Posted on October 17, 2017 by Niroshan Siriwardena

Viet-Hai Phung presents at Emergency Medicine Congress, Lisbon

Viet-Hai Phung presented his work on the perceptions and experiences of Community First Responders (CFRs) in Lincolnshire at the recent Mediterranean Emergency Medicine Congress (MEMC). The Congress, organised by the American Academy of Emergency Medicine (AAEM), took place in the very smart surroundings of the Corinthia Hotel in Lisbon, Portugal from 8-10 September 2017. Despite the title of the Congress, this was a truly international conference, with delegates from North America, the Middle East, Africa and Australasia presenting.

Professor Lee Alan Wallis, Head of Emergency Medicine for the Western Cape Government, was the keynote speaker at the opening ceremony. He talked about the particular challenges of emergency medicine provision in southern Africa, where in some countries the infrastructure is extremely basic. Other plenary speakers included: Professor James Ducharme from McMaster University in Toronto, who talked about the complex relationship between pain relief, patient satisfaction and addiction and Dr Eveline Hitti from the American University in Beirut, who spoke about the glass ceiling for women working in emergency medicine.

Viet-Hai presented the interview study that has been undertaken with colleagues Prof Niro Siriwardena, Ian Trueman and Prof Roderick Ørner on the first morning of the conference. The presentation was well-received with only minor points of clarification from the audience concerning the extent of their use in the UK and the levels of training they undertake.

What was interesting about the conference was the sharing of best practice from around the world on many salient problems in emergency medicine, such as alleviating patient overcrowding in the emergency department. All this within the setting of the wonderful city of seven hills, Lisbon.

By Viet-Hai Phung

Posted on December 5, 2015 by Niroshan Siriwardena

Rapid review published on effectiveness of different models of delivering urgent care

The NIHR commissioned rapid evidence review to assess the nature and quality of the existing evidence on delivery of emergency and urgent care services and to identify gaps for future research was published last week: Phung V-H (2015) Chapter 6 – Delivery of emergency department services in Turner J, Coster J, Chambers D, Cantrell A, Phung V-H, Knowles E, Bradbury D, Goyder (eds.). What evidence is there on the effectiveness of different models of delivering urgent care? A rapid review. Health Serv Deliv Res 2015;3(43). The team, from the School of Health And Related Research (ScHARR) at the University of Sheffield with Viet-Hai Phung, research assistant and doctoral researcher at CaHRU, undertook five separate literature reviews linked to themes in the NHS England review in 2013, which latter drove the need for this rapid evidence review. The review, which took six months to complete, incorporated findings from 45 systematic reviews and 102 primary research studies across all five reviews

Viet-Hai Phung wrote the review in Chapter 6 on the Delivery of Emergency Department (ED) services. This review included literature from 2009 to 2015. Nine papers were included in the review: two systematic reviews, which included 28 individual papers, and seven additional papers. Of the 35 included studies, there were only five randomised control trials and many uncontrolled before-and-after studies, which cannot control for other system effects.

There were three themes to this part of the review: Managing ED flow; Workforce; and managing the frail and the elderly in EDs. In the first review, interventions that aimed to increase access to primary care and ED cost-sharing were found to be effective in reducing ED use. For the Workforce review, the evidence suggested that supplementing existing ED staff with NPs can help to manage demand more effectively, especially in high-volume EDs. For the final review, there was mixed evidence about the effectiveness of Comprehensive Geriatric Assessment (CGA): CGA did not have a significant impact on outcomes nor mortality, while other studies suggested that use of CGA to inform interventions could reduce functional decline.

Viet-Hai Phung

Posted on March 1, 2015 by Niroshan Siriwardena

CaHRU to contribute to Institute for Healthcare Improvement Web and Action on Improving Prehospital Emergency Care

Professor Niro Siriwardena will join Dave Williams and EMS leaders from the United States and abroad, conducting pioneering work in the field of prehospital quality improvement, for an Institute for Healthcare Improvement Web and Action on Improving Prehospital Emergency Care the spring (March and April 2015). The Web and Action will consist of five sessions over the next two months.

In Session One, Introduction to Improving Prehospital Emergency Care Systems (Thursday, March 5, 2015, 12:00 PM – 1:00 PM Eastern Time), David Williams and Kedar Mate will introduce the agenda for the Web & Action Series, providing an overview of the history of ambulance service, the current state of the profession and improvement opportunities for prehospital care. Jerry Overton and Paul Gowens join Session Two, Early Identification of Deteriorating Patients (Thursday, March 19, 20, 12:00 PM – 1:00 PM ET), introduce the concept of early identification, resource allocation, and intervention and present the use of a prehospital early warning score to identify prehospital patients who are deteriorating (e.g., sepsis) to expedite transport, intervention, and emergency department notification.

Prof Niro Siriwardena and Jonathan Studnek present key care pathways for improving core prehospital care processes and outcomes in Session Three, Key Care Pathways – Change Package and Measurement of Time Sensitive Conditions (Thursday, April 2, 2015, 12:00 PM – 1:00 PM ET). They go on to discuss the development of a change package and measurement strategy in the NHS England Ambulance Trusts and profile case examples of improving care reliability in stroke and STEMI in the U.S. and U.K.

In Session Four, Prehospital Emergency Care Trigger Tool (Thursday, April 16, 2015, 12:00 PM – 1:00 PM ET), Loua Al Shaikh introduces the concept of trigger tools and the application the prehospital care ecosystem. Finally, Mike Taigman and Brenda Staffan lead Session Five, Paramedic Care in the Community (Thursday, April 30, 2015, 12:00 PM – 1:00 PM ET) where they define the emerging opportunity of utilising paramedics in the community through prevention, partnerships, intervention, and post discharge care.

Posted on October 9, 2014 by Niroshan Siriwardena

Three minutes to present two years’ work on prehospital care for ethnic minorities at European Congress on Emergency Medicine, Amsterdam 2014

It was a pleasure to attend the European Congress on Emergency Medicine in the beautiful environs of Westerpark, Amsterdam from Sunday 28^th September – Wednesday 1^st October. I had been invited to give a three-minute presentation on the systematic review that I had been working on for two years, ‘Barriers, facilitators, disparities and consequences for people from minority ethnic groups accessing prehospital care: systematic review and narrative synthesis’.

Prior to going to Amsterdam, I had rehearsed the presentation many times. This carried on right through to an hour before the Monday afternoon Lightning Session I was due to present in. The ‘Lightning Session’ itself was due to last 90 minutes with 23 presenters summing up their research. I was 18^th up so at least I could get a feel for what to expect. I was nervous, but not shaking, as I made my way up to the podium, without notes. Before I started, I familiarised myself with how to work the slideshow to avoid any embarrassments, which previous presenters suffered. I knew exactly what I was going to say on each slide. There were minor departures from what I had planned to say, but I got the underlying message across to the audience. I felt I answered the question from the chair about uneven translation service provision in the UK competently. And that was that. Thorough preparation had made a seemingly daunting task manageable.

There were other interesting lightning presentations on prehospital care from around the world, but the conference focused more on clinical and emergency department research. However, I gained another valuable professional skill and spent some time in lovely Amsterdam. Which were no bad things at all!