Driving change through a
pipeline of innovation

We use a pipeline of innovation to identify, test and scale clinical innovation that has high potential and demonstrated value to the health system, clinicians and the community.

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There are four points along the pipeline: continuous improvement (refining), piloting innovations (evolving), spreading promising innovations (evolving), scaling demonstrated innovations (transforming).
The ACI’s pipeline of innovation.

Innovative projects may enter at different points across the pipeline. For example, as a new idea with strong evidence and high potential; or as a promising innovation piloted locally, with potential for spread and scale across the health system.

Pilot model explores paramedics working with emergency and urgent care teams

Inspired by successful international models, we’re exploring alternate work practices in emergency and urgent care settings.

  • We’ve partnered with the Ministry of Health and local health districts (LHDs) to launch two 10-week pilots where paramedics are working alongside other healthcare professionals in emergency departments (EDs) and urgent care services.
  • Two paramedics worked as part of the Rapid Access Clinic in the Wagga Wagga Base Hospital, while three paramedics worked as part of the ED in Mudgee Health Service.
  • The pilots will inform the development of new workforce models in NSW Health to improve access to care and build future work practices.
Mudgee Hospital’s ED was the first to participate in the Integrated Paramedic Workforce Model Pilot. Three paramedics seconded from NSW Ambulance (pictured) are rostered in the ED and working as part of the multidisciplinary team.

“As a large rural centre, the wide range of [patient] presentations we see at Mudgee Hospital will see paramedics use their extensive skillsets in the ED setting, within their scope of practice.”

Mark Spittal, Chief Executive, Western NSW LHD

Same-day surgery pilot benefits patients and the health system

A Rapid Recovery Joint Replacement Program pilot is supporting patients to return home sooner, where clinically appropriate.

  • Piloted in eight facilities across metropolitan and regional LHDs, the program aims to reduce length of stay in hospital.
  • Involves monitoring the number of same-day surgeries for five targeted procedures. These will be expanded in 2025 to align with evolving evidence.
  • Supported by changes in surgical and anaesthetic techniques; communication and education facilitated by healthcare staff; and enhancing the patients' pre-operative and follow-up care.
  • New resources, such as the Perioperative toolkit and the High volume short stay surgery toolkit, are supporting surgical services in NSW public hospitals to improve efficiency and optimise care and outcomes for patients.
  • So far, patients successfully discharged within 24 hours of surgery report positive feedback about their experience.

Scaling a new emergency care program to improve patient and staff experience

The ground-breaking Emergency Care and Assessment Treatment (ECAT) program is improving patient care and experiences for people presenting to emergency departments (EDs) across NSW.

  • Started by a group of emergency nurses in 2020 to address variation in nurse-initiated protocols across NSW EDs. In 2021, NSW Health agreed to scale up the program, led by our Emergency Care Institute.
  • Collaborated with 180+ stakeholders to develop 73 statewide protocols, for the most common ED presentations from children and adults.
  • Includes an education pathway, enabling ED nurses to initiate safe and timely emergency care, while supporting career progression and staff movement between sites.
  • Now live at 151 of 172 EDs across 17 local health districts and specialty health networks.
  • South Western Sydney LHD was the first to go live in May 2024. Within the first two months:
    • 24,000 protocols commenced for patients
    • 10,000+ medications or fluids were administered under ECAT protocols
    • less experienced ED nurses are delivering independent nurse-initiated care within a structured protocol
    • more experienced nurses are delivering medications to meet patients’ needs.

Over

522,184

page views on the ECAT website since the first ED sites went live in May.

“We are still realising the benefits of the ECAT program in SWSLHD. But what we do know is that we have just begun a major change in our system that will build nurses’ capability and confidence to deliver high quality, standardised patient care.”

Kathryn Spears, Critical Care Clinical Stream Manager, South Western Sydney Local Health District

A focus on ACI

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