Clinician Connect

Innovations evolving statewide healthcare delivery

By Dr Jean-Frédéric Levesque, Chief Executive, ACI and Deputy Secretary, Clinical Innovation and Research

29 Feb 2024 Reading time approximately


In today’s dynamic healthcare landscape, we must seek alternative ways of delivering care that not only meet the needs of patients, but also optimise the use of resources and enhance clinician satisfaction.

Against a backdrop of advancements in therapeutics and technologies, a changing workforce and evolving healthcare environment; supporting health services to embrace alternate ways to deliver care that achieve similar – or better – outcomes for patients is now a clear priority.

Alternative models of care represent a different way to use limited resources. For healthcare providers, they can embrace hybrid approaches to deliver care, across different settings, using updated clinical processes or treatments. The benefits extend to rural, regional and metropolitan areas.

A good example of this in New South Wales (NSW) is a new statewide model for nurse-initiated care in emergency departments (EDs). While nurse-initiated models of care were well established in EDs, the protocols, education and governance frameworks were inconsistent across the state. This can lead to variations in patient care, nursing practice and the ability for nurses to transfer their skills between hospitals.

The NSW Health Emergency Care and Assessment Treatment (ECAT) Program leverages existing models of care across rural and metropolitan emergency departments. It aims to improve the experience for patients receiving care in an ED, and increase staff satisfaction through the delivery of consistent, high quality care across NSW.

Building capability for standardised care

Central to ECAT is the development of 73 clinical protocols for both adult and paediatric patients, alongside 27 focused assessments. These resources were launched in December last year and are available to nurses online or as a hard copy folder to suit their environment. They will be invaluable tools for frontline nurses, empowering them to deliver timely and evidence-based care to patients, no matter where they are working across NSW Health emergency settings.

By redefining where, how and by whom care is provided, ECAT ensures that patients receive timely and high-quality care, irrespective of their geographical location or the complexity of their condition. This is particularly crucial in addressing the unique challenges faced by rural communities and smaller healthcare facilities, where access to specialised care may be limited.

The program is also underpinned by a comprehensive education pathway designed to equip emergency nurses across NSW with the knowledge and skills necessary to implement these standardised protocols effectively.

Widespread input and engagement from clinicians on the ECAT program illustrates how we have been able to leverage the ACI’s 40 clinical networks for the purpose of developing a statewide model.

A statewide approach

The ECAT program is a testament to the power of collaboration in leading innovation and change on a statewide level. It has been driven by six subcommittees involving more than 180 members from diverse stakeholders, including the ACI, Ministry of Health Nursing and Midwifery Office, Clinical Excellence Commission, Health Education and Training Institute, eHealth NSW, local health districts, specialty health networks, clinicians, and consumer representatives.

Widespread input and engagement from clinicians illustrates how the ACI’s clinical networks have been leveraged to develop this statewide model.

The ACI has also been working with key partners across the health system to support enhanced access to, and outcomes from, elective surgery. We continue to develop evidence-based resources; and identify and share local models of care that add value to the health system.

In our guest editorial, Matthew Daly, Deputy Secretary, System Sustainability and Performance, highlights ongoing improvements across NSW Health that are providing safe, timely, high quality and sustainable healthcare, such as the Same Day Hip and Knee Replacement Model – an alternative care pathway for patients to access joint replacement surgery and be discharged within 24 hours.

Read more about the development and implementation of the ECAT program in our feature story; and discover the latest news from our clinical networks and statewide programs in this issue of Clinician Connect.

Read the February 2024 edition of Clinician Connect.

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