hospital EDs, cases are usually ‘worked up’ by a junior doctor before a senior consultant is brought in.
  • 100 per cent of attending doctors will be specialist emergency medicine physicians or senior ED doctors with a Diploma in Emergency Medicine. Already, 70 per cent of Cabrini’s attending doctors are Fellows of ACEM, up from five per cent just 18 months ago.
  • Wards are being reconfigured across Cabrini Malvern, so that if you need to be admitted to hospital, you won’t be stuck in ED, waiting for a bed to become free.
  • If you do not need to be admitted, you’ll be home quicker, thanks to our more efficient processes (refer to our ‘streaming’ initiative).
  • The ED will be a hub for research, education and innovation.
What we have already done
  • We have got rid of the old ‘triage’ system – you now see a nurse as soon as you walk in the door of the ED.
  • Less complex ED cases are now ‘streamed’ separately to more complex and/or life-threatening cases, so that everyone has access to rapid medical care.