Working together: innovation to improve Emergency Department (ED) performance, and patient outcomes and experience for five complex consumer cohorts

NSW Emergency Departments (EDs) are under pressure. The proportion of patients seen on time has decreased steadily over the last 5 years, and patients are spending longer in the ED.
Patients are not an homogeneous group: ED performance is worse for patients who are older with multiple comorbidities, have a disability, present with a mental health condition, are Aboriginal and Torres Strait Islander, or come from a culturally and linguistically diverse (CALD) background. Understanding and addressing the specific needs of these priority patient cohorts has potential to improve not only the outcomes and care experience for these people, but ED performance overall.
Over the next 5 years, we will apply our accumulated expertise in consumer-focused co-design, human factors and emergency department care to optimise ED performance; improving patient outcomes and the acute care experience for the diverse demographic cohorts of consumers who seek care in NSW EDs.
Our aims are:
Aim 1: To elicit needs and preferences for delivery of acute care in Western Sydney Local Health District from five priority consumer cohorts (older adults, people with mental health condition, people with a disability, Aboriginal peoples, people from a CALD background) and the clinicians who treat them.
Aim 2: To co-design, develop and implement consumer-driven new or adapted models of care that enable EDs to meet the needs of our five priority consumer cohorts.
Aim 3: Using implementation science methods, work with the NSW Emergency Care Institute (ECI) to scale-up and spread successful models of care from Aim 2 to EDs in public hospitals across NSW.
The proposed project will provide a rigorous approach, and an innovative and comprehensive systems perspective, to improving ED performance and patient experience, incorporating views from a diverse group of consumers and clinicians, and leveraging our cross-disciplinary research and clinical expertise, to provide solutions that are innovative and practical.

In NSW Emergency Departments (ED) consumers who are older, have a disability, present with a mental health condition, are Aboriginal and Torres Strait Islander, or come from culturally and linguistically diverse (CALD) backgrounds, spend longer than average in the ED and have worse outcomes. We will work with these consumers and clinicians to understand their needs and to co-design new models of care that reduce excess length of stay and improve the care outcomes and experience for these groups.