Barwon Health Research

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

Ambulance Victoria	Australasian College of Emergency Medicine	AFL
B-CORE	Deakin University	Epworth HealthCare
PREDICT	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

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

Why do ‘fast track’ patients stay more than four hours in the emergency department? an investigation of factors that predict length of stay. [NOTE - Full text for Barwon Health staff; public can view abstract]. Gill SD, Lane SE, Sheridan M, Ellis E, Smith D, Stella J. Emerg Med Australas. 2018;30: 641-647.

Cited By Citation in Context

Consumer preferences regarding physiotherapy practitioners and nurse practitioners in emergency departments – a qualitative investigation. [NOTE - Full text for Barwon Health staff; public can view abstract]. Gill SD, Stella J, McManus L. J Interprof Care. 2018;33: 209-215.

Cited By Citation in Context

Cancer diagnosed in the emergency department of a regional health service. [NOTE - Full text for Barwon Health staff; public can view abstract]. Rogers MJ, Matheson LM, Garrard B, Mukaro V, Riches S, Sheridan M, Ashley D, Pitson G. Aust J Rural Health. 2016;24: 409-414.

Cited By Citation in Context

Management of mental health patients in Victorian emergency departments: A 10 year follow-up study. [NOTE - Full text for Barwon Health staff; public can view abstract]. Alarcon Manchego P, Knott J, Graudins A, Bartley B, Mitra B. Emerg Med Australas. 2015;27: 529-536.

Cited By Citation in Context

Australasian disasters of national significance: An epidemiological analysis, 1900-2012. Bradt DA, Bartley B, Hibble BA, Varshney K. Emerg Med Australas. 2015;27: 132-138.

Cited By Citation in Context

A prospective observational study of prevalence and outcomes of patients with gold standard framework criteria in a tertiary regional australian hospital. [NOTE – Abstract only, Barwon Health staff can request full text from Library]. Milnes S, Orford NR, Berkeley L, Lambert N, Simpson N, Elderkin T, Corke C, Bailey M. BMJ Support Palliat Care. 2015;9: 92-99.

Cited By Citation in Context

Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital. [NOTE - Full text for Barwon Health staff; public can view abstract]. Phillips L, Orford N, Ragg M. Emerg Med Australas. 2014;26: 368-375.

Cited By Citation in Context

Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions. [NOTE - Full text for Barwon Health staff; public can view abstract]. Gill SD, Stella J. Emerg Med Australas. 2013;25: 558-564.

Cited By Citation in Context

Introduction of a prehospital critical incident monitoring System—Final results. [NOTE - Full text for Barwon Health staff; public can view abstract]. Stella J, Bartley B, Jennings P. Prehosp Disaster Med. 2010;25: 515-520.

Cited By Citation in Context

Use of ultrasound to facilitate accurate femoral nerve block in the emergency department. Reid N, Stella J, Ryan M, Ragg M. [NOTE - Full text for Barwon Health staff; public can view abstract]. Emerg Med Australas. 2009;21: 124-130.

Cited By Citation in Context

All Emergency 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

BHFJune0022

Dr Julian Stella MBBS, FACEM

Head of Research
Emergency Department
University Hospital Geelong
Ryrie St, Geelong Vic 3220