Emergency
The University Hospital Geelong Emergency Department research team has been involved in a wide range of clinical and systems based research around emergency department care over many years. Multisite and collaborative studies have been undertaken investigating both acute emergencies, diagnostics, treatments and public health issues around emergency presentations.
A wide range of methodologies have been employed in previous and current research including quantitative as well as qualitative and mixed methodology approaches. The wide range of clinical care provided in the University Hospital Geelong Emergency Department has lent itself to a broad range of clinical, translational and systems care research with multiple internal and external collaborations to broaden the scope of research outside of local emergency care.
The early uptake of new modalities of care, systems approaches and models of supervision has also been a consistent theme of the emergency department and is reflected in the research undertaken both in the past and currently. Increasing participation in larger collaborative clinical research projects is an ongoing focus.
Research Areas
The Driving Change Project
This large multisite project is a Deakin lead collaboration with ACEM, University Hospital Geelong Emergency Department (ED) and eight other emergency departments. It is funded by the NHMRC and Partnership Project Scheme and is a cluster randomised study looking at harm minimisation of alcohol related ED presentations.
The project explores the role of alcohol in ED presentations particularly related to interpersonal violence and injury. Anonymised ED data is shared with community agencies to reduce alcohol related injury and assaults. Evidence from the UK demonstrates a drop of up to 20% or more in alcohol related injury presentations to emergency departments. A brief intervention is also offered to at risk individuals who have alcohol related presentations to the ED.
The project runs for 36 months will finish at the end of 2021. More information can be found about the project here: https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13266
AFL Womens’ Injury Study
We are collaborating with the AFL, BCORE, Deakin university and other partners including Epworth Health, St John of God Health Care and Southwest Health Care to investigate the injury patterns of Female AFL players.
It is the largest study exploring female AFL players presenting to emergency departments and examines the type and frequency of injuries they sustain.
The popularity of females playing AFL has increased substantially over the last few years with AFL figures showing that over 530,000 females played AFL in 2018 (representing greater than 14% increase). It is vital to understand the types of injuries encountered and their frequency. There may be significant differences with male footballers and this knowledge will help inform prevention and treatment strategies leading to fewer injuries and better care for female AFL players.
The study will also explore the impact of these injuries on player’s lives inside and outside the sport to better understand the magnitude of problems created by these injuries.
The study is due to finish data collection in 2021
PREDICT network trials
We are participating in a number of PREDICT group trials and registries coordinated locally by Dr Jeremy Furyk.
- Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) – Multicentre, prospective observational study of paediatric intubations in in the emergency department.
- “Kids are not Ok”: Delphi study to identify consensus research priorities and core outcome sets in paediatric emergency department mental health presentations.
- “Kids are not Ok”: Emergency Department management of acute mental health crises in children and young people. A retrospective study.
- Management of acute asthma in children. A multicentre retrospective PREDICT study.
NHMRC funding has been secured for some of these projects.
The PREDICT group is a large international multisite collaborative program of research incorporating projects centred on paediatric and adolescent emergency care. Information on the PREDICT group can be found in the following link: https://www.predict.org.au/
Childhood Obesity Project
This is a collaboration with Deakin University, Epworth Health care and St John of God Health Care investigating the prevalence of overweight and obesity amongst the paediatric population presenting to Geelong emergency departments.
There has been an alarming increase in the prevalence of overweight and obese children in Australia over the last 20 years, a trend mirrored around the world. Many factors including lifestyle, genetic, social and environmental factors are responsible for these changes. Associated health problems are commonly associated with excess weight, particularly obesity.
This study aims to assess the prevalence of this problem across the Geelong region in presentations to both public and private emergency departments and determine if these social changes are mirrored in the ED population. The link with socio-economic factors in presentations will also be examined.
COVID-19 Research
The COVID-19 pandemic, social distancing and lockdown laws have substantially changed the face of emergency care in the short term and potentially the longer term.
A number of projects including participation in the Barwon Health COVID research group and a number of collaborative projects nationally and internationally are being explored looking at the changing epidemiology of emergency department presentations and specific impacts on key types of presentations such as paediatric, Mental Health, STEMI and stroke patients.
Collaborating Organisations
Australasian College of Emergency Medicine | AFL | |
Deakin University | Epworth HealthCare | |
Regional healthcare groups including South West Healthcare and Colac Area Health | St John of God Health Care |
Research Team
Research Staff
We have a whole of department approach to research with many contributors from medical, nursing and other clinical groups. Key contributors include:
- Dr Michael Sheridan, Director of Emergency Department
- Dr Bruce Bartley, Deputy Director Emergency Department
- Dr Julian Stella, Head of Research in the Emergency Department
- Dr Jeremy Furyk, Staff specialist and researcher
- Dr Michael Ragg, Staff specialist
- Dr Stephen Gill, Physiotherapist and researcher
- Nicole Lowry, Research Assistant
Research News
Research in Focus - Infections the major reason infants see a doctor or attend hospital
Infections account for almost three quarters of Australian infants needing to see a doctor and 1 in 10 presenting to an emergency department by 12 months of age, according to a new study of Barwon Infant Study data published in the Journal of Paediatrics and Child Health.
The research, undertaken by the Barwon Infant Study (BIS) team found 72.4 per cent infants visited a GP and 10.4 per cent infants attended the emergency department for an infection, with respiratory illnesses the most common cause.
