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30 March 2007 - Auckland

Community Outreach Medical Emergency Team ‘ COMET’ Presenter: Kerry Stubbs Hospital: St Vincent’s Hospital Sydney Key contact person for this project: A/Prof Stephen Wilson, stwilson@stvincents.com.au 61 2 8382 3262. 30 March 2007 - Auckland. KEY PROBLEM.

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30 March 2007 - Auckland

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  1. Community Outreach Medical Emergency Team ‘COMET’Presenter: Kerry Stubbs Hospital: St Vincent’s Hospital SydneyKey contact person for this project: A/Prof Stephen Wilson, stwilson@stvincents.com.au 61 2 8382 3262 30 March 2007 - Auckland

  2. KEY PROBLEM • Emergency Department Access Block “it is full” • Homeless people use ED as a GP • Homeless people have acute and sub acute health problems • Is ED the right place to treat? • 20 homeless people presented 639 times during 2006

  3. AIM OF THIS PROJECT • Reduce time in ED • Target group: homeless, IVDU and disadvantaged • Before and after intervention review of ED time and presentations, reduced within 6months • Resources: Public donations –interested medical consultant , community nurse, medical registrar

  4. KEY CHANGES IMPLEMENTED • Interventions were: Service description and guidelines Daily ward rounds of ED to identify patients Range of temporary accommodation including detox boarding house • Results: Placement of frequent presenter who had been homeless for many years “off the streets” Outpatient treatment of travellers/backpackers

  5. OUTCOMES SO FAR • First 2 weeks of operation • Positive response from many sectors of community and NGO’s who have seen the need for a “Flying Squad” • Phase 1 commenced with system in place for ED assessment and treatment. Patient recruit Mon to Fri and treat 7 days. • Phase 2 will provide outreach consults to residential institutions • Phase 3 will provide consultation and assessment in public places

  6. PROJECT EVALUATION • A Look at ED admissions profile, solve the big problems in order. Following chest and abdo pain , homeless are represented in group 3 for our hospital. 1. Chest Pain ( chest pain pathway) 2. Oesophagitis,Digestive (surgical fast track) 3.Poisoning • Toxic Effects of Drugs & OtherAlcohol • Intoxication • Mental Health Treatment • Injuries • Cellulitis • B • Target front door ED • C Add value to ED from outside (ED cannot solve the problem)

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