Rural and Remote Emergency Services Standardisation - Rural and Remote Clinical Support Unit (RRCSU)
The potentially avoidable death of a ten year old in 2002 following a head injury was investigated by the Queensland Ombudsman and the findings published in “The Neville Report-2006”. The recommendations were both administrative and clinical in nature. They required Queensland Health to review and reform the patient journey through all public hospital emergency departments.
The approach to ensure a safer journey through rural and remote emergency services uses guidelines for standardisation of a range of emergency equipment as the vehicle to achieve this goal. The following Rural and Remote Emergency Services Standardisation Guidelines can be used by all facilities with Emergency Services at Level 1 and 2 under the current Clinical Services Capability Framework throughout Queensland (and adapted for use by higher level facilities in Queensland and interstate jurisdictions on advice of local health services) to meet Quality and Safety audits and standards.
The current Rural and Remote Emergency Services Standardisation guidelines are available online :
Support for Monitoring
Consultation also revealed that support is required for monitoring the maintenance and compliance with the standardisation and to support best practice in checking the resuscitation trolley and procedural kits. In recognition of this, lists of items required are provided in a checklist format.
Questions and answers about the guidelines
Q: The layout of the resuscitation trolley is not the same as I'm used to in other locations. Why is that?
A: It was determined that for the context of practice in the target facilities (rural and remote facilities with Emergency Services at level 1 or 2 under the current Clinical Services Capability Framework) this was the most efficient way. Considerable consultation with many leaders in the management of patients requiring emergency care (see the standardised forms for details) also determined that procedural packs would complement the resuscitation trolley content and avoid overburdening the trolley. Limiting the flexibility of the resuscitation trolley allows for simple and logical flow of ABC while providing a full complement of resources within close proximity of resuscitation trolley at a reasonable cost
Q: Does our Hospital and Health Services have to follow these guidelines?
A: These are a set of best practice guidelines provided to support standardisation wherever possible. The decision regarding whether to adopt these guidelines is determined by your Hospital and Health Services.
Q: Who developed these guidelines?
A: These guidelines were developed by collaboration of a leading expert Reference Group with broad experience in rural and remote environments, retrieval medicine, emergency medicine and supporting rural networks consisting of representatives from the:
- Australian College of Rural and Remote Medicine (ACRRM)
- Australasian College for Emergency Medicine (ACCEM)
- Telehealth Emergency Management Support Unit (TEMSU)
- Nurse Practitioner
- Rural and Remote Directors of Nursing
- Rural and Remote Nurse Educators
- Clinical Nurse Consultant Clinical Service Improvement
- Queensland Ambulance Service (QAS)
- Senior Clinicians Emergency Care Institute New South Wales (ECINSW)
- Directors of Pharmacy Services Advisory Committee Queensland Health
- Royal Flying Doctor Service (RFDS)
Q: How often should these guidelines be updated
A: The guidelines should be updated
- every 2 years OR
- when major changes dictate quality and safety necessity OR
- in response to a coroners or ombudsman determination
For further information contact the Rural and Remote Clinical Support Unit