From concept to reality: A comprehensive exploration into the development and evolution of a virtual emergency department.

Emergency department (ED) overcrowding remains a persistent challenge in global public health, leading to detrimental outcomes for patients and healthcare professionals. Traditional approaches to improve this issue have been insufficient, prompting exploration of novel strategies such as virtual care interventions. Our team developed the first comprehensive statewide virtual ED in Australia, the Victorian Virtual Emergency Department, offering an alternative to in-person care for non-life-threatening emergencies. Here, we present the development and ongoing refinement of this pioneering virtual care service, aiming to provide insights for hospital administrators and policymakers seeking to implement patient-centric care solutions worldwide. By sharing our model of care, we hope to guide further work toward addressing the global problem of over crowded EDs.

Structured evaluation of a virtual emergency department triage model of care: A study protocol.

OBJECTIVE: A new virtual ED service was introduced into a hospital network in the northern suburbs of Melbourne in response to changing needs during the COVID-19 pandemic. The 'virtual ED' utilises a telehealth model as a means of assessment for appropriately selected patients to facilitate either complete care or navigation into streamlined pathways for ongoing care, in some cases bypassing the ED entirely where appropriate. The proposed study aims to evaluate the implementation of the model and identify future improvement opportunities, assess the impact on traditional health service delivery processes and patient experience, and determine the acceptability of the 'virtual ED' model of care. METHODS: The present study will consist of a pre-post- implementation evaluation using the RE-AIM framework. Routine health service data will be collected for 6 months post-implementation of the virtual ED model and compared to 24 months prior to implementation. Prospective data will be collected using routinely collected and survey data. Interviews and focus groups will be conducted to understand consumer and clinician perspectives on barriers and enablers to implementation and adoption of the virtual ED. RESULTS: Descriptive statistics will be used to describe the study population and key outcomes, including changes in ED presentations and length of stay. Thematic analysis will be conducted on transcribed interviews and focus group data. This will be triangulated with data collected from patient feedback surveys. CONCLUSION: This project will support the delivery of care to ED patients by evaluating the 'virtual ED' model of care.

The epidemiology of chemical eye exposures reported to the Victorian Poisons Information Centre.

OBJECTIVE: We aimed to determine the epidemiology of chemical eye exposures reported to the Victorian Poisons Information Centre, Australia. METHODS: This was a prospective case series comprising consecutive calls to the Victorian Poisons Information Centre that related to chemical eye exposures (January 2009-2010). Data included patient demographics, place and cause of exposure, nature of the chemical, symptoms and advice given. Patients were telephoned 48 h later to determine the outcome and whether the advice had been taken. RESULTS: One thousand four hundred and eighty patients were enroled (45.7%, aged <16 years) with 937 (63.3%) followed up. Cleaning agents (32.6%), topical personal products (25.4%), industrial agents (11.8%), herbicides/pesticides (5.7%), petroleum products (4.2%) and miscellaneous agents (20.3%) comprised the exposure groups. Men were exposed to significantly more industrial agents (74.8 vs. 25.2%) and fewer topical personal agents (31.3 vs. 68.7%) than women, (P<0.001). Children were exposed to significantly more topical personal agents (65.2 vs. 34.8%) and fewer industrial agents (28.7 vs. 71.3%) than adults (P<0.001). The median time between exposure and the call for advice was significantly shorter for children (P<0.001). Eight hundred and ten (54.7%) patients were advised that medical care was not required. The remainder were advised to seek care or were already receiving care. At follow-up, only 63 (6.7%) patients were symptomatic. Eight hundred and fifty patients (90.8%) had complied with the advice given. There were no compliance differences between men/women and children/adults (P>0.05). CONCLUSION: Most exposures are of little consequence. However, there are clear epidemiological differences between sex and age groups. These findings will help inform prevention strategies.