Proceedings of the 13th annual conference of INEBRIA

CITATION: Watson, R., et al. 2016. Proceedings of the 13th annual conference of INEBRIA. Addiction Science & Clinical Practice, 11:13, doi:10.1186/s13722-016-0062-9.The original publication is available at https://ascpjournal.biomedcentral.comENGLISH SUMMARY : Meeting abstracts.https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0062-9Publisher's versio

Emergency department overcrowding, mortality and the 4-hour rule in Western Australia

Overcrowding in emergency departments (EDs) occurs when the physical or staffing capacity of the department is exceeded by the number of patients waiting to be seen, undergoing assessment and treatment or waiting for departure. Overcrowding occurs in Australia and elsewhere in the developed world and has been well documented over the past decade. It became generally recognised that this problem had come about through a combination of factors. Upstream factors included increased numbers of patients presenting to emergency departments, a rapidly growing population and reduction of available public hospital beds. Downstream factors included lack of aged care beds in the community. It is generally accepted that overcrowding in Australia and other countries is due to bed occupancy rates above 85% rather than increased presentation of low acuity patients

Extending the theatre experience: The potential for wearable and onstage cameras

The article is a write-up of an experiment comparing the reactions to films of theatre performance captured using traditional methods with those including point of view and stage object mounted cameras. The motivation was to extend the theatre experience to on-line viewing by making the experience feel more in the moment, keeping the physicality of theatre in the film format. The films were viewed in cinemas, and in homes and compared with the live performance. An original performance was devised and performed in front of a theatre audience and two 30 min film versions were created. The project was a collaboration between Bristol Old Vic, Watershed and Hewlett-Packard and part funded by the Technology Strategy Board. It was a carried out by a multi-disciplinary team of performers, technologists, producers and psychologists as a result of our wok on extending experience of place and telepresence. Either of the 30 min films of the performance are available on request

Determining the actual cost of wound care in Australia

Aim: To determine the number and type of wounds and their treatment costs (consumables and labour) in Australian hospitals, residential aged care facilities (RACFs), general practices (GPs) and community, and to provide evidence to inform reimbursement of wound treatment costs for all Australians. Method: Data from 21,189 clients with 49,234 wounds treated by a community care provider in Western Australia, Queensland and South Australia during the financial year 2020/2021 were used to determine the mean and median costs (consumables and labour) to treat wounds. Surveys involving skin inspections and medical record audits were conducted amongst consenting adults over 18 years old in a sample of Australian hospitals, RACFs and GPs. A sample of community clients’ data for wounds treated on one day in June 2021 comprised the fourth cohort used in this analysis. The costs to treat all wounds surveyed between 14 December 2020 and 17 October 2021 in the four cohorts were modelled against the community care provider’s data for 2020/2021 (49,234 wounds). Results: There were 2,505 individuals with 3,096 wounds. The estimated cost to treat all wounds was A$1,621,768 using the mean costs of the community care provider as a basis, and A$692,144 using the median costs of the community care provider as a basis. Costs for all wound types were determined. Conclusion: The cost of treating wounds in Australia was determined and is anticipated to inform a review of equitable reimbursement of wound treatment costs for Australians with wounds.</p

Human Rhinovirus Species C Infection in Young Children With Acute Wheeze is Associated With Increased Acute Respiratory Hospital Admissions

Rationale: Human rhinovirus species C (HRV-C) is the most common cause of acute wheezing exacerbations in young children presenting to hospital, but its impact on subsequent respiratory illnesses has not been defined. Objectives: To determine whether acute wheezing exacerbations due to HRV-C are associated with increased hospital attendances due to acute respiratory illnesses (ARIs). Methods: Clinical information and nasal samples were collected prospectively from 197 children less than 5 years of age, presenting to hospital with an acute wheezing episode. Information on hospital attendances with an ARI before and after recruitment was subsequently obtained. Measurements and Main Results: HRV was the most common virus identified at recruitment (n = 135 [68.5%]). From the 120 (88.9%) samples that underwent typing, HRV-C was the most common HRV species identified, present in 81 (67.5%) samples. Children with an HRV-related wheezing illness had an increased risk of readmission with an ARI (relative risk, 3.44; 95% confidence interval, 1.17–10.17; P = 0.03) compared with those infected with any other virus. HRV-C, compared with any other virus, was associated with an increased risk of a respiratory hospital admission before (49.4% vs. 27.3%, respectively; P = 0.004) and within 12 months (34.6% vs. 17.0%; P = 0.01) of recruitment. Risk for subsequent ARI admissions was further increased in atopic subjects (relative risk, 6.82; 95% confidence interval, 2.16–21.55; P = 0.001). Admission risks were not increased for other HRV species. Conclusions: HRV-C–related wheezing illnesses were associated with an increased risk of prior and subsequent hospital respiratory admissions. These associations are consistent with HRV-C causing recurrent severe wheezing illnesses in children who are more susceptible to ARIs

Which strategies support the effective use of clinical practice guidelines and clinical quality registry data to inform health service delivery? A systematic review

Background: Empirical evidence suggests data and insights from the clinical practice guidelines and clinical quality registries are not being fully utilised, leaving health service managers, clinicians and providers without clear guidance on how best to improve healthcare delivery. This lack of uptake of existing research knowledge represents low value to the healthcare system and needs to change. Methods: Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews) were systematically searched. Included studies were published between 2000 and 2020 reporting on the attributes, evidence usage and impact of clinical practice guidelines and clinical quality registries on health service delivery. Results: Twenty-six articles including one randomised controlled trial, eight before-and-after studies, eight case studies/reviews, five surveys and four interview studies, covering a wide range of medical conditions and conducted in the USA, Australia and Europe, were identified. Five complementary strategies were derived to maximise the likelihood of best practice health service delivery: (1) feedback and transparency, (2) intervention sustainability, (3) clinical practice guideline adherence, (4) productive partnerships and (5) whole-of-team approach. Conclusion: These five strategies, used in context-relevant combinations, are most likely to support the application of existing high-quality data, adding value to health service delivery. The review highlighted the limitations of study design in opportunistic registry studies that do not produce clear, usable evidence to guide changes to health service implementation practices. Recommendations include exploration of innovative methodologies, improved coordination of national registries and the use of incentives to encourage guideline adherence and wider dissemination of strategies used by successful registries.</p