Abstract
Introduction: Providing equitable healthcare in regional and rural Australia is challenging due to large geographical distances, patient complexity, resourcing of facilities, limited access to specialist support and longstanding challenges with workforce recruitment and retention. The implementation of a virtual Emergency Department (ED) will supply Specialist physician advice to support medical officers and nurses in a remote base hospital.
Who is it for? Broken Hill Hospital is a rural referral centre servicing a population of approximately 30 000 people in the far west region of outback New South Wales (NSW), Australia. Approximately 12% of this population identify as Aboriginal and/or Torres Strait Islander.1 There are approximately 20 000 presentations to Broken Hill Hospital ED per year, of which approximately 15% of patients are seriously or critically unwell and require immediate resuscitation and critical care management.
What did you do? rED is an initiative of RPA Virtual Hospital (rpavirtual) a recently accredited virtual hospital, the first of its kind in Australia. rED is physically based in metropolitan Sydney but will provide consult virtual Emergency Medicine Specialist clinical support and advice for all patients ≥16 years and over who present to Broken Hill Hospital ED.
The service is triggered by a phone call from Medical staff in Broken Hill to a triage phone system to facilitate direct video-interactions with both the patient and medical staff at Broken Hill. Critically unwell patients will be transferred to a dedicated resuscitation bay and this interaction will occur via an overbed camera/speaker system. Less unwell patients will be reviewed via a portable WorkStation on Wheels (WOW).
Who did you involve and engage with? Key stakeholders included the medical workforce and hospital leadership team at Broken Hill Hospital. Consultation also occurred with previous successful virtual care model services, State Retrieval services and the Aboriginal Directorate in the Far West Local Health District (FWLHD).
What results did you get? What impact did you have? It is expected that rED will go live at the beginning of November 2023 following the development and installation of the required technology with an evaluation of results following this.
What is the learning for the international audience? Access to equitable healthcare should be universal and similar services to rED could be adopted internationally to service rural/remote communities who have limited resources and are geographically distant to large centres.
What are the next steps? rED performance will be evaluated using standard outcome measures and Key Performance Indicators (KPIs). Patient reported measures (PREMS and PROMS) will also be used.
List of References
1.NSW Health. Far West. NSW Government. https://www.health.nsw.gov.au/lhd/Pages/fwlhd.aspx