MCRI’s Dr Rebecca Rowland said few studies have addressed incidence rate, risk factors and health service utilisation of infection in Australian infants until now.
The research involved 1074 Geelong families in the Barwon Infant Study, a major study conducted at Barwon Health in collaboration with Deakin University and MCRI. Infection data was collected by parent reports and GP and hospital records at one, three, six, nine and 12 months of age.
Dr Rowland said the study found maternal antibiotic exposure in pregnancy, having older siblings, attending childcare, and reduced rates of breastfeeding were associated with infant infections.
“Antibiotics are potentially life-saving for bacterial infections generally and also in pregnancy, so the key messages are promoting appropriate antibiotic use in pregnancy, and also breastfeeding for at least the first month of life. These factors may help reduce the early life burden of infection,” she said.
“On average, infants who were breastfed for at least four weeks experienced about 30 per cent fewer overall infections.”
The study found a link between attending childcare for anywhere between 1 to 40 weeks and overall infection, but the researchers stressed the broad positive impacts of childcare on child development, the family and society.
On average, infants with siblings aged two to six years had more overall infections, and those with siblings aged 10 to 21 years had an increased risk of gastroenteritis.
MCRI’s Professor David Burgner said respiratory infection presentations, such as the flu, to The Royal Children’s Hospital have dropped dramatically during the COVID-19 lockdowns indicating the importance of good hand hygiene in limiting infection spread, as well as an increased uptake of the influenza vaccine.
“One of the few silver linings of the COVID-19 pandemic has been the emphasis placed on hand hygiene in potentially infectious settings, like childcare and shopping centres,” he said. “This has not only helped limit COVID-19 spread in adults, but also the normal childhood infections we would otherwise have seen over winter.”
Click here to read the full article.
What does effective distance trainee supervision look like?
The distance supervision project involved a collaboration with Colac Area Health that allowed registrars to undertake an accredited training rotation in an Acute Care setting whilst being supervised clinically via telemedicine. Details of the project and its positive findings can be found here: https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13440
Barwon Health presents outcomes in cervical spine MRIs
The MRI Cervical Spine in Trauma: a retrospective single centre study of patient outcomes was presented by Dr Brigitte Russell at the RANZCR Annual Scientific Meeting (held in Auckland) from 17-20 October 2019. A summary can be found at the following link:
https://onlinelibrary.wiley.com/doi/full/10.1111/1754-9485.3_12954
Research Grants
- NHMRC - Driving Change: 2018-2020
- NHMRC - The Kids Are Not OK: 2019-2021
- AFL - Injury profiles of female Australian Rules Football players: a survey of Geelong and South-Western Victoria: 2019-2021
Featured Publications
Support Our Research
Participate in a clinical trial
To find out about clinical trials currently underway at Barwon Health, click here.
Donate
Clinical trials require ongoing investment and there are several ways to support this amazing work.
You can make a donation today and contribute to an item on our research wish list, consider a bequest in your will, or establish a lasting legacy fund in your name. No matter what size, your philanthropic support with deliver an immediate impact.
To donate now or for more information and further discuss your support, please contact the Barwon Health Foundation.
Wish List
-
Small donations of $1000 up to $5000 would provide hours of nursing support to assist in a number of projects requiring data and coding inputs
-
Medium donations could provide seed funding for larger projects requiring more input. This could be put towards a number of projects exploring the impact of COVID and lockdown laws on ED presentations. $16000 would create a 0.3 EFT nursing research assistant position for half a year
-
Larger donations could help fund the ongoing research assistant position with $30000+ funding the research assistant for a year at 0.3+ EFT.
All Publications
2020
- Restrictive Interventions in Victorian Emergency Departments: A Study of Current Clinical Practice. Jonathan Knott, Marie Gerdtz, Sheriden Dobson, Catherine Daniel, Andis Graudins , Biswadev Mitra , Bruce Bartley , Pauline Chapman. Emergency Medicine Australasia (2020) 32, 393–400. https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13412
- Distant supervision of trainee emergency physicians undertaking a remote placement: A preliminary evaluation. Stephen D Gill, Julian Stella, Marija Blazeska, Bruce Bartley. Emergency Medicine Australasia (2020) 32, 446–456. https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13440
- Comprehensive identification of medication‐related problems occurring prior to, during and after emergency department presentation: An Australian multicentre, prospective, observational study. Simone E Taylor, Elise A Mitri Andrew M Harding David McD Taylor Adrian Weeks Leonie Abbott , et al. Emergency Medicine Australasia (2020) 32, 457–465. https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13439
- Patients With Life-Limiting Illness Presenting to the Emergency Department. Michael Ragg, James Ragg , Sharyn Milnes, Michael Bailey, Neil Orford. Emergency Medicine Australasia (2020) 32, 288–294. https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13409?af=R
2019
- Driving change: A partnership study protocol using shared emergency department data to reduce alcohol‐related harm. Peter Miller Nicolas Droste Diana Egerton‐Warburton David Caldicott Gordian Fulde Nadine Ezard Paul Preisz Andrew Walby Martyn Lloyd‐Jones Julian Stella Michael Sheridan, et al. Emergency Medicine Australasia (2019) 31, 942–947. https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13266
Last Modified: Tuesday, 09 August 2022
Research Lead
Dr Julian Stella MBBS, FACEM
Head of Research
Emergency Department
University Hospital Geelong
Ryrie St, Geelong Vic 3220